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SAN GORGONIO MEMORIAL HOSPITAL TAX SHELTERED ANNUITY PLAN 401k Plan overview

Plan NameSAN GORGONIO MEMORIAL HOSPITAL TAX SHELTERED ANNUITY PLAN
Plan identification number 001

SAN GORGONIO MEMORIAL HOSPITAL TAX SHELTERED ANNUITY PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
  • Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
  • Plan sponsor(s) received services of leased employees, as defined in Code section 414(n), during the plan year.

401k Sponsoring company profile

SAN GORGONIO MEMORIAL HOSPITAL has sponsored the creation of one or more 401k plans.

Company Name:SAN GORGONIO MEMORIAL HOSPITAL
Employer identification number (EIN):330420041
NAIC Classification:622000
NAIC Description: Hospitals

Additional information about SAN GORGONIO MEMORIAL HOSPITAL

Jurisdiction of Incorporation: California Department of State
Incorporation Date:
Company Identification Number: C1664345

More information about SAN GORGONIO MEMORIAL HOSPITAL

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SAN GORGONIO MEMORIAL HOSPITAL TAX SHELTERED ANNUITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01
0012022-01-01
0012021-01-01
0012021-01-01
0012020-01-01
0012020-01-01
0012019-01-01
0012019-01-01
0012018-01-01
0012017-01-01ANNAH KARAM ANNAH KARAM2018-10-17
0012016-01-01ANNAH KARAM ANNAH KARAM2017-10-13
0012015-01-01MARK TURNER MARK TURNER2016-10-13
0012014-01-01MARK TURNER
0012013-01-01LYNN GOMEZ
0012012-01-01LYNN GOMEZ
0012011-01-01LYNN GOMEZ
0012010-01-01LYNN GOMEZ
0012009-01-01PAMELA LILLARD

Plan Statistics for SAN GORGONIO MEMORIAL HOSPITAL TAX SHELTERED ANNUITY PLAN

401k plan membership statisitcs for SAN GORGONIO MEMORIAL HOSPITAL TAX SHELTERED ANNUITY PLAN

Measure Date Value
2022: SAN GORGONIO MEMORIAL HOSPITAL TAX SHELTERED ANNUITY PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01708
Total number of active participants reported on line 7a of the Form 55002022-01-01597
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-0198
Total of all active and inactive participants2022-01-01695
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-011
Total participants2022-01-01696
Number of participants with account balances2022-01-01491
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-0115
2021: SAN GORGONIO MEMORIAL HOSPITAL TAX SHELTERED ANNUITY PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01695
Total number of active participants reported on line 7a of the Form 55002021-01-01624
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-0183
Total of all active and inactive participants2021-01-01707
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-011
Total participants2021-01-01708
Number of participants with account balances2021-01-01474
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-0135
2020: SAN GORGONIO MEMORIAL HOSPITAL TAX SHELTERED ANNUITY PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01715
Total number of active participants reported on line 7a of the Form 55002020-01-01624
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-0165
Total of all active and inactive participants2020-01-01689
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-011
Total participants2020-01-01690
Number of participants with account balances2020-01-01487
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-0128
2019: SAN GORGONIO MEMORIAL HOSPITAL TAX SHELTERED ANNUITY PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01711
Total number of active participants reported on line 7a of the Form 55002019-01-01663
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-0145
Total of all active and inactive participants2019-01-01708
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-011
Total participants2019-01-01709
Number of participants with account balances2019-01-01512
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-0124
2018: SAN GORGONIO MEMORIAL HOSPITAL TAX SHELTERED ANNUITY PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01831
Total number of active participants reported on line 7a of the Form 55002018-01-01692
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-0120
Total of all active and inactive participants2018-01-01712
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-012
Total participants2018-01-01714
Number of participants with account balances2018-01-01574
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-0125
2017: SAN GORGONIO MEMORIAL HOSPITAL TAX SHELTERED ANNUITY PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01764
Total number of active participants reported on line 7a of the Form 55002017-01-01770
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-012
Total of all active and inactive participants2017-01-01772
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-01772
Number of participants with account balances2017-01-01369
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-014
2016: SAN GORGONIO MEMORIAL HOSPITAL TAX SHELTERED ANNUITY PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01586
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
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-01729
Number of participants with account balances2016-01-01323
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: SAN GORGONIO MEMORIAL HOSPITAL TAX SHELTERED ANNUITY PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01429
Total number of active participants reported on line 7a of the Form 55002015-01-01308
Number of other retired or separated participants entitled to future benefits2015-01-01219
Total of all active and inactive participants2015-01-01527
Total participants2015-01-01527
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-0113
2014: SAN GORGONIO MEMORIAL HOSPITAL TAX SHELTERED ANNUITY PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01393
Total number of active participants reported on line 7a of the Form 55002014-01-01282
Number of other retired or separated participants entitled to future benefits2014-01-01147
Total of all active and inactive participants2014-01-01429
Total participants2014-01-01429
Number of participants with account balances2014-01-01429
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-0114
2013: SAN GORGONIO MEMORIAL HOSPITAL TAX SHELTERED ANNUITY PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01353
Total number of active participants reported on line 7a of the Form 55002013-01-01256
Number of other retired or separated participants entitled to future benefits2013-01-01137
Total of all active and inactive participants2013-01-01393
Total participants2013-01-01393
Number of participants with account balances2013-01-01393
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-0111
2012: SAN GORGONIO MEMORIAL HOSPITAL TAX SHELTERED ANNUITY PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01456
Total number of active participants reported on line 7a of the Form 55002012-01-01228
Number of other retired or separated participants entitled to future benefits2012-01-01125
Total of all active and inactive participants2012-01-01353
Total participants2012-01-01353
Number of participants with account balances2012-01-01347
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-013
2011: SAN GORGONIO MEMORIAL HOSPITAL TAX SHELTERED ANNUITY PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01561
Total number of active participants reported on line 7a of the Form 55002011-01-01336
Number of other retired or separated participants entitled to future benefits2011-01-01120
Total of all active and inactive participants2011-01-01456
Total participants2011-01-01456
Number of participants with account balances2011-01-01302
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-015
2010: SAN GORGONIO MEMORIAL HOSPITAL TAX SHELTERED ANNUITY PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01553
Total number of active participants reported on line 7a of the Form 55002010-01-01542
Number of other retired or separated participants entitled to future benefits2010-01-0119
Total of all active and inactive participants2010-01-01561
Total participants2010-01-01561
Number of participants with account balances2010-01-01248
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-0111
2009: SAN GORGONIO MEMORIAL HOSPITAL TAX SHELTERED ANNUITY PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01569
Total number of active participants reported on line 7a of the Form 55002009-01-01260
Number of retired or separated participants receiving benefits2009-01-01104
Total of all active and inactive participants2009-01-01364
Total participants2009-01-01364
Number of participants with account balances2009-01-01265
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-015

