401k Plan data: THE HEALTH CARE SERVICE CORPORATION THE REPRESENTED 401K PLAN plan

THE HEALTH CARE SERVICE CORPORATION THE REPRESENTED 401K PLAN 401k Plan overview

Plan Name	THE HEALTH CARE SERVICE CORPORATION THE REPRESENTED 401K PLAN
Plan identification number	003

THE HEALTH CARE SERVICE CORPORATION THE REPRESENTED 401K PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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

401k Sponsoring company profile

HEALTHCARE SERVICE CORPORATION has sponsored the creation of one or more 401k plans.

Company Name: HEALTHCARE SERVICE CORPORATION

Employer identification number (EIN): 361236610

NAIC Classification: 524140

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE HEALTH CARE SERVICE CORPORATION THE REPRESENTED 401K PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
003 2017-01-01 GENE GEORGE GENE GEORGE 2018-10-14
003 2016-01-01 GENE GEORGE GENE GEORGE 2017-10-12
003 2015-01-01 GENE GEORGE GENE GEORGE 2016-10-14
003 2014-01-01 GENE GEORGE GENE GEORGE 2015-10-12
003 2013-01-01 GENE GEORGE GENE GEORGE 2014-10-15
003 2012-01-01 GENE GEORGE GENE GEORGE 2013-10-12
003 2011-01-01 GENE GEORGE
003 2010-01-01 GENE GEORGE
003 2009-01-01 GENE GEORGE EX. DIR. TREASURY DIV. GENE GEORGE EX DIR. TREASURY DIV. 2010-10-13
003 2009-01-01 GENE GEORGE EX. DIR. TREASURY DIV. GENE GEORGE EX DIR. TREASURY DIV. 2010-10-13

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
003	2017-01-01	GENE GEORGE	GENE GEORGE	2018-10-14
003	2016-01-01	GENE GEORGE	GENE GEORGE	2017-10-12
003	2015-01-01	GENE GEORGE	GENE GEORGE	2016-10-14
003	2014-01-01	GENE GEORGE	GENE GEORGE	2015-10-12
003	2013-01-01	GENE GEORGE	GENE GEORGE	2014-10-15
003	2012-01-01	GENE GEORGE	GENE GEORGE	2013-10-12
003	2011-01-01	GENE GEORGE
003	2010-01-01	GENE GEORGE
003	2009-01-01	GENE GEORGE EX. DIR. TREASURY DIV.	GENE GEORGE EX DIR. TREASURY DIV.	2010-10-13
003	2009-01-01	GENE GEORGE EX. DIR. TREASURY DIV.	GENE GEORGE EX DIR. TREASURY DIV.	2010-10-13

Plan Statistics for THE HEALTH CARE SERVICE CORPORATION THE REPRESENTED 401K PLAN

401k plan membership statisitcs for THE HEALTH CARE SERVICE CORPORATION THE REPRESENTED 401K PLAN

