401k Plan data: THE MEMORIAL HOSPITAL, INC. OF TOWANDA, PA 403(B) PLAN plan

THE MEMORIAL HOSPITAL, INC. OF TOWANDA, PA 403(B) PLAN 401k Plan overview

Plan Name	THE MEMORIAL HOSPITAL, INC. OF TOWANDA, PA 403(B) PLAN
Plan identification number	002

THE MEMORIAL HOSPITAL, INC. OF TOWANDA, PA 403(B) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.
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.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

GUTHRIE TOWANDA MEMORIAL HOSPITAL has sponsored the creation of one or more 401k plans.

Company Name: GUTHRIE TOWANDA MEMORIAL HOSPITAL

Employer identification number (EIN): 240786657

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE MEMORIAL HOSPITAL, INC. OF TOWANDA, PA 403(B) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2016-07-01 LINDA BERRY LINDA BERRY 2018-03-19
002 2015-07-01 SHAWN MADIGAN SHAWN MADIGAN 2017-03-20
002 2014-07-01 SHAWN MADIGAN SHAWN MADIGAN 2016-04-10
002 2013-07-01 SHAWN MADIGAN SHAWN MADIGAN 2015-04-02
002 2012-07-01 SHAWN MADIGAN SHAWN MADIGAN 2014-04-15
002 2011-07-01 SHAWN MADIGAN SHAWN MADIGAN 2013-03-19
002 2010-07-01 SHAWN MADIGAN SHAWN MADIGAN 2012-04-16

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
002	2016-07-01	LINDA BERRY	LINDA BERRY	2018-03-19
002	2015-07-01	SHAWN MADIGAN	SHAWN MADIGAN	2017-03-20
002	2014-07-01	SHAWN MADIGAN	SHAWN MADIGAN	2016-04-10
002	2013-07-01	SHAWN MADIGAN	SHAWN MADIGAN	2015-04-02
002	2012-07-01	SHAWN MADIGAN	SHAWN MADIGAN	2014-04-15
002	2011-07-01	SHAWN MADIGAN	SHAWN MADIGAN	2013-03-19
002	2010-07-01	SHAWN MADIGAN	SHAWN MADIGAN	2012-04-16

Plan Statistics for THE MEMORIAL HOSPITAL, INC. OF TOWANDA, PA 403(B) PLAN

401k plan membership statisitcs for THE MEMORIAL HOSPITAL, INC. OF TOWANDA, PA 403(B) PLAN

Measure Date Value
2016: THE MEMORIAL HOSPITAL, INC. OF TOWANDA, PA 403(B) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-07-01 459
Total number of active participants reported on line 7a of the Form 5500 2016-07-01 0
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 0
Total of all active and inactive participants 2016-07-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-07-01 0
Total participants 2016-07-01 0
Number of participants with account balances 2016-07-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-07-01 0
2015: THE MEMORIAL HOSPITAL, INC. OF TOWANDA, PA 403(B) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-07-01 464
Total number of active participants reported on line 7a of the Form 5500 2015-07-01 457
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 9
Total of all active and inactive participants 2015-07-01 466
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-07-01 0
Total participants 2015-07-01 466
Number of participants with account balances 2015-07-01 207
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-07-01 0
2014: THE MEMORIAL HOSPITAL, INC. OF TOWANDA, PA 403(B) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-07-01 492
Total number of active participants reported on line 7a of the Form 5500 2014-07-01 458
Number of retired or separated participants receiving benefits 2014-07-01 0
Number of other retired or separated participants entitled to future benefits 2014-07-01 6
Total of all active and inactive participants 2014-07-01 464
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-07-01 0
Total participants 2014-07-01 464
Number of participants with account balances 2014-07-01 208
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-07-01 3
2013: THE MEMORIAL HOSPITAL, INC. OF TOWANDA, PA 403(B) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-07-01 491
Total number of active participants reported on line 7a of the Form 5500 2013-07-01 482
Number of retired or separated participants receiving benefits 2013-07-01 0
Number of other retired or separated participants entitled to future benefits 2013-07-01 5
Total of all active and inactive participants 2013-07-01 487
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-07-01 0
Total participants 2013-07-01 487
Number of participants with account balances 2013-07-01 215
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-07-01 1
2012: THE MEMORIAL HOSPITAL, INC. OF TOWANDA, PA 403(B) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-07-01 490
Total number of active participants reported on line 7a of the Form 5500 2012-07-01 519
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 3
Total of all active and inactive participants 2012-07-01 522
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-07-01 0
Total participants 2012-07-01 522
Number of participants with account balances 2012-07-01 188
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-07-01 2
2011: THE MEMORIAL HOSPITAL, INC. OF TOWANDA, PA 403(B) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-07-01 419
Total number of active participants reported on line 7a of the Form 5500 2011-07-01 431
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 2
Total of all active and inactive participants 2011-07-01 433
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-07-01 0
Total participants 2011-07-01 433
Number of participants with account balances 2011-07-01 184
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-07-01 0
2010: THE MEMORIAL HOSPITAL, INC. OF TOWANDA, PA 403(B) PLAN 2010 401k membership
Total participants, beginning-of-year 2010-07-01 418
Total number of active participants reported on line 7a of the Form 5500 2010-07-01 392
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 1
Total of all active and inactive participants 2010-07-01 393
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-07-01 0
Total participants 2010-07-01 393
Number of participants with account balances 2010-07-01 181
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-07-01 10