Financial Data on SAN GORGONIO MEMORIAL HOSPITAL TAX SHELTERED ANNUITY PLAN

Measure Date Value
2022 : SAN GORGONIO MEMORIAL HOSPITAL TAX SHELTERED ANNUITY PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
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$0
Total income from all sources (including contributions)2022-12-31$-312,703
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$2,147,748
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$2,120,402
Expenses. Certain deemed distributions of participant loans2022-12-31$562
Value of total corrective distributions2022-12-31$2,689
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$3,964,863
Value of total assets at end of year2022-12-31$29,237,290
Value of total assets at beginning of year2022-12-31$31,697,741
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$24,095
Total interest from all sources2022-12-31$135,463
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$834,623
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-12-31$834,623
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$1,000,000
If this is an individual account plan, was there a blackout period2022-12-31Yes
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$2,514,375
Participant contributions at end of year2022-12-31$772,404
Participant contributions at beginning of year2022-12-31$611,453
Participant contributions at end of year2022-12-31$0
Participant contributions at beginning of year2022-12-31$105,396
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$214,514
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-12-31$9,172
Other income not declared elsewhere2022-12-31$-29,703
Administrative expenses (other) incurred2022-12-31$9,401
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-2,460,451
Value of net assets at end of year (total assets less liabilities)2022-12-31$29,237,290
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$31,697,741
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 in registered invesment companies (eg mutual funds) at end of year2022-12-31$23,387,908
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$26,136,069
Value of interest in pooled separate accounts at end of year2022-12-31$0
Value of interest in pooled separate accounts at beginning of year2022-12-31$231,700
Interest on participant loans2022-12-31$33,108
Interest earned on other investments2022-12-31$102,355
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$5,076,978
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$4,562,786
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-5,217,949
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$1,235,974
Employer contributions (assets) at end of year2022-12-31$0
Employer contributions (assets) at beginning of year2022-12-31$50,337
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$2,120,402
Contract administrator fees2022-12-31$14,694
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32022-12-31Yes
Did the plan have assets held for investment2022-12-31Yes
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 name2022-12-31WITHUM
Accountancy firm EIN2022-12-31222027092
2021 : SAN GORGONIO MEMORIAL HOSPITAL TAX SHELTERED ANNUITY PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
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$7,432,819
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$3,336,966
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$3,228,189
Expenses. Certain deemed distributions of participant loans2021-12-31$47,052
Value of total corrective distributions2021-12-31$1,578
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$3,888,367
Value of total assets at end of year2021-12-31$31,697,741
Value of total assets at beginning of year2021-12-31$27,601,888
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$107,199
Total interest from all sources2021-12-31$42,827
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$618,808
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2021-12-31$618,808
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$1,000,000
If this is an individual account plan, was there a blackout period2021-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$2,265,121
Participant contributions at end of year2021-12-31$611,453
Participant contributions at beginning of year2021-12-31$626,916
Participant contributions at end of year2021-12-31$105,396
Participant contributions at beginning of year2021-12-31$76,403
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$493,714
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2021-12-31$431
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-12-31$9,172
Other income not declared elsewhere2021-12-31$160,750
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$4,095,853
Value of net assets at end of year (total assets less liabilities)2021-12-31$31,697,741
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$27,601,888
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 in registered invesment companies (eg mutual funds) at end of year2021-12-31$26,136,069
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$22,298,345
Value of interest in pooled separate accounts at end of year2021-12-31$231,700
Interest on participant loans2021-12-31$28,872
Interest earned on other investments2021-12-31$13,955
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$4,562,786
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$4,557,312
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$2,698,763
Net investment gain/loss from pooled separate accounts2021-12-31$23,304
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 contributions2021-12-31Yes
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$1,129,532
Employer contributions (assets) at end of year2021-12-31$50,337
Employer contributions (assets) at beginning of year2021-12-31$42,912
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$3,227,758
Contract administrator fees2021-12-31$107,199
Did the plan have assets held for investment2021-12-31Yes
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 name2021-12-31WITHUM
Accountancy firm EIN2021-12-31222027092
2020 : SAN GORGONIO MEMORIAL HOSPITAL TAX SHELTERED ANNUITY PLAN 2020 401k financial data
Unrealized appreciation/depreciation of real estate assets2020-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2020-12-31$0
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total transfer of assets to this plan2020-12-31$0
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
Expenses. Interest paid2020-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022020-12-31$0
Total income from all sources (including contributions)2020-12-31$6,413,160
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$3,608,326
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$3,537,353
Expenses. Certain deemed distributions of participant loans2020-12-31$0
Value of total corrective distributions2020-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$3,663,123
Value of total assets at end of year2020-12-31$27,624,148
Value of total assets at beginning of year2020-12-31$24,819,314
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$70,973
Total income from rents2020-12-31$0
Total interest from all sources2020-12-31$141,743
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$197,989
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2020-12-31$197,989
Administrative expenses professional fees incurred2020-12-31$0
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$1,000,000
If this is an individual account plan, was there a blackout period2020-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Amount of non-exempt transactions with any party-in-interest2020-12-31$0
Contributions received from participants2020-12-31$2,127,925
Participant contributions at end of year2020-12-31$626,916
Participant contributions at beginning of year2020-12-31$580,667
Participant contributions at end of year2020-12-31$92,919
Participant contributions at beginning of year2020-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$451,089