Measure Date Value
2017: THE HEALTH CARE SERVICE CORPORATION THE REPRESENTED 401K PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 0
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 0
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 0
Total of all active and inactive participants 2017-01-01 0
Total participants 2017-01-01 0
2016: THE HEALTH CARE SERVICE CORPORATION THE REPRESENTED 401K PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 817
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 549
Number of retired or separated participants receiving benefits 2016-01-01 1
Number of other retired or separated participants entitled to future benefits 2016-01-01 166
Total of all active and inactive participants 2016-01-01 716
Total participants 2016-01-01 716
Number of participants with account balances 2016-01-01 716
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 8
2015: THE HEALTH CARE SERVICE CORPORATION THE REPRESENTED 401K PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 909
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 619
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 198
Total of all active and inactive participants 2015-01-01 817
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 817
Number of participants with account balances 2015-01-01 817
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 19
2014: THE HEALTH CARE SERVICE CORPORATION THE REPRESENTED 401K PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 914
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 723
Number of retired or separated participants receiving benefits 2014-01-01 1
Number of other retired or separated participants entitled to future benefits 2014-01-01 185
Total of all active and inactive participants 2014-01-01 909
Total participants 2014-01-01 909
Number of participants with account balances 2014-01-01 909
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: THE HEALTH CARE SERVICE CORPORATION THE REPRESENTED 401K PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 976
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 722
Number of retired or separated participants receiving benefits 2013-01-01 1
Number of other retired or separated participants entitled to future benefits 2013-01-01 191
Total of all active and inactive participants 2013-01-01 914
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 914
Number of participants with account balances 2013-01-01 914
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: THE HEALTH CARE SERVICE CORPORATION THE REPRESENTED 401K PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 1,194
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 976
Number of retired or separated participants receiving benefits 2012-01-01 1
Number of other retired or separated participants entitled to future benefits 2012-01-01 113
Total of all active and inactive participants 2012-01-01 1,090
Total participants 2012-01-01 1,090
Number of participants with account balances 2012-01-01 1,090
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 4
2011: THE HEALTH CARE SERVICE CORPORATION THE REPRESENTED 401K PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 1,319
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 1,087
Number of retired or separated participants receiving benefits 2011-01-01 1
Number of other retired or separated participants entitled to future benefits 2011-01-01 106
Total of all active and inactive participants 2011-01-01 1,194
Total participants 2011-01-01 1,194
Number of participants with account balances 2011-01-01 1,194
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 46
2010: THE HEALTH CARE SERVICE CORPORATION THE REPRESENTED 401K PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 1,399
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 1,236
Number of retired or separated participants receiving benefits 2010-01-01 2
Number of other retired or separated participants entitled to future benefits 2010-01-01 80
Total of all active and inactive participants 2010-01-01 1,318
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 1
Total participants 2010-01-01 1,319
Number of participants with account balances 2010-01-01 1,319
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 12
2009: THE HEALTH CARE SERVICE CORPORATION THE REPRESENTED 401K PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 1,424
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 1,281
Number of retired or separated participants receiving benefits 2009-01-01 2
Number of other retired or separated participants entitled to future benefits 2009-01-01 115
Total of all active and inactive participants 2009-01-01 1,398
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 1
Total participants 2009-01-01 1,399
Number of participants with account balances 2009-01-01 1,399
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 34

Measure	Date	Value
2017: THE HEALTH CARE SERVICE CORPORATION THE REPRESENTED 401K PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	0
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	0
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	0
Total of all active and inactive participants	2017-01-01	0
Total participants	2017-01-01	0
2016: THE HEALTH CARE SERVICE CORPORATION THE REPRESENTED 401K PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	817
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	549
Number of retired or separated participants receiving benefits	2016-01-01	1
Number of other retired or separated participants entitled to future benefits	2016-01-01	166
Total of all active and inactive participants	2016-01-01	716
Total participants	2016-01-01	716
Number of participants with account balances	2016-01-01	716
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	8
2015: THE HEALTH CARE SERVICE CORPORATION THE REPRESENTED 401K PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	909
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	619
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	198
Total of all active and inactive participants	2015-01-01	817
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	817
Number of participants with account balances	2015-01-01	817
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	19
2014: THE HEALTH CARE SERVICE CORPORATION THE REPRESENTED 401K PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	914
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	723
Number of retired or separated participants receiving benefits	2014-01-01	1
Number of other retired or separated participants entitled to future benefits	2014-01-01	185
Total of all active and inactive participants	2014-01-01	909
Total participants	2014-01-01	909
Number of participants with account balances	2014-01-01	909
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: THE HEALTH CARE SERVICE CORPORATION THE REPRESENTED 401K PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	976
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	722
Number of retired or separated participants receiving benefits	2013-01-01	1
Number of other retired or separated participants entitled to future benefits	2013-01-01	191
Total of all active and inactive participants	2013-01-01	914
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	914
Number of participants with account balances	2013-01-01	914
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: THE HEALTH CARE SERVICE CORPORATION THE REPRESENTED 401K PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	1,194
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	976
Number of retired or separated participants receiving benefits	2012-01-01	1
Number of other retired or separated participants entitled to future benefits	2012-01-01	113
Total of all active and inactive participants	2012-01-01	1,090
Total participants	2012-01-01	1,090
Number of participants with account balances	2012-01-01	1,090
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	4
2011: THE HEALTH CARE SERVICE CORPORATION THE REPRESENTED 401K PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	1,319
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	1,087
Number of retired or separated participants receiving benefits	2011-01-01	1
Number of other retired or separated participants entitled to future benefits	2011-01-01	106
Total of all active and inactive participants	2011-01-01	1,194
Total participants	2011-01-01	1,194
Number of participants with account balances	2011-01-01	1,194
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	46
2010: THE HEALTH CARE SERVICE CORPORATION THE REPRESENTED 401K PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	1,399
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	1,236
Number of retired or separated participants receiving benefits	2010-01-01	2
Number of other retired or separated participants entitled to future benefits	2010-01-01	80
Total of all active and inactive participants	2010-01-01	1,318
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	1
Total participants	2010-01-01	1,319
Number of participants with account balances	2010-01-01	1,319
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	12
2009: THE HEALTH CARE SERVICE CORPORATION THE REPRESENTED 401K PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	1,424
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	1,281
Number of retired or separated participants receiving benefits	2009-01-01	2
Number of other retired or separated participants entitled to future benefits	2009-01-01	115
Total of all active and inactive participants	2009-01-01	1,398
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	1
Total participants	2009-01-01	1,399
Number of participants with account balances	2009-01-01	1,399
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	34