Measure	Date	Value
2016: THE MEMORIAL HOSPITAL, INC. OF TOWANDA, PA 403(B) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-07-01	459
Total number of active participants reported on line 7a of the Form 5500	2016-07-01	0
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	0
Total of all active and inactive participants	2016-07-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-07-01	0
Total participants	2016-07-01	0
Number of participants with account balances	2016-07-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-07-01	0
2015: THE MEMORIAL HOSPITAL, INC. OF TOWANDA, PA 403(B) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-07-01	464
Total number of active participants reported on line 7a of the Form 5500	2015-07-01	457
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	9
Total of all active and inactive participants	2015-07-01	466
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-07-01	0
Total participants	2015-07-01	466
Number of participants with account balances	2015-07-01	207
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-07-01	0
2014: THE MEMORIAL HOSPITAL, INC. OF TOWANDA, PA 403(B) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-07-01	492
Total number of active participants reported on line 7a of the Form 5500	2014-07-01	458
Number of retired or separated participants receiving benefits	2014-07-01	0
Number of other retired or separated participants entitled to future benefits	2014-07-01	6
Total of all active and inactive participants	2014-07-01	464
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-07-01	0
Total participants	2014-07-01	464
Number of participants with account balances	2014-07-01	208
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-07-01	3
2013: THE MEMORIAL HOSPITAL, INC. OF TOWANDA, PA 403(B) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-07-01	491
Total number of active participants reported on line 7a of the Form 5500	2013-07-01	482
Number of retired or separated participants receiving benefits	2013-07-01	0
Number of other retired or separated participants entitled to future benefits	2013-07-01	5
Total of all active and inactive participants	2013-07-01	487
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-07-01	0
Total participants	2013-07-01	487
Number of participants with account balances	2013-07-01	215
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-07-01	1
2012: THE MEMORIAL HOSPITAL, INC. OF TOWANDA, PA 403(B) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-07-01	490
Total number of active participants reported on line 7a of the Form 5500	2012-07-01	519
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	3
Total of all active and inactive participants	2012-07-01	522
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-07-01	0
Total participants	2012-07-01	522
Number of participants with account balances	2012-07-01	188
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-07-01	2
2011: THE MEMORIAL HOSPITAL, INC. OF TOWANDA, PA 403(B) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-07-01	419
Total number of active participants reported on line 7a of the Form 5500	2011-07-01	431
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	2
Total of all active and inactive participants	2011-07-01	433
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-07-01	0
Total participants	2011-07-01	433
Number of participants with account balances	2011-07-01	184
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-07-01	0
2010: THE MEMORIAL HOSPITAL, INC. OF TOWANDA, PA 403(B) PLAN 2010 401k membership
Total participants, beginning-of-year	2010-07-01	418
Total number of active participants reported on line 7a of the Form 5500	2010-07-01	392
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	1
Total of all active and inactive participants	2010-07-01	393
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-07-01	0
Total participants	2010-07-01	393
Number of participants with account balances	2010-07-01	181
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-07-01	10