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2020-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-12-31$0
Other income not declared elsewhere2020-12-31$56,666
Administrative expenses (other) incurred2020-12-31$0
Liabilities. Value of operating payables at beginning of year2020-12-31$0
Total non interest bearing cash at end of year2020-12-31$0
Total non interest bearing cash at beginning of year2020-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Income. Non cash contributions2020-12-31$0
Value of net income/loss2020-12-31$2,804,834
Value of net assets at end of year (total assets less liabilities)2020-12-31$27,624,148
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$24,819,314
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
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year2020-12-31$0
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year2020-12-31$0
Investment advisory and management fees2020-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$22,298,345
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$11,861,678
Value of interest in pooled separate accounts at end of year2020-12-31$0
Value of interest in pooled separate accounts at beginning of year2020-12-31$7,774,397
Interest on participant loans2020-12-31$34,083
Income. Interest from loans (other than to participants)2020-12-31$0
Interest earned on other investments2020-12-31$107,660
Income. Interest from US Government securities2020-12-31$0
Income. Interest from corporate debt instruments2020-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$4,557,312
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$4,602,572
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$2,353,639
Net investment gain/loss from pooled separate accounts2020-12-31$0
Net investment gain or loss from common/collective trusts2020-12-31$0
Net gain/loss from 103.12 investment entities2020-12-31$0
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 contributions2020-12-31Yes
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$1,084,109
Employer contributions (assets) at end of year2020-12-31$48,656
Employer contributions (assets) at beginning of year2020-12-31$0
Income. Dividends from preferred stock2020-12-31$0
Income. Dividends from common stock2020-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$3,537,353
Contract administrator fees2020-12-31$70,973
Liabilities. Value of benefit claims payable at beginning of year2020-12-31$0
Did the plan have assets held for investment2020-12-31Yes
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
Aggregate proceeds on sale of assets2020-12-31$0
Aggregate carrying amount (costs) on sale of assets2020-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2020-12-31$0
Opinion of an independent qualified public accountant for this plan2020-12-31Disclaimer
Accountancy firm name2020-12-31WITHUMSMITH + BROWN, PC
Accountancy firm EIN2020-12-31222027092
2019 : SAN GORGONIO MEMORIAL HOSPITAL TAX SHELTERED ANNUITY PLAN 2019 401k financial data
Unrealized appreciation/depreciation of real estate assets2019-12-31$0
Unrealized appreciation/depreciation of real estate assets2019-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2019-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2019-12-31$0
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total transfer of assets to this plan2019-12-31$0
Total transfer of assets to this plan2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at 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 liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Expenses. Interest paid2019-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022019-12-31$0
Expenses. Interest paid2019-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022019-12-31$0
Total income from all sources (including contributions)2019-12-31$6,800,064
Total income from all sources (including contributions)2019-12-31$6,800,064
Total loss/gain on sale of assets2019-12-31$0
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$2,513,285
Total of all expenses incurred2019-12-31$2,513,285
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$2,427,259
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$2,427,259
Expenses. Certain deemed distributions of participant loans2019-12-31$0
Expenses. Certain deemed distributions of participant loans2019-12-31$0
Value of total corrective distributions2019-12-31$0
Value of total corrective distributions2019-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$3,193,611
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$3,193,611
Value of total assets at end of year2019-12-31$24,819,314
Value of total assets at end of year2019-12-31$24,819,314
Value of total assets at beginning of year2019-12-31$20,532,535
Value of total assets at beginning of year2019-12-31$20,532,535
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$86,026
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$86,026
Total income from rents2019-12-31$0
Total income from rents2019-12-31$0
Total interest from all sources2019-12-31$151,516
Total interest from all sources2019-12-31$151,516
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$236,143
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$236,143
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$236,143
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$236,143
Administrative expenses professional fees incurred2019-12-31$0
Administrative expenses professional fees incurred2019-12-31$0
Was this plan covered by a fidelity bond2019-12-31Yes
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$1,000,000
Value of fidelity bond cover2019-12-31$1,000,000
If this is an individual account plan, was there a blackout period2019-12-31No
If this is an individual account plan, was there a blackout period2019-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Amount of non-exempt transactions with any party-in-interest2019-12-31$0
Amount of non-exempt transactions with any party-in-interest2019-12-31$0
Contributions received from participants2019-12-31$1,914,816
Contributions received from participants2019-12-31$1,914,816
Participant contributions at end of year2019-12-31$580,667
Participant contributions at end of year2019-12-31$580,667
Participant contributions at beginning of year2019-12-31$362,334
Participant contributions at beginning of year2019-12-31$362,334
Participant contributions at end of year2019-12-31$0
Participant contributions at end of year2019-12-31$0
Participant contributions at beginning of year2019-12-31$0
Participant contributions at beginning of year2019-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$275,024
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$275,024
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2019-12-31$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2019-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-12-31$0
Other income not declared elsewhere2019-12-31$918
Other income not declared elsewhere2019-12-31$918
Administrative expenses (other) incurred2019-12-31$0
Administrative expenses (other) incurred2019-12-31$0
Liabilities. Value of operating payables at beginning of year2019-12-31$0
Liabilities. Value of operating payables at beginning of year2019-12-31$0
Total non interest bearing cash at end of year2019-12-31$0
Total non interest bearing cash at end of year2019-12-31$0
Total non interest bearing cash at beginning of year2019-12-31$0
Total non interest bearing cash at beginning of year2019-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
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
Income. Non cash contributions2019-12-31$0
Income. Non cash contributions2019-12-31$0
Value of net income/loss2019-12-31$4,286,779
Value of net income/loss2019-12-31$4,286,779
Value of net assets at end of year (total assets less liabilities)2019-12-31$24,819,314
Value of net assets at end of year (total assets less liabilities)2019-12-31$24,819,314
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$20,532,535
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$20,532,535
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
