401k Plan data: COMMUNITY MEDICAL CENTER 401(A)SUPPLEMENTAL RETIREMENT PLAN plan

COMMUNITY MEDICAL CENTER 401(A)SUPPLEMENTAL RETIREMENT PLAN 401k Plan overview

Plan Name	COMMUNITY MEDICAL CENTER 401(A)SUPPLEMENTAL RETIREMENT PLAN
Plan identification number	002

COMMUNITY MEDICAL CENTER 401(A)SUPPLEMENTAL RETIREMENT PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
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.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

COMMUNITY MEDICAL CENTER has sponsored the creation of one or more 401k plans.

Company Name: COMMUNITY MEDICAL CENTER

Employer identification number (EIN): 240862246

NAIC Classification: 622000
NAIC Description: Hospitals

Additional information about COMMUNITY MEDICAL CENTER

Jurisdiction of Incorporation: Iowa Secretary of State Business Entities

Incorporation Date: 1984-04-20

Company Identification Number: 094369

Legal Registered Office Address: 1603 MORGAN ST STE 6

KEOKUK
United States of America (USA)
52632

More information about COMMUNITY MEDICAL CENTER

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COMMUNITY MEDICAL CENTER 401(A)SUPPLEMENTAL RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2017-01-01 WENDY M. MARSHALL
002 2016-01-01 WENDY M. MARSHALL
002 2015-07-01 WENDY M. MARSHALL
002 2014-07-01 WENDY M. MARSHALL
002 2013-07-01 WENDY MARSHALL
002 2012-07-01 AMY BRAYFORD
002 2011-07-01 AMY BRAYFORD
002 2009-07-01 LOIS WOLFE LOIS WOLFE 2011-04-15

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
002	2017-01-01	WENDY M. MARSHALL
002	2016-01-01	WENDY M. MARSHALL
002	2015-07-01	WENDY M. MARSHALL
002	2014-07-01	WENDY M. MARSHALL
002	2013-07-01	WENDY MARSHALL
002	2012-07-01	AMY BRAYFORD
002	2011-07-01	AMY BRAYFORD
002	2009-07-01	LOIS WOLFE	LOIS WOLFE	2011-04-15

Plan Statistics for COMMUNITY MEDICAL CENTER 401(A)SUPPLEMENTAL RETIREMENT PLAN

401k plan membership statisitcs for COMMUNITY MEDICAL CENTER 401(A)SUPPLEMENTAL RETIREMENT PLAN

Measure Date Value
2017: COMMUNITY MEDICAL CENTER 401(A)SUPPLEMENTAL RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 3,066
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 0
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 0
Total of all active and inactive participants 2017-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 84
2016: COMMUNITY MEDICAL CENTER 401(A)SUPPLEMENTAL RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 2,964
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 1,755
Number of retired or separated participants receiving benefits 2016-01-01 41
Number of other retired or separated participants entitled to future benefits 2016-01-01 1,259
Total of all active and inactive participants 2016-01-01 3,055
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 11
Total participants 2016-01-01 3,066
Number of participants with account balances 2016-01-01 3,051
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 71
2015: COMMUNITY MEDICAL CENTER 401(A)SUPPLEMENTAL RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-07-01 2,964
Total number of active participants reported on line 7a of the Form 5500 2015-07-01 1,723
Number of retired or separated participants receiving benefits 2015-07-01 52
Number of other retired or separated participants entitled to future benefits 2015-07-01 1,180
Total of all active and inactive participants 2015-07-01 2,955
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-07-01 9
Total participants 2015-07-01 2,964
Number of participants with account balances 2015-07-01 2,962
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-07-01 69
2014: COMMUNITY MEDICAL CENTER 401(A)SUPPLEMENTAL RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-07-01 2,862
Total number of active participants reported on line 7a of the Form 5500 2014-07-01 1,694
Number of retired or separated participants receiving benefits 2014-07-01 47
Number of other retired or separated participants entitled to future benefits 2014-07-01 1,215
Total of all active and inactive participants 2014-07-01 2,956
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-07-01 8
Total participants 2014-07-01 2,964
Number of participants with account balances 2014-07-01 2,954
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-07-01 151
2013: COMMUNITY MEDICAL CENTER 401(A)SUPPLEMENTAL RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-07-01 2,654
Total number of active participants reported on line 7a of the Form 5500 2013-07-01 1,734
Number of retired or separated participants receiving benefits 2013-07-01 41
Number of other retired or separated participants entitled to future benefits 2013-07-01 1,079
Total of all active and inactive participants 2013-07-01 2,854
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-07-01 7
Total participants 2013-07-01 2,861
Number of participants with account balances 2013-07-01 2,699
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-07-01 109
2012: COMMUNITY MEDICAL CENTER 401(A)SUPPLEMENTAL RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-07-01 2,270
Total number of active participants reported on line 7a of the Form 5500 2012-07-01 2,028
Number of retired or separated participants receiving benefits 2012-07-01 46
Number of other retired or separated participants entitled to future benefits 2012-07-01 562
Total of all active and inactive participants 2012-07-01 2,636
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-07-01 8
Total participants 2012-07-01 2,644
Number of participants with account balances 2012-07-01 2,525
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-07-01 84
2011: COMMUNITY MEDICAL CENTER 401(A)SUPPLEMENTAL RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-07-01 2,058
Total number of active participants reported on line 7a of the Form 5500 2011-07-01 1,878
Number of retired or separated participants receiving benefits 2011-07-01 9
Number of other retired or separated participants entitled to future benefits 2011-07-01 383
Total of all active and inactive participants 2011-07-01 2,270
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-07-01 0
Total participants 2011-07-01 2,270
Number of participants with account balances 2011-07-01 2,270
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-07-01 41
2009: COMMUNITY MEDICAL CENTER 401(A)SUPPLEMENTAL RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-07-01 1,966
Total number of active participants reported on line 7a of the Form 5500 2009-07-01 2,018
Number of retired or separated participants receiving benefits 2009-07-01 8
Number of other retired or separated participants entitled to future benefits 2009-07-01 49
Total of all active and inactive participants 2009-07-01 2,075
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-07-01 0
Total participants 2009-07-01 2,075
Number of participants with account balances 2009-07-01 2,075
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-07-01 6

