401k Plan data: SHERIDAN COMMUNITY HOSPITAL 401K PLAN plan

SHERIDAN COMMUNITY HOSPITAL 401K PLAN 401k Plan overview

Plan Name	SHERIDAN COMMUNITY HOSPITAL 401K PLAN
Plan identification number	001

SHERIDAN COMMUNITY HOSPITAL 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 provides for automatic enrollment in plan that has employee contributions deducted from payroll.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
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.

401k Sponsoring company profile

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

Company Name: SHERIDAN COMMUNITY HOSPITAL

Employer identification number (EIN): 381369796

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SHERIDAN COMMUNITY HOSPITAL 401K PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01
001 2021-01-01
001 2020-01-01
001 2019-01-01
001 2018-01-01
001 2017-01-01 DENISE IDE
001 2016-01-01 DENISE IDE
001 2015-01-01 RANDOLPH FLECHSIG
001 2015-01-01 RANDOLPH FLECHSIG
001 2014-01-01 RANDOLPH FLECHSIG RANDOLPH FLECHSIG 2015-10-14
001 2013-01-01 RANDY FLECHSIG
001 2012-01-01 RANDY FLECHSIG
001 2011-01-01 LISA MARGARET MARTIN
001 2010-01-01 KEVIN J. CAWLEY
001 2009-01-01 KEVIN J. CAWLEY

Plan Statistics for SHERIDAN COMMUNITY HOSPITAL 401K PLAN

401k plan membership statisitcs for SHERIDAN COMMUNITY HOSPITAL 401K PLAN

Measure Date Value
2022: SHERIDAN COMMUNITY HOSPITAL 401K PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 156
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 133
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 67
Total of all active and inactive participants 2022-01-01 200
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 200
Number of participants with account balances 2022-01-01 120
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 6
2021: SHERIDAN COMMUNITY HOSPITAL 401K PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 170
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 81
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 75
Total of all active and inactive participants 2021-01-01 156
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 156
Number of participants with account balances 2021-01-01 129
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 13
2020: SHERIDAN COMMUNITY HOSPITAL 401K PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 164
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 110
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 60
Total of all active and inactive participants 2020-01-01 170
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 170
Number of participants with account balances 2020-01-01 131
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 5
2019: SHERIDAN COMMUNITY HOSPITAL 401K PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 175
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 105
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 59
Total of all active and inactive participants 2019-01-01 164
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 164
Number of participants with account balances 2019-01-01 129
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 1
2018: SHERIDAN COMMUNITY HOSPITAL 401K PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 206
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 125
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 50
Total of all active and inactive participants 2018-01-01 175
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 175
Number of participants with account balances 2018-01-01 133
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: SHERIDAN COMMUNITY HOSPITAL 401K PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 225
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 181
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 25
Total of all active and inactive participants 2017-01-01 206
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 206
Number of participants with account balances 2017-01-01 111
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: SHERIDAN COMMUNITY HOSPITAL 401K PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 238
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 198
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 36
Total of all active and inactive participants 2016-01-01 234
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 234
Number of participants with account balances 2016-01-01 136
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: SHERIDAN COMMUNITY HOSPITAL 401K PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 230
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 209
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 29
Total of all active and inactive participants 2015-01-01 238
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 238
Number of participants with account balances 2015-01-01 139
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: SHERIDAN COMMUNITY HOSPITAL 401K PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 220
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 224
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 22
Total of all active and inactive participants 2014-01-01 246
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 246
Number of participants with account balances 2014-01-01 159
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: SHERIDAN COMMUNITY HOSPITAL 401K PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 2,013
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 190
Number of retired or separated participants receiving benefits 2013-01-01 3
Number of other retired or separated participants entitled to future benefits 2013-01-01 27
Total of all active and inactive participants 2013-01-01 220
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 220
Number of participants with account balances 2013-01-01 154
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: SHERIDAN COMMUNITY HOSPITAL 401K PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 203
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 169
Number of retired or separated participants receiving benefits 2012-01-01 8
Number of other retired or separated participants entitled to future benefits 2012-01-01 28
Total of all active and inactive participants 2012-01-01 205
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 205
Number of participants with account balances 2012-01-01 163
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: SHERIDAN COMMUNITY HOSPITAL 401K PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 253
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 163
Number of retired or separated participants receiving benefits 2011-01-01 2
Number of other retired or separated participants entitled to future benefits 2011-01-01 38
Total of all active and inactive participants 2011-01-01 203
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 203
Number of participants with account balances 2011-01-01 161
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: SHERIDAN COMMUNITY HOSPITAL 401K PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 264
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 196
Number of retired or separated participants receiving benefits 2010-01-01 7
Number of other retired or separated participants entitled to future benefits 2010-01-01 49
Total of all active and inactive participants 2010-01-01 252
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 1
Total participants 2010-01-01 253
Number of participants with account balances 2010-01-01 175
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: SHERIDAN COMMUNITY HOSPITAL 401K PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 266
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 203
Number of retired or separated participants receiving benefits 2009-01-01 21
Number of other retired or separated participants entitled to future benefits 2009-01-01 40
Total of all active and inactive participants 2009-01-01 264
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 264
Number of participants with account balances 2009-01-01 186
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2022: SHERIDAN COMMUNITY HOSPITAL 401K PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	156
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	133
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	67
Total of all active and inactive participants	2022-01-01	200
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	200
Number of participants with account balances	2022-01-01	120
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	6
2021: SHERIDAN COMMUNITY HOSPITAL 401K PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	170
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	81
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	75
Total of all active and inactive participants	2021-01-01	156
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	156
Number of participants with account balances	2021-01-01	129
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	13
2020: SHERIDAN COMMUNITY HOSPITAL 401K PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	164
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	110
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	60
Total of all active and inactive participants	2020-01-01	170
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	170
Number of participants with account balances	2020-01-01	131
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	5
2019: SHERIDAN COMMUNITY HOSPITAL 401K PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	175
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	105
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	59
Total of all active and inactive participants	2019-01-01	164
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	164
Number of participants with account balances	2019-01-01	129
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	1
2018: SHERIDAN COMMUNITY HOSPITAL 401K PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	206
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	125
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	50
Total of all active and inactive participants	2018-01-01	175
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	175
Number of participants with account balances	2018-01-01	133
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: SHERIDAN COMMUNITY HOSPITAL 401K PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	225
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	181
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	25
Total of all active and inactive participants	2017-01-01	206
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	206
Number of participants with account balances	2017-01-01	111
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: SHERIDAN COMMUNITY HOSPITAL 401K PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	238
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	198
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	36
Total of all active and inactive participants	2016-01-01	234
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	234
Number of participants with account balances	2016-01-01	136
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: SHERIDAN COMMUNITY HOSPITAL 401K PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	230
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	209
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	29
Total of all active and inactive participants	2015-01-01	238
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	238
Number of participants with account balances	2015-01-01	139
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: SHERIDAN COMMUNITY HOSPITAL 401K PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	220
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	224
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	22
Total of all active and inactive participants	2014-01-01	246
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	246
Number of participants with account balances	2014-01-01	159
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: SHERIDAN COMMUNITY HOSPITAL 401K PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	2,013
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	190
Number of retired or separated participants receiving benefits	2013-01-01	3
Number of other retired or separated participants entitled to future benefits	2013-01-01	27
Total of all active and inactive participants	2013-01-01	220
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	220
Number of participants with account balances	2013-01-01	154
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: SHERIDAN COMMUNITY HOSPITAL 401K PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	203
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	169
Number of retired or separated participants receiving benefits	2012-01-01	8
Number of other retired or separated participants entitled to future benefits	2012-01-01	28
Total of all active and inactive participants	2012-01-01	205
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	205
Number of participants with account balances	2012-01-01	163
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: SHERIDAN COMMUNITY HOSPITAL 401K PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	253
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	163
Number of retired or separated participants receiving benefits	2011-01-01	2
Number of other retired or separated participants entitled to future benefits	2011-01-01	38
Total of all active and inactive participants	2011-01-01	203
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	203
Number of participants with account balances	2011-01-01	161
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: SHERIDAN COMMUNITY HOSPITAL 401K PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	264
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	196
Number of retired or separated participants receiving benefits	2010-01-01	7
Number of other retired or separated participants entitled to future benefits	2010-01-01	49
Total of all active and inactive participants	2010-01-01	252
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	1
Total participants	2010-01-01	253
Number of participants with account balances	2010-01-01	175
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: SHERIDAN COMMUNITY HOSPITAL 401K PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	266
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	203
Number of retired or separated participants receiving benefits	2009-01-01	21
Number of other retired or separated participants entitled to future benefits	2009-01-01	40
Total of all active and inactive participants	2009-01-01	264
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	264
Number of participants with account balances	2009-01-01	186
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on SHERIDAN COMMUNITY HOSPITAL 401K PLAN

