401k Plan data: EASTRIDGE HEALTH SYSTEMS 403(B) PLAN plan

EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 401k Plan overview

Plan Name	EASTRIDGE HEALTH SYSTEMS 403(B) PLAN
Plan identification number	001

EASTRIDGE HEALTH SYSTEMS 403(B) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
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 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
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.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
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.

401k Sponsoring company profile

EASTERN PANHANDLE MENTAL HEALTH CENTER, INC. has sponsored the creation of one or more 401k plans.

Company Name: EASTERN PANHANDLE MENTAL HEALTH CENTER, INC.

Employer identification number (EIN): 237116164

NAIC Classification: 621420
NAIC Description: Outpatient Mental Health and Substance Abuse Centers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EASTRIDGE HEALTH SYSTEMS 403(B) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2021-07-01
001 2020-07-01
001 2020-07-01
001 2019-07-01
001 2018-07-01
001 2017-07-01
001 2016-07-01
001 2015-07-01
001 2014-07-01
001 2013-07-01 GARY WHITE
001 2012-07-01 GARY WHITE
001 2011-07-01 JANICE KI
001 2010-07-01 JANICE KI
001 2009-07-01 G. PAUL MACOM

Plan Statistics for EASTRIDGE HEALTH SYSTEMS 403(B) PLAN

401k plan membership statisitcs for EASTRIDGE HEALTH SYSTEMS 403(B) PLAN

Measure Date Value
2021: EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-07-01 248
Total number of active participants reported on line 7a of the Form 5500 2021-07-01 207
Number of retired or separated participants receiving benefits 2021-07-01 0
Number of other retired or separated participants entitled to future benefits 2021-07-01 82
Total of all active and inactive participants 2021-07-01 289
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-07-01 0
Total participants 2021-07-01 289
Number of participants with account balances 2021-07-01 179
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-07-01 2
2020: EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-07-01 346
Total number of active participants reported on line 7a of the Form 5500 2020-07-01 109
Number of retired or separated participants receiving benefits 2020-07-01 0
Number of other retired or separated participants entitled to future benefits 2020-07-01 73
Total of all active and inactive participants 2020-07-01 182
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-07-01 2
Total participants 2020-07-01 184
Number of participants with account balances 2020-07-01 180
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-07-01 18
2019: EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-07-01 356
Total number of active participants reported on line 7a of the Form 5500 2019-07-01 278
Number of retired or separated participants receiving benefits 2019-07-01 0
Number of other retired or separated participants entitled to future benefits 2019-07-01 66
Total of all active and inactive participants 2019-07-01 344
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-07-01 2
Total participants 2019-07-01 346
Number of participants with account balances 2019-07-01 175
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-07-01 14
2018: EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-07-01 431
Total number of active participants reported on line 7a of the Form 5500 2018-07-01 291
Number of retired or separated participants receiving benefits 2018-07-01 0
Number of other retired or separated participants entitled to future benefits 2018-07-01 63
Total of all active and inactive participants 2018-07-01 354
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-07-01 2
Total participants 2018-07-01 356
Number of participants with account balances 2018-07-01 175
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-07-01 16
2017: EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-07-01 433
Total number of active participants reported on line 7a of the Form 5500 2017-07-01 293
Number of retired or separated participants receiving benefits 2017-07-01 0
Number of other retired or separated participants entitled to future benefits 2017-07-01 135
Total of all active and inactive participants 2017-07-01 428
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-07-01 3
Total participants 2017-07-01 431
Number of participants with account balances 2017-07-01 236
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-07-01 17
2016: EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-07-01 440
Total number of active participants reported on line 7a of the Form 5500 2016-07-01 312
Number of retired or separated participants receiving benefits 2016-07-01 0
Number of other retired or separated participants entitled to future benefits 2016-07-01 120
Total of all active and inactive participants 2016-07-01 432
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-07-01 1
Total participants 2016-07-01 433
Number of participants with account balances 2016-07-01 238
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-07-01 15
2015: EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-07-01 406
Total number of active participants reported on line 7a of the Form 5500 2015-07-01 301
Number of retired or separated participants receiving benefits 2015-07-01 0
Number of other retired or separated participants entitled to future benefits 2015-07-01 121
Total of all active and inactive participants 2015-07-01 422
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-07-01 1
Total participants 2015-07-01 423
Number of participants with account balances 2015-07-01 235
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-07-01 17
2014: EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-07-01 432
Total number of active participants reported on line 7a of the Form 5500 2014-07-01 295
Number of other retired or separated participants entitled to future benefits 2014-07-01 109
Total of all active and inactive participants 2014-07-01 404
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-07-01 1
Total participants 2014-07-01 405
Number of participants with account balances 2014-07-01 212
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-07-01 8
2013: EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-07-01 401
Total number of active participants reported on line 7a of the Form 5500 2013-07-01 327
Number of other retired or separated participants entitled to future benefits 2013-07-01 104
Total of all active and inactive participants 2013-07-01 431
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-07-01 1
Total participants 2013-07-01 432
Number of participants with account balances 2013-07-01 204
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-07-01 8
2012: EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-07-01 318
Total number of active participants reported on line 7a of the Form 5500 2012-07-01 197
Number of retired or separated participants receiving benefits 2012-07-01 0
Number of other retired or separated participants entitled to future benefits 2012-07-01 108
Total of all active and inactive participants 2012-07-01 305
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-07-01 0
Total participants 2012-07-01 305
Number of participants with account balances 2012-07-01 190
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-07-01 11
2011: EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-07-01 293
Total number of active participants reported on line 7a of the Form 5500 2011-07-01 211
Number of retired or separated participants receiving benefits 2011-07-01 0
Number of other retired or separated participants entitled to future benefits 2011-07-01 103
Total of all active and inactive participants 2011-07-01 314
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-07-01 0
Total participants 2011-07-01 314
Number of participants with account balances 2011-07-01 190
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-07-01 10
2010: EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2010 401k membership
Total participants, beginning-of-year 2010-07-01 146
Total number of active participants reported on line 7a of the Form 5500 2010-07-01 156
Number of retired or separated participants receiving benefits 2010-07-01 0
Number of other retired or separated participants entitled to future benefits 2010-07-01 104
Total of all active and inactive participants 2010-07-01 260
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-07-01 0
Total participants 2010-07-01 260
Number of participants with account balances 2010-07-01 186
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-07-01 4
2009: EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-07-01 195
Total number of active participants reported on line 7a of the Form 5500 2009-07-01 94
Number of other retired or separated participants entitled to future benefits 2009-07-01 116
Total of all active and inactive participants 2009-07-01 210
Total participants 2009-07-01 210
Number of participants with account balances 2009-07-01 177