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 loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year2019-12-31$0
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year2019-12-31$0
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year2019-12-31$0
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year2019-12-31$0
Investment advisory and management fees2019-12-31$0
Investment advisory and management fees2019-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$11,861,678
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$11,861,678
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$8,068,243
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$8,068,243
Value of interest in pooled separate accounts at end of year2019-12-31$7,774,397
Value of interest in pooled separate accounts at beginning of year2019-12-31$7,284,544
Value of interest in pooled separate accounts at beginning of year2019-12-31$7,284,544
Interest on participant loans2019-12-31$26,583
Interest on participant loans2019-12-31$26,583
Income. Interest from loans (other than to participants)2019-12-31$0
Income. Interest from loans (other than to participants)2019-12-31$0
Interest earned on other investments2019-12-31$124,933
Interest earned on other investments2019-12-31$124,933
Income. Interest from US Government securities2019-12-31$0
Income. Interest from US Government securities2019-12-31$0
Income. Interest from corporate debt instruments2019-12-31$0
Income. Interest from corporate debt instruments2019-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$4,602,572
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$4,602,572
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$4,817,414
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$4,817,414
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$1,708,527
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$1,708,527
Net investment gain/loss from pooled separate accounts2019-12-31$1,509,349
Net investment gain/loss from pooled separate accounts2019-12-31$1,509,349
Net investment gain or loss from common/collective trusts2019-12-31$0
Net investment gain or loss from common/collective trusts2019-12-31$0
Net gain/loss from 103.12 investment entities2019-12-31$0
Net gain/loss from 103.12 investment entities2019-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
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
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
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$1,003,771
Contributions received in cash from employer2019-12-31$1,003,771
Employer contributions (assets) at end of year2019-12-31$0
Employer contributions (assets) at end of year2019-12-31$0
Employer contributions (assets) at beginning of year2019-12-31$0
Employer contributions (assets) at beginning of year2019-12-31$0
Income. Dividends from preferred stock2019-12-31$0
Income. Dividends from preferred stock2019-12-31$0
Income. Dividends from common stock2019-12-31$0
Income. Dividends from common stock2019-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$2,427,259
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$2,427,259
Contract administrator fees2019-12-31$86,026
Contract administrator fees2019-12-31$86,026
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$0
Did the plan have assets held for investment2019-12-31Yes
Did the plan have assets held for investment2019-12-31Yes
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
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
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Aggregate proceeds on sale of assets2019-12-31$0
Aggregate proceeds on sale of assets2019-12-31$0
Aggregate carrying amount (costs) on sale of assets2019-12-31$0
Aggregate carrying amount (costs) on sale of assets2019-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2019-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2019-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31WITHUMSMITH+BROWN, PC
Accountancy firm name2019-12-31WITHUMSMITH+BROWN, PC
Accountancy firm EIN2019-12-31222027092
Accountancy firm EIN2019-12-31222027092
2018 : SAN GORGONIO MEMORIAL HOSPITAL TAX SHELTERED ANNUITY PLAN 2018 401k financial data
Unrealized appreciation/depreciation of real estate assets2018-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2018-12-31$0
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total transfer of assets to this plan2018-12-31$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
Expenses. Interest paid2018-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022018-12-31$0
Total income from all sources (including contributions)2018-12-31$1,978,445
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$2,239,347
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$2,152,051
Expenses. Certain deemed distributions of participant loans2018-12-31$0
Value of total corrective distributions2018-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$2,933,173
Value of total assets at end of year2018-12-31$20,532,535
Value of total assets at beginning of year2018-12-31$20,793,437
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$87,296
Total income from rents2018-12-31$0
Total interest from all sources2018-12-31$153,454
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$201,383
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2018-12-31$201,383
Administrative expenses professional fees incurred2018-12-31$0
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$1,000,000
If this is an individual account plan, was there a blackout period2018-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Amount of non-exempt transactions with any party-in-interest2018-12-31$0
Contributions received from participants2018-12-31$1,788,794
Participant contributions at end of year2018-12-31$362,334
Participant contributions at beginning of year2018-12-31$171,118
Participant contributions at end of year2018-12-31$0
Participant contributions at beginning of year2018-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$129,192
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2018-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-12-31$0
Other income not declared elsewhere2018-12-31$9,402
Administrative expenses (other) incurred2018-12-31$0
Liabilities. Value of operating payables at beginning of year2018-12-31$0
Total non interest bearing cash at end of year2018-12-31$0
Total non interest bearing cash at beginning of year2018-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Income. Non cash contributions2018-12-31$0
Value of net income/loss2018-12-31$-260,902
Value of net assets at end of year (total assets less liabilities)2018-12-31$20,532,535
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$20,793,437
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
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year2018-12-31$0
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year2018-12-31$0
Investment advisory and management fees2018-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$8,068,243
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$6,194,620
Value of interest in pooled separate accounts at end of year2018-12-31$7,284,544
Value of interest in pooled separate accounts at beginning of year2018-12-31$8,994,736
Interest on participant loans2018-12-31$13,277
Income. Interest from loans (other than to participants)2018-12-31$0
Interest earned on other investments2018-12-31$140,177
Income. Interest from US Government securities2018-12-31$0
Income. Interest from corporate debt instruments2018-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$4,817,414
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$5,432,963
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-699,364
Net investment gain/loss from pooled separate accounts2018-12-31$-619,603
Net investment gain or loss from common/collective trusts2018-12-31$0
Net gain/loss from 103.12 investment entities2018-12-31$0
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 plan2018-12-31Yes
Contributions received in cash from employer2018-12-31$1,015,187
Employer contributions (assets) at end of year2018-12-31$0