Measure	Date	Value
2022 : SHERIDAN COMMUNITY HOSPITAL 401K PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$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	$-352,596
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$691,391
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$658,876
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$347,157
Value of total assets at end of year	2022-12-31	$3,188,068
Value of total assets at beginning of year	2022-12-31	$4,232,055
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$32,515
Total interest from all sources	2022-12-31	$108
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Assets. Real estate other than employer real property at end of year	2022-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2022-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2022-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2022-12-31	$0
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$500,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$230,949
Participant contributions at end of year	2022-12-31	$2,625
Participant contributions at beginning of year	2022-12-31	$2,673
Participant contributions at end of year	2022-12-31	$0
Participant contributions at beginning of year	2022-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2022-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2022-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$17,189
Value of other receiveables (less allowance for doubtful accounts) at end of year	2022-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2022-12-31	$0
Assets. Loans (other than to participants) at end of year	2022-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2022-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2022-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2022-12-31	$0
Liabilities. Value of operating payables at end of year	2022-12-31	$0
Liabilities. Value of operating payables at beginning of year	2022-12-31	$0
Total non interest bearing cash at end of year	2022-12-31	$0
Total non interest bearing cash at beginning of year	2022-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$-1,043,987
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$3,188,068
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$4,232,055
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Assets. partnership/joint venture interests at end of year	2022-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2022-12-31	$0
Investment advisory and management fees	2022-12-31	$4,200
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$0
Value of interest in pooled separate accounts at end of year	2022-12-31	$3,164,552
Value of interest in pooled separate accounts at beginning of year	2022-12-31	$4,222,513
Interest on participant loans	2022-12-31	$108
Value of interest in master investment trust accounts at end of year	2022-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2022-12-31	$0
Value of interest in common/collective trusts at end of year	2022-12-31	$0
Value of interest in common/collective trusts at beginning of year	2022-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2022-12-31	$10,724
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2022-12-31	$2,433
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2022-12-31	$2,433
Assets. Value of investments in 103.12 investment entities at end of year	2022-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2022-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$0
Asset value of US Government securities at end of year	2022-12-31	$0
Asset value of US Government securities at beginning of year	2022-12-31	$0
Net investment gain/loss from pooled separate accounts	2022-12-31	$-699,861
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Assets. Invements in employer securities at end of year	2022-12-31	$0
Assets. Invements in employer securities at beginning of year	2022-12-31	$0
Assets. Value of employer real property at end of year	2022-12-31	$0
Assets. Value of employer real property at beginning of year	2022-12-31	$0
Contributions received in cash from employer	2022-12-31	$99,019
Employer contributions (assets) at end of year	2022-12-31	$10,167
Employer contributions (assets) at beginning of year	2022-12-31	$4,436
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$658,876
Asset. Corporate debt instrument preferred debt at end of year	2022-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2022-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2022-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2022-12-31	$0
Contract administrator fees	2022-12-31	$28,315
Assets. Corporate common stocks other than exployer securities at end of year	2022-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2022-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2022-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2022-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2022-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2022-12-31	$0
Did the plan have assets held for investment	2022-12-31	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	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Liabilities. Value of acquisition indebtedness at end of year	2022-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2022-12-31	$0
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	BRICKLEY DELONG, PC
Accountancy firm EIN	2022-12-31	382088116
2021 : SHERIDAN COMMUNITY HOSPITAL 401K PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$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	$842,174
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$180,745
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$147,069
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$334,099
Value of total assets at end of year	2021-12-31	$4,232,055
Value of total assets at beginning of year	2021-12-31	$3,570,626
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$33,676
Total interest from all sources	2021-12-31	$141
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Assets. Real estate other than employer real property at end of year	2021-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2021-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2021-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2021-12-31	$0
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$224,398
Participant contributions at end of year	2021-12-31	$2,673
Participant contributions at beginning of year	2021-12-31	$4,513
Participant contributions at end of year	2021-12-31	$0
Participant contributions at beginning of year	2021-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2021-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2021-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$10,671
Value of other receiveables (less allowance for doubtful accounts) at end of year	2021-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2021-12-31	$0
Assets. Loans (other than to participants) at end of year	2021-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2021-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2021-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2021-12-31	$0
Liabilities. Value of operating payables at end of year	2021-12-31	$0
Liabilities. Value of operating payables at beginning of year	2021-12-31	$0
Total non interest bearing cash at end of year	2021-12-31	$0
Total non interest bearing cash at beginning of year	2021-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$661,429
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$4,232,055
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$3,570,626
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Assets. partnership/joint venture interests at end of year	2021-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2021-12-31	$0
Investment advisory and management fees	2021-12-31	$1,450
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$0
Value of interest in pooled separate accounts at end of year	2021-12-31	$4,222,513
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$3,559,171
Interest on participant loans	2021-12-31	$141
Value of interest in master investment trust accounts at end of year	2021-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2021-12-31	$0
Value of interest in common/collective trusts at end of year	2021-12-31	$0
Value of interest in common/collective trusts at beginning of year	2021-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2021-12-31	$2,433
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2021-12-31	$420
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2021-12-31	$420
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$0
Asset value of US Government securities at end of year	2021-12-31	$0
Asset value of US Government securities at beginning of year	2021-12-31	$0
Net investment gain/loss from pooled separate accounts	2021-12-31	$507,934
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Assets. Invements in employer securities at end of year	2021-12-31	$0
Assets. Invements in employer securities at beginning of year	2021-12-31	$0
Assets. Value of employer real property at end of year	2021-12-31	$0
Assets. Value of employer real property at beginning of year	2021-12-31	$0
Contributions received in cash from employer	2021-12-31	$99,030
Employer contributions (assets) at end of year	2021-12-31	$4,436
Employer contributions (assets) at beginning of year	2021-12-31	$6,522
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$147,069