Measure	Date	Value
2021: EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-07-01	248
Total number of active participants reported on line 7a of the Form 5500	2021-07-01	207
Number of retired or separated participants receiving benefits	2021-07-01	0
Number of other retired or separated participants entitled to future benefits	2021-07-01	82
Total of all active and inactive participants	2021-07-01	289
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-07-01	0
Total participants	2021-07-01	289
Number of participants with account balances	2021-07-01	179
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-07-01	2
2020: EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-07-01	346
Total number of active participants reported on line 7a of the Form 5500	2020-07-01	109
Number of retired or separated participants receiving benefits	2020-07-01	0
Number of other retired or separated participants entitled to future benefits	2020-07-01	73
Total of all active and inactive participants	2020-07-01	182
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-07-01	2
Total participants	2020-07-01	184
Number of participants with account balances	2020-07-01	180
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-07-01	18
2019: EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-07-01	356
Total number of active participants reported on line 7a of the Form 5500	2019-07-01	278
Number of retired or separated participants receiving benefits	2019-07-01	0
Number of other retired or separated participants entitled to future benefits	2019-07-01	66
Total of all active and inactive participants	2019-07-01	344
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-07-01	2
Total participants	2019-07-01	346
Number of participants with account balances	2019-07-01	175
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-07-01	14
2018: EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-07-01	431
Total number of active participants reported on line 7a of the Form 5500	2018-07-01	291
Number of retired or separated participants receiving benefits	2018-07-01	0
Number of other retired or separated participants entitled to future benefits	2018-07-01	63
Total of all active and inactive participants	2018-07-01	354
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-07-01	2
Total participants	2018-07-01	356
Number of participants with account balances	2018-07-01	175
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-07-01	16
2017: EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-07-01	433
Total number of active participants reported on line 7a of the Form 5500	2017-07-01	293
Number of retired or separated participants receiving benefits	2017-07-01	0
Number of other retired or separated participants entitled to future benefits	2017-07-01	135
Total of all active and inactive participants	2017-07-01	428
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-07-01	3
Total participants	2017-07-01	431
Number of participants with account balances	2017-07-01	236
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-07-01	17
2016: EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-07-01	440
Total number of active participants reported on line 7a of the Form 5500	2016-07-01	312
Number of retired or separated participants receiving benefits	2016-07-01	0
Number of other retired or separated participants entitled to future benefits	2016-07-01	120
Total of all active and inactive participants	2016-07-01	432
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-07-01	1
Total participants	2016-07-01	433
Number of participants with account balances	2016-07-01	238
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-07-01	15
2015: EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-07-01	406
Total number of active participants reported on line 7a of the Form 5500	2015-07-01	301
Number of retired or separated participants receiving benefits	2015-07-01	0
Number of other retired or separated participants entitled to future benefits	2015-07-01	121
Total of all active and inactive participants	2015-07-01	422
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-07-01	1
Total participants	2015-07-01	423
Number of participants with account balances	2015-07-01	235
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-07-01	17
2014: EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-07-01	432
Total number of active participants reported on line 7a of the Form 5500	2014-07-01	295
Number of other retired or separated participants entitled to future benefits	2014-07-01	109
Total of all active and inactive participants	2014-07-01	404
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-07-01	1
Total participants	2014-07-01	405
Number of participants with account balances	2014-07-01	212
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-07-01	8
2013: EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-07-01	401
Total number of active participants reported on line 7a of the Form 5500	2013-07-01	327
Number of other retired or separated participants entitled to future benefits	2013-07-01	104
Total of all active and inactive participants	2013-07-01	431
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-07-01	1
Total participants	2013-07-01	432
Number of participants with account balances	2013-07-01	204
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-07-01	8
2012: EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-07-01	318
Total number of active participants reported on line 7a of the Form 5500	2012-07-01	197
Number of retired or separated participants receiving benefits	2012-07-01	0
Number of other retired or separated participants entitled to future benefits	2012-07-01	108
Total of all active and inactive participants	2012-07-01	305
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-07-01	0
Total participants	2012-07-01	305
Number of participants with account balances	2012-07-01	190
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-07-01	11
2011: EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-07-01	293
Total number of active participants reported on line 7a of the Form 5500	2011-07-01	211
Number of retired or separated participants receiving benefits	2011-07-01	0
Number of other retired or separated participants entitled to future benefits	2011-07-01	103
Total of all active and inactive participants	2011-07-01	314
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-07-01	0
Total participants	2011-07-01	314
Number of participants with account balances	2011-07-01	190
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-07-01	10
2010: EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2010 401k membership
Total participants, beginning-of-year	2010-07-01	146
Total number of active participants reported on line 7a of the Form 5500	2010-07-01	156
Number of retired or separated participants receiving benefits	2010-07-01	0
Number of other retired or separated participants entitled to future benefits	2010-07-01	104
Total of all active and inactive participants	2010-07-01	260
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-07-01	0
Total participants	2010-07-01	260
Number of participants with account balances	2010-07-01	186
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-07-01	4
2009: EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-07-01	195
Total number of active participants reported on line 7a of the Form 5500	2009-07-01	94
Number of other retired or separated participants entitled to future benefits	2009-07-01	116
Total of all active and inactive participants	2009-07-01	210
Total participants	2009-07-01	210
Number of participants with account balances	2009-07-01	177