Measure	Date	Value
2017: COMMUNITY MEDICAL CENTER 401(A)SUPPLEMENTAL RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	3,066
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	0
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	0
Total of all active and inactive participants	2017-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	84
2016: COMMUNITY MEDICAL CENTER 401(A)SUPPLEMENTAL RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	2,964
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	1,755
Number of retired or separated participants receiving benefits	2016-01-01	41
Number of other retired or separated participants entitled to future benefits	2016-01-01	1,259
Total of all active and inactive participants	2016-01-01	3,055
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	11
Total participants	2016-01-01	3,066
Number of participants with account balances	2016-01-01	3,051
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	71
2015: COMMUNITY MEDICAL CENTER 401(A)SUPPLEMENTAL RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-07-01	2,964
Total number of active participants reported on line 7a of the Form 5500	2015-07-01	1,723
Number of retired or separated participants receiving benefits	2015-07-01	52
Number of other retired or separated participants entitled to future benefits	2015-07-01	1,180
Total of all active and inactive participants	2015-07-01	2,955
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-07-01	9
Total participants	2015-07-01	2,964
Number of participants with account balances	2015-07-01	2,962
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-07-01	69
2014: COMMUNITY MEDICAL CENTER 401(A)SUPPLEMENTAL RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-07-01	2,862
Total number of active participants reported on line 7a of the Form 5500	2014-07-01	1,694
Number of retired or separated participants receiving benefits	2014-07-01	47
Number of other retired or separated participants entitled to future benefits	2014-07-01	1,215
Total of all active and inactive participants	2014-07-01	2,956
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-07-01	8
Total participants	2014-07-01	2,964
Number of participants with account balances	2014-07-01	2,954
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-07-01	151
2013: COMMUNITY MEDICAL CENTER 401(A)SUPPLEMENTAL RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-07-01	2,654
Total number of active participants reported on line 7a of the Form 5500	2013-07-01	1,734
Number of retired or separated participants receiving benefits	2013-07-01	41
Number of other retired or separated participants entitled to future benefits	2013-07-01	1,079
Total of all active and inactive participants	2013-07-01	2,854
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-07-01	7
Total participants	2013-07-01	2,861
Number of participants with account balances	2013-07-01	2,699
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-07-01	109
2012: COMMUNITY MEDICAL CENTER 401(A)SUPPLEMENTAL RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-07-01	2,270
Total number of active participants reported on line 7a of the Form 5500	2012-07-01	2,028
Number of retired or separated participants receiving benefits	2012-07-01	46
Number of other retired or separated participants entitled to future benefits	2012-07-01	562
Total of all active and inactive participants	2012-07-01	2,636
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-07-01	8
Total participants	2012-07-01	2,644
Number of participants with account balances	2012-07-01	2,525
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-07-01	84
2011: COMMUNITY MEDICAL CENTER 401(A)SUPPLEMENTAL RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-07-01	2,058
Total number of active participants reported on line 7a of the Form 5500	2011-07-01	1,878
Number of retired or separated participants receiving benefits	2011-07-01	9
Number of other retired or separated participants entitled to future benefits	2011-07-01	383
Total of all active and inactive participants	2011-07-01	2,270
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-07-01	0
Total participants	2011-07-01	2,270
Number of participants with account balances	2011-07-01	2,270
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-07-01	41
2009: COMMUNITY MEDICAL CENTER 401(A)SUPPLEMENTAL RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-07-01	1,966
Total number of active participants reported on line 7a of the Form 5500	2009-07-01	2,018
Number of retired or separated participants receiving benefits	2009-07-01	8
Number of other retired or separated participants entitled to future benefits	2009-07-01	49
Total of all active and inactive participants	2009-07-01	2,075
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-07-01	0
Total participants	2009-07-01	2,075
Number of participants with account balances	2009-07-01	2,075
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-07-01	6