Asset. Corporate debt instrument preferred debt at end of year	2021-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2021-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2021-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2021-12-31	$0
Contract administrator fees	2021-12-31	$32,226
Assets. Corporate common stocks other than exployer securities at end of year	2021-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2021-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2021-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2021-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2021-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2021-12-31	$0
Did the plan have assets held for investment	2021-12-31	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	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Liabilities. Value of acquisition indebtedness at end of year	2021-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2021-12-31	$0
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	BRICKLEY DELONG, PC
Accountancy firm EIN	2021-12-31	382088116
2020 : SHERIDAN COMMUNITY HOSPITAL 401K PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$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
Total income from all sources (including contributions)	2020-12-31	$799,728
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$534,126
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$505,559
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$248,983
Value of total assets at end of year	2020-12-31	$3,570,626
Value of total assets at beginning of year	2020-12-31	$3,305,024
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$28,567
Total interest from all sources	2020-12-31	$246
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Assets. Real estate other than employer real property at end of year	2020-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2020-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2020-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2020-12-31	$0
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$153,424
Participant contributions at end of year	2020-12-31	$4,513
Participant contributions at beginning of year	2020-12-31	$7,061
Participant contributions at end of year	2020-12-31	$0
Participant contributions at beginning of year	2020-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2020-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2020-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$9,486
Value of other receiveables (less allowance for doubtful accounts) at end of year	2020-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2020-12-31	$0
Assets. Loans (other than to participants) at end of year	2020-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2020-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2020-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2020-12-31	$0
Liabilities. Value of operating payables at end of year	2020-12-31	$0
Liabilities. Value of operating payables at beginning of year	2020-12-31	$0
Total non interest bearing cash at end of year	2020-12-31	$0
Total non interest bearing cash at beginning of year	2020-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$265,602
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$3,570,626
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$3,305,024
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Assets. partnership/joint venture interests at end of year	2020-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2020-12-31	$0
Investment advisory and management fees	2020-12-31	$2,625
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$0
Value of interest in pooled separate accounts at end of year	2020-12-31	$3,559,171
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$3,296,539
Interest on participant loans	2020-12-31	$246
Value of interest in master investment trust accounts at end of year	2020-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2020-12-31	$0
Value of interest in common/collective trusts at end of year	2020-12-31	$0
Value of interest in common/collective trusts at beginning of year	2020-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2020-12-31	$420
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2020-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2020-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$0
Asset value of US Government securities at end of year	2020-12-31	$0
Asset value of US Government securities at beginning of year	2020-12-31	$0
Net investment gain/loss from pooled separate accounts	2020-12-31	$550,499
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Assets. Invements in employer securities at end of year	2020-12-31	$0
Assets. Invements in employer securities at beginning of year	2020-12-31	$0
Assets. Value of employer real property at end of year	2020-12-31	$0
Assets. Value of employer real property at beginning of year	2020-12-31	$0
Contributions received in cash from employer	2020-12-31	$86,073
Employer contributions (assets) at end of year	2020-12-31	$6,522
Employer contributions (assets) at beginning of year	2020-12-31	$1,424
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$505,559
Asset. Corporate debt instrument preferred debt at end of year	2020-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2020-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2020-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2020-12-31	$0
Contract administrator fees	2020-12-31	$25,942
Assets. Corporate common stocks other than exployer securities at end of year	2020-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2020-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2020-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2020-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2020-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2020-12-31	$0
Did the plan have assets held for investment	2020-12-31	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	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Liabilities. Value of acquisition indebtedness at end of year	2020-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2020-12-31	$0
Opinion of an independent qualified public accountant for this plan	2020-12-31	Unqualified
Accountancy firm name	2020-12-31	BRICKLEY DELONG, PC
Accountancy firm EIN	2020-12-31	382088116
2019 : SHERIDAN COMMUNITY HOSPITAL 401K PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	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 income from all sources (including contributions)	2019-12-31	$1,061,421
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$1,506,546
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$1,476,548
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$311,884
Value of total assets at end of year	2019-12-31	$3,305,024
Value of total assets at beginning of year	2019-12-31	$3,750,149
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$29,998
Total interest from all sources	2019-12-31	$1,132
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Assets. Real estate other than employer real property at end of year	2019-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2019-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2019-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2019-12-31	$0
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$197,274
Participant contributions at end of year	2019-12-31	$7,061
Participant contributions at beginning of year	2019-12-31	$32,745
Participant contributions at end of year	2019-12-31	$0
Participant contributions at beginning of year	2019-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2019-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2019-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$1,303
Value of other receiveables (less allowance for doubtful accounts) at end of year	2019-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2019-12-31	$0
Assets. Loans (other than to participants) at end of year	2019-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2019-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2019-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2019-12-31	$0
Liabilities. Value of operating payables at end of year	2019-12-31	$0
Liabilities. Value of operating payables at beginning of year	2019-12-31	$0
Total non interest bearing cash at end of year	2019-12-31	$0
Total non interest bearing cash at beginning of year	2019-12-31	$10,940
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$-445,125
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$3,305,024
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$3,750,149
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Assets. partnership/joint venture interests at end of year	2019-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2019-12-31	$0
Investment advisory and management fees	2019-12-31	$500
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$0
Value of interest in pooled separate accounts at end of year	2019-12-31	$3,296,539
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$3,706,464
Income. Interest from loans (other than to participants)	2019-12-31	$1,132
Value of interest in master investment trust accounts at end of year	2019-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2019-12-31	$0
Value of interest in common/collective trusts at end of year	2019-12-31	$0
Value of interest in common/collective trusts at beginning of year	2019-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2019-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2019-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2019-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$0