Financial Data on THE HEALTH CARE SERVICE CORPORATION THE REPRESENTED 401K PLAN

Measure	Date	Value
2017 : THE HEALTH CARE SERVICE CORPORATION THE REPRESENTED 401K PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total transfer of assets from this plan	2017-12-31	$25,690,023
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$6,463,009
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$2,758,050
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$2,415,353
Expenses. Certain deemed distributions of participant loans	2017-12-31	$307,212
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$3,390,934
Value of total assets at end of year	2017-12-31	$0
Value of total assets at beginning of year	2017-12-31	$21,985,064
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$35,485
Total interest from all sources	2017-12-31	$45,414
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$59,400
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2017-12-31	$0
Administrative expenses professional fees incurred	2017-12-31	$35,485
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$30,000,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$1,295,661
Participant contributions at end of year	2017-12-31	$-1,320,174
Participant contributions at beginning of year	2017-12-31	$1,320,174
Assets. Other investments not covered elsewhere at end of year	2017-12-31	$15,110,666
Assets. Other investments not covered elsewhere at beginning of year	2017-12-31	$6,874,398
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$1,306,498
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2017-12-31	$1,326,697
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$3,704,959
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$21,985,064
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$-2,669,007
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$2,669,007
Value of interest in pooled separate accounts at end of year	2017-12-31	$-11,121,485
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$11,121,485
Interest on participant loans	2017-12-31	$45,414
Net investment gain/loss from pooled separate accounts	2017-12-31	$2,754,423
Net investment gain or loss from common/collective trusts	2017-12-31	$212,838
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$788,775
Income. Dividends from common stock	2017-12-31	$59,400
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$1,088,656
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2017-12-31	No
Did the plan have assets held for investment	2017-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	MITCHELL&TITUS
Accountancy firm EIN	2017-12-31	132781641
2016 : THE HEALTH CARE SERVICE CORPORATION THE REPRESENTED 401K PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$3,493,236
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$2,506,054
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$2,467,188
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$2,158,947
Value of total assets at end of year	2016-12-31	$21,985,064
Value of total assets at beginning of year	2016-12-31	$20,997,882
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$38,866
Total interest from all sources	2016-12-31	$40,730
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$57,529
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$57,529
Was this plan covered by a fidelity bond	2016-12-31	No
If this is an individual account plan, was there a blackout period	2016-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$1,318,652
Participant contributions at end of year	2016-12-31	$1,320,174
Participant contributions at beginning of year	2016-12-31	$1,244,383
Assets. Other investments not covered elsewhere at end of year	2016-12-31	$6,874,398
Assets. Other investments not covered elsewhere at beginning of year	2016-12-31	$6,889,039
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$32,679
Administrative expenses (other) incurred	2016-12-31	$32,966
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$987,182
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$21,985,064
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$20,997,882
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$2,669,007
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$2,353,798
Value of interest in pooled separate accounts at end of year	2016-12-31	$11,121,485
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$10,510,662
Interest on participant loans	2016-12-31	$40,730
Net investment gain/loss from pooled separate accounts	2016-12-31	$194,127
Net investment gain or loss from common/collective trusts	2016-12-31	$1,041,903
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$807,616
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$2,467,188
Contract administrator fees	2016-12-31	$5,900
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2016-12-31	No
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	Yes
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	MITCHELL&TITUS
Accountancy firm EIN	2016-12-31	132781641
2015 : THE HEALTH CARE SERVICE CORPORATION THE REPRESENTED 401K PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$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	$2,730,153
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$4,689,526
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$4,661,267
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$2,533,796
Value of total assets at end of year	2015-12-31	$20,997,882
Value of total assets at beginning of year	2015-12-31	$22,957,255
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$28,259
Total interest from all sources	2015-12-31	$41,855
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$52,906
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$52,906
Administrative expenses professional fees incurred	2015-12-31	$22,759
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$30,000,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$1,476,833
Participant contributions at end of year	2015-12-31	$1,244,383
Participant contributions at beginning of year	2015-12-31	$1,404,027
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$123,743
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$-1,959,373
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$20,997,882
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$22,957,255
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$2,353,798
