401k Plan data: THE UNIONTOWN HOSPITAL EMPLOYEE CONTROLLED RETIREMENT ACCOUNT plan

THE UNIONTOWN HOSPITAL EMPLOYEE CONTROLLED RETIREMENT ACCOUNT 401k Plan overview

Plan Name	THE UNIONTOWN HOSPITAL EMPLOYEE CONTROLLED RETIREMENT ACCOUNT
Plan identification number	002

THE UNIONTOWN HOSPITAL EMPLOYEE CONTROLLED RETIREMENT ACCOUNT Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.

401k Sponsoring company profile

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

Company Name: UNIONTOWN HOSPITAL

Employer identification number (EIN): 250965588

NAIC Classification: 622000
NAIC Description: Hospitals

Additional information about UNIONTOWN HOSPITAL

Jurisdiction of Incorporation: COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF STATE

Incorporation Date:

Company Identification Number: 368225

More information about UNIONTOWN HOSPITAL

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE UNIONTOWN HOSPITAL EMPLOYEE CONTROLLED RETIREMENT ACCOUNT

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2022-07-01
002 2021-07-01
002 2020-07-01
002 2009-07-01 JAMES PROUD JAMES PROUD 2011-04-15

Plan Statistics for THE UNIONTOWN HOSPITAL EMPLOYEE CONTROLLED RETIREMENT ACCOUNT

401k plan membership statisitcs for THE UNIONTOWN HOSPITAL EMPLOYEE CONTROLLED RETIREMENT ACCOUNT

Measure Date Value
2022: THE UNIONTOWN HOSPITAL EMPLOYEE CONTROLLED RETIREMENT ACCOUNT 2022 401k membership
Total participants, beginning-of-year 2022-07-01 1,108
Total number of active participants reported on line 7a of the Form 5500 2022-07-01 0
Number of retired or separated participants receiving benefits 2022-07-01 0
Number of other retired or separated participants entitled to future benefits 2022-07-01 0
Total of all active and inactive participants 2022-07-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-07-01 0
Total participants 2022-07-01 0
Number of participants with account balances 2022-07-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-07-01 0
2021: THE UNIONTOWN HOSPITAL EMPLOYEE CONTROLLED RETIREMENT ACCOUNT 2021 401k membership
Total participants, beginning-of-year 2021-07-01 1,132
Total number of active participants reported on line 7a of the Form 5500 2021-07-01 791
Number of retired or separated participants receiving benefits 2021-07-01 6
Number of other retired or separated participants entitled to future benefits 2021-07-01 307
Total of all active and inactive participants 2021-07-01 1,104
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-07-01 4
Total participants 2021-07-01 1,108
Number of participants with account balances 2021-07-01 1,108
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-07-01 0
2020: THE UNIONTOWN HOSPITAL EMPLOYEE CONTROLLED RETIREMENT ACCOUNT 2020 401k membership
Total participants, beginning-of-year 2020-07-01 1,324
Total number of active participants reported on line 7a of the Form 5500 2020-07-01 785
Number of retired or separated participants receiving benefits 2020-07-01 1
Number of other retired or separated participants entitled to future benefits 2020-07-01 344
Total of all active and inactive participants 2020-07-01 1,130
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-07-01 2
Total participants 2020-07-01 1,132
Number of participants with account balances 2020-07-01 1,132
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-07-01 0
2009: THE UNIONTOWN HOSPITAL EMPLOYEE CONTROLLED RETIREMENT ACCOUNT 2009 401k membership
Total participants, beginning-of-year 2009-07-01 975
Total number of active participants reported on line 7a of the Form 5500 2009-07-01 887
Number of other retired or separated participants entitled to future benefits 2009-07-01 191
Total of all active and inactive participants 2009-07-01 1,078
Total participants 2009-07-01 1,078
Number of participants with account balances 2009-07-01 1,071
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-07-01 0