Financial Data on COMMUNITY MEDICAL CENTER 401(A)SUPPLEMENTAL RETIREMENT PLAN

Measure	Date	Value
2017 : COMMUNITY MEDICAL CENTER 401(A)SUPPLEMENTAL RETIREMENT PLAN 2017 401k financial data
Total transfer of assets from this plan	2017-12-31	$50,119,265
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$4,890
Total income from all sources (including contributions)	2017-12-31	$11,220,937
Total of all expenses incurred	2017-12-31	$2,909,456
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$2,872,306
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$3,274,281
Value of total assets at end of year	2017-12-31	$0
Value of total assets at beginning of year	2017-12-31	$41,812,674
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$37,150
Total interest from all sources	2017-12-31	$8,009
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$1,038,752
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$1,038,752
Administrative expenses professional fees incurred	2017-12-31	$8,946
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$5,000,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Assets. Other investments not covered elsewhere at beginning of year	2017-12-31	$6,928,443
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$17,002
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2017-12-31	$4,651
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2017-12-31	$2,924
Other income not declared elsewhere	2017-12-31	$135,605
Administrative expenses (other) incurred	2017-12-31	$6,337
Liabilities. Value of operating payables at beginning of year	2017-12-31	$1,966
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$8,311,481
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$41,807,784
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Investment advisory and management fees	2017-12-31	$21,867
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$19,351,452
Interest earned on other investments	2017-12-31	$7,182
Value of interest in common/collective trusts at beginning of year	2017-12-31	$15,183,009
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2017-12-31	$61,865
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2017-12-31	$61,865
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2017-12-31	$827
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$283,254
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$2,851,283
Net investment gain/loss from pooled separate accounts	2017-12-31	$12,895
Net investment gain or loss from common/collective trusts	2017-12-31	$3,900,112
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$3,257,279
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$2,872,306
Did the plan have assets held for investment	2017-12-31	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	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	BAKER TILLY VIRCHOW KRAUSE, LLP
Accountancy firm EIN	2017-12-31	390859910
2016 : COMMUNITY MEDICAL CENTER 401(A)SUPPLEMENTAL RETIREMENT PLAN 2016 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$4,890
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$10,224
Total income from all sources (including contributions)	2016-12-31	$5,301,257
Total of all expenses incurred	2016-12-31	$2,938,224
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$2,903,332
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$3,179,909
Value of total assets at end of year	2016-12-31	$41,812,674
Value of total assets at beginning of year	2016-12-31	$39,454,975
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$34,892
Total interest from all sources	2016-12-31	$9,146
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$584,431
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	$584,431
Administrative expenses professional fees incurred	2016-12-31	$4,903
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$5,000,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Assets. Other investments not covered elsewhere at end of year	2016-12-31	$6,928,443
Assets. Other investments not covered elsewhere at beginning of year	2016-12-31	$7,023,371
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$84,225
Value of other receiveables (less allowance for doubtful accounts) at end of year	2016-12-31	$4,651
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2016-12-31	$3,441
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2016-12-31	$2,924
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2016-12-31	$8,108
Other income not declared elsewhere	2016-12-31	$139,670
Administrative expenses (other) incurred	2016-12-31	$8,284
Liabilities. Value of operating payables at end of year	2016-12-31	$1,966
Liabilities. Value of operating payables at beginning of year	2016-12-31	$2,116
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	$2,363,033
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$41,807,784
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$39,444,751
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
Investment advisory and management fees	2016-12-31	$21,705
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$19,351,452
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$25,083,944
Interest earned on other investments	2016-12-31	$8,896
Value of interest in common/collective trusts at end of year	2016-12-31	$15,183,009
Value of interest in common/collective trusts at beginning of year	2016-12-31	$6,990,597
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2016-12-31	$61,865
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2016-12-31	$61,666
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2016-12-31	$61,666
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2016-12-31	$250
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$283,254
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$291,956
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$61,528
Net investment gain/loss from pooled separate accounts	2016-12-31	$308
Net investment gain or loss from common/collective trusts	2016-12-31	$1,326,265
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	$3,095,684
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$2,903,332
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	GRANT THORNTON, LLP
Accountancy firm EIN	2016-12-31	366055558
2015 : COMMUNITY MEDICAL CENTER 401(A)SUPPLEMENTAL RETIREMENT PLAN 2015 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$10,224
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$4,137
Total income from all sources (including contributions)	2015-12-31	$999,493
Total of all expenses incurred	2015-12-31	$1,182,422