Asset value of US Government securities at end of year	2019-12-31	$0
Asset value of US Government securities at beginning of year	2019-12-31	$0
Net investment gain/loss from pooled separate accounts	2019-12-31	$748,405
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Assets. Invements in employer securities at end of year	2019-12-31	$0
Assets. Invements in employer securities at beginning of year	2019-12-31	$0
Assets. Value of employer real property at end of year	2019-12-31	$0
Assets. Value of employer real property at beginning of year	2019-12-31	$0
Contributions received in cash from employer	2019-12-31	$113,307
Employer contributions (assets) at end of year	2019-12-31	$1,424
Employer contributions (assets) at beginning of year	2019-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$1,476,548
Asset. Corporate debt instrument preferred debt at end of year	2019-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2019-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2019-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2019-12-31	$0
Contract administrator fees	2019-12-31	$29,498
Assets. Corporate common stocks other than exployer securities at end of year	2019-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2019-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2019-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2019-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2019-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2019-12-31	$0
Did the plan have assets held for investment	2019-12-31	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	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Liabilities. Value of acquisition indebtedness at end of year	2019-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2019-12-31	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	BRICKLEY DELONG, PC
Accountancy firm EIN	2019-12-31	382088116
2018 : SHERIDAN COMMUNITY HOSPITAL 401K PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$224,044
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$616,210
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$580,956
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$543,087
Value of total assets at end of year	2018-12-31	$3,750,149
Value of total assets at beginning of year	2018-12-31	$4,142,315
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$35,254
Total interest from all sources	2018-12-31	$1,641
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Assets. Real estate other than employer real property at end of year	2018-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2018-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2018-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2018-12-31	$0
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$500,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$387,318
Participant contributions at end of year	2018-12-31	$32,745
Participant contributions at beginning of year	2018-12-31	$51,417
Participant contributions at end of year	2018-12-31	$0
Participant contributions at beginning of year	2018-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2018-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2018-12-31	$28,620
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$10,940
Value of other receiveables (less allowance for doubtful accounts) at end of year	2018-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2018-12-31	$0
Assets. Loans (other than to participants) at end of year	2018-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2018-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2018-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2018-12-31	$0
Liabilities. Value of operating payables at end of year	2018-12-31	$0
Liabilities. Value of operating payables at beginning of year	2018-12-31	$0
Total non interest bearing cash at end of year	2018-12-31	$10,940
Total non interest bearing cash at beginning of year	2018-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$-392,166
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$3,750,149
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$4,142,315
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Assets. partnership/joint venture interests at end of year	2018-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2018-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$3,524,961
Value of interest in pooled separate accounts at end of year	2018-12-31	$3,706,464
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$0
Interest on participant loans	2018-12-31	$1,641
Value of interest in master investment trust accounts at end of year	2018-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2018-12-31	$0
Value of interest in common/collective trusts at end of year	2018-12-31	$0
Value of interest in common/collective trusts at beginning of year	2018-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2018-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2018-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2018-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$537,317
Asset value of US Government securities at end of year	2018-12-31	$0
Asset value of US Government securities at beginning of year	2018-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-320,684
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Assets. Invements in employer securities at end of year	2018-12-31	$0
Assets. Invements in employer securities at beginning of year	2018-12-31	$0
Assets. Value of employer real property at end of year	2018-12-31	$0
Assets. Value of employer real property at beginning of year	2018-12-31	$0
Contributions received in cash from employer	2018-12-31	$144,829
Employer contributions (assets) at end of year	2018-12-31	$0
Employer contributions (assets) at beginning of year	2018-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$580,956
Asset. Corporate debt instrument preferred debt at end of year	2018-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2018-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2018-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2018-12-31	$0
Contract administrator fees	2018-12-31	$35,254
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	2018-12-31	No
Assets. Corporate common stocks other than exployer securities at end of year	2018-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2018-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2018-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2018-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2018-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2018-12-31	$0
Did the plan have assets held for investment	2018-12-31	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	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Liabilities. Value of acquisition indebtedness at end of year	2018-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2018-12-31	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	WIPFLI, LLP
Accountancy firm EIN	2018-12-31	390758449
2017 : SHERIDAN COMMUNITY HOSPITAL 401K PLAN 2017 401k financial data
Unrealized appreciation/depreciation of real estate assets	2017-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2017-12-31	$0
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total transfer of assets to this plan	2017-12-31	$0
Total transfer of assets from this plan	2017-12-31	$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 paid	2017-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$837,137
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$440,333
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$398,388
Expenses. Certain deemed distributions of participant loans	2017-12-31	$0
Value of total corrective distributions	2017-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$415,224
Value of total assets at end of year	2017-12-31	$4,142,315
Value of total assets at beginning of year	2017-12-31	$3,745,511
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$41,945
Total income from rents	2017-12-31	$0
Total interest from all sources	2017-12-31	$7,888
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$0
Assets. Real estate other than employer real property at end of year	2017-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2017-12-31	$0
Administrative expenses professional fees incurred	2017-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2017-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2017-12-31	$0
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$226,451
Participant contributions at end of year	2017-12-31	$51,417
Participant contributions at beginning of year	2017-12-31	$49,847
Participant contributions at end of year	2017-12-31	$0
Participant contributions at beginning of year	2017-12-31	$7,125
Assets. Other investments not covered elsewhere at end of year	2017-12-31	$28,620
Assets. Other investments not covered elsewhere at beginning of year	2017-12-31	$14,688
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$66,288
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2017-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2017-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2017-12-31	$0
Assets. Loans (other than to participants) at end of year	2017-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2017-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2017-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2017-12-31	$0