Measure	Date	Value
2022: THE UNIONTOWN HOSPITAL EMPLOYEE CONTROLLED RETIREMENT ACCOUNT 2022 401k membership
Total participants, beginning-of-year	2022-07-01	1,108
Total number of active participants reported on line 7a of the Form 5500	2022-07-01	0
Number of retired or separated participants receiving benefits	2022-07-01	0
Number of other retired or separated participants entitled to future benefits	2022-07-01	0
Total of all active and inactive participants	2022-07-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-07-01	0
Total participants	2022-07-01	0
Number of participants with account balances	2022-07-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-07-01	0
2021: THE UNIONTOWN HOSPITAL EMPLOYEE CONTROLLED RETIREMENT ACCOUNT 2021 401k membership
Total participants, beginning-of-year	2021-07-01	1,132
Total number of active participants reported on line 7a of the Form 5500	2021-07-01	791
Number of retired or separated participants receiving benefits	2021-07-01	6
Number of other retired or separated participants entitled to future benefits	2021-07-01	307
Total of all active and inactive participants	2021-07-01	1,104
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-07-01	4
Total participants	2021-07-01	1,108
Number of participants with account balances	2021-07-01	1,108
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-07-01	0
2020: THE UNIONTOWN HOSPITAL EMPLOYEE CONTROLLED RETIREMENT ACCOUNT 2020 401k membership
Total participants, beginning-of-year	2020-07-01	1,324
Total number of active participants reported on line 7a of the Form 5500	2020-07-01	785
Number of retired or separated participants receiving benefits	2020-07-01	1
Number of other retired or separated participants entitled to future benefits	2020-07-01	344
Total of all active and inactive participants	2020-07-01	1,130
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-07-01	2
Total participants	2020-07-01	1,132
Number of participants with account balances	2020-07-01	1,132
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-07-01	0
2009: THE UNIONTOWN HOSPITAL EMPLOYEE CONTROLLED RETIREMENT ACCOUNT 2009 401k membership
Total participants, beginning-of-year	2009-07-01	975
Total number of active participants reported on line 7a of the Form 5500	2009-07-01	887
Number of other retired or separated participants entitled to future benefits	2009-07-01	191
Total of all active and inactive participants	2009-07-01	1,078
Total participants	2009-07-01	1,078
Number of participants with account balances	2009-07-01	1,071
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-07-01	0

