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KNOX COMMUNITY HOSPITAL EMPLOYEE HEALTH PLAN 401k Plan overview

Plan NameKNOX COMMUNITY HOSPITAL EMPLOYEE HEALTH PLAN
Plan identification number 507

KNOX COMMUNITY HOSPITAL EMPLOYEE HEALTH PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

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

Company Name:KNOX COMMUNITY HOSPITAL
Employer identification number (EIN):310929576
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan KNOX COMMUNITY HOSPITAL EMPLOYEE HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5072024-01-01LISA BRAGG
5072023-01-01
5072023-01-01LISA BRAGG
5072022-01-01
5072022-01-01LISA BRAGG
5072021-01-01
5072021-01-01LISA BRAGG
5072020-01-01
5072019-01-01
5072017-01-01LISA BRAGG
5072016-01-01LISA BRAGG
5072015-01-01LISA R. BRAGG
5072014-01-01LISA R. BRAGG
5072013-01-01LISA R. BRAGG
5072012-01-01LISA R. BRAGG LISA R BRAGG2013-10-10
5072011-01-01LISA R. BRAGG
5072010-01-01LISA R. BRAGG
5072009-01-01LISA R. BEEKMAN

Plan Statistics for KNOX COMMUNITY HOSPITAL EMPLOYEE HEALTH PLAN

401k plan membership statisitcs for KNOX COMMUNITY HOSPITAL EMPLOYEE HEALTH PLAN

Measure Date Value
2023: KNOX COMMUNITY HOSPITAL EMPLOYEE HEALTH PLAN 2023 401k membership
Total participants, beginning-of-year2023-01-01878
Total number of active participants reported on line 7a of the Form 55002023-01-01938
Number of retired or separated participants receiving benefits2023-01-010
Number of other retired or separated participants entitled to future benefits2023-01-010
Total of all active and inactive participants2023-01-01938
2022: KNOX COMMUNITY HOSPITAL EMPLOYEE HEALTH PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01917
Total number of active participants reported on line 7a of the Form 55002022-01-01878
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01878
2021: KNOX COMMUNITY HOSPITAL EMPLOYEE HEALTH PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01972
Total number of active participants reported on line 7a of the Form 55002021-01-01899
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01899
2020: KNOX COMMUNITY HOSPITAL EMPLOYEE HEALTH PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01931
Total number of active participants reported on line 7a of the Form 55002020-01-01972
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01972
2019: KNOX COMMUNITY HOSPITAL EMPLOYEE HEALTH PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01813
Total number of active participants reported on line 7a of the Form 55002019-01-01842
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01842
2017: KNOX COMMUNITY HOSPITAL EMPLOYEE HEALTH PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01735
Total number of active participants reported on line 7a of the Form 55002017-01-01761
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01761
2016: KNOX COMMUNITY HOSPITAL EMPLOYEE HEALTH PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01707
Total number of active participants reported on line 7a of the Form 55002016-01-01729
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01729
2015: KNOX COMMUNITY HOSPITAL EMPLOYEE HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01665
Total number of active participants reported on line 7a of the Form 55002015-01-01707
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01707
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
2014: KNOX COMMUNITY HOSPITAL EMPLOYEE HEALTH PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01676
Total number of active participants reported on line 7a of the Form 55002014-01-01689
Total of all active and inactive participants2014-01-01689
2013: KNOX COMMUNITY HOSPITAL EMPLOYEE HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01705
Total number of active participants reported on line 7a of the Form 55002013-01-01668
Number of retired or separated participants receiving benefits2013-01-011
Total of all active and inactive participants2013-01-01669
2012: KNOX COMMUNITY HOSPITAL EMPLOYEE HEALTH PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01731
Total number of active participants reported on line 7a of the Form 55002012-01-01692
Total of all active and inactive participants2012-01-01692
2011: KNOX COMMUNITY HOSPITAL EMPLOYEE HEALTH PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01629
Total number of active participants reported on line 7a of the Form 55002011-01-01729
Number of retired or separated participants receiving benefits2011-01-012
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-01731
2010: KNOX COMMUNITY HOSPITAL EMPLOYEE HEALTH PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01610
Total number of active participants reported on line 7a of the Form 55002010-01-01624
Number of retired or separated participants receiving benefits2010-01-015
Number of other retired or separated participants entitled to future benefits2010-01-010
Total of all active and inactive participants2010-01-01629
2009: KNOX COMMUNITY HOSPITAL EMPLOYEE HEALTH PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01560
Total number of active participants reported on line 7a of the Form 55002009-01-01606
Number of retired or separated participants receiving benefits2009-01-014
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-01610

Financial Data on KNOX COMMUNITY HOSPITAL EMPLOYEE HEALTH PLAN

Measure Date Value
2023 : KNOX COMMUNITY HOSPITAL EMPLOYEE HEALTH PLAN 2023 401k financial data
Total unrealized appreciation/depreciation of assets2023-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-12-31$0
Total income from all sources (including contributions)2023-12-31$30,024,686
Total loss/gain on sale of assets2023-12-31$0
Total of all expenses incurred2023-12-31$30,099,013
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-12-31$26,942,644
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-12-31$30,024,686
Value of total assets at end of year2023-12-31$32,063
Value of total assets at beginning of year2023-12-31$106,390
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-12-31$3,156,369
