401k Plan data: JERSEY SHORE HOSPITAL TAX-SHELTERED ANNUITY RETIREMENT PLAN plan

JERSEY SHORE HOSPITAL TAX-SHELTERED ANNUITY RETIREMENT PLAN 401k Plan overview

Plan Name	JERSEY SHORE HOSPITAL TAX-SHELTERED ANNUITY RETIREMENT PLAN
Plan identification number	002

JERSEY SHORE HOSPITAL TAX-SHELTERED ANNUITY RETIREMENT 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)(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.
Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.

401k Sponsoring company profile

JERSEY SHORE HOSPITAL has sponsored the creation of one or more 401k plans.

Company Name: JERSEY SHORE HOSPITAL

Employer identification number (EIN): 240792115

NAIC Classification: 622000
NAIC Description: Hospitals

Additional information about JERSEY SHORE HOSPITAL

Jurisdiction of Incorporation: COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF STATE

Incorporation Date:

Company Identification Number: 179361

More information about JERSEY SHORE HOSPITAL

Form 5500 Filing Information

Submission information for form 5500 for 401k plan JERSEY SHORE HOSPITAL TAX-SHELTERED ANNUITY RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2016-01-01
002 2015-01-01 MARK RICE
002 2014-01-01 MARK RICE
002 2013-01-01 MARK RICE
002 2012-01-01 CAREY W. PLUMMER
002 2011-01-01 CAREY W. PLUMMER
002 2010-01-01 GREGORY METZLER
002 2009-01-01 CAREY PLUMMER
002 2009-01-01 GREGORY METZLER

Plan Statistics for JERSEY SHORE HOSPITAL TAX-SHELTERED ANNUITY RETIREMENT PLAN

401k plan membership statisitcs for JERSEY SHORE HOSPITAL TAX-SHELTERED ANNUITY RETIREMENT PLAN

Measure Date Value
2016: JERSEY SHORE HOSPITAL TAX-SHELTERED ANNUITY RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 454
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 290
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 147
Total of all active and inactive participants 2016-01-01 437
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 437
Number of participants with account balances 2016-01-01 406
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 43
2015: JERSEY SHORE HOSPITAL TAX-SHELTERED ANNUITY RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 455
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 306
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 148
Total of all active and inactive participants 2015-01-01 454
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 454
Number of participants with account balances 2015-01-01 439
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 46
2014: JERSEY SHORE HOSPITAL TAX-SHELTERED ANNUITY RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 438
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 335
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 120
Total of all active and inactive participants 2014-01-01 455
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 455
Number of participants with account balances 2014-01-01 433
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 32
2013: JERSEY SHORE HOSPITAL TAX-SHELTERED ANNUITY RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 432
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 332
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 106
Total of all active and inactive participants 2013-01-01 438
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 438
Number of participants with account balances 2013-01-01 415
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 33
2012: JERSEY SHORE HOSPITAL TAX-SHELTERED ANNUITY RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 409
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 341
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 90
Total of all active and inactive participants 2012-01-01 431
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 431
Number of participants with account balances 2012-01-01 398
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 40
2011: JERSEY SHORE HOSPITAL TAX-SHELTERED ANNUITY RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 383
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 339
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 70
Total of all active and inactive participants 2011-01-01 409
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 409
Number of participants with account balances 2011-01-01 370
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 32
2010: JERSEY SHORE HOSPITAL TAX-SHELTERED ANNUITY RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 403
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 334
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 49
Total of all active and inactive participants 2010-01-01 383
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 383
Number of participants with account balances 2010-01-01 344
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 2
2009: JERSEY SHORE HOSPITAL TAX-SHELTERED ANNUITY RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 311
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 328
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 75
Total of all active and inactive participants 2009-01-01 403
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 403
Number of participants with account balances 2009-01-01 359
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 31

Measure	Date	Value
2016: JERSEY SHORE HOSPITAL TAX-SHELTERED ANNUITY RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	454
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	290
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	147
Total of all active and inactive participants	2016-01-01	437
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	437
Number of participants with account balances	2016-01-01	406
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	43
2015: JERSEY SHORE HOSPITAL TAX-SHELTERED ANNUITY RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	455
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	306
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	148
Total of all active and inactive participants	2015-01-01	454
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	454
Number of participants with account balances	2015-01-01	439
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	46
2014: JERSEY SHORE HOSPITAL TAX-SHELTERED ANNUITY RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	438
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	335
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	120
Total of all active and inactive participants	2014-01-01	455
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	455
Number of participants with account balances	2014-01-01	433
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	32
2013: JERSEY SHORE HOSPITAL TAX-SHELTERED ANNUITY RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	432
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	332
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	106
Total of all active and inactive participants	2013-01-01	438
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	438
Number of participants with account balances	2013-01-01	415
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	33
2012: JERSEY SHORE HOSPITAL TAX-SHELTERED ANNUITY RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	409
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	341
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	90
Total of all active and inactive participants	2012-01-01	431
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	431
Number of participants with account balances	2012-01-01	398
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	40
2011: JERSEY SHORE HOSPITAL TAX-SHELTERED ANNUITY RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	383
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	339
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	70
Total of all active and inactive participants	2011-01-01	409
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	409
Number of participants with account balances	2011-01-01	370
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	32
2010: JERSEY SHORE HOSPITAL TAX-SHELTERED ANNUITY RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	403
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	334
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	49
Total of all active and inactive participants	2010-01-01	383
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	383
Number of participants with account balances	2010-01-01	344
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	2
2009: JERSEY SHORE HOSPITAL TAX-SHELTERED ANNUITY RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	311
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	328
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	75
Total of all active and inactive participants	2009-01-01	403
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	403
Number of participants with account balances	2009-01-01	359
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	31