Other income not declared elsewhere	2017-12-31	$2,795
Administrative expenses (other) incurred	2017-12-31	$0
Liabilities. Value of operating payables at end of year	2017-12-31	$0
Liabilities. Value of operating payables at beginning of year	2017-12-31	$0
Total non interest bearing cash at end of year	2017-12-31	$0
Total non interest bearing cash at beginning of year	2017-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Income. Non cash contributions	2017-12-31	$0
Value of net income/loss	2017-12-31	$396,804
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$4,142,315
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$3,745,511
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
Assets. partnership/joint venture interests at end of year	2017-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2017-12-31	$0
Investment advisory and management fees	2017-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$3,524,961
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$3,069,670
Value of interest in pooled separate accounts at end of year	2017-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$0
Interest on participant loans	2017-12-31	$2,145
Income. Interest from loans (other than to participants)	2017-12-31	$0
Interest earned on other investments	2017-12-31	$5,743
Income. Interest from US Government securities	2017-12-31	$0
Income. Interest from corporate debt instruments	2017-12-31	$0
Value of interest in master investment trust accounts at end of year	2017-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2017-12-31	$0
Value of interest in common/collective trusts at end of year	2017-12-31	$0
Value of interest in common/collective trusts at beginning of year	2017-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2017-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2017-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2017-12-31	$0
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 year	2017-12-31	$537,317
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$598,976
Expenses. Payments to insurance carriers foe the provision of benefits	2017-12-31	$0
Asset value of US Government securities at end of year	2017-12-31	$0
Asset value of US Government securities at beginning of year	2017-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$411,230
Net investment gain/loss from pooled separate accounts	2017-12-31	$0
Net investment gain or loss from common/collective trusts	2017-12-31	$0
Net gain/loss from 103.12 investment entities	2017-12-31	$0
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
Assets. Invements in employer securities at end of year	2017-12-31	$0
Assets. Invements in employer securities at beginning of year	2017-12-31	$0
Assets. Value of employer real property at end of year	2017-12-31	$0
Assets. Value of employer real property at beginning of year	2017-12-31	$0
Contributions received in cash from employer	2017-12-31	$122,485
Employer contributions (assets) at end of year	2017-12-31	$0
Employer contributions (assets) at beginning of year	2017-12-31	$5,205
Income. Dividends from preferred stock	2017-12-31	$0
Income. Dividends from common stock	2017-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$398,388
Asset. Corporate debt instrument preferred debt at end of year	2017-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2017-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2017-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2017-12-31	$0
Contract administrator fees	2017-12-31	$41,945
Assets. Corporate common stocks other than exployer securities at end of year	2017-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2017-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2017-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2017-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2017-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2017-12-31	$0
Did the plan have assets held for investment	2017-12-31	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	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	No
Aggregate proceeds on sale of assets	2017-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2017-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2017-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2017-12-31	$0
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	WIPFLI, LLP
Accountancy firm EIN	2017-12-31	390758449
2016 : SHERIDAN COMMUNITY HOSPITAL 401K PLAN 2016 401k financial data
Unrealized appreciation/depreciation of real estate assets	2016-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2016-12-31	$0
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total transfer of assets to this plan	2016-12-31	$0
Total transfer of assets from this plan	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
Expenses. Interest paid	2016-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$652,662
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$865,114
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$825,871
Expenses. Certain deemed distributions of participant loans	2016-12-31	$0
Value of total corrective distributions	2016-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$428,014
Value of total assets at end of year	2016-12-31	$3,745,511
Value of total assets at beginning of year	2016-12-31	$3,957,963
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$39,243
Total income from rents	2016-12-31	$0
Total interest from all sources	2016-12-31	$10,341
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$0
Assets. Real estate other than employer real property at end of year	2016-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2016-12-31	$0
Administrative expenses professional fees incurred	2016-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2016-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2016-12-31	$0
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$217,710
Participant contributions at end of year	2016-12-31	$49,847
Participant contributions at beginning of year	2016-12-31	$60,752
Participant contributions at end of year	2016-12-31	$7,125
Participant contributions at beginning of year	2016-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2016-12-31	$14,688
Assets. Other investments not covered elsewhere at beginning of year	2016-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$90,641
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 year	2016-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2016-12-31	$0
Assets. Loans (other than to participants) at end of year	2016-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2016-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2016-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2016-12-31	$0
Other income not declared elsewhere	2016-12-31	$914
Administrative expenses (other) incurred	2016-12-31	$0
Liabilities. Value of operating payables at end of year	2016-12-31	$0
Liabilities. Value of operating payables at beginning of year	2016-12-31	$0
Total non interest bearing cash at end of year	2016-12-31	$0
Total non interest bearing cash at beginning of year	2016-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Income. Non cash contributions	2016-12-31	$0
Value of net income/loss	2016-12-31	$-212,452
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$3,745,511
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$3,957,963
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
Assets. partnership/joint venture interests at end of year	2016-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2016-12-31	$0
Investment advisory and management fees	2016-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$3,069,670
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$3,177,809
Value of interest in pooled separate accounts at end of year	2016-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$0
Interest on participant loans	2016-12-31	$2,302
Income. Interest from loans (other than to participants)	2016-12-31	$0
Interest earned on other investments	2016-12-31	$8,039
Income. Interest from US Government securities	2016-12-31	$0
Income. Interest from corporate debt instruments	2016-12-31	$0
Value of interest in master investment trust accounts at end of year	2016-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2016-12-31	$0
Value of interest in common/collective trusts at end of year	2016-12-31	$0
Value of interest in common/collective trusts at beginning of year	2016-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2016-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2016-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2016-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2016-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$598,976
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$707,043
Expenses. Payments to insurance carriers foe the provision of benefits	2016-12-31	$0
Asset value of US Government securities at end of year	2016-12-31	$0
Asset value of US Government securities at beginning of year	2016-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$213,393
Net investment gain/loss from pooled separate accounts	2016-12-31	$0
Net investment gain or loss from common/collective trusts	2016-12-31	$0
Net gain/loss from 103.12 investment entities	2016-12-31	$0
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
Assets. Invements in employer securities at end of year	2016-12-31	$0
Assets. Invements in employer securities at beginning of year	2016-12-31	$0
Assets. Value of employer real property at end of year	2016-12-31	$0