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$1,150,619
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$1,549,657
Value of total assets at end of year	2015-12-31	$39,454,975
Value of total assets at beginning of year	2015-12-31	$39,631,817
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$31,803
Total interest from all sources	2015-12-31	$4,501
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$987,301
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	$987,301
Administrative expenses professional fees incurred	2015-12-31	$14,710
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$5,000,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Assets. Other investments not covered elsewhere at end of year	2015-12-31	$7,023,371
Assets. Other investments not covered elsewhere at beginning of year	2015-12-31	$6,978,138
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$6,952
Value of other receiveables (less allowance for doubtful accounts) at end of year	2015-12-31	$3,441
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2015-12-31	$19,599
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2015-12-31	$8,108
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2015-12-31	$2,023
Other income not declared elsewhere	2015-12-31	$75,159
Administrative expenses (other) incurred	2015-12-31	$3,501
Liabilities. Value of operating payables at end of year	2015-12-31	$2,116
Liabilities. Value of operating payables at beginning of year	2015-12-31	$2,114
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	$-182,929
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$39,444,751
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$39,627,680
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
Investment advisory and management fees	2015-12-31	$13,592
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$25,083,944
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$26,091,275
Interest earned on other investments	2015-12-31	$4,428
Value of interest in common/collective trusts at end of year	2015-12-31	$6,990,597
Value of interest in common/collective trusts at beginning of year	2015-12-31	$6,163,941
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2015-12-31	$61,666
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2015-12-31	$89,741
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2015-12-31	$89,741
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2015-12-31	$73
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$291,956
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$289,123
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-1,424,381
Net investment gain/loss from pooled separate accounts	2015-12-31	$-301
Net investment gain or loss from common/collective trusts	2015-12-31	$-192,443
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	$1,542,705
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$1,150,619
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
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-06-30	$4,137
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-06-30	$4,848
Total income from all sources (including contributions)	2015-06-30	$5,030,360
Total of all expenses incurred	2015-06-30	$2,267,222
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-06-30	$2,235,006
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-06-30	$2,939,759
Value of total assets at end of year	2015-06-30	$39,631,817
Value of total assets at beginning of year	2015-06-30	$36,869,390
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-06-30	$32,216
Total interest from all sources	2015-06-30	$4,837
Total dividends received (eg from common stock, registered investment company shares)	2015-06-30	$1,074,191
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	$1,074,191
Was this plan covered by a fidelity bond	2015-06-30	Yes
Value of fidelity bond cover	2015-06-30	$5,000,000
If this is an individual account plan, was there a blackout period	2015-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2015-06-30	No
Assets. Other investments not covered elsewhere at end of year	2015-06-30	$6,978,138
Assets. Other investments not covered elsewhere at beginning of year	2015-06-30	$7,248,133
Income. Received or receivable in cash from other sources (including rollovers)	2015-06-30	$28,430
Value of other receiveables (less allowance for doubtful accounts) at end of year	2015-06-30	$19,599
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2015-06-30	$5,271
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2015-06-30	$2,023
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2015-06-30	$2,612
Other income not declared elsewhere	2015-06-30	$142,606
Administrative expenses (other) incurred	2015-06-30	$5,784
Liabilities. Value of operating payables at end of year	2015-06-30	$2,114
Liabilities. Value of operating payables at beginning of year	2015-06-30	$2,236
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-06-30	No
Value of net income/loss	2015-06-30	$2,763,138
Value of net assets at end of year (total assets less liabilities)	2015-06-30	$39,627,680
Value of net assets at beginning of year (total assets less liabilities)	2015-06-30	$36,864,542
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-06-30	No
Were any leases to which the plan was party in default or uncollectible	2015-06-30	No
Investment advisory and management fees	2015-06-30	$26,432
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-06-30	$26,091,275
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-06-30	$25,748,432
Value of interest in pooled separate accounts at beginning of year	2015-06-30	$77,443
Interest earned on other investments	2015-06-30	$4,800
Value of interest in common/collective trusts at end of year	2015-06-30	$6,163,941
Value of interest in common/collective trusts at beginning of year	2015-06-30	$3,423,583
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2015-06-30	$89,741
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2015-06-30	$37,022
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2015-06-30	$37,022
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2015-06-30	$37
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-06-30	$289,123
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-06-30	$329,506
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-06-30	$742,539
Net investment gain/loss from pooled separate accounts	2015-06-30	$1,622
Net investment gain or loss from common/collective trusts	2015-06-30	$124,806
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	$2,911,329
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-06-30	$2,235,006