Financial Data on THE MEMORIAL HOSPITAL, INC. OF TOWANDA, PA 403(B) PLAN

Measure	Date	Value
2017 : THE MEMORIAL HOSPITAL, INC. OF TOWANDA, PA 403(B) PLAN 2017 401k financial data
Unrealized appreciation/depreciation of real estate assets	2017-05-15	$-1,129
Unrealized appreciation/depreciation of other (non real estate) assets	2017-05-15	$0
Total unrealized appreciation/depreciation of assets	2017-05-15	$-1,129
Total transfer of assets to this plan	2017-05-15	$0
Total transfer of assets from this plan	2017-05-15	$8,783,204
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-05-15	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-05-15	$0
Expenses. Interest paid	2017-05-15	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2017-05-15	$0
Total income from all sources (including contributions)	2017-05-15	$1,417,721
Total loss/gain on sale of assets	2017-05-15	$0
Total of all expenses incurred	2017-05-15	$804,037
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-05-15	$783,215
Value of total corrective distributions	2017-05-15	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-05-15	$594,325
Value of total assets at end of year	2017-05-15	$0
Value of total assets at beginning of year	2017-05-15	$8,169,520
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-05-15	$20,822
Total income from rents	2017-05-15	$0
Total interest from all sources	2017-05-15	$3,777
Total dividends received (eg from common stock, registered investment company shares)	2017-05-15	$133,609
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-05-15	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-05-15	$133,609
Assets. Real estate other than employer real property at end of year	2017-05-15	$0
Assets. Real estate other than employer real property at beginning of year	2017-05-15	$0
Administrative expenses professional fees incurred	2017-05-15	$0
Was this plan covered by a fidelity bond	2017-05-15	Yes
Value of fidelity bond cover	2017-05-15	$500,000
If this is an individual account plan, was there a blackout period	2017-05-15	Yes
Were there any nonexempt tranactions with any party-in-interest	2017-05-15	No
Amount of non-exempt transactions with any party-in-interest	2017-05-15	$0
Contributions received from participants	2017-05-15	$416,688
Participant contributions at end of year	2017-05-15	$0
Participant contributions at beginning of year	2017-05-15	$0
Assets. Other investments not covered elsewhere at end of year	2017-05-15	$0
Assets. Other investments not covered elsewhere at beginning of year	2017-05-15	$0
Income. Received or receivable in cash from other sources (including rollovers)	2017-05-15	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2017-05-15	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2017-05-15	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2017-05-15	$914
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2017-05-15	$0
Other income not declared elsewhere	2017-05-15	$39,088
Administrative expenses (other) incurred	2017-05-15	$0
Liabilities. Value of operating payables at beginning of year	2017-05-15	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-05-15	No
Income. Non cash contributions	2017-05-15	$0
Value of net income/loss	2017-05-15	$613,684
Value of net assets at end of year (total assets less liabilities)	2017-05-15	$0
Value of net assets at beginning of year (total assets less liabilities)	2017-05-15	$8,169,520
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-05-15	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-05-15	No
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year	2017-05-15	$0
Were any leases to which the plan was party in default or uncollectible	2017-05-15	No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year	2017-05-15	$0
Investment advisory and management fees	2017-05-15	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-05-15	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-05-15	$7,784,121
Income. Interest from loans (other than to participants)	2017-05-15	$0
Interest earned on other investments	2017-05-15	$3,777
Income. Interest from US Government securities	2017-05-15	$0
Income. Interest from corporate debt instruments	2017-05-15	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2017-05-15	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2017-05-15	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2017-05-15	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2017-05-15	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-05-15	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-05-15	$384,485
Expenses. Payments to insurance carriers foe the provision of benefits	2017-05-15	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-05-15	$648,051
Net investment gain/loss from pooled separate accounts	2017-05-15	$0
Net investment gain or loss from common/collective trusts	2017-05-15	$0
Net gain/loss from 103.12 investment entities	2017-05-15	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-05-15	No
Was there a failure to transmit to the plan any participant contributions	2017-05-15	No
Has the plan failed to provide any benefit when due under the plan	2017-05-15	No
Contributions received in cash from employer	2017-05-15	$177,637
Employer contributions (assets) at end of year	2017-05-15	$0
Employer contributions (assets) at beginning of year	2017-05-15	$0
Income. Dividends from preferred stock	2017-05-15	$0
Income. Dividends from common stock	2017-05-15	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-05-15	$783,215
Contract administrator fees	2017-05-15	$20,822
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2017-05-15	Yes
Liabilities. Value of benefit claims payable at beginning of year	2017-05-15	$0
Did the plan have assets held for investment	2017-05-15	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	2017-05-15	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-05-15	Yes
Aggregate proceeds on sale of assets	2017-05-15	$0
Aggregate carrying amount (costs) on sale of assets	2017-05-15	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2017-05-15	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-05-15	Yes
Opinion of an independent qualified public accountant for this plan	2017-05-15	Disclaimer
Accountancy firm name	2017-05-15	BAKER TILLY VIRCHOW KRAUSE
Accountancy firm EIN	2017-05-15	390859910
2016 : THE MEMORIAL HOSPITAL, INC. OF TOWANDA, PA 403(B) PLAN 2016 401k financial data
Unrealized appreciation/depreciation of real estate assets	2016-06-30	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2016-06-30	$0
Total unrealized appreciation/depreciation of assets	2016-06-30	$0
Total transfer of assets to this plan	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
Expenses. Interest paid	2016-06-30	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2016-06-30	$0
Total income from all sources (including contributions)	2016-06-30	$733,048
Total loss/gain on sale of assets	2016-06-30	$0
Total of all expenses incurred	2016-06-30	$786,771
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-06-30	$766,234
Value of total corrective distributions	2016-06-30	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-06-30	$818,383
Value of total assets at end of year	2016-06-30	$8,169,520
Value of total assets at beginning of year	2016-06-30	$8,223,243