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$2,636,723
Value of interest in pooled separate accounts at end of year	2015-12-31	$10,510,662
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$11,576,906
Interest on participant loans	2015-12-31	$41,855
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$6,889,039
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$7,339,599
Net investment gain/loss from pooled separate accounts	2015-12-31	$219,900
Net investment gain or loss from common/collective trusts	2015-12-31	$-118,304
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$933,220
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$4,661,267
Contract administrator fees	2015-12-31	$5,500
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2015-12-31	No
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	MITCHELL&TITUS
Accountancy firm EIN	2015-12-31	132781641
2014 : THE HEALTH CARE SERVICE CORPORATION THE REPRESENTED 401K PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$3,799,487
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$4,837,430
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$4,828,577
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$2,709,264
Value of total assets at end of year	2014-12-31	$22,957,255
Value of total assets at beginning of year	2014-12-31	$23,995,198
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$8,853
Total interest from all sources	2014-12-31	$47,488
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$56,798
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$56,798
Administrative expenses professional fees incurred	2014-12-31	$6,050
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$30,000,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$1,592,673
Participant contributions at end of year	2014-12-31	$1,404,027
Participant contributions at beginning of year	2014-12-31	$1,663,064
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$117,053
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$-1,037,943
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$22,957,255
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$23,995,198
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$2,636,723
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$2,682,519
Value of interest in pooled separate accounts at end of year	2014-12-31	$11,576,906
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$11,626,332
Interest on participant loans	2014-12-31	$47,488
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$7,339,599
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$8,023,283
Net investment gain/loss from pooled separate accounts	2014-12-31	$767,639
Net investment gain or loss from common/collective trusts	2014-12-31	$218,298
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$999,538
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$4,828,577
Contract administrator fees	2014-12-31	$2,803
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2014-12-31	No
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	MITCHELL&TITUS MEMBER ERNST&YOUNG
Accountancy firm EIN	2014-12-31	132781641
2013 : THE HEALTH CARE SERVICE CORPORATION THE REPRESENTED 401K PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$13,050,390
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$7,353,434
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$7,340,950
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$9,908,384
Value of total assets at end of year	2013-12-31	$23,995,198
Value of total assets at beginning of year	2013-12-31	$18,298,242
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$12,484
Total interest from all sources	2013-12-31	$46,991
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$42,412
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Administrative expenses professional fees incurred	2013-12-31	$4,884
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$300,000,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$1,578,902
Participant contributions at end of year	2013-12-31	$1,663,064
Participant contributions at beginning of year	2013-12-31	$1,249,857
Assets. Other investments not covered elsewhere at end of year	2013-12-31	$8,023,283
Assets. Other investments not covered elsewhere at beginning of year	2013-12-31	$9,257,979
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$7,364,227
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$5,696,956
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$23,995,198
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$18,298,242
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$2,682,519
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$1,592,878
Value of interest in pooled separate accounts at end of year	2013-12-31	$11,626,332
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$6,197,528
Interest on participant loans	2013-12-31	$46,991
Net investment gain/loss from pooled separate accounts	2013-12-31	$243,897
Net investment gain or loss from common/collective trusts	2013-12-31	$2,808,706
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$965,255
Income. Dividends from common stock	2013-12-31	$42,412
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$7,340,950
Contract administrator fees	2013-12-31	$7,600
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2013-12-31	No
Did the plan have assets held for investment	2013-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	MITCHELL & TITUS FBO E&Y
Accountancy firm EIN	2013-12-31	132781641
2012 : THE HEALTH CARE SERVICE CORPORATION THE REPRESENTED 401K PLAN 2012 401k financial data
Total income from all sources (including contributions)	2012-12-31	$3,355,979
Total of all expenses incurred	2012-12-31	$2,146,088
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$2,127,531
Expenses. Certain deemed distributions of participant loans	2012-12-31	$4,723
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$1,919,946
Value of total assets at end of year	2012-12-31	$18,298,242
Value of total assets at beginning of year	2012-12-31	$17,088,351
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$13,834
Total interest from all sources	2012-12-31	$36,877
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$34,549
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-12-31	$34,549
Administrative expenses professional fees incurred	2012-12-31	$3,827
