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WILLIAM B KESSLER MEMORIAL HOSPITAL TAS SHELTERED ANNUITY PLAN 401k Plan overview

Plan NameWILLIAM B KESSLER MEMORIAL HOSPITAL TAS SHELTERED ANNUITY PLAN
Plan identification number 004

WILLIAM B KESSLER MEMORIAL HOSPITAL TAS SHELTERED ANNUITY PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
  • Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
  • Life insurance

401k Sponsoring company profile

WILLIAM B KESSLER MEMORIAL HOSPITAL has sponsored the creation of one or more 401k plans.

Company Name:WILLIAM B KESSLER MEMORIAL HOSPITAL
Employer identification number (EIN):221739910
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WILLIAM B KESSLER MEMORIAL HOSPITAL TAS SHELTERED ANNUITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0042019-01-01
0042018-01-01
0042017-01-01
0042016-01-01
0042015-01-01RONALD SAHLI2016-10-10 RONALD SAHLI2016-10-10
0042014-01-01RONALD SAHLI2015-10-14
0042013-01-01RONALD SAHLI2014-10-15 RONALD SAHLI2014-10-15
0042009-01-01RONALD W SAHLI
0042008-01-01RONALD SAHLI
0042007-01-01RONALD SAHLI
0042006-01-01RONALD SAHLI

Plan Statistics for WILLIAM B KESSLER MEMORIAL HOSPITAL TAS SHELTERED ANNUITY PLAN

401k plan membership statisitcs for WILLIAM B KESSLER MEMORIAL HOSPITAL TAS SHELTERED ANNUITY PLAN

Measure Date Value
2009: WILLIAM B KESSLER MEMORIAL HOSPITAL TAS SHELTERED ANNUITY PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01417
Total number of active participants reported on line 7a of the Form 55002009-01-010
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-01121
Total of all active and inactive participants2009-01-01121
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-01121
Number of participants with account balances2009-01-01121
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on WILLIAM B KESSLER MEMORIAL HOSPITAL TAS SHELTERED ANNUITY PLAN

Measure Date Value
2012 : WILLIAM B KESSLER MEMORIAL HOSPITAL TAS SHELTERED ANNUITY PLAN 2012 401k financial data
Total income from all sources (including contributions)2012-12-31$87,917
Total of all expenses incurred2012-12-31$210,378
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$209,441
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$1,719
Value of total assets at end of year2012-12-31$799,735
Value of total assets at beginning of year2012-12-31$922,196
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$937
Total interest from all sources2012-12-31$4,220
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan2012-12-31$0
Was this plan covered by a fidelity bond2012-12-31No
If this is an individual account plan, was there a blackout period2012-12-31No
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Participant contributions at end of year2012-12-31$10,553
Participant contributions at beginning of year2012-12-31$10,587
Assets. Other investments not covered elsewhere at end of year2012-12-31$536,425
Assets. Other investments not covered elsewhere at beginning of year2012-12-31$609,932
Income. Received or receivable in cash from other sources (including rollovers)2012-12-31$1,719
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2012-12-31$19,174
Other income not declared elsewhere2012-12-31$37,419
Total non interest bearing cash at beginning of year2012-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$-122,461
Value of net assets at end of year (total assets less liabilities)2012-12-31$799,735
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$922,196
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-12-31$11,475
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$35,143
Interest on participant loans2012-12-31$-1,885
Interest earned on other investments2012-12-31$6,105
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-12-31$7,993
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-12-31$233,289
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-12-31$266,534
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-12-31$44,559
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31Yes
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$190,267
Contract administrator fees2012-12-31$937
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
2011 : WILLIAM B KESSLER MEMORIAL HOSPITAL TAS SHELTERED ANNUITY PLAN 2011 401k financial data
Total income from all sources (including contributions)2011-12-31$30,625
Total of all expenses incurred2011-12-31$1,520,992
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$1,519,929
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$2,673
Value of total assets at end of year2011-12-31$922,196
Value of total assets at beginning of year2011-12-31$2,412,564
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$1,063
Total interest from all sources2011-12-31$8,618
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan2011-12-31$0
Was this plan covered by a fidelity bond2011-12-31No
If this is an individual account plan, was there a blackout period2011-12-31No
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Participant contributions at end of year2011-12-31$10,587
Participant contributions at beginning of year2011-12-31$11,092
Assets. Other investments not covered elsewhere at end of year2011-12-31$609,932
Assets. Other investments not covered elsewhere at beginning of year2011-12-31$1,545,915
Income. Received or receivable in cash from other sources (including rollovers)2011-12-31$2,673
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2011-12-31$1,835
Other income not declared elsewhere2011-12-31$12,781
Total non interest bearing cash at end of year2011-12-31$0
Total non interest bearing cash at beginning of year2011-12-31$19
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-1,490,367
Value of net assets at end of year (total assets less liabilities)2011-12-31$922,196
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$2,412,564
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-12-31$35,143
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-12-31$287,072
Interest on participant loans2011-12-31$-987
Interest earned on other investments2011-12-31$9,605
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-12-31$266,534
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-12-31$568,466
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-12-31$6,553
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31Yes
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$1,518,094
Contract administrator fees2011-12-31$1,063
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32011-12-31No
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
2010 : WILLIAM B KESSLER MEMORIAL HOSPITAL TAS SHELTERED ANNUITY PLAN 2010 401k financial data
Total income from all sources (including contributions)2010-12-31$285,637
Total of all expenses incurred2010-12-31$1,070,015
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$1,068,016
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$20,486
Value of total assets at end of year2010-12-31$2,412,564
Value of total assets at beginning of year2010-12-31$3,196,942
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$1,999
Total interest from all sources2010-12-31$16,938
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Was this plan covered by a fidelity bond2010-12-31No
If this is an individual account plan, was there a blackout period2010-12-31No
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Participant contributions at end of year2010-12-31$11,092
Participant contributions at beginning of year2010-12-31$15,420
Assets. Other investments not covered elsewhere at end of year2010-12-31$1,545,915
Assets. Other investments not covered elsewhere at beginning of year2010-12-31$1,846,961
Income. Received or receivable in cash from other sources (including rollovers)2010-12-31$20,486
Other income not declared elsewhere2010-12-31$121,948
Total non interest bearing cash at end of year2010-12-31$19
Total non interest bearing cash at beginning of year2010-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$-784,378
Value of net assets at end of year (total assets less liabilities)2010-12-31$2,412,564
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$3,196,942
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2010-12-31$287,072
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$387,541
Interest on participant loans2010-12-31$525
Interest earned on other investments2010-12-31$16,413
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2010-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2010-12-31$13,520
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2010-12-31$13,520
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$568,466
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$933,500
Net investment gain/loss from registered investment companies (e.g. mutual funds)2010-12-31$126,265
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31Yes
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$1,068,016
Contract administrator fees2010-12-31$1,999
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No