Did the plan have assets held for investment	2015-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2015-06-30	Disclaimer
Accountancy firm name	2015-06-30	GRANT THORNTON, LLP
Accountancy firm EIN	2015-06-30	366055558
2014 : COMMUNITY MEDICAL CENTER 401(A)SUPPLEMENTAL RETIREMENT PLAN 2014 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-06-30	$4,848
Total income from all sources (including contributions)	2014-06-30	$7,392,979
Total of all expenses incurred	2014-06-30	$2,076,523
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-06-30	$2,047,054
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-06-30	$2,628,019
Value of total assets at end of year	2014-06-30	$36,869,390
Value of total assets at beginning of year	2014-06-30	$31,548,086
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-06-30	$29,469
Total interest from all sources	2014-06-30	$10,320
Total dividends received (eg from common stock, registered investment company shares)	2014-06-30	$908,470
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	$908,470
Was this plan covered by a fidelity bond	2014-06-30	Yes
Value of fidelity bond cover	2014-06-30	$5,000,000
If this is an individual account plan, was there a blackout period	2014-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2014-06-30	No
Assets. Other investments not covered elsewhere at end of year	2014-06-30	$7,248,133
Value of other receiveables (less allowance for doubtful accounts) at end of year	2014-06-30	$5,271
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2014-06-30	$2,612
Other income not declared elsewhere	2014-06-30	$143,025
Liabilities. Value of operating payables at end of year	2014-06-30	$2,236
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-06-30	No
Value of net income/loss	2014-06-30	$5,316,456
Value of net assets at end of year (total assets less liabilities)	2014-06-30	$36,864,542
Value of net assets at beginning of year (total assets less liabilities)	2014-06-30	$31,548,086
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-06-30	No
Were any leases to which the plan was party in default or uncollectible	2014-06-30	No
Investment advisory and management fees	2014-06-30	$27,064
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-06-30	$25,748,432
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-06-30	$23,606,062
Value of interest in pooled separate accounts at end of year	2014-06-30	$77,443
Value of interest in pooled separate accounts at beginning of year	2014-06-30	$100,563
Interest earned on other investments	2014-06-30	$10,134
Value of interest in common/collective trusts at end of year	2014-06-30	$3,423,583
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2014-06-30	$37,022
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2014-06-30	$13,248
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2014-06-30	$13,248
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2014-06-30	$186
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-06-30	$329,506
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-06-30	$7,828,213
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-06-30	$3,372,344
Net investment gain or loss from common/collective trusts	2014-06-30	$330,801
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	$2,628,019
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-06-30	$2,047,054
Contract administrator fees	2014-06-30	$2,405
Did the plan have assets held for investment	2014-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2014-06-30	Disclaimer
Accountancy firm name	2014-06-30	GRANT THORNTON, LLP
Accountancy firm EIN	2014-06-30	366055558
2013 : COMMUNITY MEDICAL CENTER 401(A)SUPPLEMENTAL RETIREMENT PLAN 2013 401k financial data
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-06-30	$368
Total income from all sources (including contributions)	2013-06-30	$5,789,026
Total of all expenses incurred	2013-06-30	$2,100,056
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-06-30	$2,099,766
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-06-30	$2,561,556
Value of total assets at end of year	2013-06-30	$31,548,086
Value of total assets at beginning of year	2013-06-30	$27,859,484
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-06-30	$290
Total interest from all sources	2013-06-30	$130,571
Total dividends received (eg from common stock, registered investment company shares)	2013-06-30	$383,312
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	$383,312
Was this plan covered by a fidelity bond	2013-06-30	Yes
Value of fidelity bond cover	2013-06-30	$5,000,000
If this is an individual account plan, was there a blackout period	2013-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2013-06-30	No
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2013-06-30	$368
Administrative expenses (other) incurred	2013-06-30	$290
Total non interest bearing cash at beginning of year	2013-06-30	$7
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-06-30	No
Value of net income/loss	2013-06-30	$3,688,970
Value of net assets at end of year (total assets less liabilities)	2013-06-30	$31,548,086
Value of net assets at beginning of year (total assets less liabilities)	2013-06-30	$27,859,116
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-06-30	No
Were any leases to which the plan was party in default or uncollectible	2013-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-06-30	$23,606,062
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-06-30	$20,090,751
Value of interest in pooled separate accounts at end of year	2013-06-30	$100,563
Value of interest in pooled separate accounts at beginning of year	2013-06-30	$150,299
Interest earned on other investments	2013-06-30	$130,571
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2013-06-30	$13,248
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2013-06-30	$22,083
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2013-06-30	$22,083
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-06-30	$7,828,213
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-06-30	$7,586,804
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-06-30	$2,713,587
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	$2,561,556
Employer contributions (assets) at beginning of year	2013-06-30	$9,540
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-06-30	$2,099,766
Did the plan have assets held for investment	2013-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2013-06-30	Disclaimer
Accountancy firm name	2013-06-30	PARENTEBEARD, LLC
Accountancy firm EIN	2013-06-30	232932984