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-06-30	$20,537
Total income from rents	2016-06-30	$0
Total interest from all sources	2016-06-30	$4,297
Total dividends received (eg from common stock, registered investment company shares)	2016-06-30	$506,664
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-06-30	$506,664
Administrative expenses professional fees incurred	2016-06-30	$0
Was this plan covered by a fidelity bond	2016-06-30	Yes
Value of fidelity bond cover	2016-06-30	$500,000
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
Amount of non-exempt transactions with any party-in-interest	2016-06-30	$0
Contributions received from participants	2016-06-30	$546,418
Participant contributions at end of year	2016-06-30	$0
Participant contributions at beginning of year	2016-06-30	$0
Income. Received or receivable in cash from other sources (including rollovers)	2016-06-30	$34,871
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2016-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2016-06-30	$914
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2016-06-30	$1,399
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	$0
Administrative expenses (other) incurred	2016-06-30	$0
Liabilities. Value of operating payables at beginning of year	2016-06-30	$0
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
Income. Non cash contributions	2016-06-30	$0
Value of net income/loss	2016-06-30	$-53,723
Value of net assets at end of year (total assets less liabilities)	2016-06-30	$8,169,520
Value of net assets at beginning of year (total assets less liabilities)	2016-06-30	$8,223,243
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
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year	2016-06-30	$0
Were any leases to which the plan was party in default or uncollectible	2016-06-30	No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year	2016-06-30	$0
Investment advisory and management fees	2016-06-30	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-06-30	$7,784,121
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-06-30	$7,861,233
Income. Interest from loans (other than to participants)	2016-06-30	$0
Interest earned on other investments	2016-06-30	$4,297
Income. Interest from US Government securities	2016-06-30	$0
Income. Interest from corporate debt instruments	2016-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2016-06-30	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2016-06-30	$37,722
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2016-06-30	$37,722
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2016-06-30	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-06-30	$384,485
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-06-30	$322,889
Expenses. Payments to insurance carriers foe the provision of benefits	2016-06-30	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-06-30	$-596,296
Net investment gain/loss from pooled separate accounts	2016-06-30	$0
Net investment gain or loss from common/collective trusts	2016-06-30	$0
Net gain/loss from 103.12 investment entities	2016-06-30	$0
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	$237,094
Employer contributions (assets) at end of year	2016-06-30	$0
Employer contributions (assets) at beginning of year	2016-06-30	$0
Income. Dividends from preferred stock	2016-06-30	$0
Income. Dividends from common stock	2016-06-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-06-30	$766,234
Contract administrator fees	2016-06-30	$20,537
Liabilities. Value of benefit claims payable at beginning of year	2016-06-30	$0
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
Aggregate proceeds on sale of assets	2016-06-30	$0
Aggregate carrying amount (costs) on sale of assets	2016-06-30	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2016-06-30	$0
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	BAKER TILLY VIRCHOW KRAUSE LLP
Accountancy firm EIN	2016-06-30	390859910
2015 : THE MEMORIAL HOSPITAL, INC. OF TOWANDA, PA 403(B) PLAN 2015 401k financial data
Unrealized appreciation/depreciation of real estate assets	2015-06-30	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2015-06-30	$0
Total unrealized appreciation/depreciation of assets	2015-06-30	$0
Total transfer of assets to this plan	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
Expenses. Interest paid	2015-06-30	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2015-06-30	$0
Total income from all sources (including contributions)	2015-06-30	$1,140,108
Total loss/gain on sale of assets	2015-06-30	$0
Total of all expenses incurred	2015-06-30	$423,533
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-06-30	$396,898
Value of total corrective distributions	2015-06-30	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-06-30	$984,847
Value of total assets at end of year	2015-06-30	$8,223,243
Value of total assets at beginning of year	2015-06-30	$7,506,668
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-06-30	$26,635
Total income from rents	2015-06-30	$0
Total interest from all sources	2015-06-30	$3,989
Total dividends received (eg from common stock, registered investment company shares)	2015-06-30	$388,582
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-06-30	$388,582
Administrative expenses professional fees incurred	2015-06-30	$0
Was this plan covered by a fidelity bond	2015-06-30	Yes
Value of fidelity bond cover	2015-06-30	$500,000
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
Amount of non-exempt transactions with any party-in-interest	2015-06-30	$0
Contributions received from participants	2015-06-30	$693,443
Participant contributions at end of year	2015-06-30	$0
Participant contributions at beginning of year	2015-06-30	$0
Income. Received or receivable in cash from other sources (including rollovers)	2015-06-30	$23,814
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2015-06-30	$1,781
Value of other receiveables (less allowance for doubtful accounts) at end of year	2015-06-30	$1,399
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2015-06-30	$1,582
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	$825
Administrative expenses (other) incurred	2015-06-30	$0
Liabilities. Value of operating payables at beginning of year	2015-06-30	$0
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
Income. Non cash contributions	2015-06-30	$0
Value of net income/loss	2015-06-30	$716,575
Value of net assets at end of year (total assets less liabilities)	2015-06-30	$8,223,243
Value of net assets at beginning of year (total assets less liabilities)	2015-06-30	$7,506,668
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
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year	2015-06-30	$0
Were any leases to which the plan was party in default or uncollectible	2015-06-30	No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year	2015-06-30	$0
Investment advisory and management fees	2015-06-30	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-06-30	$7,861,233
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-06-30	$7,174,022
Income. Interest from loans (other than to participants)	2015-06-30	$0
Interest earned on other investments	2015-06-30	$3,989
Income. Interest from US Government securities	2015-06-30	$0