Total interest from all sources2023-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2023-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2023-12-31No
Was this plan covered by a fidelity bond2023-12-31No
If this is an individual account plan, was there a blackout period2023-12-31No
Were there any nonexempt tranactions with any party-in-interest2023-12-31No
Contributions received from participants2023-12-31$5,586,049
Income. Received or receivable in cash from other sources (including rollovers)2023-12-31$2,519,491
Administrative expenses (other) incurred2023-12-31$2,701,554
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-12-31No
Value of net income/loss2023-12-31$-74,327
Value of net assets at end of year (total assets less liabilities)2023-12-31$32,063
Value of net assets at beginning of year (total assets less liabilities)2023-12-31$106,390
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2023-12-31No
Were any leases to which the plan was party in default or uncollectible2023-12-31No
Investment advisory and management fees2023-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2023-12-31$32,063
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2023-12-31$106,390
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2023-12-31$106,390
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-12-31No
Was there a failure to transmit to the plan any participant contributions2023-12-31No
Has the plan failed to provide any benefit when due under the plan2023-12-31No
Contributions received in cash from employer2023-12-31$21,919,146
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2023-12-31$26,942,644
Contract administrator fees2023-12-31$454,815
Did the plan have assets held for investment2023-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-12-31No
Opinion of an independent qualified public accountant for this plan2023-12-31Unqualified
Accountancy firm name2023-12-31BLUE & CO., LLC
Accountancy firm EIN2023-12-31351178661
Total unrealized appreciation/depreciation of assets2023-01-01$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-01-01$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-01-01$0
Total income from all sources (including contributions)2023-01-01$30,024,686
Total loss/gain on sale of assets2023-01-01$0
Total of all expenses incurred2023-01-01$30,099,013
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-01-01$26,942,644
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-01-01$30,024,686
Value of total assets at end of year2023-01-01$32,063
Value of total assets at beginning of year2023-01-01$106,390
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-01-01$3,156,369
Total interest from all sources2023-01-01$0
Total dividends received (eg from common stock, registered investment company shares)2023-01-01$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2023-01-01No
Was this plan covered by a fidelity bond2023-01-01No
If this is an individual account plan, was there a blackout period2023-01-01No
Were there any nonexempt tranactions with any party-in-interest2023-01-01No
Contributions received from participants2023-01-01$5,586,049
Income. Received or receivable in cash from other sources (including rollovers)2023-01-01$2,519,491
Administrative expenses (other) incurred2023-01-01$2,701,554
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-01-01No
Value of net income/loss2023-01-01$-74,327
Value of net assets at end of year (total assets less liabilities)2023-01-01$32,063
Value of net assets at beginning of year (total assets less liabilities)2023-01-01$106,390
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-01-01No
Were any loans by the plan or fixed income obligations due to the plan in default2023-01-01No
Were any leases to which the plan was party in default or uncollectible2023-01-01No
Investment advisory and management fees2023-01-01$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2023-01-01$32,063
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-01-01No
Was there a failure to transmit to the plan any participant contributions2023-01-01No
Has the plan failed to provide any benefit when due under the plan2023-01-01No
Contributions received in cash from employer2023-01-01$21,919,146
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2023-01-01$26,942,644
Contract administrator fees2023-01-01$454,815
Did the plan have assets held for investment2023-01-01No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-01-01No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-01-01No
Opinion of an independent qualified public accountant for this plan2023-01-011
Accountancy firm name2023-01-01BLUE & CO., LLC
Accountancy firm EIN2023-01-01351178661
2022 : KNOX COMMUNITY HOSPITAL EMPLOYEE HEALTH PLAN 2022 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2022-12-31$0
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total transfer of assets to this plan2022-12-31$-109,047
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total income from all sources (including contributions)2022-12-31$27,153,638
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$27,154,822
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$23,938,376
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$27,153,638
Value of total assets at end of year2022-12-31$106,390
Value of total assets at beginning of year2022-12-31$216,621
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$3,216,446
Total interest from all sources2022-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Was this plan covered by a fidelity bond2022-12-31No
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$5,551,985
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$124,903
Administrative expenses (other) incurred2022-12-31$2,779,931
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Income. Non cash contributions2022-12-31$0
Value of net income/loss2022-12-31$-1,184
Value of net assets at end of year (total assets less liabilities)2022-12-31$106,390
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$216,621
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-12-31$106,390
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-12-31$216,621