Assets. Value of employer real property at beginning of year	2016-12-31	$0
Contributions received in cash from employer	2016-12-31	$119,663
Employer contributions (assets) at end of year	2016-12-31	$5,205
Employer contributions (assets) at beginning of year	2016-12-31	$12,359
Income. Dividends from preferred stock	2016-12-31	$0
Income. Dividends from common stock	2016-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$825,871
Asset. Corporate debt instrument preferred debt at end of year	2016-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2016-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2016-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2016-12-31	$0
Contract administrator fees	2016-12-31	$39,243
Assets. Corporate common stocks other than exployer securities at end of year	2016-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2016-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2016-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2016-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2016-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2016-12-31	$0
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Aggregate proceeds on sale of assets	2016-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2016-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2016-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2016-12-31	$0
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	WIPFLI, LLP
Accountancy firm EIN	2016-12-31	390758449
2015 : SHERIDAN COMMUNITY HOSPITAL 401K PLAN 2015 401k financial data
Unrealized appreciation/depreciation of real estate assets	2015-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2015-12-31	$0
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total transfer of assets to this plan	2015-12-31	$0
Total transfer of assets from this plan	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
Expenses. Interest paid	2015-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$500,163
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$946,572
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$905,823
Expenses. Certain deemed distributions of participant loans	2015-12-31	$0
Value of total corrective distributions	2015-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$536,624
Value of total assets at end of year	2015-12-31	$3,957,963
Value of total assets at beginning of year	2015-12-31	$4,404,372
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$40,749
Total income from rents	2015-12-31	$0
Total interest from all sources	2015-12-31	$10,256
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 year	2015-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$0
Assets. Real estate other than employer real property at end of year	2015-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2015-12-31	$0
Administrative expenses professional fees incurred	2015-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2015-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2015-12-31	$0
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$500,000
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	$271,202
Participant contributions at end of year	2015-12-31	$60,752
Participant contributions at beginning of year	2015-12-31	$102,376
Participant contributions at end of year	2015-12-31	$0
Participant contributions at beginning of year	2015-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2015-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2015-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$127,876
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2015-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2015-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2015-12-31	$0
Assets. Loans (other than to participants) at end of year	2015-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2015-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2015-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2015-12-31	$0
Other income not declared elsewhere	2015-12-31	$0
Administrative expenses (other) incurred	2015-12-31	$0
Liabilities. Value of operating payables at end of year	2015-12-31	$0
Liabilities. Value of operating payables at beginning of year	2015-12-31	$0
Total non interest bearing cash at end of year	2015-12-31	$0
Total non interest bearing cash at beginning of year	2015-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Income. Non cash contributions	2015-12-31	$0
Value of net income/loss	2015-12-31	$-446,409
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$3,957,963
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$4,404,372
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
Assets. partnership/joint venture interests at end of year	2015-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2015-12-31	$0
Investment advisory and management fees	2015-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$3,177,809
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$3,420,514
Value of interest in pooled separate accounts at end of year	2015-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$0
Interest on participant loans	2015-12-31	$2,782
Income. Interest from loans (other than to participants)	2015-12-31	$0
Interest earned on other investments	2015-12-31	$7,474
Income. Interest from US Government securities	2015-12-31	$0
Income. Interest from corporate debt instruments	2015-12-31	$0
Value of interest in master investment trust accounts at end of year	2015-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2015-12-31	$0
Value of interest in common/collective trusts at end of year	2015-12-31	$0
Value of interest in common/collective trusts at beginning of year	2015-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2015-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2015-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2015-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2015-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$707,043
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$881,482
Expenses. Payments to insurance carriers foe the provision of benefits	2015-12-31	$0
Asset value of US Government securities at end of year	2015-12-31	$0
Asset value of US Government securities at beginning of year	2015-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-46,717
Net investment gain/loss from pooled separate accounts	2015-12-31	$0
Net investment gain or loss from common/collective trusts	2015-12-31	$0
Net gain/loss from 103.12 investment entities	2015-12-31	$0
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
Assets. Invements in employer securities at end of year	2015-12-31	$0
Assets. Invements in employer securities at beginning of year	2015-12-31	$0
Assets. Value of employer real property at end of year	2015-12-31	$0
Assets. Value of employer real property at beginning of year	2015-12-31	$0
Contributions received in cash from employer	2015-12-31	$137,546
Employer contributions (assets) at end of year	2015-12-31	$12,359
Employer contributions (assets) at beginning of year	2015-12-31	$0
Income. Dividends from preferred stock	2015-12-31	$0
Income. Dividends from common stock	2015-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$905,823
Asset. Corporate debt instrument preferred debt at end of year	2015-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2015-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2015-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2015-12-31	$0
Contract administrator fees	2015-12-31	$40,749
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	Yes
Assets. Corporate common stocks other than exployer securities at end of year	2015-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2015-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2015-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2015-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2015-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2015-12-31	$0
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
Aggregate proceeds on sale of assets	2015-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2015-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2015-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2015-12-31	$0
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	WIPFLI, LLP
Accountancy firm EIN	2015-12-31	390758449
2014 : SHERIDAN COMMUNITY HOSPITAL 401K PLAN 2014 401k financial data
Unrealized appreciation/depreciation of real estate assets	2014-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2014-12-31	$0
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total transfer of assets to this plan	2014-12-31	$0
Total transfer of assets from this plan	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	$680
Expenses. Interest paid	2014-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$897,444
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$1,413,018
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$1,336,506
Expenses. Certain deemed distributions of participant loans	2014-12-31	$0
Value of total corrective distributions	2014-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$725,738
Value of total assets at end of year	2014-12-31	$4,404,372
Value of total assets at beginning of year	2014-12-31	$4,920,626
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$76,512
Total income from rents	2014-12-31	$0
Total interest from all sources	2014-12-31	$29,503
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$0
Assets. Real estate other than employer real property at end of year	2014-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2014-12-31	$0