Income. Interest from corporate debt instruments	2015-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2015-06-30	$37,722
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2015-06-30	$39,832
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2015-06-30	$39,832
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2015-06-30	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-06-30	$322,889
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-06-30	$291,232
Expenses. Payments to insurance carriers foe the provision of benefits	2015-06-30	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-06-30	$-238,135
Net investment gain/loss from pooled separate accounts	2015-06-30	$0
Net investment gain or loss from common/collective trusts	2015-06-30	$0
Net gain/loss from 103.12 investment entities	2015-06-30	$0
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	$267,590
Employer contributions (assets) at end of year	2015-06-30	$0
Employer contributions (assets) at beginning of year	2015-06-30	$0
Income. Dividends from preferred stock	2015-06-30	$0
Income. Dividends from common stock	2015-06-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-06-30	$395,117
Contract administrator fees	2015-06-30	$26,635
Liabilities. Value of benefit claims payable at beginning of year	2015-06-30	$0
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
Aggregate proceeds on sale of assets	2015-06-30	$0
Aggregate carrying amount (costs) on sale of assets	2015-06-30	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2015-06-30	$0
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	BAKER TILLY VIRCHOW KRAUSE, LLP
Accountancy firm EIN	2015-06-30	390859910
2014 : THE MEMORIAL HOSPITAL, INC. OF TOWANDA, PA 403(B) PLAN 2014 401k financial data
Unrealized appreciation/depreciation of real estate assets	2014-06-30	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2014-06-30	$0
Total unrealized appreciation/depreciation of assets	2014-06-30	$0
Total transfer of assets to this plan	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	$0
Expenses. Interest paid	2014-06-30	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2014-06-30	$0
Total income from all sources (including contributions)	2014-06-30	$4,903,111
Total loss/gain on sale of assets	2014-06-30	$0
Total of all expenses incurred	2014-06-30	$1,178,535
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-06-30	$1,139,213
Value of total corrective distributions	2014-06-30	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-06-30	$3,920,903
Value of total assets at end of year	2014-06-30	$7,506,668
Value of total assets at beginning of year	2014-06-30	$3,782,092
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-06-30	$39,322
Total income from rents	2014-06-30	$0
Total interest from all sources	2014-06-30	$3,079
Total dividends received (eg from common stock, registered investment company shares)	2014-06-30	$82,456
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-06-30	$82,456
Administrative expenses professional fees incurred	2014-06-30	$0
Was this plan covered by a fidelity bond	2014-06-30	Yes
Value of fidelity bond cover	2014-06-30	$500,000
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
Amount of non-exempt transactions with any party-in-interest	2014-06-30	$0
Contributions received from participants	2014-06-30	$645,724
Participant contributions at end of year	2014-06-30	$0
Participant contributions at beginning of year	2014-06-30	$23,039
Income. Received or receivable in cash from other sources (including rollovers)	2014-06-30	$3,005,046
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2014-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2014-06-30	$1,582
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2014-06-30	$1,143
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2014-06-30	$0
Other income not declared elsewhere	2014-06-30	$8,799
Administrative expenses (other) incurred	2014-06-30	$0
Liabilities. Value of operating payables at beginning of year	2014-06-30	$0
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
Income. Non cash contributions	2014-06-30	$0
Value of net income/loss	2014-06-30	$3,724,576
Value of net assets at end of year (total assets less liabilities)	2014-06-30	$7,506,668
Value of net assets at beginning of year (total assets less liabilities)	2014-06-30	$3,782,092
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
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year	2014-06-30	$0
Were any leases to which the plan was party in default or uncollectible	2014-06-30	No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year	2014-06-30	$0
Investment advisory and management fees	2014-06-30	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-06-30	$7,174,022
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-06-30	$3,558,712
Income. Interest from loans (other than to participants)	2014-06-30	$0
Interest earned on other investments	2014-06-30	$3,079
Income. Interest from US Government securities	2014-06-30	$0
Income. Interest from corporate debt instruments	2014-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2014-06-30	$39,832
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2014-06-30	$76,969
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2014-06-30	$76,969
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2014-06-30	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-06-30	$291,232
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-06-30	$111,977
Expenses. Payments to insurance carriers foe the provision of benefits	2014-06-30	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-06-30	$887,874
Net investment gain/loss from pooled separate accounts	2014-06-30	$0
Net investment gain or loss from common/collective trusts	2014-06-30	$0
Net gain/loss from 103.12 investment entities	2014-06-30	$0
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	$270,133
Employer contributions (assets) at end of year	2014-06-30	$0
Employer contributions (assets) at beginning of year	2014-06-30	$10,252
Income. Dividends from preferred stock	2014-06-30	$0
Income. Dividends from common stock	2014-06-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-06-30	$1,139,213
Contract administrator fees	2014-06-30	$39,322
Liabilities. Value of benefit claims payable at beginning of year	2014-06-30	$0
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
Aggregate proceeds on sale of assets	2014-06-30	$0
Aggregate carrying amount (costs) on sale of assets	2014-06-30	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2014-06-30	$0
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	BAKER TILLY VIRCHOW KRAUSE, LLP
Accountancy firm EIN	2014-06-30	390859910
2013 : THE MEMORIAL HOSPITAL, INC. OF TOWANDA, PA 403(B) PLAN 2013 401k financial data
Unrealized appreciation/depreciation of real estate assets	2013-06-30	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2013-06-30	$0
Total unrealized appreciation/depreciation of assets	2013-06-30	$0
Total transfer of assets to this plan	2013-06-30	$0
Total transfer of assets from this plan	2013-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-06-30	$0
Expenses. Interest paid	2013-06-30	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2013-06-30	$0
Total income from all sources (including contributions)	2013-06-30	$1,302,419
Total loss/gain on sale of assets	2013-06-30	$0