2012 : COMMUNITY MEDICAL CENTER 401(A)SUPPLEMENTAL RETIREMENT PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-06-30	$368
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-06-30	$0
Total income from all sources (including contributions)	2012-06-30	$2,430,738
Total loss/gain on sale of assets	2012-06-30	$0
Total of all expenses incurred	2012-06-30	$928,234
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-06-30	$927,743
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-06-30	$2,426,522
Value of total assets at end of year	2012-06-30	$27,859,484
Value of total assets at beginning of year	2012-06-30	$26,356,612
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-06-30	$491
Total interest from all sources	2012-06-30	$218,969
Total dividends received (eg from common stock, registered investment company shares)	2012-06-30	$229,851
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	$229,851
Was this plan covered by a fidelity bond	2012-06-30	Yes
Value of fidelity bond cover	2012-06-30	$1,000,000
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
Income. Received or receivable in cash from other sources (including rollovers)	2012-06-30	$5,987
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2012-06-30	$368
Other income not declared elsewhere	2012-06-30	$-1,874
Administrative expenses (other) incurred	2012-06-30	$491
Total non interest bearing cash at end of year	2012-06-30	$7
Total non interest bearing cash at beginning of year	2012-06-30	$7,025
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-06-30	No
Value of net income/loss	2012-06-30	$1,502,504
Value of net assets at end of year (total assets less liabilities)	2012-06-30	$27,859,116
Value of net assets at beginning of year (total assets less liabilities)	2012-06-30	$26,356,612
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-06-30	No
Were any leases to which the plan was party in default or uncollectible	2012-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-06-30	$20,090,751
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-06-30	$19,410,558
Value of interest in pooled separate accounts at end of year	2012-06-30	$150,299
Value of interest in pooled separate accounts at beginning of year	2012-06-30	$151,204
Interest earned on other investments	2012-06-30	$218,963
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-06-30	$22,083
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-06-30	$30,642
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-06-30	$30,642
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-06-30	$6
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-06-30	$7,586,804
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-06-30	$6,747,550
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-06-30	$-442,066
Net investment gain/loss from pooled separate accounts	2012-06-30	$-664
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	$2,420,535
Employer contributions (assets) at end of year	2012-06-30	$9,540
Employer contributions (assets) at beginning of year	2012-06-30	$9,633
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-06-30	$927,743
Did the plan have assets held for investment	2012-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2012-06-30	Disclaimer
Accountancy firm name	2012-06-30	PARENTEBEARD, LLC
Accountancy firm EIN	2012-06-30	232932984
2011 : COMMUNITY MEDICAL CENTER 401(A)SUPPLEMENTAL RETIREMENT PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-06-30	$0
Total income from all sources (including contributions)	2011-06-30	$6,577,186
Total loss/gain on sale of assets	2011-06-30	$0
Total of all expenses incurred	2011-06-30	$1,159,036
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-06-30	$1,158,556
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-06-30	$2,281,313
Value of total assets at end of year	2011-06-30	$26,356,612
Value of total assets at beginning of year	2011-06-30	$20,938,462
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-06-30	$480
Total interest from all sources	2011-06-30	$209,286
Total dividends received (eg from common stock, registered investment company shares)	2011-06-30	$190,471
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	$190,471
Was this plan covered by a fidelity bond	2011-06-30	Yes
Value of fidelity bond cover	2011-06-30	$1,000,000
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
Income. Received or receivable in cash from other sources (including rollovers)	2011-06-30	$4,600
Other income not declared elsewhere	2011-06-30	$1,168
Administrative expenses (other) incurred	2011-06-30	$480
Total non interest bearing cash at end of year	2011-06-30	$7,025
Total non interest bearing cash at beginning of year	2011-06-30	$1,344
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-06-30	No
Value of net income/loss	2011-06-30	$5,418,150
Value of net assets at end of year (total assets less liabilities)	2011-06-30	$26,356,612
Value of net assets at beginning of year (total assets less liabilities)	2011-06-30	$20,938,462
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-06-30	No
Were any leases to which the plan was party in default or uncollectible	2011-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-06-30	$19,410,558
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-06-30	$14,197,741
Value of interest in pooled separate accounts at end of year	2011-06-30	$151,204
Value of interest in pooled separate accounts at beginning of year	2011-06-30	$120,751
Interest earned on other investments	2011-06-30	$209,274
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-06-30	$30,642
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-06-30	$71,281
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-06-30	$71,281
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-06-30	$12
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-06-30	$6,747,550
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-06-30	$6,547,345
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-06-30	$3,864,229
Net investment gain/loss from pooled separate accounts	2011-06-30	$30,719
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	$2,276,713
Employer contributions (assets) at end of year	2011-06-30	$9,633
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-06-30	$1,158,556
Did the plan have assets held for investment	2011-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2011-06-30	Disclaimer
Accountancy firm name	2011-06-30	PARENTEBEARD, LLC
Accountancy firm EIN	2011-06-30	232932984
2010 : COMMUNITY MEDICAL CENTER 401(A)SUPPLEMENTAL RETIREMENT PLAN 2010 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-06-30	$0