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-12-31$216,621
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$21,476,750
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$23,938,376
Contract administrator fees2022-12-31$436,515
Did the plan have assets held for investment2022-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31BLUE & CO., LLC
Accountancy firm EIN2022-12-31351178661
Unrealized appreciation/depreciation of other (non real estate) assets2022-01-01$0
Total unrealized appreciation/depreciation of assets2022-01-01$0
Total transfer of assets to this plan2022-01-01$-109,047
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-01-01$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-01-01$0
Total income from all sources (including contributions)2022-01-01$27,153,638
Total loss/gain on sale of assets2022-01-01$0
Total of all expenses incurred2022-01-01$27,154,822
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-01-01$23,938,376
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-01-01$27,153,638
Value of total assets at end of year2022-01-01$106,390
Value of total assets at beginning of year2022-01-01$216,621
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-01-01$3,216,446
Total interest from all sources2022-01-01$0
Total dividends received (eg from common stock, registered investment company shares)2022-01-01$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-01-01No
Was this plan covered by a fidelity bond2022-01-01No
If this is an individual account plan, was there a blackout period2022-01-01No
Were there any nonexempt tranactions with any party-in-interest2022-01-01No
Contributions received from participants2022-01-01$5,551,985
Income. Received or receivable in cash from other sources (including rollovers)2022-01-01$124,903
Administrative expenses (other) incurred2022-01-01$2,779,931
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-01-01No
Income. Non cash contributions2022-01-01$0
Value of net income/loss2022-01-01$-1,184
Value of net assets at end of year (total assets less liabilities)2022-01-01$106,390
Value of net assets at beginning of year (total assets less liabilities)2022-01-01$216,621
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-01-01No
Were any loans by the plan or fixed income obligations due to the plan in default2022-01-01No
Were any leases to which the plan was party in default or uncollectible2022-01-01No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-01-01$106,390
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-01-01No
Was there a failure to transmit to the plan any participant contributions2022-01-01No
Has the plan failed to provide any benefit when due under the plan2022-01-01No
Contributions received in cash from employer2022-01-01$21,476,750
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-01-01$23,938,376
Contract administrator fees2022-01-01$436,515
Did the plan have assets held for investment2022-01-01No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-01-01No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-01-01No
Opinion of an independent qualified public accountant for this plan2022-01-011
Accountancy firm name2022-01-01BLUE & CO., LLC
Accountancy firm EIN2022-01-01351178661
2021 : KNOX COMMUNITY HOSPITAL EMPLOYEE HEALTH PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total transfer of assets to this plan2021-12-31$-10,473
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total income from all sources (including contributions)2021-12-31$24,021,804
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$24,018,213
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$21,036,751
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$24,021,804
Value of total assets at end of year2021-12-31$216,621
Value of total assets at beginning of year2021-12-31$223,503
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$2,981,462
Total interest from all sources2021-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Was this plan covered by a fidelity bond2021-12-31No
If this is an individual account plan, was there a blackout period2021-12-31No
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$5,656,346
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$36,188
Administrative expenses (other) incurred2021-12-31$2,567,413
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$3,591
Value of net assets at end of year (total assets less liabilities)2021-12-31$216,621
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$223,503
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-12-31$216,621
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-12-31$223,503
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-12-31$223,503
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$18,329,270
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$21,036,751
Contract administrator fees2021-12-31$414,049
Did the plan have assets held for investment2021-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31BLUE & CO., LLC
Accountancy firm EIN2021-12-31351178661
2020 : KNOX COMMUNITY HOSPITAL EMPLOYEE HEALTH PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total transfer of assets to this plan2020-12-31$34,191
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total income from all sources (including contributions)2020-12-31$21,671,755
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$21,659,644
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$19,045,740
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$21,671,755
Value of total assets at end of year2020-12-31$223,503
Value of total assets at beginning of year2020-12-31$177,201
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$2,613,904
Total interest from all sources2020-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Was this plan covered by a fidelity bond2020-12-31No
If this is an individual account plan, was there a blackout period2020-12-31No
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$4,790,560
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$517,566
Administrative expenses (other) incurred2020-12-31$2,215,849