Total of all expenses incurred	2013-06-30	$301,752
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-06-30	$278,100
Value of total corrective distributions	2013-06-30	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-06-30	$966,021
Value of total assets at end of year	2013-06-30	$3,782,092
Value of total assets at beginning of year	2013-06-30	$2,781,425
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-06-30	$23,652
Total income from rents	2013-06-30	$0
Total interest from all sources	2013-06-30	$1,439
Total dividends received (eg from common stock, registered investment company shares)	2013-06-30	$34,038
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-06-30	$34,038
Administrative expenses professional fees incurred	2013-06-30	$0
Was this plan covered by a fidelity bond	2013-06-30	Yes
Value of fidelity bond cover	2013-06-30	$500,000
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
Amount of non-exempt transactions with any party-in-interest	2013-06-30	$0
Contributions received from participants	2013-06-30	$544,980
Participant contributions at end of year	2013-06-30	$23,039
Participant contributions at beginning of year	2013-06-30	$19,341
Income. Received or receivable in cash from other sources (including rollovers)	2013-06-30	$167,568
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2013-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2013-06-30	$1,143
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2013-06-30	$1,267
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	$7,120
Administrative expenses (other) incurred	2013-06-30	$0
Liabilities. Value of operating payables at beginning of year	2013-06-30	$0
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
Income. Non cash contributions	2013-06-30	$0
Value of net income/loss	2013-06-30	$1,000,667
Value of net assets at end of year (total assets less liabilities)	2013-06-30	$3,782,092
Value of net assets at beginning of year (total assets less liabilities)	2013-06-30	$2,781,425
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
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year	2013-06-30	$0
Were any leases to which the plan was party in default or uncollectible	2013-06-30	No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year	2013-06-30	$0
Investment advisory and management fees	2013-06-30	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-06-30	$3,558,712
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-06-30	$2,599,829
Income. Interest from loans (other than to participants)	2013-06-30	$0
Interest earned on other investments	2013-06-30	$1,439
Income. Interest from US Government securities	2013-06-30	$0
Income. Interest from corporate debt instruments	2013-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2013-06-30	$76,969
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2013-06-30	$78,407
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2013-06-30	$78,407
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2013-06-30	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-06-30	$111,977
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-06-30	$73,490
Expenses. Payments to insurance carriers foe the provision of benefits	2013-06-30	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-06-30	$293,801
Net investment gain/loss from pooled separate accounts	2013-06-30	$0
Net investment gain or loss from common/collective trusts	2013-06-30	$0
Net gain/loss from 103.12 investment entities	2013-06-30	$0
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	$253,473
Employer contributions (assets) at end of year	2013-06-30	$10,252
Employer contributions (assets) at beginning of year	2013-06-30	$9,091
Income. Dividends from preferred stock	2013-06-30	$0
Income. Dividends from common stock	2013-06-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-06-30	$278,100
Contract administrator fees	2013-06-30	$23,652
Liabilities. Value of benefit claims payable at beginning of year	2013-06-30	$0
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
Aggregate proceeds on sale of assets	2013-06-30	$0
Aggregate carrying amount (costs) on sale of assets	2013-06-30	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2013-06-30	$0
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	PARENTEBEARD, LLC
Accountancy firm EIN	2013-06-30	232932984
2012 : THE MEMORIAL HOSPITAL, INC. OF TOWANDA, PA 403(B) PLAN 2012 401k financial data
Unrealized appreciation/depreciation of real estate assets	2012-06-30	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2012-06-30	$0
Total unrealized appreciation/depreciation of assets	2012-06-30	$0
Total transfer of assets to this plan	2012-06-30	$0
Total transfer of assets from this plan	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
Expenses. Interest paid	2012-06-30	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2012-06-30	$0
Total income from all sources (including contributions)	2012-06-30	$954,129
Total loss/gain on sale of assets	2012-06-30	$0
Total of all expenses incurred	2012-06-30	$48,357
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-06-30	$37,201
Value of total corrective distributions	2012-06-30	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-06-30	$929,995
Value of total assets at end of year	2012-06-30	$2,781,425
Value of total assets at beginning of year	2012-06-30	$1,875,653
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-06-30	$11,156
Total income from rents	2012-06-30	$0
Total interest from all sources	2012-06-30	$1,664
Total dividends received (eg from common stock, registered investment company shares)	2012-06-30	$18,755
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-06-30	$18,755
Administrative expenses professional fees incurred	2012-06-30	$0
Was this plan covered by a fidelity bond	2012-06-30	Yes
Value of fidelity bond cover	2012-06-30	$500,000
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
Amount of non-exempt transactions with any party-in-interest	2012-06-30	$0
Contributions received from participants	2012-06-30	$478,520
Participant contributions at end of year	2012-06-30	$19,341
Participant contributions at beginning of year	2012-06-30	$0
Income. Received or receivable in cash from other sources (including rollovers)	2012-06-30	$209,100
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2012-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2012-06-30	$1,267
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2012-06-30	$1,076
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2012-06-30	$0
Other income not declared elsewhere	2012-06-30	$0
Administrative expenses (other) incurred	2012-06-30	$0
Liabilities. Value of operating payables at beginning of year	2012-06-30	$0
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
Income. Non cash contributions	2012-06-30	$0
Value of net income/loss	2012-06-30	$905,772
Value of net assets at end of year (total assets less liabilities)	2012-06-30	$2,781,425
Value of net assets at beginning of year (total assets less liabilities)	2012-06-30	$1,875,653
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
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year	2012-06-30	$0
Were any leases to which the plan was party in default or uncollectible	2012-06-30	No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year	2012-06-30	$0