Financial Data on THE UNIONTOWN HOSPITAL EMPLOYEE CONTROLLED RETIREMENT ACCOUNT

Measure	Date	Value
2023 : THE UNIONTOWN HOSPITAL EMPLOYEE CONTROLLED RETIREMENT ACCOUNT 2023 401k financial data
Total transfer of assets from this plan	2023-02-06	$17,257,626
Total income from all sources (including contributions)	2023-02-06	$1,948,658
Total of all expenses incurred	2023-02-06	$1,167,284
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2023-02-06	$1,110,279
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2023-02-06	$766,474
Value of total assets at end of year	2023-02-06	$0
Value of total assets at beginning of year	2023-02-06	$16,476,252
Total of administrative expenses incurred including professional, contract, advisory and management fees	2023-02-06	$57,005
Total interest from all sources	2023-02-06	$4,976
Total dividends received (eg from common stock, registered investment company shares)	2023-02-06	$325,257
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2023-02-06	No
Total dividends received from registered investment company shares (eg mutual funds)	2023-02-06	$325,257
Was this plan covered by a fidelity bond	2023-02-06	Yes
Value of fidelity bond cover	2023-02-06	$1,000,000
If this is an individual account plan, was there a blackout period	2023-02-06	Yes
Were there any nonexempt tranactions with any party-in-interest	2023-02-06	No
Administrative expenses (other) incurred	2023-02-06	$29,202
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2023-02-06	No
Value of net income/loss	2023-02-06	$781,374
Value of net assets at end of year (total assets less liabilities)	2023-02-06	$0
Value of net assets at beginning of year (total assets less liabilities)	2023-02-06	$16,476,252
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2023-02-06	No
Were any loans by the plan or fixed income obligations due to the plan in default	2023-02-06	No
Were any leases to which the plan was party in default or uncollectible	2023-02-06	No
Investment advisory and management fees	2023-02-06	$27,803
Value of interest in registered invesment companies (eg mutual funds) at end of year	2023-02-06	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2023-02-06	$16,036,693
Interest earned on other investments	2023-02-06	$4,976
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2023-02-06	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2023-02-06	$439,559
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2023-02-06	$851,951
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2023-02-06	No
Was there a failure to transmit to the plan any participant contributions	2023-02-06	No
Has the plan failed to provide any benefit when due under the plan	2023-02-06	No
Contributions received in cash from employer	2023-02-06	$766,474
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2023-02-06	$1,110,279
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2023-02-06	Yes
Did the plan have assets held for investment	2023-02-06	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	2023-02-06	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2023-02-06	Yes
Opinion of an independent qualified public accountant for this plan	2023-02-06	Unqualified
Accountancy firm name	2023-02-06	FORVIS, LLP
Accountancy firm EIN	2023-02-06	440160260
2022 : THE UNIONTOWN HOSPITAL EMPLOYEE CONTROLLED RETIREMENT ACCOUNT 2022 401k financial data
Total transfer of assets from this plan	2022-06-30	$45,606
Total income from all sources (including contributions)	2022-06-30	$-1,314,158
Total of all expenses incurred	2022-06-30	$2,985,494
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-06-30	$2,896,405
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-06-30	$1,330,585
Value of total assets at end of year	2022-06-30	$16,476,252
Value of total assets at beginning of year	2022-06-30	$20,821,510
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-06-30	$89,089
Total interest from all sources	2022-06-30	$5,602
Total dividends received (eg from common stock, registered investment company shares)	2022-06-30	$403,770
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-06-30	$403,770
Was this plan covered by a fidelity bond	2022-06-30	Yes
Value of fidelity bond cover	2022-06-30	$1,000,000
If this is an individual account plan, was there a blackout period	2022-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2022-06-30	No
Administrative expenses (other) incurred	2022-06-30	$51,580
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-06-30	No
Value of net income/loss	2022-06-30	$-4,299,652
Value of net assets at end of year (total assets less liabilities)	2022-06-30	$16,476,252
Value of net assets at beginning of year (total assets less liabilities)	2022-06-30	$20,821,510
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-06-30	No
Were any leases to which the plan was party in default or uncollectible	2022-06-30	No
Investment advisory and management fees	2022-06-30	$37,509
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-06-30	$16,036,693
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-06-30	$20,502,781
Interest earned on other investments	2022-06-30	$5,602
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-06-30	$439,559
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-06-30	$318,729
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-06-30	$-3,054,115
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-06-30	No
Was there a failure to transmit to the plan any participant contributions	2022-06-30	No
Has the plan failed to provide any benefit when due under the plan	2022-06-30	No
Contributions received in cash from employer	2022-06-30	$1,330,585
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-06-30	$2,896,405
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2022-06-30	No
Did the plan have assets held for investment	2022-06-30	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	2022-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-06-30	No
Opinion of an independent qualified public accountant for this plan	2022-06-30	Unqualified
Accountancy firm name	2022-06-30	FORVIS, LLP
Accountancy firm EIN	2022-06-30	440160260
2021 : THE UNIONTOWN HOSPITAL EMPLOYEE CONTROLLED RETIREMENT ACCOUNT 2021 401k financial data
Total income from all sources (including contributions)	2021-06-30	$6,175,776
Total of all expenses incurred	2021-06-30	$2,881,953
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-06-30	$2,788,173
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-06-30	$1,671,622
Value of total assets at end of year	2021-06-30	$20,821,510
Value of total assets at beginning of year	2021-06-30	$17,527,687
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-06-30	$93,780
Total interest from all sources	2021-06-30	$6,109
Total dividends received (eg from common stock, registered investment company shares)	2021-06-30	$334,364
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2021-06-30	$334,364
Was this plan covered by a fidelity bond	2021-06-30	Yes
Value of fidelity bond cover	2021-06-30	$1,000,000
If this is an individual account plan, was there a blackout period	2021-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2021-06-30	No
Administrative expenses (other) incurred	2021-06-30	$53,499
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-06-30	No
Value of net income/loss	2021-06-30	$3,293,823
Value of net assets at end of year (total assets less liabilities)	2021-06-30	$20,821,510
Value of net assets at beginning of year (total assets less liabilities)	2021-06-30	$17,527,687
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-06-30	No
Were any leases to which the plan was party in default or uncollectible	2021-06-30	No
Investment advisory and management fees	2021-06-30	$40,281
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-06-30	$20,502,781
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-06-30	$17,153,447
Interest earned on other investments	2021-06-30	$6,109
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-06-30	$318,729
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-06-30	$374,240
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-06-30	$4,163,681
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-06-30	No
Was there a failure to transmit to the plan any participant contributions	2021-06-30	No
Has the plan failed to provide any benefit when due under the plan	2021-06-30	No
Contributions received in cash from employer	2021-06-30	$1,671,622
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-06-30	$2,788,173
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2021-06-30	No
Did the plan have assets held for investment	2021-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-06-30	No
Opinion of an independent qualified public accountant for this plan	2021-06-30	Unqualified
Accountancy firm name	2021-06-30	BKD, LLP
Accountancy firm EIN	2021-06-30	440160260
2011 : THE UNIONTOWN HOSPITAL EMPLOYEE CONTROLLED RETIREMENT ACCOUNT 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	$1,983,949
Total loss/gain on sale of assets	2011-06-30	$0
Total of all expenses incurred	2011-06-30	$179,872
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-06-30	$147,306
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-06-30	$1,165,842
Value of total assets at end of year	2011-06-30	$4,942,770
Value of total assets at beginning of year	2011-06-30	$3,138,693
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-06-30	$32,566
Total interest from all sources	2011-06-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2011-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-06-30	No
Was this plan covered by a fidelity bond	2011-06-30	Yes
Value of fidelity bond cover	2011-06-30	$1,000,000
If this is an individual account plan, was there a blackout period	2011-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2011-06-30	No
Administrative expenses (other) incurred	2011-06-30	$32,566
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	$1,804,077
Value of net assets at end of year (total assets less liabilities)	2011-06-30	$4,942,770
Value of net assets at beginning of year (total assets less liabilities)	2011-06-30	$3,138,693
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	$4,942,770
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-06-30	$3,138,693
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-06-30	$818,107
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	$1,165,842
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-06-30	$147,306
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	BKD, LLP
Accountancy firm EIN	2011-06-30	440160260
2010 : THE UNIONTOWN HOSPITAL EMPLOYEE CONTROLLED RETIREMENT ACCOUNT 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 THE UNIONTOWN HOSPITAL EMPLOYEE CONTROLLED RETIREMENT ACCOUNT