Financial Data on JERSEY SHORE HOSPITAL TAX-SHELTERED ANNUITY RETIREMENT PLAN

Measure	Date	Value
2016 : JERSEY SHORE HOSPITAL TAX-SHELTERED ANNUITY RETIREMENT PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$110
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$135
Total income from all sources (including contributions)	2016-12-31	$2,644,210
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$2,184,329
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$2,076,994
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$1,349,493
Value of total assets at end of year	2016-12-31	$13,929,922
Value of total assets at beginning of year	2016-12-31	$13,470,066
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$107,335
Total interest from all sources	2016-12-31	$6,000
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$364,098
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$364,098
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$855,245
Participant contributions at end of year	2016-12-31	$118,787
Participant contributions at beginning of year	2016-12-31	$162,091
Participant contributions at end of year	2016-12-31	$0
Participant contributions at beginning of year	2016-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$218,060
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2016-12-31	$110
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2016-12-31	$135
Administrative expenses (other) incurred	2016-12-31	$107,335
Total non interest bearing cash at end of year	2016-12-31	$145
Total non interest bearing cash at beginning of year	2016-12-31	$44,595
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$459,881
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$13,929,812
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$13,469,931
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$13,115,558
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$11,870,199
Interest on participant loans	2016-12-31	$6,000
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2016-12-31	$264,419
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2016-12-31	$956,798
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2016-12-31	$956,798
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$431,013
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$436,383
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$924,619
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$276,188
Employer contributions (assets) at end of year	2016-12-31	$0
Employer contributions (assets) at beginning of year	2016-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$2,076,994
Did the plan have assets held for investment	2016-12-31	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	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	BAKER TILLY VIRCHOW KRAUSE, LLP
Accountancy firm EIN	2016-12-31	390859910
2015 : JERSEY SHORE HOSPITAL TAX-SHELTERED ANNUITY RETIREMENT PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$135
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$21,303
Total income from all sources (including contributions)	2015-12-31	$1,135,358
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$2,527,385
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$2,482,738
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$1,387,840
Value of total assets at end of year	2015-12-31	$13,470,066
Value of total assets at beginning of year	2015-12-31	$14,883,261
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$44,647
Total interest from all sources	2015-12-31	$6,345
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$340,848
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$340,848
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$937,828
Participant contributions at end of year	2015-12-31	$162,091
Participant contributions at beginning of year	2015-12-31	$168,445
Participant contributions at end of year	2015-12-31	$0
Participant contributions at beginning of year	2015-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$41,349
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2015-12-31	$135
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2015-12-31	$21,303
Administrative expenses (other) incurred	2015-12-31	$44,647
Total non interest bearing cash at end of year	2015-12-31	$44,595
Total non interest bearing cash at beginning of year	2015-12-31	$43,017
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$-1,392,027
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$13,469,931
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$14,861,958
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$11,870,199
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$13,376,960
Interest on participant loans	2015-12-31	$6,345
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2015-12-31	$956,798
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2015-12-31	$861,786
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2015-12-31	$861,786
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$436,383
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$433,053
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-599,675
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$408,663
Employer contributions (assets) at end of year	2015-12-31	$0
Employer contributions (assets) at beginning of year	2015-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$2,482,738
Did the plan have assets held for investment	2015-12-31	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	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	BAKER TILLY VIRCHOW KRAUSE, LLP
Accountancy firm EIN	2015-12-31	390859910
2014 : JERSEY SHORE HOSPITAL TAX-SHELTERED ANNUITY RETIREMENT PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$21,303
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$2,052,391
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$828,244
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$819,441
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$1,350,775
Value of total assets at end of year	2014-12-31	$14,883,261
Value of total assets at beginning of year	2014-12-31	$13,637,811
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$8,803
Total interest from all sources	2014-12-31	$6,038
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$337,863
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$337,863
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$834,499
Participant contributions at end of year	2014-12-31	$168,445
Participant contributions at beginning of year	2014-12-31	$168,837
Participant contributions at end of year	2014-12-31	$0
Participant contributions at beginning of year	2014-12-31	$22,320
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$55,941
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2014-12-31	$21,303
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2014-12-31	$0
Administrative expenses (other) incurred	2014-12-31	$8,803
Total non interest bearing cash at end of year	2014-12-31	$43,017
Total non interest bearing cash at beginning of year	2014-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$1,224,147
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$14,861,958
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$13,637,811
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$13,376,960
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$12,156,707
Interest on participant loans	2014-12-31	$6,038
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2014-12-31	$861,786
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2014-12-31	$796,096
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2014-12-31	$796,096
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$433,053
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$478,325
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$357,715
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$460,335
Employer contributions (assets) at end of year	2014-12-31	$0
Employer contributions (assets) at beginning of year	2014-12-31	$15,526
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$819,441
Did the plan have assets held for investment	2014-12-31	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	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	BAKER TILLY VIRCHOW KRAUSE, LLP
Accountancy firm EIN	2014-12-31	390859910
2013 : JERSEY SHORE HOSPITAL TAX-SHELTERED ANNUITY RETIREMENT PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$3,238,713
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$455,976
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$446,541
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$1,224,284
Value of total assets at end of year	2013-12-31	$13,637,811
Value of total assets at beginning of year	2013-12-31	$10,855,074
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$9,435
Total interest from all sources	2013-12-31	$5,459
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$303,991
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-12-31	$303,991
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$10,000,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$751,643
Participant contributions at end of year	2013-12-31	$168,837
Participant contributions at beginning of year	2013-12-31	$130,027
Participant contributions at end of year	2013-12-31	$22,320
Participant contributions at beginning of year	2013-12-31	$24,040
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$9,752
Administrative expenses (other) incurred	2013-12-31	$9,435
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$2,782,737
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$13,637,811
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$10,855,074
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$12,156,707
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$9,235,908
Interest on participant loans	2013-12-31	$5,459
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2013-12-31	$796,096