Financial Data on EASTRIDGE HEALTH SYSTEMS 403(B) PLAN

Measure	Date	Value
2022 : EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2022 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2022-06-30	$0
Total unrealized appreciation/depreciation of assets	2022-06-30	$0
Total transfer of assets from this plan	2022-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-06-30	$0
Total income from all sources (including contributions)	2022-06-30	$-152,740
Total loss/gain on sale of assets	2022-06-30	$0
Total of all expenses incurred	2022-06-30	$349,262
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-06-30	$347,691
Expenses. Certain deemed distributions of participant loans	2022-06-30	$0
Value of total corrective distributions	2022-06-30	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-06-30	$420,152
Value of total assets at end of year	2022-06-30	$4,705,419
Value of total assets at beginning of year	2022-06-30	$5,207,421
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-06-30	$1,571
Total interest from all sources	2022-06-30	$15,849
Total dividends received (eg from common stock, registered investment company shares)	2022-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-06-30	$0
Assets. Real estate other than employer real property at end of year	2022-06-30	$0
Assets. Real estate other than employer real property at beginning of year	2022-06-30	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2022-06-30	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2022-06-30	$0
Was this plan covered by a fidelity bond	2022-06-30	Yes
Value of fidelity bond cover	2022-06-30	$500,000
If this is an individual account plan, was there a blackout period	2022-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2022-06-30	No
Contributions received from participants	2022-06-30	$223,992
Participant contributions at end of year	2022-06-30	$0
Participant contributions at beginning of year	2022-06-30	$0
Participant contributions at end of year	2022-06-30	$0
Participant contributions at beginning of year	2022-06-30	$0
Assets. Other investments not covered elsewhere at end of year	2022-06-30	$0
Assets. Other investments not covered elsewhere at beginning of year	2022-06-30	$0
Income. Received or receivable in cash from other sources (including rollovers)	2022-06-30	$27,062
Assets. Loans (other than to participants) at end of year	2022-06-30	$0
Assets. Loans (other than to participants) at beginning of year	2022-06-30	$0
Other income not declared elsewhere	2022-06-30	$0
Administrative expenses (other) incurred	2022-06-30	$1,571
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-06-30	No
Income. Non cash contributions	2022-06-30	$0
Value of net income/loss	2022-06-30	$-502,002
Value of net assets at end of year (total assets less liabilities)	2022-06-30	$4,705,419
Value of net assets at beginning of year (total assets less liabilities)	2022-06-30	$5,207,421
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-06-30	No
Were any leases to which the plan was party in default or uncollectible	2022-06-30	No
Assets. partnership/joint venture interests at end of year	2022-06-30	$0
Assets. partnership/joint venture interests at beginning of year	2022-06-30	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-06-30	$3,840,964
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-06-30	$4,396,156
Value of interest in pooled separate accounts at end of year	2022-06-30	$0
Value of interest in pooled separate accounts at beginning of year	2022-06-30	$0
Interest on participant loans	2022-06-30	$0
Income. Interest from loans (other than to participants)	2022-06-30	$0
Interest earned on other investments	2022-06-30	$15,849
Income. Interest from US Government securities	2022-06-30	$0
Income. Interest from corporate debt instruments	2022-06-30	$0
Value of interest in master investment trust accounts at end of year	2022-06-30	$0
Value of interest in master investment trust accounts at beginning of year	2022-06-30	$0
Value of interest in common/collective trusts at end of year	2022-06-30	$0
Value of interest in common/collective trusts at beginning of year	2022-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2022-06-30	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2022-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2022-06-30	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2022-06-30	$0
Assets. Value of investments in 103.12 investment entities at end of year	2022-06-30	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2022-06-30	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-06-30	$864,455
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-06-30	$811,265
Expenses. Payments to insurance carriers foe the provision of benefits	2022-06-30	$0
Asset value of US Government securities at end of year	2022-06-30	$0
Asset value of US Government securities at beginning of year	2022-06-30	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-06-30	$0
Net investment gain/loss from pooled separate accounts	2022-06-30	$-588,741
Net investment gain or loss from common/collective trusts	2022-06-30	$0
Net gain/loss from 103.12 investment entities	2022-06-30	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-06-30	No
Was there a failure to transmit to the plan any participant contributions	2022-06-30	No
Has the plan failed to provide any benefit when due under the plan	2022-06-30	No
Contributions received in cash from employer	2022-06-30	$169,098
Employer contributions (assets) at end of year	2022-06-30	$0
Employer contributions (assets) at beginning of year	2022-06-30	$0
Income. Dividends from preferred stock	2022-06-30	$0
Income. Dividends from common stock	2022-06-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-06-30	$347,691
Asset. Corporate debt instrument preferred debt at end of year	2022-06-30	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2022-06-30	$0
Asset. Corporate debt instrument debt (other) at end of year	2022-06-30	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2022-06-30	$0
Assets. Corporate common stocks other than exployer securities at end of year	2022-06-30	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2022-06-30	$0
Did the plan have assets held for investment	2022-06-30	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-06-30	No
Aggregate proceeds on sale of assets	2022-06-30	$0
Aggregate carrying amount (costs) on sale of assets	2022-06-30	$0
Opinion of an independent qualified public accountant for this plan	2022-06-30	Unqualified
Accountancy firm name	2022-06-30	PENSION ASSURANCE
Accountancy firm EIN	2022-06-30	300840934
2021 : EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-06-30	$0
Total income from all sources (including contributions)	2021-06-30	$1,334,804
Total loss/gain on sale of assets	2021-06-30	$0
Total of all expenses incurred	2021-06-30	$969,288
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-06-30	$967,786
Expenses. Certain deemed distributions of participant loans	2021-06-30	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-06-30	$332,770
Value of total assets at end of year	2021-06-30	$5,207,421
Value of total assets at beginning of year	2021-06-30	$4,841,905
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-06-30	$1,502
Total interest from all sources	2021-06-30	$18,598
Total dividends received (eg from common stock, registered investment company shares)	2021-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-06-30	No
Was this plan covered by a fidelity bond	2021-06-30	Yes
Value of fidelity bond cover	2021-06-30	$500,000
If this is an individual account plan, was there a blackout period	2021-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2021-06-30	No
Contributions received from participants	2021-06-30	$171,574
Participant contributions at end of year	2021-06-30	$0
Participant contributions at beginning of year	2021-06-30	$0
Income. Received or receivable in cash from other sources (including rollovers)	2021-06-30	$0
Administrative expenses (other) incurred	2021-06-30	$1,502
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-06-30	No
Value of net income/loss	2021-06-30	$365,516
Value of net assets at end of year (total assets less liabilities)	2021-06-30	$5,207,421
Value of net assets at beginning of year (total assets less liabilities)	2021-06-30	$4,841,905
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-06-30	No
Were any leases to which the plan was party in default or uncollectible	2021-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-06-30	$4,396,156
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-06-30	$3,896,303
Interest on participant loans	2021-06-30	$0
Interest earned on other investments	2021-06-30	$18,598
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-06-30	$811,265
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-06-30	$945,602
Expenses. Payments to insurance carriers foe the provision of benefits	2021-06-30	$0
Net investment gain/loss from pooled separate accounts	2021-06-30	$983,436
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-06-30	No
Was there a failure to transmit to the plan any participant contributions	2021-06-30	No
Has the plan failed to provide any benefit when due under the plan	2021-06-30	No
Contributions received in cash from employer	2021-06-30	$161,196
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-06-30	$967,786
Did the plan have assets held for investment	2021-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-06-30	No
Opinion of an independent qualified public accountant for this plan	2021-06-30	Unqualified
Accountancy firm name	2021-06-30	PENSION ASSURANCE
Accountancy firm EIN	2021-06-30	300840934
2020 : EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-06-30	$0
Total income from all sources (including contributions)	2020-06-30	$444,441
Total loss/gain on sale of assets	2020-06-30	$0
Total of all expenses incurred	2020-06-30	$219,182
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-06-30	$203,131
Expenses. Certain deemed distributions of participant loans	2020-06-30	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-06-30	$343,300
Value of total assets at end of year	2020-06-30	$4,841,905
Value of total assets at beginning of year	2020-06-30	$4,616,646
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-06-30	$16,051
Total interest from all sources	2020-06-30	$18,027
Total dividends received (eg from common stock, registered investment company shares)	2020-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-06-30	No
Was this plan covered by a fidelity bond	2020-06-30	Yes
Value of fidelity bond cover	2020-06-30	$500,000
If this is an individual account plan, was there a blackout period	2020-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2020-06-30	No
Contributions received from participants	2020-06-30	$182,774
Participant contributions at end of year	2020-06-30	$0
Participant contributions at beginning of year	2020-06-30	$0
Income. Received or receivable in cash from other sources (including rollovers)	2020-06-30	$0