Employer contributions (assets) at beginning of year2018-12-31$0
Income. Dividends from preferred stock2018-12-31$0
Income. Dividends from common stock2018-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$2,152,051
Contract administrator fees2018-12-31$87,296
Liabilities. Value of benefit claims payable at beginning of year2018-12-31$0
Did the plan have assets held for investment2018-12-31Yes
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
Aggregate proceeds on sale of assets2018-12-31$0
Aggregate carrying amount (costs) on sale of assets2018-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2018-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31KSJG, LLP
Accountancy firm EIN2018-12-31953322166
2017 : SAN GORGONIO MEMORIAL HOSPITAL TAX SHELTERED ANNUITY PLAN 2017 401k financial data
Unrealized appreciation/depreciation of real estate assets2017-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2017-12-31$0
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total transfer of assets to this plan2017-12-31$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
Expenses. Interest paid2017-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022017-12-31$0
Total income from all sources (including contributions)2017-12-31$5,435,192
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$2,516,294
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$2,446,787
Expenses. Certain deemed distributions of participant loans2017-12-31$0
Value of total corrective distributions2017-12-31$2,881
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$3,274,649
Value of total assets at end of year2017-12-31$20,793,437
Value of total assets at beginning of year2017-12-31$17,874,539
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$66,626
Total income from rents2017-12-31$0
Total interest from all sources2017-12-31$74,863
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$139,177
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2017-12-31$139,177
Administrative expenses professional fees incurred2017-12-31$0
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$1,000,000
If this is an individual account plan, was there a blackout period2017-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Amount of non-exempt transactions with any party-in-interest2017-12-31$0
Contributions received from participants2017-12-31$1,887,965
Participant contributions at end of year2017-12-31$171,118
Participant contributions at end of year2017-12-31$0
Participant contributions at beginning of year2017-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$317,623
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2017-12-31$26,723
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-12-31$0
Other income not declared elsewhere2017-12-31$34,968
Administrative expenses (other) incurred2017-12-31$0
Liabilities. Value of operating payables at beginning of year2017-12-31$0
Total non interest bearing cash at end of year2017-12-31$0
Total non interest bearing cash at beginning of year2017-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Income. Non cash contributions2017-12-31$0
Value of net income/loss2017-12-31$2,918,898
Value of net assets at end of year (total assets less liabilities)2017-12-31$20,793,437
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$17,874,539
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
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year2017-12-31$0
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year2017-12-31$0
Investment advisory and management fees2017-12-31$7,500
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$6,194,620
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$1,610,994
Value of interest in pooled separate accounts at end of year2017-12-31$8,994,736
Value of interest in pooled separate accounts at beginning of year2017-12-31$10,300,337
Interest on participant loans2017-12-31$0
Income. Interest from loans (other than to participants)2017-12-31$0
Interest earned on other investments2017-12-31$74,863
Income. Interest from US Government securities2017-12-31$0
Income. Interest from corporate debt instruments2017-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-12-31$91,349
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-12-31$91,349
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-12-31$5,432,963
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-12-31$5,871,859
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-12-31$444,092
Net investment gain/loss from pooled separate accounts2017-12-31$1,467,443
Net investment gain or loss from common/collective trusts2017-12-31$0
Net gain/loss from 103.12 investment entities2017-12-31$0
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$1,069,061
Employer contributions (assets) at end of year2017-12-31$0
Employer contributions (assets) at beginning of year2017-12-31$0
Income. Dividends from preferred stock2017-12-31$0
Income. Dividends from common stock2017-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$2,420,064
Contract administrator fees2017-12-31$59,126
Liabilities. Value of benefit claims payable at beginning of year2017-12-31$0
Did the plan have assets held for investment2017-12-31Yes
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
Aggregate proceeds on sale of assets2017-12-31$0
Aggregate carrying amount (costs) on sale of assets2017-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2017-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31KSJG, LLP
Accountancy firm EIN2017-12-31953322166
2016 : SAN GORGONIO MEMORIAL HOSPITAL TAX SHELTERED ANNUITY PLAN 2016 401k financial data
Unrealized appreciation/depreciation of real estate assets2016-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2016-12-31$0
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total transfer of assets to this plan2016-12-31$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
Expenses. Interest paid2016-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022016-12-31$0
Total income from all sources (including contributions)2016-12-31$3,841,357
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$1,789,546
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$1,751,108
Value of total corrective distributions2016-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$2,854,487
Value of total assets at end of year2016-12-31$17,874,539
Value of total assets at beginning of year2016-12-31$15,822,728
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$38,438
Total income from rents2016-12-31$0
Total interest from all sources2016-12-31$139,272
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$20,491
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2016-12-31$20,491
Administrative expenses professional fees incurred2016-12-31$0
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$1,000,000
If this is an individual account plan, was there a blackout period2016-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Amount of non-exempt transactions with any party-in-interest2016-12-31$0
Contributions received from participants2016-12-31$1,684,116
Participant contributions at end of year2016-12-31$0
Participant contributions at beginning of year2016-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$213,915
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2016-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-12-31$0
Other income not declared elsewhere2016-12-31$0
Administrative expenses (other) incurred2016-12-31$0
Liabilities. Value of operating payables at beginning of year2016-12-31$0
Total non interest bearing cash at end of year2016-12-31$0
Total non interest bearing cash at beginning of year2016-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Income. Non cash contributions2016-12-31$0
Value of net income/loss2016-12-31$2,051,811
Value of net assets at end of year (total assets less liabilities)2016-12-31$17,874,539
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$15,822,728
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
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year2016-12-31$0