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$30,000,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$1,198,254
Participant contributions at end of year	2012-12-31	$1,249,857
Participant contributions at beginning of year	2012-12-31	$1,159,205
Assets. Other investments not covered elsewhere at end of year	2012-12-31	$9,257,979
Assets. Other investments not covered elsewhere at beginning of year	2012-12-31	$9,229,814
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$82,864
Administrative expenses (other) incurred	2012-12-31	$3,307
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$1,209,891
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$18,298,242
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$17,088,351
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$1,592,878
Value of interest in pooled separate accounts at end of year	2012-12-31	$6,197,528
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$6,699,332
Interest on participant loans	2012-12-31	$36,877
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$251,174
Net investment gain/loss from pooled separate accounts	2012-12-31	$774,100
Net investment gain or loss from common/collective trusts	2012-12-31	$339,333
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$638,828
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$2,127,531
Contract administrator fees	2012-12-31	$6,700
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2012-12-31	No
Did the plan have assets held for investment	2012-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	MITCHELL&TITUS FBO E&Y
Accountancy firm EIN	2012-12-31	132781641
2011 : THE HEALTH CARE SERVICE CORPORATION THE REPRESENTED 401K PLAN 2011 401k financial data
Total income from all sources (including contributions)	2011-12-31	$2,375,674
Total of all expenses incurred	2011-12-31	$2,334,468
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$2,255,672
Expenses. Certain deemed distributions of participant loans	2011-12-31	$2,053
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$2,061,119
Value of total assets at end of year	2011-12-31	$17,088,351
Value of total assets at beginning of year	2011-12-31	$17,047,145
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$76,743
Total interest from all sources	2011-12-31	$37,644
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$31,036
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Administrative expenses professional fees incurred	2011-12-31	$76,743
Was this plan covered by a fidelity bond	2011-12-31	No
If this is an individual account plan, was there a blackout period	2011-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$1,315,005
Participant contributions at end of year	2011-12-31	$1,159,205
Participant contributions at beginning of year	2011-12-31	$1,170,476
Assets. Other investments not covered elsewhere at end of year	2011-12-31	$9,229,814
Assets. Other investments not covered elsewhere at beginning of year	2011-12-31	$8,947,566
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$31,956
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$41,206
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$17,088,351
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$17,047,145
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in pooled separate accounts at end of year	2011-12-31	$6,699,332
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$6,929,103
Interest on participant loans	2011-12-31	$39,587
Interest earned on other investments	2011-12-31	$-1,943
Net investment gain/loss from pooled separate accounts	2011-12-31	$-123,989
Net investment gain or loss from common/collective trusts	2011-12-31	$369,864
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$714,158
Income. Dividends from common stock	2011-12-31	$31,036
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$2,255,672
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2011-12-31	No
Did the plan have assets held for investment	2011-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	MITCHELL&TITUS MEMBER ERNST&YOUNG
Accountancy firm EIN	2011-12-31	132781641
2010 : THE HEALTH CARE SERVICE CORPORATION THE REPRESENTED 401K PLAN 2010 401k financial data
Total income from all sources (including contributions)	2010-12-31	$3,101,157
Total of all expenses incurred	2010-12-31	$1,993,948
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$1,961,467
Expenses. Certain deemed distributions of participant loans	2010-12-31	$3,082
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$1,818,876
Value of total assets at end of year	2010-12-31	$17,047,145
Value of total assets at beginning of year	2010-12-31	$15,939,936
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$29,399
Total interest from all sources	2010-12-31	$43,884
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$12,485
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Administrative expenses professional fees incurred	2010-12-31	$29,399
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$30,000,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$1,250,330
Participant contributions at end of year	2010-12-31	$1,170,476
Participant contributions at beginning of year	2010-12-31	$1,071,236
Assets. Other investments not covered elsewhere at end of year	2010-12-31	$8,947,566
Assets. Other investments not covered elsewhere at beginning of year	2010-12-31	$9,124,195
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$6,519
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$1,107,209
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$17,047,145
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$15,939,936
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in pooled separate accounts at end of year	2010-12-31	$6,929,103
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$5,744,505
Interest on participant loans	2010-12-31	$43,884
Net investment gain/loss from pooled separate accounts	2010-12-31	$842,629
Net investment gain or loss from common/collective trusts	2010-12-31	$383,283
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$562,027
Income. Dividends from common stock	2010-12-31	$12,485
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$1,961,467
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2010-12-31	No
Did the plan have assets held for investment	2010-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	ERNST & YOUNG LLP
Accountancy firm EIN	2010-12-31	346565596