Other income not declared elsewhere	2020-06-30	$13,937
Administrative expenses (other) incurred	2020-06-30	$6,653
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-06-30	No
Value of net income/loss	2020-06-30	$225,259
Value of net assets at end of year (total assets less liabilities)	2020-06-30	$4,841,905
Value of net assets at beginning of year (total assets less liabilities)	2020-06-30	$4,616,646
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-06-30	No
Were any leases to which the plan was party in default or uncollectible	2020-06-30	No
Investment advisory and management fees	2020-06-30	$8,733
Value of interest in pooled separate accounts at end of year	2020-06-30	$3,896,303
Value of interest in pooled separate accounts at beginning of year	2020-06-30	$3,945,898
Interest on participant loans	2020-06-30	$0
Interest earned on other investments	2020-06-30	$18,027
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-06-30	$945,602
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-06-30	$670,748
Expenses. Payments to insurance carriers foe the provision of benefits	2020-06-30	$0
Net investment gain/loss from pooled separate accounts	2020-06-30	$69,177
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-06-30	No
Was there a failure to transmit to the plan any participant contributions	2020-06-30	No
Has the plan failed to provide any benefit when due under the plan	2020-06-30	No
Contributions received in cash from employer	2020-06-30	$160,526
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-06-30	$203,131
Contract administrator fees	2020-06-30	$665
Did the plan have assets held for investment	2020-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2020-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2020-06-30	Disclaimer
Accountancy firm name	2020-06-30	PENSION ASSURANCE
Accountancy firm EIN	2020-06-30	300840934
2019 : EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-06-30	$0
Total income from all sources (including contributions)	2019-06-30	$592,696
Total loss/gain on sale of assets	2019-06-30	$0
Total of all expenses incurred	2019-06-30	$268,650
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-06-30	$258,370
Expenses. Certain deemed distributions of participant loans	2019-06-30	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-06-30	$333,866
Value of total assets at end of year	2019-06-30	$4,616,646
Value of total assets at beginning of year	2019-06-30	$4,292,600
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-06-30	$10,280
Total interest from all sources	2019-06-30	$16,531
Total dividends received (eg from common stock, registered investment company shares)	2019-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-06-30	No
Was this plan covered by a fidelity bond	2019-06-30	Yes
Value of fidelity bond cover	2019-06-30	$500,000
If this is an individual account plan, was there a blackout period	2019-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2019-06-30	No
Contributions received from participants	2019-06-30	$161,355
Participant contributions at end of year	2019-06-30	$0
Participant contributions at beginning of year	2019-06-30	$0
Income. Received or receivable in cash from other sources (including rollovers)	2019-06-30	$0
Other income not declared elsewhere	2019-06-30	$13,868
Administrative expenses (other) incurred	2019-06-30	$10,280
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-06-30	No
Value of net income/loss	2019-06-30	$324,046
Value of net assets at end of year (total assets less liabilities)	2019-06-30	$4,616,646
Value of net assets at beginning of year (total assets less liabilities)	2019-06-30	$4,292,600
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-06-30	No
Were any leases to which the plan was party in default or uncollectible	2019-06-30	No
Value of interest in pooled separate accounts at end of year	2019-06-30	$3,945,898
Value of interest in pooled separate accounts at beginning of year	2019-06-30	$3,648,104
Interest on participant loans	2019-06-30	$0
Interest earned on other investments	2019-06-30	$16,531
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-06-30	$670,748
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-06-30	$644,496
Expenses. Payments to insurance carriers foe the provision of benefits	2019-06-30	$0
Net investment gain/loss from pooled separate accounts	2019-06-30	$228,431
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-06-30	No
Was there a failure to transmit to the plan any participant contributions	2019-06-30	No
Has the plan failed to provide any benefit when due under the plan	2019-06-30	No
Contributions received in cash from employer	2019-06-30	$172,511
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-06-30	$258,370
Did the plan have assets held for investment	2019-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2019-06-30	Disclaimer
Accountancy firm name	2019-06-30	PENSION ASSURANCE LLP
Accountancy firm EIN	2019-06-30	300840934
2018 : EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-06-30	$0
Total income from all sources (including contributions)	2018-06-30	$721,073
Total loss/gain on sale of assets	2018-06-30	$0
Total of all expenses incurred	2018-06-30	$320,481
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-06-30	$318,451
Expenses. Certain deemed distributions of participant loans	2018-06-30	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-06-30	$384,246
Value of total assets at end of year	2018-06-30	$4,292,600
Value of total assets at beginning of year	2018-06-30	$3,892,008
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-06-30	$2,030
Total interest from all sources	2018-06-30	$16,861
Total dividends received (eg from common stock, registered investment company shares)	2018-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-06-30	No
Was this plan covered by a fidelity bond	2018-06-30	Yes
Value of fidelity bond cover	2018-06-30	$500,000
If this is an individual account plan, was there a blackout period	2018-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2018-06-30	No
Contributions received from participants	2018-06-30	$194,489
Participant contributions at end of year	2018-06-30	$0
Participant contributions at beginning of year	2018-06-30	$50,488
Participant contributions at end of year	2018-06-30	$0
Participant contributions at beginning of year	2018-06-30	$0
Income. Received or receivable in cash from other sources (including rollovers)	2018-06-30	$23,020
Value of other receiveables (less allowance for doubtful accounts) at end of year	2018-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2018-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2018-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2018-06-30	$0
Other income not declared elsewhere	2018-06-30	$0
Administrative expenses (other) incurred	2018-06-30	$2,030
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-06-30	No
Value of net income/loss	2018-06-30	$400,592
Value of net assets at end of year (total assets less liabilities)	2018-06-30	$4,292,600
Value of net assets at beginning of year (total assets less liabilities)	2018-06-30	$3,892,008
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-06-30	No
Were any leases to which the plan was party in default or uncollectible	2018-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-06-30	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-06-30	$0
Value of interest in pooled separate accounts at end of year	2018-06-30	$3,648,104
Value of interest in pooled separate accounts at beginning of year	2018-06-30	$3,324,024
Interest on participant loans	2018-06-30	$1,075
Interest earned on other investments	2018-06-30	$15,786
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2018-06-30	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2018-06-30	$179
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2018-06-30	$179
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-06-30	$644,496
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-06-30	$517,317
Expenses. Payments to insurance carriers foe the provision of benefits	2018-06-30	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-06-30	$0
Net investment gain/loss from pooled separate accounts	2018-06-30	$319,966
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-06-30	No
Was there a failure to transmit to the plan any participant contributions	2018-06-30	No
Has the plan failed to provide any benefit when due under the plan	2018-06-30	No
Contributions received in cash from employer	2018-06-30	$166,737
Employer contributions (assets) at end of year	2018-06-30	$0
Employer contributions (assets) at beginning of year	2018-06-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-06-30	$318,451
Liabilities. Value of benefit claims payable at end of year	2018-06-30	$0
Liabilities. Value of benefit claims payable at beginning of year	2018-06-30	$0
Did the plan have assets held for investment	2018-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2018-06-30	Disclaimer
Accountancy firm name	2018-06-30	PENSION ASSURANCE LLP
Accountancy firm EIN	2018-06-30	300840934
2017 : EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-06-30	$0
Total income from all sources (including contributions)	2017-06-30	$759,357
Total loss/gain on sale of assets	2017-06-30	$0
Total of all expenses incurred	2017-06-30	$203,017
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-06-30	$199,725
Value of total corrective distributions	2017-06-30	$858
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-06-30	$349,800
Value of total assets at end of year	2017-06-30	$3,892,008
Value of total assets at beginning of year	2017-06-30	$3,335,668
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-06-30	$2,434
Total interest from all sources	2017-06-30	$1,945
Total dividends received (eg from common stock, registered investment company shares)	2017-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-06-30	No
Was this plan covered by a fidelity bond	2017-06-30	Yes
Value of fidelity bond cover	2017-06-30	$350,000
If this is an individual account plan, was there a blackout period	2017-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2017-06-30	No
Contributions received from participants	2017-06-30	$176,526
Participant contributions at end of year	2017-06-30	$50,488
Participant contributions at beginning of year	2017-06-30	$37,829
Income. Received or receivable in cash from other sources (including rollovers)	2017-06-30	$3,026
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2017-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2017-06-30	$0
Other income not declared elsewhere	2017-06-30	$14,996
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-06-30	No
Value of net income/loss	2017-06-30	$556,340
Value of net assets at end of year (total assets less liabilities)	2017-06-30	$3,892,008
Value of net assets at beginning of year (total assets less liabilities)	2017-06-30	$3,335,668
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-06-30	No