2022: THE UNIONTOWN HOSPITAL EMPLOYEE CONTROLLED RETIREMENT ACCOUNT 2022 form 5500 responses
2022-07-01	Type of plan entity	Single employer plan
2022-07-01	This submission is the final filing	Yes
2022-07-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2022-07-01	Plan funding arrangement – Insurance	Yes
2022-07-01	Plan funding arrangement – Trust	Yes
2022-07-01	Plan benefit arrangement – Insurance	Yes
2022-07-01	Plan benefit arrangement - Trust	Yes
2021: THE UNIONTOWN HOSPITAL EMPLOYEE CONTROLLED RETIREMENT ACCOUNT 2021 form 5500 responses
2021-07-01	Type of plan entity	Single employer plan
2021-07-01	Plan funding arrangement – Insurance	Yes
2021-07-01	Plan funding arrangement – Trust	Yes
2021-07-01	Plan benefit arrangement – Insurance	Yes
2021-07-01	Plan benefit arrangement - Trust	Yes
2020: THE UNIONTOWN HOSPITAL EMPLOYEE CONTROLLED RETIREMENT ACCOUNT 2020 form 5500 responses
2020-07-01	Type of plan entity	Single employer plan
2020-07-01	Plan funding arrangement – Insurance	Yes
2020-07-01	Plan funding arrangement – Trust	Yes
2020-07-01	Plan benefit arrangement – Insurance	Yes
2020-07-01	Plan benefit arrangement - Trust	Yes
2009: THE UNIONTOWN HOSPITAL EMPLOYEE CONTROLLED RETIREMENT ACCOUNT 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 – Trust	Yes
2009-07-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )

Policy contract number

TA069844

Policy instance

Insurance contract or identification number	TA069844
Number of Individuals Covered	0
Insurance policy start date	2022-07-01
Insurance policy end date	2023-02-06
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

PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )

Policy contract number

TA069844

Policy instance

Insurance contract or identification number	TA069844
Number of Individuals Covered	1108
Insurance policy start date	2021-07-01
Insurance policy end date	2022-06-30
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

PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )

Policy contract number

TA069844

Policy instance

Insurance contract or identification number	TA069844
Number of Individuals Covered	1132
Insurance policy start date	2020-07-01
Insurance policy end date	2021-06-30
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

Potentially related plans

THE UNIONTOWN HOSPITAL EMPLOYEE CONTROLLED RETIREMENT ACCOUNT [EIN = 251451183]

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Company Name:	UNIONTOWN HOSPITAL
Employer identification number (EIN):	250965588
NAIC Classification:	622000
NAIC Description:	Hospitals

Jurisdiction of Incorporation:	COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF STATE
Incorporation Date:
Company Identification Number:	368225