Form 5500 Responses for COMMUNITY MEDICAL CENTER 401(A)SUPPLEMENTAL RETIREMENT PLAN

2017: COMMUNITY MEDICAL CENTER 401(A)SUPPLEMENTAL RETIREMENT PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	This submission is the final filing	Yes
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: COMMUNITY MEDICAL CENTER 401(A)SUPPLEMENTAL RETIREMENT PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
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: COMMUNITY MEDICAL CENTER 401(A)SUPPLEMENTAL RETIREMENT PLAN 2015 form 5500 responses
2015-07-01	Type of plan entity	Single employer plan
2015-07-01	This return/report is a short plan year return/report (less than 12 months)	Yes
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: COMMUNITY MEDICAL CENTER 401(A)SUPPLEMENTAL RETIREMENT PLAN 2014 form 5500 responses
2014-07-01	Type of plan entity	Single employer plan
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: COMMUNITY MEDICAL CENTER 401(A)SUPPLEMENTAL RETIREMENT PLAN 2013 form 5500 responses
2013-07-01	Type of plan entity	Single employer plan
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: COMMUNITY MEDICAL CENTER 401(A)SUPPLEMENTAL RETIREMENT PLAN 2012 form 5500 responses
2012-07-01	Type of plan entity	Single employer plan
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: COMMUNITY MEDICAL CENTER 401(A)SUPPLEMENTAL RETIREMENT PLAN 2011 form 5500 responses
2011-07-01	Type of plan entity	Single employer plan
2011-07-01	Submission has been amended	No
2011-07-01	This submission is the final filing	No
2011-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-07-01	Plan is a collectively bargained plan	No
2011-07-01	Plan funding arrangement – Insurance	Yes
2011-07-01	Plan funding arrangement – Trust	Yes
2011-07-01	Plan benefit arrangement – Insurance	Yes
2011-07-01	Plan benefit arrangement - Trust	Yes
2009: COMMUNITY MEDICAL CENTER 401(A)SUPPLEMENTAL RETIREMENT PLAN 2009 form 5500 responses
2009-07-01	Type of plan entity	Single employer plan
2009-07-01	Submission has been amended	No
2009-07-01	This submission is the final filing	No
2009-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-07-01	Plan is a collectively bargained plan	No
2009-07-01	Plan funding arrangement – Insurance	Yes
2009-07-01	Plan funding arrangement – Trust	Yes
2009-07-01	Plan benefit arrangement – Insurance	Yes
2009-07-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )

Policy contract number

929666

Policy instance

Insurance contract or identification number	929666
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of fees paid to insurance company	USD $12
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
Amount paid for insurance broker fees	12
Additional information about fees paid to insurance broker	ASSET ALLOC. & REBALANCING ADVICE
Insurance broker organization code?	3
Insurance broker name	BRIGHTHOUSE SECURITIES LLC

METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )

Policy contract number

917759

Policy instance

Insurance contract or identification number	917759
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of fees paid to insurance company	USD $13
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
Amount paid for insurance broker fees	13
Additional information about fees paid to insurance broker	ASSET ALLOC. ADVICE & REBALANCING
Insurance broker organization code?	3
Insurance broker name	BRIGHTHOUSE SECURITIES LLC

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G05057

Policy instance

Insurance contract or identification number	G05057
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

METLIFE INVESTORS (National Association of Insurance Commissioners NAIC id number: 80950 )

Policy contract number

929666

Policy instance

Insurance contract or identification number	929666
Number of Individuals Covered	9
Insurance policy start date	2015-07-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $6
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 $6
Additional information about fees paid to insurance broker	ASSET ALLOC. & REBALANCING ADVICE
Insurance broker organization code?	3
Insurance broker name	METLIFE SECURITIES INC

METLIFE INVESTORS (National Association of Insurance Commissioners NAIC id number: 80950 )

Policy contract number

917759

Policy instance

Insurance contract or identification number	917759
Insurance policy start date	2015-07-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $19
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 $19
Additional information about fees paid to insurance broker	ASSET ALLOC. ADVICE & REBALANCING
Insurance broker organization code?	3
Insurance broker name	METIFE SECURITIES INC

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G05057

Policy instance

Insurance contract or identification number	G05057
Number of Individuals Covered	19
Insurance policy start date	2015-07-01
Insurance policy end date	2015-12-31
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