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$12,111
Value of net assets at end of year (total assets less liabilities)2020-12-31$223,503
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$177,201
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-12-31$223,503
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-12-31$177,201
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-12-31$177,201
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$16,363,629
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$19,045,740
Contract administrator fees2020-12-31$398,055
Did the plan have assets held for investment2020-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Unqualified
Accountancy firm name2020-12-31BLUE & CO., LLC
Accountancy firm EIN2020-12-31351178661
2019 : KNOX COMMUNITY HOSPITAL EMPLOYEE HEALTH PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total income from all sources (including contributions)2019-12-31$20,997,169
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$20,895,201
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$19,594,904
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$20,997,169
Value of total assets at end of year2019-12-31$177,201
Value of total assets at beginning of year2019-12-31$75,233
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$1,300,297
Total interest from all sources2019-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31No
If this is an individual account plan, was there a blackout period2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$4,280,700
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$1,411,957
Administrative expenses (other) incurred2019-12-31$933,651
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$101,968
Value of net assets at end of year (total assets less liabilities)2019-12-31$177,201
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$75,233
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$177,201
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$75,233
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$75,233
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$15,304,512
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$19,594,904
Contract administrator fees2019-12-31$366,646
Did the plan have assets held for investment2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Accountancy firm name2019-12-31BLUE & CO., LLC
Accountancy firm EIN2019-12-31351178661
2018 : KNOX COMMUNITY HOSPITAL EMPLOYEE HEALTH PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total income from all sources (including contributions)2018-12-31$19,369,772
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$19,329,339
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$18,385,584
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$19,369,772
Value of total assets at end of year2018-12-31$75,233
Value of total assets at beginning of year2018-12-31$34,800
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$943,755
Total interest from all sources2018-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Was this plan covered by a fidelity bond2018-12-31No
If this is an individual account plan, was there a blackout period2018-12-31No
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$3,544,537
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$2,929,513
Administrative expenses (other) incurred2018-12-31$617,152
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$40,433
Value of net assets at end of year (total assets less liabilities)2018-12-31$75,233
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$34,800
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-12-31$75,233
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-12-31$34,800
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-12-31$34,800
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$12,895,722
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$18,385,584
Contract administrator fees2018-12-31$326,603
Did the plan have assets held for investment2018-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31No
Opinion of an independent qualified public accountant for this plan2018-12-31Unqualified
Accountancy firm name2018-12-31BLUE & CO., LLC
Accountancy firm EIN2018-12-31351178661
2017 : KNOX COMMUNITY HOSPITAL EMPLOYEE HEALTH PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
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$0
Total income from all sources (including contributions)2017-12-31$14,720,689
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$14,854,933
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$14,069,665
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$14,720,689
Value of total assets at end of year2017-12-31$34,800
Value of total assets at beginning of year2017-12-31$169,044
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$785,268
Total interest from all sources2017-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31No
If this is an individual account plan, was there a blackout period2017-12-31No
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$3,292,086
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$194,702
Administrative expenses (other) incurred2017-12-31$529,151
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$-134,244
Value of net assets at end of year (total assets less liabilities)2017-12-31$34,800
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$169,044
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-12-31$34,800
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-12-31$169,044
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-12-31$169,044
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$11,233,901
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$14,069,665
Contract administrator fees2017-12-31$256,117
Did the plan have assets held for investment2017-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31No
Opinion of an independent qualified public accountant for this plan2017-12-31Unqualified
Accountancy firm name2017-12-31BLUE & CO., LLC
Accountancy firm EIN2017-12-31351178661