Were any leases to which the plan was party in default or uncollectible	2017-06-30	No
Value of interest in pooled separate accounts at end of year	2017-06-30	$3,324,024
Value of interest in pooled separate accounts at beginning of year	2017-06-30	$2,792,797
Income. Interest from loans (other than to participants)	2017-06-30	$1,947
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2017-06-30	$179
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2017-06-30	$185
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2017-06-30	$185
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2017-06-30	$-2
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-06-30	$517,317
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-06-30	$504,857
Net investment gain/loss from pooled separate accounts	2017-06-30	$392,616
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-06-30	No
Was there a failure to transmit to the plan any participant contributions	2017-06-30	No
Has the plan failed to provide any benefit when due under the plan	2017-06-30	No
Contributions received in cash from employer	2017-06-30	$170,248
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-06-30	$199,725
Contract administrator fees	2017-06-30	$2,434
Did the plan have assets held for investment	2017-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2017-06-30	Disclaimer
Accountancy firm name	2017-06-30	PENSION ASSURANCE LLP
Accountancy firm EIN	2017-06-30	300840934
2016 : EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-06-30	$0
Total income from all sources (including contributions)	2016-06-30	$493,442
Total loss/gain on sale of assets	2016-06-30	$0
Total of all expenses incurred	2016-06-30	$250,462
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-06-30	$246,596
Value of total corrective distributions	2016-06-30	$1,649
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-06-30	$574,221
Value of total assets at end of year	2016-06-30	$3,335,668
Value of total assets at beginning of year	2016-06-30	$3,092,688
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-06-30	$2,217
Total interest from all sources	2016-06-30	$1,486
Total dividends received (eg from common stock, registered investment company shares)	2016-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-06-30	No
Was this plan covered by a fidelity bond	2016-06-30	Yes
Value of fidelity bond cover	2016-06-30	$350,000
If this is an individual account plan, was there a blackout period	2016-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2016-06-30	No
Contributions received from participants	2016-06-30	$172,074
Participant contributions at end of year	2016-06-30	$37,829
Participant contributions at beginning of year	2016-06-30	$31,575
Income. Received or receivable in cash from other sources (including rollovers)	2016-06-30	$239,510
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2016-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2016-06-30	$0
Other income not declared elsewhere	2016-06-30	$15,224
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-06-30	No
Value of net income/loss	2016-06-30	$242,980
Value of net assets at end of year (total assets less liabilities)	2016-06-30	$3,335,668
Value of net assets at beginning of year (total assets less liabilities)	2016-06-30	$3,092,688
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-06-30	No
Were any leases to which the plan was party in default or uncollectible	2016-06-30	No
Value of interest in pooled separate accounts at end of year	2016-06-30	$2,792,797
Value of interest in pooled separate accounts at beginning of year	2016-06-30	$2,536,403
Interest on participant loans	2016-06-30	$1,489
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2016-06-30	$185
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2016-06-30	$192
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2016-06-30	$192
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2016-06-30	$-3
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-06-30	$504,857
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-06-30	$524,518
Net investment gain/loss from pooled separate accounts	2016-06-30	$-97,489
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-06-30	No
Was there a failure to transmit to the plan any participant contributions	2016-06-30	No
Has the plan failed to provide any benefit when due under the plan	2016-06-30	No
Contributions received in cash from employer	2016-06-30	$162,637
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-06-30	$246,596
Contract administrator fees	2016-06-30	$2,217
Did the plan have assets held for investment	2016-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2016-06-30	Disclaimer
Accountancy firm name	2016-06-30	ALBRIGHT CRUMBACKER MOUL & ITELL
Accountancy firm EIN	2016-06-30	521130974
2015 : EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-06-30	$0
Total income from all sources (including contributions)	2015-06-30	$336,388
Total loss/gain on sale of assets	2015-06-30	$0
Total of all expenses incurred	2015-06-30	$212,137
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-06-30	$205,866
Value of total corrective distributions	2015-06-30	$3,736
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-06-30	$269,330
Value of total assets at end of year	2015-06-30	$3,092,688
Value of total assets at beginning of year	2015-06-30	$2,968,437
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-06-30	$2,535
Total interest from all sources	2015-06-30	$1,465
Total dividends received (eg from common stock, registered investment company shares)	2015-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-06-30	No
Was this plan covered by a fidelity bond	2015-06-30	Yes
Value of fidelity bond cover	2015-06-30	$350,000
If this is an individual account plan, was there a blackout period	2015-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2015-06-30	No
Contributions received from participants	2015-06-30	$148,191
Participant contributions at end of year	2015-06-30	$31,575
Participant contributions at beginning of year	2015-06-30	$32,431
Income. Received or receivable in cash from other sources (including rollovers)	2015-06-30	$3,637
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2015-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2015-06-30	$0
Other income not declared elsewhere	2015-06-30	$16,299
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-06-30	No
Value of net income/loss	2015-06-30	$124,251
Value of net assets at end of year (total assets less liabilities)	2015-06-30	$3,092,688
Value of net assets at beginning of year (total assets less liabilities)	2015-06-30	$2,968,437
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-06-30	No
Were any leases to which the plan was party in default or uncollectible	2015-06-30	No
Value of interest in pooled separate accounts at end of year	2015-06-30	$2,536,403
Value of interest in pooled separate accounts at beginning of year	2015-06-30	$2,373,226
Interest on participant loans	2015-06-30	$1,468
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2015-06-30	$192
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2015-06-30	$198
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2015-06-30	$198
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2015-06-30	$-3
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-06-30	$524,518
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-06-30	$562,582
Net investment gain/loss from pooled separate accounts	2015-06-30	$49,294
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-06-30	No
Was there a failure to transmit to the plan any participant contributions	2015-06-30	No
Has the plan failed to provide any benefit when due under the plan	2015-06-30	No
Contributions received in cash from employer	2015-06-30	$117,502
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-06-30	$205,866
Contract administrator fees	2015-06-30	$2,535
Did the plan have assets held for investment	2015-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2015-06-30	Disclaimer
Accountancy firm name	2015-06-30	ALBRIGHT CRUMBACKER MOUL & ITELL
Accountancy firm EIN	2015-06-30	521130974
2014 : EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-06-30	$8,750
Total income from all sources (including contributions)	2014-06-30	$592,891
Total loss/gain on sale of assets	2014-06-30	$0
Total of all expenses incurred	2014-06-30	$114,325
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-06-30	$106,764
Value of total corrective distributions	2014-06-30	$2,894
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-06-30	$225,209
Value of total assets at end of year	2014-06-30	$2,968,437
Value of total assets at beginning of year	2014-06-30	$2,498,621
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-06-30	$4,667
Total interest from all sources	2014-06-30	$910
Total dividends received (eg from common stock, registered investment company shares)	2014-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-06-30	No
Was this plan covered by a fidelity bond	2014-06-30	Yes
Value of fidelity bond cover	2014-06-30	$350,000
If this is an individual account plan, was there a blackout period	2014-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2014-06-30	No
Contributions received from participants	2014-06-30	$124,930
Participant contributions at end of year	2014-06-30	$32,431
Participant contributions at beginning of year	2014-06-30	$21,591
Income. Received or receivable in cash from other sources (including rollovers)	2014-06-30	$502
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2014-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2014-06-30	$8,750
Other income not declared elsewhere	2014-06-30	$16,683
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-06-30	No
Value of net income/loss	2014-06-30	$478,566
Value of net assets at end of year (total assets less liabilities)	2014-06-30	$2,968,437
Value of net assets at beginning of year (total assets less liabilities)	2014-06-30	$2,489,871
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-06-30	No
Were any leases to which the plan was party in default or uncollectible	2014-06-30	No
Value of interest in pooled separate accounts at end of year	2014-06-30	$2,373,226
Value of interest in pooled separate accounts at beginning of year	2014-06-30	$1,905,689
Interest on participant loans	2014-06-30	$913
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2014-06-30	$198
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2014-06-30	$207
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2014-06-30	$207
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2014-06-30	$-3
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-06-30	$562,582
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-06-30	$571,134
Net investment gain/loss from pooled separate accounts	2014-06-30	$350,089
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-06-30	No
Was there a failure to transmit to the plan any participant contributions	2014-06-30	No