Administrative expenses professional fees incurred	2014-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2014-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2014-12-31	$0
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$1,000
If this is an individual account plan, was there a blackout period	2014-12-31	Yes
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	$273,957
Participant contributions at end of year	2014-12-31	$102,376
Participant contributions at beginning of year	2014-12-31	$64,758
Participant contributions at end of year	2014-12-31	$0
Participant contributions at beginning of year	2014-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2014-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2014-12-31	$3,168
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$379,368
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2014-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2014-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2014-12-31	$0
Assets. Loans (other than to participants) at end of year	2014-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2014-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2014-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2014-12-31	$680
Other income not declared elsewhere	2014-12-31	$0
Administrative expenses (other) incurred	2014-12-31	$0
Liabilities. Value of operating payables at end of year	2014-12-31	$0
Liabilities. Value of operating payables at beginning of year	2014-12-31	$0
Total non interest bearing cash at end of year	2014-12-31	$0
Total non interest bearing cash at beginning of year	2014-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Income. Non cash contributions	2014-12-31	$0
Value of net income/loss	2014-12-31	$-515,574
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$4,404,372
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$4,919,946
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
Assets. partnership/joint venture interests at end of year	2014-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2014-12-31	$0
Investment advisory and management fees	2014-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$3,420,514
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$944,102
Value of interest in pooled separate accounts at end of year	2014-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$0
Interest on participant loans	2014-12-31	$3,791
Income. Interest from loans (other than to participants)	2014-12-31	$0
Interest earned on other investments	2014-12-31	$25,712
Income. Interest from US Government securities	2014-12-31	$0
Income. Interest from corporate debt instruments	2014-12-31	$0
Value of interest in master investment trust accounts at end of year	2014-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2014-12-31	$0
Value of interest in common/collective trusts at end of year	2014-12-31	$0
Value of interest in common/collective trusts at beginning of year	2014-12-31	$2,572,871
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2014-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2014-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2014-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2014-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$881,482
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$1,335,727
Expenses. Payments to insurance carriers foe the provision of benefits	2014-12-31	$0
Asset value of US Government securities at end of year	2014-12-31	$0
Asset value of US Government securities at beginning of year	2014-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$142,203
Net investment gain/loss from pooled separate accounts	2014-12-31	$0
Net investment gain or loss from common/collective trusts	2014-12-31	$0
Net gain/loss from 103.12 investment entities	2014-12-31	$0
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
Assets. Invements in employer securities at end of year	2014-12-31	$0
Assets. Invements in employer securities at beginning of year	2014-12-31	$0
Assets. Value of employer real property at end of year	2014-12-31	$0
Assets. Value of employer real property at beginning of year	2014-12-31	$0
Contributions received in cash from employer	2014-12-31	$72,413
Employer contributions (assets) at end of year	2014-12-31	$0
Employer contributions (assets) at beginning of year	2014-12-31	$0
Income. Dividends from preferred stock	2014-12-31	$0
Income. Dividends from common stock	2014-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$1,336,506
Asset. Corporate debt instrument preferred debt at end of year	2014-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2014-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2014-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2014-12-31	$0
Contract administrator fees	2014-12-31	$76,512
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	Yes
Assets. Corporate common stocks other than exployer securities at end of year	2014-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2014-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2014-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2014-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2014-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2014-12-31	$0
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
Aggregate proceeds on sale of assets	2014-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2014-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2014-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2014-12-31	$0
2013 : SHERIDAN COMMUNITY HOSPITAL 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	$680
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	$873,972
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$598,609
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$569,595
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$366,767
Value of total assets at end of year	2013-12-31	$4,920,626
Value of total assets at beginning of year	2013-12-31	$4,644,583
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$29,014
Total interest from all sources	2013-12-31	$47,723
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$43,542
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-12-31	$43,542
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$500,000
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	$281,490
Participant contributions at end of year	2013-12-31	$64,758
Participant contributions at beginning of year	2013-12-31	$63,191
Assets. Other investments not covered elsewhere at end of year	2013-12-31	$3,168
Assets. Other investments not covered elsewhere at beginning of year	2013-12-31	$636
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$20,339
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2013-12-31	$680
Administrative expenses (other) incurred	2013-12-31	$9,509
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	$275,363
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$4,919,946
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$4,644,583
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
Investment advisory and management fees	2013-12-31	$19,505
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$944,102
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$1,014,598
Interest on participant loans	2013-12-31	$2,211
Value of interest in common/collective trusts at end of year	2013-12-31	$2,572,871
Value of interest in common/collective trusts at beginning of year	2013-12-31	$2,248,949
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2013-12-31	$45,512
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$1,335,727
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$1,317,209
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$73,150
Net investment gain or loss from common/collective trusts	2013-12-31	$342,790
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	$64,938
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$569,595
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	No
Opinion of an independent qualified public accountant for this plan	2013-12-31	Unqualified
Accountancy firm name	2013-12-31	PLANTE & MORAN, PLLC
Accountancy firm EIN	2013-12-31	381357951
2012 : SHERIDAN COMMUNITY HOSPITAL 401K PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$748,586
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$377,895
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$355,407
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$384,060
Value of total assets at end of year	2012-12-31	$4,644,583
Value of total assets at beginning of year	2012-12-31	$4,273,892
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$22,488
Total interest from all sources	2012-12-31	$48,617
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$34,067
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	$34,067
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$500,000
If this is an individual account plan, was there a blackout period	2012-12-31	Yes
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$311,148
Participant contributions at end of year	2012-12-31	$63,191
Participant contributions at beginning of year	2012-12-31	$77,613
Participant contributions at beginning of year	2012-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2012-12-31	$636
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$10,119
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2012-12-31	$0
Administrative expenses (other) incurred	2012-12-31	$2