COMM00PA00P1

Policy instance

Insurance contract or identification number	COMM00PA00P1
Number of Individuals Covered	4
Insurance policy start date	2015-07-01
Insurance policy end date	2015-12-31
Total amount of fees paid to insurance company	USD $60
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
Amount paid for insurance broker fees	60
Additional information about fees paid to insurance broker	PROFESSIONAL SERVICES
Insurance broker organization code?	3
Insurance broker name	NATIONWIDE LIFE INSURANCE COMPANY

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

COMM00PA00P1

Policy instance

Insurance contract or identification number	COMM00PA00P1
Number of Individuals Covered	5
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Total amount of fees paid to insurance company	USD $152
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
Amount paid for insurance broker fees	152
Additional information about fees paid to insurance broker	PROFESSIONAL SERVICES
Insurance broker organization code?	3
Insurance broker name	NATIONWIDE LIFE INSURANCE COMPANY

METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )

Policy contract number

917759

Policy instance

Insurance contract or identification number	917759
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Total amount of commissions paid to insurance broker	USD $37
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 $37
Additional information about fees paid to insurance broker	ASSET ALLOC. ADVICE & REBALANCING
Insurance broker organization code?	3
Insurance broker name	METIFE SECURITIES INC

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G05057

Policy instance

Insurance contract or identification number	G05057
Number of Individuals Covered	19
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
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

METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )

Policy contract number

929666

Policy instance

Insurance contract or identification number	929666
Number of Individuals Covered	9
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Total amount of commissions paid to insurance broker	USD $11
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 $11
Additional information about fees paid to insurance broker	ASSET ALLOC. & REBALANCING ADVICE
Insurance broker organization code?	3
Insurance broker name	METLIFE SECURITIES INC

METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )

Policy contract number

929666

Policy instance

Insurance contract or identification number	929666
Number of Individuals Covered	10
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
Total amount of commissions paid to insurance broker	USD $11
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 $11
Additional information about fees paid to insurance broker	ASSET ALLOC. & REBALANCING ADVICE
Insurance broker organization code?	3
Insurance broker name	METLIFE SECURITIES INC

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

COMM00PA00P1

Policy instance

Insurance contract or identification number	COMM00PA00P1
Number of Individuals Covered	5
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
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

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G05057

Policy instance

Insurance contract or identification number	G05057
Number of Individuals Covered	22
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
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

METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )

Policy contract number

917759

Policy instance

Insurance contract or identification number	917759
Number of Individuals Covered	1
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
Total amount of commissions paid to insurance broker	USD $36
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 $36
Additional information about fees paid to insurance broker	ASSET ALLOC. ADVICE & REBALANCING
Insurance broker organization code?	3
Insurance broker name	METIFE SECURITIES INC

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

COMM00PA00PI

Policy instance

Insurance contract or identification number	COMM00PA00PI
Number of Individuals Covered	7
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
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

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G05057

Policy instance

Insurance contract or identification number	G05057
Number of Individuals Covered	22
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
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

PRUDENTIAL INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

310283

Policy instance

Insurance contract or identification number	310283
Insurance policy start date	2012-07-01
Insurance policy end date	2013-01-14
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )

Policy contract number

917759

Policy instance

Insurance contract or identification number	917759
Number of Individuals Covered	1
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
Total amount of fees paid to insurance company	USD $34
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
Amount paid for insurance broker fees	34
Insurance broker organization code?	3
Insurance broker name	METLIFE SECURITIES INC

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

310283

Policy instance

Insurance contract or identification number	310283
Number of Individuals Covered	2270
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $14,642
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )

Policy contract number

917759

Policy instance

Insurance contract or identification number	917759
Number of Individuals Covered	1
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

COMM00PA00PI

Policy instance

Insurance contract or identification number	COMM00PA00PI
Number of Individuals Covered	8
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G05057

Policy instance

Insurance contract or identification number	G05057
Number of Individuals Covered	23
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

COMM00PA00PI

Policy instance

Insurance contract or identification number	COMM00PA00PI
Insurance policy start date	2010-07-01
Insurance policy end date	2011-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G05057

Policy instance

Insurance contract or identification number	G05057
Insurance policy start date	2010-07-01
Insurance policy end date	2011-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

310283

Policy instance

Insurance contract or identification number	310283
Number of Individuals Covered	2058
Insurance policy start date	2010-07-01
Insurance policy end date	2011-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $14,806
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )

Policy contract number

917759

Policy instance

Insurance contract or identification number	917759
Insurance policy start date	2010-07-01
Insurance policy end date	2011-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No

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Company Name:	COMMUNITY MEDICAL CENTER
Employer identification number (EIN):	240862246
NAIC Classification:	622000
NAIC Description:	Hospitals

Jurisdiction of Incorporation:	Iowa Secretary of State Business Entities
Incorporation Date:	1984-04-20
Company Identification Number:	094369
Legal Registered Office Address:	1603 MORGAN ST STE 6 KEOKUK United States of America (USA) 52632