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2013-12-31	$986,448
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2013-12-31	$986,448
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$478,325
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$464,005
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$1,704,979
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$462,889
Employer contributions (assets) at end of year	2013-12-31	$15,526
Employer contributions (assets) at beginning of year	2013-12-31	$14,646
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$446,541
Did the plan have assets held for investment	2013-12-31	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	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	BAKER TILLY VIRCHOW KRAUSE, LLP
Accountancy firm EIN	2013-12-31	390859910
2012 : JERSEY SHORE HOSPITAL TAX-SHELTERED ANNUITY RETIREMENT PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$2,299,575
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$838,642
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$830,256
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$1,252,205
Value of total assets at end of year	2012-12-31	$10,855,074
Value of total assets at beginning of year	2012-12-31	$9,394,141
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$8,386
Total interest from all sources	2012-12-31	$4,062
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$280,604
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-12-31	$280,604
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$804,235
Participant contributions at end of year	2012-12-31	$130,027
Participant contributions at beginning of year	2012-12-31	$117,511
Participant contributions at end of year	2012-12-31	$24,040
Participant contributions at beginning of year	2012-12-31	$25,925
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$7,299
Value of other receiveables (less allowance for doubtful accounts) at end of year	2012-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2012-12-31	$0
Administrative expenses (other) incurred	2012-12-31	$8,386
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$1,460,933
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$10,855,074
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$9,394,141
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$9,235,908
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$7,757,640
Interest on participant loans	2012-12-31	$4,062
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-12-31	$986,448
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-12-31	$1,030,904
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-12-31	$1,030,904
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$464,005
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$446,608
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$762,704
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$440,671
Employer contributions (assets) at end of year	2012-12-31	$14,646
Employer contributions (assets) at beginning of year	2012-12-31	$15,553
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$830,256
Did the plan have assets held for investment	2012-12-31	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	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	PARENTEBEARD LLC
Accountancy firm EIN	2012-12-31	232932984
2011 : JERSEY SHORE HOSPITAL TAX-SHELTERED ANNUITY RETIREMENT PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$1,064,923
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$831,739
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$823,598
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$1,155,790
Value of total assets at end of year	2011-12-31	$9,394,141
Value of total assets at beginning of year	2011-12-31	$9,160,957
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$8,141
Total interest from all sources	2011-12-31	$4,077
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$237,749
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2011-12-31	$237,749
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$745,880
Participant contributions at end of year	2011-12-31	$117,511
Participant contributions at beginning of year	2011-12-31	$104,136
Participant contributions at end of year	2011-12-31	$25,925
Participant contributions at beginning of year	2011-12-31	$21,655
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$3,461
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-12-31	$0
Administrative expenses (other) incurred	2011-12-31	$8,141
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$233,184
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$9,394,141
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$9,160,957
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$7,757,640
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$8,137,107
Interest on participant loans	2011-12-31	$4,077
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-12-31	$1,030,904
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-12-31	$449,244
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-12-31	$449,244
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$446,608
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$435,208
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-332,693
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$406,449
Employer contributions (assets) at end of year	2011-12-31	$15,553
Employer contributions (assets) at beginning of year	2011-12-31	$13,607
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$823,598
Did the plan have assets held for investment	2011-12-31	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	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	PARENTEBEARD LLC
Accountancy firm EIN	2011-12-31	232932984
2010 : JERSEY SHORE HOSPITAL TAX-SHELTERED ANNUITY RETIREMENT PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total income from all sources (including contributions)	2010-12-31	$2,140,248
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$563,568
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$555,696
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$1,122,458
Value of total assets at end of year	2010-12-31	$9,160,957
Value of total assets at beginning of year	2010-12-31	$7,584,277
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$7,872
Total interest from all sources	2010-12-31	$2,834
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$175,387
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2010-12-31	$175,387
Assets. Real estate other than employer real property at beginning of year	2010-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2010-12-31	$0
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$716,121
Participant contributions at end of year	2010-12-31	$104,136
Participant contributions at beginning of year	2010-12-31	$55,373
Participant contributions at end of year	2010-12-31	$21,655
Participant contributions at beginning of year	2010-12-31	$24,462
Assets. Other investments not covered elsewhere at beginning of year	2010-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2010-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2010-12-31	$459
Assets. Loans (other than to participants) at beginning of year	2010-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2010-12-31	$0
Administrative expenses (other) incurred	2010-12-31	$7,872
Liabilities. Value of operating payables at beginning of year	2010-12-31	$0
Total non interest bearing cash at beginning of year	2010-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$1,576,680
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$9,160,957
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$7,584,277
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Assets. partnership/joint venture interests at beginning of year	2010-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$8,137,107
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$6,213,777
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$446,302
Interest on participant loans	2010-12-31	$2,834
Value of interest in master investment trust accounts at beginning of year	2010-12-31	$0
Value of interest in common/collective trusts at beginning of year	2010-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2010-12-31	$449,244
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2010-12-31	$404,288
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2010-12-31	$404,288
Assets. Value of investments in 103.12 investment entities at beginning of year	2010-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$435,208
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$426,005
Asset value of US Government securities at beginning of year	2010-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$839,569
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Assets. Invements in employer securities at beginning of year	2010-12-31	$0
Assets. Value of employer real property at beginning of year	2010-12-31	$0
Contributions received in cash from employer	2010-12-31	$406,337
Employer contributions (assets) at end of year	2010-12-31	$13,607
Employer contributions (assets) at beginning of year	2010-12-31	$13,611
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$555,696
Asset. Corporate debt instrument preferred debt at beginning of year	2010-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2010-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2010-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2010-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2010-12-31	$0
Did the plan have assets held for investment	2010-12-31	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	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Liabilities. Value of acquisition indebtedness at beginning of year	2010-12-31	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	PARENTEBEARD LLC
Accountancy firm EIN	2010-12-31	232932984