2016 : KNOX COMMUNITY HOSPITAL EMPLOYEE HEALTH PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total income from all sources (including contributions)2016-12-31$15,436,028
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$15,275,297
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$14,530,485
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$15,436,028
Value of total assets at end of year2016-12-31$169,044
Value of total assets at beginning of year2016-12-31$8,313
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$744,812
Total interest from all sources2016-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Was this plan covered by a fidelity bond2016-12-31No
If this is an individual account plan, was there a blackout period2016-12-31No
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$2,900,036
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$571,989
Administrative expenses (other) incurred2016-12-31$441,174
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$160,731
Value of net assets at end of year (total assets less liabilities)2016-12-31$169,044
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$8,313
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$169,044
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$8,313
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$8,313
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$11,964,003
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$14,530,485
Contract administrator fees2016-12-31$303,638
Did the plan have assets held for investment2016-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31No
Opinion of an independent qualified public accountant for this plan2016-12-31Unqualified
Accountancy firm name2016-12-31BLUE & CO., LLC
Accountancy firm EIN2016-12-31351178661
2015 : KNOX COMMUNITY HOSPITAL EMPLOYEE HEALTH PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total income from all sources (including contributions)2015-12-31$11,722,784
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$11,730,047
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$10,951,011
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$11,722,784
Value of total assets at end of year2015-12-31$8,313
Value of total assets at beginning of year2015-12-31$15,576
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$779,036
Total interest from all sources2015-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Was this plan covered by a fidelity bond2015-12-31No
If this is an individual account plan, was there a blackout period2015-12-31No
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$2,676,984
Administrative expenses (other) incurred2015-12-31$499,710
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$-7,263
Value of net assets at end of year (total assets less liabilities)2015-12-31$8,313
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$15,576
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-12-31$8,313
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-12-31$15,576
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-12-31$15,576
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$9,045,800
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$10,951,011
Contract administrator fees2015-12-31$279,326
Did the plan have assets held for investment2015-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31No
Opinion of an independent qualified public accountant for this plan2015-12-31Unqualified
Accountancy firm name2015-12-31BLUE & CO., LLC
Accountancy firm EIN2015-12-31351178661
2014 : KNOX COMMUNITY HOSPITAL EMPLOYEE HEALTH PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total income from all sources (including contributions)2014-12-31$12,192,669
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$12,277,468
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$11,684,922
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$12,192,669
Value of total assets at end of year2014-12-31$15,576
Value of total assets at beginning of year2014-12-31$100,375
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$592,546
Total interest from all sources2014-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Was this plan covered by a fidelity bond2014-12-31No
If this is an individual account plan, was there a blackout period2014-12-31No
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$2,412,870
Administrative expenses (other) incurred2014-12-31$318,446
Total non interest bearing cash at beginning of year2014-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$-84,799
Value of net assets at end of year (total assets less liabilities)2014-12-31$15,576
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$100,375
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-12-31$15,576
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-12-31$100,375
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-12-31$100,375
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$9,779,799
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$11,684,922
Contract administrator fees2014-12-31$274,100
Did the plan have assets held for investment2014-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31No
Opinion of an independent qualified public accountant for this plan2014-12-31Unqualified
Accountancy firm name2014-12-31BLUE & CO., LLC
Accountancy firm EIN2014-12-31351178661
2013 : KNOX COMMUNITY HOSPITAL EMPLOYEE HEALTH PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total income from all sources (including contributions)2013-12-31$10,849,590
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$10,522,344
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$9,989,241
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$10,849,590
Value of total assets at end of year2013-12-31$100,375
Value of total assets at beginning of year2013-12-31$-226,871
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$533,103
Total interest from all sources2013-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Was this plan covered by a fidelity bond2013-12-31No
If this is an individual account plan, was there a blackout period2013-12-31No