Form 5500 Responses for THE HEALTH CARE SERVICE CORPORATION THE REPRESENTED 401K PLAN

2017: THE HEALTH CARE SERVICE CORPORATION THE REPRESENTED 401K PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	Yes
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: THE HEALTH CARE SERVICE CORPORATION THE REPRESENTED 401K PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	Yes
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: THE HEALTH CARE SERVICE CORPORATION THE REPRESENTED 401K PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	Yes
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: THE HEALTH CARE SERVICE CORPORATION THE REPRESENTED 401K PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	Yes
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: THE HEALTH CARE SERVICE CORPORATION THE REPRESENTED 401K PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	First time form 5500 has been submitted	Yes
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	Yes
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: THE HEALTH CARE SERVICE CORPORATION THE REPRESENTED 401K PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	Yes
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: THE HEALTH CARE SERVICE CORPORATION THE REPRESENTED 401K PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	Yes
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: THE HEALTH CARE SERVICE CORPORATION THE REPRESENTED 401K PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	Yes
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	Yes
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: THE HEALTH CARE SERVICE CORPORATION THE REPRESENTED 401K PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

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

Policy contract number

031576

Policy instance

Insurance contract or identification number	031576
Number of Individuals Covered	0
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No

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

Policy contract number

031576

Policy instance

Insurance contract or identification number	031576
Number of Individuals Covered	817
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

031576

Policy instance

Insurance contract or identification number	031576
Number of Individuals Covered	909
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

Policy instance

Number of Individuals Covered	914
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

Policy instance

Number of Individuals Covered	1090
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0

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

Policy contract number

66480

Policy instance

Insurance contract or identification number	66480
Number of Individuals Covered	1319
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0

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

Policy contract number

66480

Policy instance

Insurance contract or identification number	66480
Number of Individuals Covered	1319
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $26,131
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	HEALTHCARE SERVICE CORPORATION
Employer identification number (EIN):	361236610
NAIC Classification:	524140