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year2016-12-31$0
Investment advisory and management fees2016-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-31$1,610,994
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$0
Value of interest in pooled separate accounts at end of year2016-12-31$10,300,337
Value of interest in pooled separate accounts at beginning of year2016-12-31$10,665,355
Income. Interest from loans (other than to participants)2016-12-31$0
Interest earned on other investments2016-12-31$137,291
Income. Interest from US Government securities2016-12-31$0
Income. Interest from corporate debt instruments2016-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$91,349
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$56,189
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$56,189
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-12-31$1,981
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-12-31$5,871,859
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-12-31$5,101,184
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-12-31$-24,295
Net investment gain/loss from pooled separate accounts2016-12-31$851,402
Net investment gain or loss from common/collective trusts2016-12-31$0
Net gain/loss from 103.12 investment entities2016-12-31$0
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$956,456
Employer contributions (assets) at end of year2016-12-31$0
Employer contributions (assets) at beginning of year2016-12-31$0
Income. Dividends from preferred stock2016-12-31$0
Income. Dividends from common stock2016-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$1,751,108
Contract administrator fees2016-12-31$38,438
Liabilities. Value of benefit claims payable at beginning of year2016-12-31$0
Did the plan have assets held for investment2016-12-31Yes
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
Aggregate proceeds on sale of assets2016-12-31$0
Aggregate carrying amount (costs) on sale of assets2016-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2016-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31KSJG, LLP
Accountancy firm EIN2016-12-31953322166
2015 : SAN GORGONIO MEMORIAL HOSPITAL TAX SHELTERED ANNUITY 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$2,690,017
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$854,877
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$807,340
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$2,726,847
Value of total assets at end of year2015-12-31$15,822,728
Value of total assets at beginning of year2015-12-31$13,987,588
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$47,537
Total interest from all sources2015-12-31$150,948
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 bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$1,000,000
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$1,629,175
Participant contributions at beginning of year2015-12-31$37,195
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$235,789
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$1,835,140
Value of net assets at end of year (total assets less liabilities)2015-12-31$15,822,728
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$13,987,588
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
Investment advisory and management fees2015-12-31$47,537
Value of interest in pooled separate accounts at end of year2015-12-31$10,665,355
Value of interest in pooled separate accounts at beginning of year2015-12-31$9,279,955
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-12-31$56,189
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-12-31$41,391
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-12-31$41,391
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-12-31$150,948
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-12-31$5,101,184
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-12-31$4,606,998
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$-187,778
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$861,883
Employer contributions (assets) at beginning of year2015-12-31$22,049
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$807,340
Did the plan have assets held for investment2015-12-31Yes
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)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31KSJG CERTIFIED PUBLIC ACCOUNTANTS
Accountancy firm EIN2015-12-31953322166
2014 : SAN GORGONIO MEMORIAL HOSPITAL TAX SHELTERED ANNUITY PLAN 2014 401k financial data
Total transfer of assets to this plan2014-12-31$10,061
Total income from all sources (including contributions)2014-12-31$2,729,063
Total of all expenses incurred2014-12-31$981,541
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$949,119
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$2,212,507
Value of total assets at end of year2014-12-31$13,987,588
Value of total assets at beginning of year2014-12-31$12,230,005
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$32,422
Total interest from all sources2014-12-31$137,704
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 bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$1,000,000
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$1,417,015
Participant contributions at end of year2014-12-31$22,049
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$1,747,522
Value of net assets at end of year (total assets less liabilities)2014-12-31$13,987,588
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$12,230,005
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
Investment advisory and management fees2014-12-31$32,422
Value of interest in pooled separate accounts at end of year2014-12-31$9,279,955
Value of interest in pooled separate accounts at beginning of year2014-12-31$7,911,241
Value of interest in common/collective trusts at end of year2014-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-12-31$41,391
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-12-31$20,821
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-12-31$20,821
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-12-31$137,704
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-12-31$4,606,998
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-12-31$4,297,943
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-12-31$378,852
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$795,492
Employer contributions (assets) at end of year2014-12-31$37,195
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$949,119
Did the plan have assets held for investment2014-12-31Yes
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)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31TEAMAN RAMIREZ & SMITH, INC.
Accountancy firm EIN2014-12-31953636462
2013 : SAN GORGONIO MEMORIAL HOSPITAL TAX SHELTERED ANNUITY PLAN 2013 401k financial data
Total transfer of assets to this plan2013-12-31$240,187
Total income from all sources (including contributions)2013-12-31$3,271,170
Total of all expenses incurred2013-12-31$805,508
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$771,576
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$1,813,998
Value of total assets at end of year2013-12-31$12,230,005
Value of total assets at beginning of year2013-12-31$9,524,156
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$33,932
Total interest from all sources2013-12-31$122,093
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 bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$1,000,000
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$1,191,994
Participant contributions at beginning of year2013-12-31$444,845
Participant contributions at beginning of year2013-12-31$43,706
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$2,465,662
Value of net assets at end of year (total assets less liabilities)2013-12-31$12,230,005
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$9,524,156
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
Investment advisory and management fees2013-12-31$33,932
Value of interest in pooled separate accounts at end of year2013-12-31$7,911,241