Has the plan failed to provide any benefit when due under the plan	2014-06-30	No
Contributions received in cash from employer	2014-06-30	$99,777
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-06-30	$106,764
Contract administrator fees	2014-06-30	$4,667
Did the plan have assets held for investment	2014-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2014-06-30	Disclaimer
Accountancy firm name	2014-06-30	ALBRIGHT CRUMBACKER MOUL & ITELL
Accountancy firm EIN	2014-06-30	521130974
2013 : EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-06-30	$8,750
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-06-30	$0
Total income from all sources (including contributions)	2013-06-30	$619,387
Total loss/gain on sale of assets	2013-06-30	$0
Total of all expenses incurred	2013-06-30	$125,098
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-06-30	$122,053
Value of total corrective distributions	2013-06-30	$155
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-06-30	$413,903
Value of total assets at end of year	2013-06-30	$2,498,621
Value of total assets at beginning of year	2013-06-30	$1,995,582
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-06-30	$2,890
Total interest from all sources	2013-06-30	$998
Total dividends received (eg from common stock, registered investment company shares)	2013-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-06-30	No
Was this plan covered by a fidelity bond	2013-06-30	Yes
Value of fidelity bond cover	2013-06-30	$200,000
If this is an individual account plan, was there a blackout period	2013-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2013-06-30	No
Contributions received from participants	2013-06-30	$116,274
Participant contributions at end of year	2013-06-30	$21,591
Participant contributions at beginning of year	2013-06-30	$17,004
Income. Received or receivable in cash from other sources (including rollovers)	2013-06-30	$181,547
Value of other receiveables (less allowance for doubtful accounts) at end of year	2013-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2013-06-30	$2,758
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2013-06-30	$8,750
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2013-06-30	$0
Other income not declared elsewhere	2013-06-30	$16,782
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-06-30	No
Value of net income/loss	2013-06-30	$494,289
Value of net assets at end of year (total assets less liabilities)	2013-06-30	$2,489,871
Value of net assets at beginning of year (total assets less liabilities)	2013-06-30	$1,995,582
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-06-30	No
Were any leases to which the plan was party in default or uncollectible	2013-06-30	No
Value of interest in pooled separate accounts at end of year	2013-06-30	$1,905,689
Value of interest in pooled separate accounts at beginning of year	2013-06-30	$1,405,205
Interest on participant loans	2013-06-30	$1,001
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2013-06-30	$207
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2013-06-30	$218
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2013-06-30	$218
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2013-06-30	$-3
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-06-30	$571,134
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-06-30	$570,218
Net investment gain/loss from pooled separate accounts	2013-06-30	$187,704
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-06-30	No
Was there a failure to transmit to the plan any participant contributions	2013-06-30	No
Has the plan failed to provide any benefit when due under the plan	2013-06-30	No
Contributions received in cash from employer	2013-06-30	$116,082
Employer contributions (assets) at end of year	2013-06-30	$0
Employer contributions (assets) at beginning of year	2013-06-30	$179
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-06-30	$122,053
Contract administrator fees	2013-06-30	$2,890
Did the plan have assets held for investment	2013-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2013-06-30	Disclaimer
Accountancy firm name	2013-06-30	ALBRIGHT CRUMBACKER MOUL & ITELL
Accountancy firm EIN	2013-06-30	521130974
2012 : EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-06-30	$0
Total income from all sources (including contributions)	2012-06-30	$284,843
Total loss/gain on sale of assets	2012-06-30	$0
Total of all expenses incurred	2012-06-30	$46,191
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-06-30	$43,371
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-06-30	$255,217
Value of total assets at end of year	2012-06-30	$1,995,582
Value of total assets at beginning of year	2012-06-30	$1,756,930
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-06-30	$2,820
Total interest from all sources	2012-06-30	$745
Total dividends received (eg from common stock, registered investment company shares)	2012-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-06-30	No
Was this plan covered by a fidelity bond	2012-06-30	Yes
Value of fidelity bond cover	2012-06-30	$170,000
If this is an individual account plan, was there a blackout period	2012-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2012-06-30	No
Contributions received from participants	2012-06-30	$108,689
Participant contributions at end of year	2012-06-30	$17,004
Participant contributions at beginning of year	2012-06-30	$0
Income. Received or receivable in cash from other sources (including rollovers)	2012-06-30	$36,614
Value of other receiveables (less allowance for doubtful accounts) at end of year	2012-06-30	$2,758
Other income not declared elsewhere	2012-06-30	$16,691
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-06-30	No
Value of net income/loss	2012-06-30	$238,652
Value of net assets at end of year (total assets less liabilities)	2012-06-30	$1,995,582
Value of net assets at beginning of year (total assets less liabilities)	2012-06-30	$1,756,930
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-06-30	No
Were any leases to which the plan was party in default or uncollectible	2012-06-30	No
Value of interest in pooled separate accounts at end of year	2012-06-30	$1,405,205
Value of interest in pooled separate accounts at beginning of year	2012-06-30	$1,191,426
Interest on participant loans	2012-06-30	$748
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-06-30	$218
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-06-30	$225
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-06-30	$225
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-06-30	$-3
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-06-30	$570,218
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-06-30	$565,218
Net investment gain/loss from pooled separate accounts	2012-06-30	$12,190
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-06-30	No
Was there a failure to transmit to the plan any participant contributions	2012-06-30	No
Has the plan failed to provide any benefit when due under the plan	2012-06-30	No
Contributions received in cash from employer	2012-06-30	$109,914
Employer contributions (assets) at end of year	2012-06-30	$179
Employer contributions (assets) at beginning of year	2012-06-30	$61
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-06-30	$43,371
Contract administrator fees	2012-06-30	$2,820
Did the plan have assets held for investment	2012-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2012-06-30	Disclaimer
Accountancy firm name	2012-06-30	ALBRIGHT CRUMBACKER MOUL & ITELL
Accountancy firm EIN	2012-06-30	521130974
2011 : EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-06-30	$0
Total income from all sources (including contributions)	2011-06-30	$450,127
Total loss/gain on sale of assets	2011-06-30	$0
Total of all expenses incurred	2011-06-30	$165,022
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-06-30	$139,108
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-06-30	$252,997
Value of total assets at end of year	2011-06-30	$1,756,930
Value of total assets at beginning of year	2011-06-30	$1,471,825
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-06-30	$25,914
Total interest from all sources	2011-06-30	$1,015
Total dividends received (eg from common stock, registered investment company shares)	2011-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-06-30	No
Was this plan covered by a fidelity bond	2011-06-30	Yes
Value of fidelity bond cover	2011-06-30	$170,000
If this is an individual account plan, was there a blackout period	2011-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2011-06-30	No
Contributions received from participants	2011-06-30	$68,130
Participant contributions at end of year	2011-06-30	$0
Participant contributions at beginning of year	2011-06-30	$15,957
Income. Received or receivable in cash from other sources (including rollovers)	2011-06-30	$91,859
Other income not declared elsewhere	2011-06-30	$24,257
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-06-30	No
Value of net income/loss	2011-06-30	$285,105
Value of net assets at end of year (total assets less liabilities)	2011-06-30	$1,756,930
Value of net assets at beginning of year (total assets less liabilities)	2011-06-30	$1,471,825
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-06-30	No
Were any leases to which the plan was party in default or uncollectible	2011-06-30	No
Value of interest in pooled separate accounts at end of year	2011-06-30	$1,191,426
Value of interest in pooled separate accounts at beginning of year	2011-06-30	$640,495
Interest on participant loans	2011-06-30	$1,035
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-06-30	$225
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-06-30	$1,332
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-06-30	$1,332
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-06-30	$-20
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-06-30	$565,218
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-06-30	$814,041
Net investment gain/loss from pooled separate accounts	2011-06-30	$171,858
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-06-30	No
Was there a failure to transmit to the plan any participant contributions	2011-06-30	No
Has the plan failed to provide any benefit when due under the plan	2011-06-30	No
Contributions received in cash from employer	2011-06-30	$93,008
Employer contributions (assets) at end of year	2011-06-30	$61
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-06-30	$139,108
Contract administrator fees	2011-06-30	$25,914
Did the plan have assets held for investment	2011-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2011-06-30	Disclaimer
Accountancy firm name	2011-06-30	ALBRIGHT CRUMBACKER MOUL & ITELL
Accountancy firm EIN	2011-06-30	521130974
2010 : EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2010 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-06-30	$0
Funding deficiency by the employer to the plan for this plan year	2010-06-30	$0
Minimum employer required contribution for this plan year	2010-06-30	$0