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$2,089,546
Income. Received or receivable in cash from other sources (including rollovers)2013-12-31$128,280
Administrative expenses (other) incurred2013-12-31$276,397
Total non interest bearing cash at end of year2013-12-31$0
Total non interest bearing cash at beginning of year2013-12-31$-226,871
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$327,246
Value of net assets at end of year (total assets less liabilities)2013-12-31$100,375
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$-226,871
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-12-31$100,375
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$8,631,764
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$9,989,241
Contract administrator fees2013-12-31$256,706
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32013-12-31No
Did the plan have assets held for investment2013-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31No
Opinion of an independent qualified public accountant for this plan2013-12-31Unqualified
Accountancy firm name2013-12-31BLUE & CO., LLC
Accountancy firm EIN2013-12-31351178661
2012 : KNOX COMMUNITY HOSPITAL EMPLOYEE HEALTH PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total income from all sources (including contributions)2012-12-31$12,839,333
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$13,193,575
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$12,577,613
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$12,839,333
Value of total assets at end of year2012-12-31$-226,871
Value of total assets at beginning of year2012-12-31$127,371
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$615,962
Total interest from all sources2012-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Was this plan covered by a fidelity bond2012-12-31No
If this is an individual account plan, was there a blackout period2012-12-31No
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$1,877,066
Income. Received or receivable in cash from other sources (including rollovers)2012-12-31$90,956
Administrative expenses (other) incurred2012-12-31$397,611
Total non interest bearing cash at end of year2012-12-31$-226,871
Total non interest bearing cash at beginning of year2012-12-31$127,371
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$-354,242
Value of net assets at end of year (total assets less liabilities)2012-12-31$-226,871
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$127,371
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$10,871,311
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$12,577,613
Contract administrator fees2012-12-31$218,351
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32012-12-31No
Did the plan have assets held for investment2012-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31No
Opinion of an independent qualified public accountant for this plan2012-12-31Unqualified
Accountancy firm name2012-12-31BLUE AND CO., LLC
Accountancy firm EIN2012-12-31351178661
2011 : KNOX COMMUNITY HOSPITAL EMPLOYEE HEALTH PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-12-31$0
Total transfer of assets to this plan2011-12-31$0
Total transfer of assets from this plan2011-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
Total income from all sources (including contributions)2011-12-31$10,778,991
Total loss/gain on sale of assets2011-12-31$0
Total of all expenses incurred2011-12-31$10,673,845
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$10,130,305
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$10,778,991
Value of total assets at end of year2011-12-31$127,371
Value of total assets at beginning of year2011-12-31$22,225
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$543,540
Total interest from all sources2011-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Was this plan covered by a fidelity bond2011-12-31No
If this is an individual account plan, was there a blackout period2011-12-31No
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$1,892,644
Income. Received or receivable in cash from other sources (including rollovers)2011-12-31$234,719
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2011-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2011-12-31$0
Administrative expenses (other) incurred2011-12-31$351,826
Total non interest bearing cash at end of year2011-12-31$127,371
Total non interest bearing cash at beginning of year2011-12-31$22,225
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$105,146
Value of net assets at end of year (total assets less liabilities)2011-12-31$127,371
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$22,225
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$8,651,628
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$10,130,305
Contract administrator fees2011-12-31$191,714
Liabilities. Value of benefit claims payable at end of year2011-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2011-12-31$0
Did the plan have assets held for investment2011-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31No
Opinion of an independent qualified public accountant for this plan2011-12-31Unqualified
Accountancy firm name2011-12-31HIRTH NORRIS & GARRISON, LLP
Accountancy firm EIN2011-12-31311158488
2010 : KNOX COMMUNITY HOSPITAL EMPLOYEE HEALTH PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets2010-12-31$0
Total transfer of assets to this plan2010-12-31$0
Total transfer of assets from this plan2010-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total income from all sources (including contributions)2010-12-31$9,368,250
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$9,412,692
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$8,876,317
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$9,368,250
Value of total assets at end of year2010-12-31$22,225
Value of total assets at beginning of year2010-12-31$66,667
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$536,375
Total interest from all sources2010-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Was this plan covered by a fidelity bond2010-12-31No