Value of interest in pooled separate accounts at beginning of year2013-12-31$5,664,330
Value of interest in common/collective trusts at end of year2013-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-12-31$20,821
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-12-31$5,212
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-12-31$5,212
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-12-31$122,093
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-12-31$4,297,943
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-12-31$3,343,229
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-12-31$1,335,079
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$622,004
Employer contributions (assets) at beginning of year2013-12-31$22,834
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$771,576
Did the plan have assets held for investment2013-12-31Yes
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)2013-12-31Yes
Opinion of an independent qualified public accountant for this plan2013-12-31Disclaimer
Accountancy firm name2013-12-31TEAMAN RAMIREZ & SMITH, INC.
Accountancy firm EIN2013-12-31953636462
2012 : SAN GORGONIO MEMORIAL HOSPITAL TAX SHELTERED ANNUITY PLAN 2012 401k financial data
Total transfer of assets to this plan2012-12-31$38,325
Total income from all sources (including contributions)2012-12-31$2,241,905
Total of all expenses incurred2012-12-31$546,916
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$531,404
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$1,491,965
Value of total assets at end of year2012-12-31$9,524,156
Value of total assets at beginning of year2012-12-31$7,790,842
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$15,512
Total interest from all sources2012-12-31$110,957
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
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$974,875
Participant contributions at end of year2012-12-31$444,845
Participant contributions at beginning of year2012-12-31$404,277
Participant contributions at end of year2012-12-31$43,706
Participant contributions at beginning of year2012-12-31$159
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$1,694,989
Value of net assets at end of year (total assets less liabilities)2012-12-31$9,524,156
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$7,790,842
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
Investment advisory and management fees2012-12-31$15,512
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$4,220,824
Value of interest in pooled separate accounts at end of year2012-12-31$5,664,330
Interest on participant loans2012-12-31$17,175
Value of interest in common/collective trusts at end of year2012-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-12-31$5,212
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-12-31$93,782
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-12-31$3,343,229
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-12-31$3,165,582
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-12-31$638,983
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$517,090
Employer contributions (assets) at end of year2012-12-31$22,834
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$531,404
Did the plan have assets held for investment2012-12-31Yes
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)2012-12-31Yes
Opinion of an independent qualified public accountant for this plan2012-12-31Disclaimer
Accountancy firm name2012-12-31TEAMAN RAMIREZ & SMITH, INC.
Accountancy firm EIN2012-12-31953636462
2011 : SAN GORGONIO MEMORIAL HOSPITAL TAX SHELTERED ANNUITY PLAN 2011 401k financial data
Total transfer of assets to this plan2011-12-31$160,977
Total income from all sources (including contributions)2011-12-31$505,745
Total of all expenses incurred2011-12-31$569,814
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$557,810
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$558,235
Value of total assets at end of year2011-12-31$7,790,842
Value of total assets at beginning of year2011-12-31$7,693,934
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$12,004
Total interest from all sources2011-12-31$111,530
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
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$558,235
Participant contributions at end of year2011-12-31$404,277
Participant contributions at beginning of year2011-12-31$334,868
Participant contributions at end of year2011-12-31$159
Participant contributions at beginning of year2011-12-31$82,965
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-12-31$6,086
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-64,069
Value of net assets at end of year (total assets less liabilities)2011-12-31$7,790,842
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$7,693,934
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
Investment advisory and management fees2011-12-31$12,004
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-12-31$4,220,824
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-12-31$4,287,474
Interest on participant loans2011-12-31$15,315
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$96,215
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-12-31$3,165,582
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-12-31$2,982,541
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-12-31$-164,020
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$557,810
Did the plan have assets held for investment2011-12-31Yes
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)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31TEAMAN RAMIREZ & SMITH, INC.
Accountancy firm EIN2011-12-31953636462
2010 : SAN GORGONIO MEMORIAL HOSPITAL TAX SHELTERED ANNUITY PLAN 2010 401k financial data
Total transfer of assets to this plan2010-12-31$8,875
Total income from all sources (including contributions)2010-12-31$1,162,601
Total of all expenses incurred2010-12-31$388,304
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$379,076
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$478,385
Value of total assets at end of year2010-12-31$7,693,934
Value of total assets at beginning of year2010-12-31$6,910,762
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$9,228
Total interest from all sources2010-12-31$121,646
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
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$478,385
Participant contributions at end of year2010-12-31$334,868
Participant contributions at beginning of year2010-12-31$368,204
Participant contributions at end of year2010-12-31$82,965
Participant contributions at beginning of year2010-12-31$49,672
Value of other receiveables (less allowance for doubtful accounts) at end of year2010-12-31$6,086
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$774,297
Value of net assets at end of year (total assets less liabilities)2010-12-31$7,693,934
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$6,910,762
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
Investment advisory and management fees2010-12-31$9,228
Value of interest in registered invesment companies (eg mutual funds) at end of year2010-12-31$4,287,474
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$3,440,477
Interest on participant loans2010-12-31$16,203
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$105,443
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$2,982,541
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$2,833,682
Net investment gain/loss from registered investment companies (e.g. mutual funds)2010-12-31$562,570
Net investment gain/loss from pooled separate accounts2010-12-31$562,570
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 contributions2010-12-31Yes
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Employer contributions (assets) at beginning of year2010-12-31$218,727
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$379,076
Did the plan have assets held for investment2010-12-31Yes
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)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31TEAMAN RAMIREZ & SMITH, INC.
Accountancy firm EIN2010-12-31953636462