Form 5500 Responses for EASTRIDGE HEALTH SYSTEMS 403(B) PLAN

2021: EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2021 form 5500 responses
2021-07-01	Type of plan entity	Single employer plan
2021-07-01	Submission has been amended	Yes
2021-07-01	This submission is the final filing	No
2021-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-07-01	Plan is a collectively bargained plan	No
2021-07-01	Plan funding arrangement – Insurance	Yes
2021-07-01	Plan benefit arrangement – Insurance	Yes
2020: EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2020 form 5500 responses
2020-07-01	Type of plan entity	Single employer plan
2020-07-01	Submission has been amended	No
2020-07-01	This submission is the final filing	No
2020-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-07-01	Plan is a collectively bargained plan	No
2020-07-01	Plan funding arrangement – Insurance	Yes
2020-07-01	Plan benefit arrangement – Insurance	Yes
2019: EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2019 form 5500 responses
2019-07-01	Type of plan entity	Single employer plan
2019-07-01	Submission has been amended	No
2019-07-01	This submission is the final filing	No
2019-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-07-01	Plan is a collectively bargained plan	No
2019-07-01	Plan funding arrangement – Insurance	Yes
2019-07-01	Plan benefit arrangement – Insurance	Yes
2018: EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2018 form 5500 responses
2018-07-01	Type of plan entity	Single employer plan
2018-07-01	Submission has been amended	No
2018-07-01	This submission is the final filing	No
2018-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-07-01	Plan is a collectively bargained plan	No
2018-07-01	Plan funding arrangement – Insurance	Yes
2018-07-01	Plan benefit arrangement – Insurance	Yes
2017: EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2017 form 5500 responses
2017-07-01	Type of plan entity	Single employer plan
2017-07-01	Submission has been amended	No
2017-07-01	This submission is the final filing	No
2017-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-07-01	Plan is a collectively bargained plan	No
2017-07-01	Plan funding arrangement – Insurance	Yes
2017-07-01	Plan benefit arrangement – Insurance	Yes
2016: EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2016 form 5500 responses
2016-07-01	Type of plan entity	Single employer plan
2016-07-01	Submission has been amended	No
2016-07-01	This submission is the final filing	No
2016-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-07-01	Plan is a collectively bargained plan	No
2016-07-01	Plan funding arrangement – Insurance	Yes
2016-07-01	Plan funding arrangement – Trust	Yes
2016-07-01	Plan benefit arrangement – Insurance	Yes
2016-07-01	Plan benefit arrangement - Trust	Yes
2015: EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2015 form 5500 responses
2015-07-01	Type of plan entity	Single employer plan
2015-07-01	Submission has been amended	No
2015-07-01	This submission is the final filing	No
2015-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-07-01	Plan is a collectively bargained plan	No
2015-07-01	Plan funding arrangement – Insurance	Yes
2015-07-01	Plan funding arrangement – Trust	Yes
2015-07-01	Plan benefit arrangement – Insurance	Yes
2015-07-01	Plan benefit arrangement - Trust	Yes
2014: EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2014 form 5500 responses
2014-07-01	Type of plan entity	Single employer plan
2014-07-01	Submission has been amended	No
2014-07-01	This submission is the final filing	No
2014-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-07-01	Plan is a collectively bargained plan	No
2014-07-01	Plan funding arrangement – Insurance	Yes
2014-07-01	Plan funding arrangement – Trust	Yes
2014-07-01	Plan benefit arrangement – Insurance	Yes
2014-07-01	Plan benefit arrangement - Trust	Yes
2013: EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2013 form 5500 responses
2013-07-01	Type of plan entity	Single employer plan
2013-07-01	Submission has been amended	No
2013-07-01	This submission is the final filing	No
2013-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-07-01	Plan is a collectively bargained plan	No
2013-07-01	Plan funding arrangement – Insurance	Yes
2013-07-01	Plan funding arrangement – Trust	Yes
2013-07-01	Plan benefit arrangement – Insurance	Yes
2013-07-01	Plan benefit arrangement - Trust	Yes
2012: EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2012 form 5500 responses
2012-07-01	Type of plan entity	Single employer plan
2012-07-01	Submission has been amended	No
2012-07-01	This submission is the final filing	No
2012-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-07-01	Plan is a collectively bargained plan	No
2012-07-01	Plan funding arrangement – Insurance	Yes
2012-07-01	Plan funding arrangement – Trust	Yes
2012-07-01	Plan benefit arrangement – Insurance	Yes
2012-07-01	Plan benefit arrangement - Trust	Yes
2011: EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2011 form 5500 responses
2011-07-01	Type of plan entity	Single employer plan
2011-07-01	Submission has been amended	No
2011-07-01	This submission is the final filing	No
2011-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-07-01	Plan is a collectively bargained plan	No
2011-07-01	Plan funding arrangement – Insurance	Yes
2011-07-01	Plan funding arrangement – Trust	Yes
2011-07-01	Plan benefit arrangement – Insurance	Yes
2011-07-01	Plan benefit arrangement - Trust	Yes
2010: EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2010 form 5500 responses
2010-07-01	Type of plan entity	Single employer plan
2010-07-01	Submission has been amended	No
2010-07-01	This submission is the final filing	No
2010-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-07-01	Plan is a collectively bargained plan	No
2010-07-01	Plan funding arrangement – Insurance	Yes
2010-07-01	Plan funding arrangement – Trust	Yes
2010-07-01	Plan benefit arrangement – Insurance	Yes
2010-07-01	Plan benefit arrangement - Trust	Yes
2009: EASTRIDGE HEALTH SYSTEMS 403(B) PLAN 2009 form 5500 responses
2009-07-01	Type of plan entity	Single employer plan
2009-07-01	Plan funding arrangement – Insurance	Yes
2009-07-01	Plan funding arrangement – Trust	Yes
2009-07-01	Plan benefit arrangement – Insurance	Yes
2009-07-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