Form 5500 Responses for WILLIAM B KESSLER MEMORIAL HOSPITAL TAS SHELTERED ANNUITY PLAN

2009: WILLIAM B KESSLER MEMORIAL HOSPITAL TAS SHELTERED ANNUITY PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes
2008: WILLIAM B KESSLER MEMORIAL HOSPITAL TAS SHELTERED ANNUITY PLAN 2008 form 5500 responses
2008-01-01Type of plan entitySingle employer plan
2008-01-01Submission has been amendedNo
2008-01-01This submission is the final filingNo
2008-01-01This return/report is a short plan year return/report (less than 12 months)No
2008-01-01Plan is a collectively bargained planNo
2007: WILLIAM B KESSLER MEMORIAL HOSPITAL TAS SHELTERED ANNUITY PLAN 2007 form 5500 responses
2007-01-01Type of plan entitySingle employer plan
2007-01-01Submission has been amendedNo
2007-01-01This submission is the final filingNo
2007-01-01This return/report is a short plan year return/report (less than 12 months)No
2007-01-01Plan is a collectively bargained planNo
2006: WILLIAM B KESSLER MEMORIAL HOSPITAL TAS SHELTERED ANNUITY PLAN 2006 form 5500 responses
2006-01-01Type of plan entitySingle employer plan
2006-01-01Submission has been amendedNo
2006-01-01This submission is the final filingNo
2006-01-01This return/report is a short plan year return/report (less than 12 months)No
2006-01-01Plan is a collectively bargained planNo

Insurance Providers Used on plan

METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )
Policy contract number924804
Policy instance 1
Insurance contract or identification number924804
Number of Individuals Covered24
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $431
Total amount of fees paid to insurance companyUSD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number1071116
Policy instance 2
Insurance contract or identification number1071116
Number of Individuals Covered6
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract numberVF6041
Policy instance 3
Insurance contract or identification numberVF6041
Number of Individuals Covered1
Insurance policy start date2011-10-01
Insurance policy end date2012-09-30
Total amount of commissions paid to insurance brokerUSD $17
Total amount of fees paid to insurance companyUSD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number08971
Policy instance 4
Insurance contract or identification number08971
Number of Individuals Covered14
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Life Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number1014194-01
Policy instance 5
Insurance contract or identification number1014194-01
Number of Individuals Covered53
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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