Form 5500 Responses for JERSEY SHORE HOSPITAL TAX-SHELTERED ANNUITY RETIREMENT PLAN

2016: JERSEY SHORE HOSPITAL TAX-SHELTERED ANNUITY RETIREMENT PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: JERSEY SHORE HOSPITAL TAX-SHELTERED ANNUITY RETIREMENT PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: JERSEY SHORE HOSPITAL TAX-SHELTERED ANNUITY RETIREMENT PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: JERSEY SHORE HOSPITAL TAX-SHELTERED ANNUITY RETIREMENT PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: JERSEY SHORE HOSPITAL TAX-SHELTERED ANNUITY RETIREMENT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: JERSEY SHORE HOSPITAL TAX-SHELTERED ANNUITY RETIREMENT PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: JERSEY SHORE HOSPITAL TAX-SHELTERED ANNUITY RETIREMENT PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	Yes
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: JERSEY SHORE HOSPITAL TAX-SHELTERED ANNUITY RETIREMENT PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	JERSEY SHORE HOSPITAL
Employer identification number (EIN):	240792115
NAIC Classification:	622000
NAIC Description:	Hospitals

Jurisdiction of Incorporation:	COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF STATE
Incorporation Date:
Company Identification Number:	179361

Plan id#	Filing Submission Date	Name of Administrator
002	2016-01-01
002	2015-01-01	MARK RICE
002	2014-01-01	MARK RICE
002	2013-01-01	MARK RICE
002	2012-01-01	CAREY W. PLUMMER
002	2011-01-01	CAREY W. PLUMMER
002	2010-01-01	GREGORY METZLER
002	2009-01-01	CAREY PLUMMER
002	2009-01-01	GREGORY METZLER