775946-000

Policy instance

Insurance contract or identification number	775946-000
Number of Individuals Covered	191
Insurance policy start date	2021-07-01
Insurance policy end date	2022-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

007276J

Policy instance

Insurance contract or identification number	007276J
Number of Individuals Covered	191
Insurance policy start date	2021-07-01
Insurance policy end date	2022-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $637
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	637
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

007276J

Policy instance

Insurance contract or identification number	007276J
Number of Individuals Covered	191
Insurance policy start date	2021-07-01
Insurance policy end date	2022-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $637
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	637
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

007276J

Policy instance

Insurance contract or identification number	007276J
Number of Individuals Covered	191
Insurance policy start date	2021-07-01
Insurance policy end date	2022-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $637
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	637
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

775946-000

Policy instance

Insurance contract or identification number	775946-000
Number of Individuals Covered	191
Insurance policy start date	2021-07-01
Insurance policy end date	2022-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

007276J

Policy instance

Insurance contract or identification number	007276J
Number of Individuals Covered	184
Insurance policy start date	2020-07-01
Insurance policy end date	2021-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $637
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	637
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP
Insurance broker organization code?	3

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

775946-000

Policy instance

Insurance contract or identification number	775946-000
Number of Individuals Covered	184
Insurance policy start date	2020-07-01
Insurance policy end date	2021-06-30
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

775946-000

Policy instance

Insurance contract or identification number	775946-000
Number of Individuals Covered	346
Insurance policy start date	2019-07-01
Insurance policy end date	2020-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

007276J

Policy instance

Insurance contract or identification number	007276J
Number of Individuals Covered	346
Insurance policy start date	2019-07-01
Insurance policy end date	2020-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $509
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	509
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

775946-000

Policy instance

Insurance contract or identification number	775946-000
Number of Individuals Covered	358
Insurance policy start date	2018-07-01
Insurance policy end date	2019-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

007276J

Policy instance

Insurance contract or identification number	007276J
Number of Individuals Covered	356
Insurance policy start date	2018-07-01
Insurance policy end date	2019-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $13,783
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	13783
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

007276J

Policy instance

Insurance contract or identification number	007276J
Number of Individuals Covered	188
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

775946-000

Policy instance

Insurance contract or identification number	775946-000
Number of Individuals Covered	67
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

775946

Policy instance

Insurance contract or identification number	775946
Number of Individuals Covered	80
Insurance policy start date	2015-07-01
Insurance policy end date	2016-06-30
Total amount of commissions paid to insurance broker	USD $67
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $67
Insurance broker organization code?	3
Insurance broker name	N. ABEREGG

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

752867

Policy instance

Insurance contract or identification number	752867
Number of Individuals Covered	155
Insurance policy start date	2015-07-01
Insurance policy end date	2016-06-30
Total amount of commissions paid to insurance broker	USD $8,949
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $8,949
Insurance broker organization code?	3
Insurance broker name	PARK AVENUE SECURITIES, LLC

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

775946

Policy instance

Insurance contract or identification number	775946
Number of Individuals Covered	80
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

752867

Policy instance

Insurance contract or identification number	752867
Number of Individuals Covered	132
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Total amount of commissions paid to insurance broker	USD $6,495
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,495
Insurance broker organization code?	3
Insurance broker name	PARK AVENUE SECURITIES, LLC

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

775946

Policy instance

Insurance contract or identification number	775946
Number of Individuals Covered	84
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

752867

Policy instance

Insurance contract or identification number	752867
Number of Individuals Covered	120
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
Total amount of commissions paid to insurance broker	USD $4,589
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,589
Insurance broker organization code?	3
Insurance broker name	PARK AVENUE SECURITIES, LLC

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

775946

Policy instance

Insurance contract or identification number	775946
Number of Individuals Covered	96
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

752867

Policy instance

Insurance contract or identification number	752867
Number of Individuals Covered	96
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
Total amount of commissions paid to insurance broker	USD $5,827
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,827
Insurance broker organization code?	3
Insurance broker name	PARK AVENUE SECURITIES, LLC

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

775946

Policy instance

Insurance contract or identification number	775946
Number of Individuals Covered	103
Insurance policy start date	2011-07-01
Insurance policy end date	2112-06-30
Total amount of commissions paid to insurance broker	USD $1,771
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

752867

Policy instance

Insurance contract or identification number	752867
Number of Individuals Covered	99
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $4,504
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

775946

Policy instance

Insurance contract or identification number	775946
Number of Individuals Covered	115
Insurance policy start date	2010-07-01
Insurance policy end date	2111-06-30
Total amount of commissions paid to insurance broker	USD $4,793
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

752867

Policy instance

Insurance contract or identification number	752867
Number of Individuals Covered	80
Insurance policy start date	2011-06-01
Insurance policy end date	2011-06-30
Total amount of commissions paid to insurance broker	USD $5,120
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	EASTERN PANHANDLE MENTAL HEALTH CENTER, INC.
Employer identification number (EIN):	237116164
NAIC Classification:	621420
NAIC Description:	Outpatient Mental Health and Substance Abuse Centers