If this is an individual account plan, was there a blackout period2010-12-31No
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$1,678,738
Income. Received or receivable in cash from other sources (including rollovers)2010-12-31$303,135
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2010-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2010-12-31$0
Administrative expenses (other) incurred2010-12-31$361,230
Total non interest bearing cash at end of year2010-12-31$22,225
Total non interest bearing cash at beginning of year2010-12-31$66,667
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$-44,442
Value of net assets at end of year (total assets less liabilities)2010-12-31$22,225
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$66,667
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$7,386,377
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$8,876,317
Contract administrator fees2010-12-31$175,145
Liabilities. Value of benefit claims payable at end of year2010-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2010-12-31$0
Did the plan have assets held for investment2010-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31No
Opinion of an independent qualified public accountant for this plan2010-12-31Unqualified
Accountancy firm name2010-12-31HIRTH NORRIS & GARRISON, LLP
Accountancy firm EIN2010-12-31311158488

Form 5500 Responses for KNOX COMMUNITY HOSPITAL EMPLOYEE HEALTH PLAN

2023: KNOX COMMUNITY HOSPITAL EMPLOYEE HEALTH PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Submission has been amendedNo
2023-01-01This submission is the final filingNo
2023-01-01This return/report is a short plan year return/report (less than 12 months)No
2023-01-01Plan is a collectively bargained planNo
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – InsuranceYes
2022: KNOX COMMUNITY HOSPITAL EMPLOYEE HEALTH PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: KNOX COMMUNITY HOSPITAL EMPLOYEE HEALTH PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: KNOX COMMUNITY HOSPITAL EMPLOYEE HEALTH PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: KNOX COMMUNITY HOSPITAL EMPLOYEE HEALTH PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2017: KNOX COMMUNITY HOSPITAL EMPLOYEE HEALTH PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement - TrustYes
2016: KNOX COMMUNITY HOSPITAL EMPLOYEE HEALTH PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement - TrustYes
2015: KNOX COMMUNITY HOSPITAL EMPLOYEE HEALTH PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement - TrustYes
2014: KNOX COMMUNITY HOSPITAL EMPLOYEE HEALTH PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement - TrustYes
2013: KNOX COMMUNITY HOSPITAL EMPLOYEE HEALTH PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement - TrustYes
2012: KNOX COMMUNITY HOSPITAL EMPLOYEE HEALTH PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedYes
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement - TrustYes
2011: KNOX COMMUNITY HOSPITAL EMPLOYEE HEALTH PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement - TrustYes
2010: KNOX COMMUNITY HOSPITAL EMPLOYEE HEALTH PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement - TrustYes
2009: KNOX COMMUNITY HOSPITAL EMPLOYEE HEALTH PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK962280
Policy instance 2
Insurance contract or identification numberLK962280
Number of Individuals Covered938
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $15,393
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $190,285
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX963156
Policy instance 1
Insurance contract or identification numberFLX963156
Number of Individuals Covered938
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $29,429
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $169,433
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberVDT962684
Policy instance 3
Insurance contract or identification numberVDT962684
Number of Individuals Covered938
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $14,133
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $121,970
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK964811
Policy instance 4
Insurance contract or identification numberOK964811
Number of Individuals Covered938
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $1,923
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $11,068
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberAI960873
Policy instance 5
Insurance contract or identification numberAI960873
Number of Individuals Covered938
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $3,817
Total amount of fees paid to insurance companyUSD $1,441
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL INJURY
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $104,208
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberCI960839
Policy instance 6
Insurance contract or identification numberCI960839
Number of Individuals Covered938
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $4,804
Total amount of fees paid to insurance companyUSD $1,745
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedCRITICAL ILLNESS
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $130,299
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberHC960328
Policy instance 7
Insurance contract or identification numberHC960328
Number of Individuals Covered938
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $3,536
Total amount of fees paid to insurance companyUSD $1,202
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedHOSPITAL CARE
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $95,511
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number300379181
Policy instance 8
Insurance contract or identification number300379181
Number of Individuals Covered997
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $6,454
Total amount of fees paid to insurance companyUSD $30,954
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $162,915
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 )
Policy contract numberKNOX001
Policy instance 9