Investment advisory and management fees	2012-06-30	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-06-30	$2,599,829
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-06-30	$1,750,670
Income. Interest from loans (other than to participants)	2012-06-30	$0
Interest earned on other investments	2012-06-30	$1,664
Income. Interest from US Government securities	2012-06-30	$0
Income. Interest from corporate debt instruments	2012-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-06-30	$78,407
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-06-30	$48,823
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-06-30	$48,823
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-06-30	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-06-30	$73,490
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-06-30	$75,084
Expenses. Payments to insurance carriers foe the provision of benefits	2012-06-30	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-06-30	$3,715
Net investment gain/loss from pooled separate accounts	2012-06-30	$0
Net investment gain or loss from common/collective trusts	2012-06-30	$0
Net gain/loss from 103.12 investment entities	2012-06-30	$0
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	$242,375
Employer contributions (assets) at end of year	2012-06-30	$9,091
Employer contributions (assets) at beginning of year	2012-06-30	$0
Income. Dividends from preferred stock	2012-06-30	$0
Income. Dividends from common stock	2012-06-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-06-30	$37,201
Contract administrator fees	2012-06-30	$11,156
Liabilities. Value of benefit claims payable at beginning of year	2012-06-30	$0
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
Aggregate proceeds on sale of assets	2012-06-30	$0
Aggregate carrying amount (costs) on sale of assets	2012-06-30	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2012-06-30	$0
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	PARENTEBEARD, LLC
Accountancy firm EIN	2012-06-30	232932984
2011 : THE MEMORIAL HOSPITAL, INC. OF TOWANDA, PA 403(B) PLAN 2011 401k financial data
Unrealized appreciation/depreciation of real estate assets	2011-06-30	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2011-06-30	$0
Total unrealized appreciation/depreciation of assets	2011-06-30	$0
Total transfer of assets to this plan	2011-06-30	$0
Total transfer of assets from this plan	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
Expenses. Interest paid	2011-06-30	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2011-06-30	$0
Total income from all sources (including contributions)	2011-06-30	$983,932
Total loss/gain on sale of assets	2011-06-30	$0
Total of all expenses incurred	2011-06-30	$143,978
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-06-30	$133,162
Value of total corrective distributions	2011-06-30	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-06-30	$728,625
Value of total assets at end of year	2011-06-30	$1,875,653
Value of total assets at beginning of year	2011-06-30	$1,035,699
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-06-30	$10,816
Total income from rents	2011-06-30	$0
Total interest from all sources	2011-06-30	$831
Total dividends received (eg from common stock, registered investment company shares)	2011-06-30	$5,347
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2011-06-30	$5,347
Administrative expenses professional fees incurred	2011-06-30	$0
Was this plan covered by a fidelity bond	2011-06-30	Yes
Value of fidelity bond cover	2011-06-30	$500,000
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
Amount of non-exempt transactions with any party-in-interest	2011-06-30	$0
Contributions received from participants	2011-06-30	$365,354
Participant contributions at end of year	2011-06-30	$0
Participant contributions at beginning of year	2011-06-30	$0
Assets. Other investments not covered elsewhere at end of year	2011-06-30	$0
Assets. Other investments not covered elsewhere at beginning of year	2011-06-30	$0
Income. Received or receivable in cash from other sources (including rollovers)	2011-06-30	$219,131
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2011-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-06-30	$1,076
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-06-30	$774
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2011-06-30	$0
Other income not declared elsewhere	2011-06-30	$-314
Administrative expenses (other) incurred	2011-06-30	$0
Liabilities. Value of operating payables at beginning of year	2011-06-30	$0
Total non interest bearing cash at end of year	2011-06-30	$0
Total non interest bearing cash at beginning of year	2011-06-30	$12
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
Income. Non cash contributions	2011-06-30	$0
Value of net income/loss	2011-06-30	$839,954
Value of net assets at end of year (total assets less liabilities)	2011-06-30	$1,875,653
Value of net assets at beginning of year (total assets less liabilities)	2011-06-30	$1,035,699
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
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year	2011-06-30	$0
Were any leases to which the plan was party in default or uncollectible	2011-06-30	No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year	2011-06-30	$0
Investment advisory and management fees	2011-06-30	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-06-30	$1,750,670
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-06-30	$1,021,708
Income. Interest from loans (other than to participants)	2011-06-30	$0
Interest earned on other investments	2011-06-30	$831
Income. Interest from US Government securities	2011-06-30	$0
Income. Interest from corporate debt instruments	2011-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-06-30	$48,823
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-06-30	$13,205
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-06-30	$13,205
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-06-30	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-06-30	$75,084
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-06-30	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2011-06-30	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-06-30	$249,443
Net investment gain/loss from pooled separate accounts	2011-06-30	$0
Net investment gain or loss from common/collective trusts	2011-06-30	$0
Net gain/loss from 103.12 investment entities	2011-06-30	$0
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	$144,140
Employer contributions (assets) at end of year	2011-06-30	$0
Employer contributions (assets) at beginning of year	2011-06-30	$0
Income. Dividends from preferred stock	2011-06-30	$0
Income. Dividends from common stock	2011-06-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-06-30	$133,162
Contract administrator fees	2011-06-30	$10,816
Liabilities. Value of benefit claims payable at beginning of year	2011-06-30	$0
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
Aggregate proceeds on sale of assets	2011-06-30	$0
Aggregate carrying amount (costs) on sale of assets	2011-06-30	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2011-06-30	$0
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	PARENTEBEARD, LLC
Accountancy firm EIN	2011-06-30	232932984