Form 5500 Responses for SAN GORGONIO MEMORIAL HOSPITAL TAX SHELTERED ANNUITY PLAN

2022: SAN GORGONIO MEMORIAL HOSPITAL TAX SHELTERED ANNUITY 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 funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: SAN GORGONIO MEMORIAL HOSPITAL TAX SHELTERED ANNUITY PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedYes
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 funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: SAN GORGONIO MEMORIAL HOSPITAL TAX SHELTERED ANNUITY PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedYes
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 funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: SAN GORGONIO MEMORIAL HOSPITAL TAX SHELTERED ANNUITY PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedYes
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 funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: SAN GORGONIO MEMORIAL HOSPITAL TAX SHELTERED ANNUITY PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: SAN GORGONIO MEMORIAL HOSPITAL TAX SHELTERED ANNUITY PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
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 – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: SAN GORGONIO MEMORIAL HOSPITAL TAX SHELTERED ANNUITY PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
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 – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: SAN GORGONIO MEMORIAL HOSPITAL TAX SHELTERED ANNUITY 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 – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: SAN GORGONIO MEMORIAL HOSPITAL TAX SHELTERED ANNUITY PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: SAN GORGONIO MEMORIAL HOSPITAL TAX SHELTERED ANNUITY PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: SAN GORGONIO MEMORIAL HOSPITAL TAX SHELTERED ANNUITY PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedYes
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: SAN GORGONIO MEMORIAL HOSPITAL TAX SHELTERED ANNUITY PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: SAN GORGONIO MEMORIAL HOSPITAL TAX SHELTERED ANNUITY PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: SAN GORGONIO MEMORIAL HOSPITAL TAX SHELTERED ANNUITY PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract number664577
Policy instance 3
Insurance contract or identification number664577
Number of Individuals Covered696
Insurance policy start date2022-10-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
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?Yes
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
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VALIC (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number59849
Policy instance 2
Insurance contract or identification number59849
Number of Individuals Covered0
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
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?Yes
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
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number613953
Policy instance 1
Insurance contract or identification number613953
Number of Individuals Covered0
Insurance policy start date2022-01-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $0
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?Yes
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
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VALIC (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number59849
Policy instance 2
Insurance contract or identification number59849
Number of Individuals Covered0
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number613953
Policy instance 1
Insurance contract or identification number613953
Number of Individuals Covered708
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VALIC (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number59849
Policy instance 2
Insurance contract or identification number59849
Number of Individuals Covered690
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number613953
Policy instance 1
Insurance contract or identification number613953
Number of Individuals Covered690
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VALIC (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number59849
Policy instance 2
Insurance contract or identification number59849
Number of Individuals Covered0
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number613953
Policy instance 1
Insurance contract or identification number613953
Number of Individuals Covered709
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number613953
Policy instance 1
Insurance contract or identification number613953
Number of Individuals Covered714
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VALIC (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number59849
Policy instance 2
Insurance contract or identification number59849
Number of Individuals Covered714
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number59849
Policy instance 2
Insurance contract or identification number59849
Number of Individuals Covered369
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number613953
Policy instance 1
Insurance contract or identification number613953
Number of Individuals Covered772
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number59849
Policy instance 1
Insurance contract or identification number59849
Number of Individuals Covered527
Total amount of commissions paid to insurance brokerUSD $43,443
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration1
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
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,800
Insurance broker organization code?3
Insurance broker nameSTEFAN JACKSON
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number59849
Policy instance 1
Insurance contract or identification number59849
Number of Individuals Covered429
Total amount of commissions paid to insurance brokerUSD $34,300
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,858
Insurance broker organization code?3
Insurance broker nameNICHOLAS A OLIGNY
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number59849
Policy instance 1
Insurance contract or identification number59849
Number of Individuals Covered393
Total amount of commissions paid to insurance brokerUSD $34,813
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,882
Insurance broker organization code?3
Insurance broker nameERIN JOHNSON
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number59849
Policy instance 1
Insurance contract or identification number59849
Number of Individuals Covered347
Total amount of commissions paid to insurance brokerUSD $38,049
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $23
Insurance broker nameTIM MCDONALD
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number59849
Policy instance 1
Insurance contract or identification number59849
Number of Individuals Covered302
Total amount of commissions paid to insurance brokerUSD $13,520
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number59849
Policy instance 1
Insurance contract or identification number59849
Number of Individuals Covered248
Total amount of commissions paid to insurance brokerUSD $13,357
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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