Insurance contract or identification numberKNOX001
Number of Individuals Covered938
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $695,822
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,141,081
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberVDT962684
Policy instance 3
Insurance contract or identification numberVDT962684
Number of Individuals Covered878
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $15,914
Total amount of fees paid to insurance companyUSD $1,854
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $159,136
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK962280
Policy instance 2
Insurance contract or identification numberLK962280
Number of Individuals Covered878
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $21,520
Total amount of fees paid to insurance companyUSD $3,311
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $307,434
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX963156
Policy instance 1
Insurance contract or identification numberFLX963156
Number of Individuals Covered878
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $37,804
Total amount of fees paid to insurance companyUSD $2,805
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $253,332
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number300379181
Policy instance 8
Insurance contract or identification number300379181
Number of Individuals Covered933
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $1,020
Total amount of fees paid to insurance companyUSD $2,369
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $12,469
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK964811
Policy instance 4
Insurance contract or identification numberOK964811
Number of Individuals Covered878
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $2,573
Total amount of fees paid to insurance companyUSD $180
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $17,154
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberAI960873
Policy instance 5
Insurance contract or identification numberAI960873
Number of Individuals Covered878
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $4,813
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL INJURY
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $96,266
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberCI960839
Policy instance 6
Insurance contract or identification numberCI960839
Number of Individuals Covered878
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $5,337
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedCRITICAL ILLNESS
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $106,729
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberHC960328
Policy instance 7
Insurance contract or identification numberHC960328
Number of Individuals Covered878
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $4,083
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedHOSPITAL CARE
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $81,666
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 )
Policy contract numberKNOX001
Policy instance 9
Insurance contract or identification numberKNOX001
Number of Individuals Covered0
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $103,057
Total amount of fees paid to insurance companyUSD $575,359
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,262,760
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberVDT962684
Policy instance 3
TELEMEDICINE MANAGEMENT, INC. DBA SWIFTMD (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberKNOX01
Policy instance 12
RITE BITE INC., DBA ALYFE WELLBEING STRATEGIES (National Association of Insurance Commissioners NAIC id number: NA )
Policy contract numberKNOX
Policy instance 11
COMPSYCH (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberKNOX
Policy instance 10
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 )
Policy contract numberKNOX001
Policy instance 9
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30037918
Policy instance 8
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberHC960328
Policy instance 7
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberCI960839
Policy instance 6
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberAI960873
Policy instance 5
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK964811
Policy instance 4
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK962280
Policy instance 2
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX963156
Policy instance 1
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberCI960839
Policy instance 6
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberAI960873
Policy instance 5
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK964811
Policy instance 4
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberVDT962684
Policy instance 3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK962280
Policy instance 2
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX963156
Policy instance 1
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberHC960328
Policy instance 7
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL32018
Policy instance 8
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30037918
Policy instance 9
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 )
Policy contract numberKNOX001
Policy instance 10
TRUSTMARK VOLUNTARY BENEFIT SOLUTIONS (National Association of Insurance Commissioners NAIC id number: 62863 )
Policy contract numberKNOX
Policy instance 11
COMPSYCH (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberKNOX
Policy instance 12
RITE BITE INC., DBA ALYFE WELLBEING STRATEGIES (National Association of Insurance Commissioners NAIC id number: NA )
Policy contract numberKNOX
Policy instance 13
TELEMEDICINE MANAGEMENT, INC. DBA SWIFTMD (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberKNOX01
Policy instance 14
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 54380 )
Policy contract number30037918
Policy instance 2
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL32018
Policy instance 1

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