Form 5500 Responses for THE MEMORIAL HOSPITAL, INC. OF TOWANDA, PA 403(B) PLAN

2016: THE MEMORIAL HOSPITAL, INC. OF TOWANDA, PA 403(B) PLAN 2016 form 5500 responses
2016-07-01	Type of plan entity	Single employer plan
2016-07-01	This submission is the final filing	Yes
2016-07-01	This return/report is a short plan year return/report (less than 12 months)	Yes
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: THE MEMORIAL HOSPITAL, INC. OF TOWANDA, PA 403(B) PLAN 2015 form 5500 responses
2015-07-01	Type of plan entity	Single employer plan
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: THE MEMORIAL HOSPITAL, INC. OF TOWANDA, PA 403(B) PLAN 2014 form 5500 responses
2014-07-01	Type of plan entity	Single employer plan
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: THE MEMORIAL HOSPITAL, INC. OF TOWANDA, PA 403(B) PLAN 2013 form 5500 responses
2013-07-01	Type of plan entity	Single employer plan
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: THE MEMORIAL HOSPITAL, INC. OF TOWANDA, PA 403(B) PLAN 2012 form 5500 responses
2012-07-01	Type of plan entity	Single employer plan
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: THE MEMORIAL HOSPITAL, INC. OF TOWANDA, PA 403(B) PLAN 2011 form 5500 responses
2011-07-01	Type of plan entity	Single employer plan
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: THE MEMORIAL HOSPITAL, INC. OF TOWANDA, PA 403(B) PLAN 2010 form 5500 responses
2010-07-01	Type of plan entity	Single employer plan
2010-07-01	First time form 5500 has been submitted	Yes
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

Insurance Providers Used on plan

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

613953

Policy instance

Insurance contract or identification number	613953
Number of Individuals Covered	466
Insurance policy start date	2015-07-01
Insurance policy end date	2016-06-30
Total amount of commissions paid to insurance broker	USD $847
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $847
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	KREISCHER, PAUL E.

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

613953

Policy instance

Insurance contract or identification number	613953
Number of Individuals Covered	464
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Total amount of commissions paid to insurance broker	USD $716
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $716
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	KREISCHER, PAUL E.

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

613953

Policy instance

Insurance contract or identification number	613953
Number of Individuals Covered	487
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
Total amount of commissions paid to insurance broker	USD $10,163
Total amount of fees paid to insurance company	USD $476
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $10,163
Amount paid for insurance broker fees	476
Additional information about fees paid to insurance broker	REFERRAL/SERVICE FEE
Insurance broker organization code?	3
Insurance broker name	KREISCHER, PAUL E.

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

613953

Policy instance

Insurance contract or identification number	613953
Number of Individuals Covered	522
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
Total amount of commissions paid to insurance broker	USD $3,886
Total amount of fees paid to insurance company	USD $334
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,886
Amount paid for insurance broker fees	334
Additional information about fees paid to insurance broker	REFERRAL/SERVICE FEE
Insurance broker organization code?	3
Insurance broker name	KREISCHER, PAUL E.

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

613953

Policy instance

Insurance contract or identification number	613953
Number of Individuals Covered	433
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $1,705
Total amount of fees paid to insurance company	USD $114
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

613953

Policy instance

Insurance contract or identification number	613953
Number of Individuals Covered	393
Insurance policy start date	2010-11-01
Insurance policy end date	2011-06-30
Total amount of commissions paid to insurance broker	USD $764
Total amount of fees paid to insurance company	USD $25
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	GUTHRIE TOWANDA MEMORIAL HOSPITAL
Employer identification number (EIN):	240786657
NAIC Classification:	622000
NAIC Description:	Hospitals