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	$370,691
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$4,644,583
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$4,273,892
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
Investment advisory and management fees	2012-12-31	$18,676
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$1,014,598
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$836,989
Interest on participant loans	2012-12-31	$2,781
Interest earned on other investments	2012-12-31	$45,836
Value of interest in common/collective trusts at end of year	2012-12-31	$2,248,949
Value of interest in common/collective trusts at beginning of year	2012-12-31	$2,001,527
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$1,317,209
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$1,357,763
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$283,351
Net investment gain or loss from common/collective trusts	2012-12-31	$-1,509
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	$62,793
Employer contributions (assets) at beginning of year	2012-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$355,407
Contract administrator fees	2012-12-31	$3,810
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	Yes
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	No
Opinion of an independent qualified public accountant for this plan	2012-12-31	Unqualified
Accountancy firm name	2012-12-31	PLANTE & MORAN, PLLC
Accountancy firm EIN	2012-12-31	381357951
2011 : SHERIDAN COMMUNITY HOSPITAL 401K PLAN 2011 401k financial data
Total income from all sources (including contributions)	2011-12-31	$481,716
Total of all expenses incurred	2011-12-31	$219,227
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$199,347
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$470,026
Value of total assets at end of year	2011-12-31	$4,273,892
Value of total assets at beginning of year	2011-12-31	$4,011,403
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$19,880
Total interest from all sources	2011-12-31	$52,955
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$23,791
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2011-12-31	$23,791
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$500,000
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	$300,463
Participant contributions at end of year	2011-12-31	$77,613
Participant contributions at beginning of year	2011-12-31	$73,243
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$104,183
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-12-31	$2,705
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
Income. Non cash contributions	2011-12-31	$0
Value of net income/loss	2011-12-31	$262,489
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$4,273,892
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$4,011,403
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
Investment advisory and management fees	2011-12-31	$17,400
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$836,989
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$730,318
Interest on participant loans	2011-12-31	$4,372
Interest earned on other investments	2011-12-31	$48,583
Value of interest in common/collective trusts at end of year	2011-12-31	$2,001,527
Value of interest in common/collective trusts at beginning of year	2011-12-31	$1,787,704
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$1,357,763
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$1,417,377
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-33,490
Net investment gain or loss from common/collective trusts	2011-12-31	$-31,566
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	$65,380
Employer contributions (assets) at end of year	2011-12-31	$0
Employer contributions (assets) at beginning of year	2011-12-31	$56
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$199,347
Contract administrator fees	2011-12-31	$2,480
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	No
Opinion of an independent qualified public accountant for this plan	2011-12-31	Unqualified
Accountancy firm name	2011-12-31	PLANTE & MORAN, PLLC
Accountancy firm EIN	2011-12-31	381357951
2010 : SHERIDAN COMMUNITY HOSPITAL 401K PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total transfer of assets to this plan	2010-12-31	$0
Total transfer of assets from this plan	2010-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total income from all sources (including contributions)	2010-12-31	$685,957
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$283,090
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$239,493
Expenses. Certain deemed distributions of participant loans	2010-12-31	$25,461
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$348,438
Value of total assets at end of year	2010-12-31	$4,011,403
Value of total assets at beginning of year	2010-12-31	$3,608,536
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$18,136
Total interest from all sources	2010-12-31	$53,497
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$17,622
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2010-12-31	$17,622
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$240,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$291,486
Participant contributions at end of year	2010-12-31	$73,243
Participant contributions at beginning of year	2010-12-31	$78,075
Assets. Other investments not covered elsewhere at end of year	2010-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2010-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$3,430
Value of other receiveables (less allowance for doubtful accounts) at end of year	2010-12-31	$2,705
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2010-12-31	$9,910
Administrative expenses (other) incurred	2010-12-31	$16
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	$402,867
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$4,011,403
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$3,608,536
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
Investment advisory and management fees	2010-12-31	$15,390
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$730,318
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$471,332
Interest on participant loans	2010-12-31	$4,447
Interest earned on other investments	2010-12-31	$49,050
Value of interest in common/collective trusts at end of year	2010-12-31	$1,787,704
Value of interest in common/collective trusts at beginning of year	2010-12-31	$1,553,940
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$1,417,377
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$1,495,279
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$266,400
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	$53,522
Employer contributions (assets) at end of year	2010-12-31	$56
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$239,493
Contract administrator fees	2010-12-31	$2,730
Liabilities. Value of benefit claims payable at beginning of year	2010-12-31	$0
Did the plan have assets held for investment	2010-12-31	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	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	No
Opinion of an independent qualified public accountant for this plan	2010-12-31	Unqualified
Accountancy firm name	2010-12-31	PLANTE & MORAN, PLLC
Accountancy firm EIN	2010-12-31	381357951
2009 : SHERIDAN COMMUNITY HOSPITAL 401K PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for SHERIDAN COMMUNITY HOSPITAL 401K PLAN

2022: SHERIDAN COMMUNITY HOSPITAL 401K PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: SHERIDAN COMMUNITY HOSPITAL 401K PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: SHERIDAN COMMUNITY HOSPITAL 401K PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: SHERIDAN COMMUNITY HOSPITAL 401K PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: SHERIDAN COMMUNITY HOSPITAL 401K PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: SHERIDAN COMMUNITY HOSPITAL 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	No
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 benefit arrangement - Trust	Yes
2016: SHERIDAN COMMUNITY HOSPITAL 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	No
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: SHERIDAN COMMUNITY HOSPITAL 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	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: SHERIDAN COMMUNITY HOSPITAL 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	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: SHERIDAN COMMUNITY HOSPITAL 401K PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
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	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: SHERIDAN COMMUNITY HOSPITAL 401K PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	Yes
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	No
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: SHERIDAN COMMUNITY HOSPITAL 401K PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	Yes
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	No
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: SHERIDAN COMMUNITY HOSPITAL 401K PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
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	No
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: SHERIDAN COMMUNITY HOSPITAL 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

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

132379

Policy instance

Insurance contract or identification number	132379
Number of Individuals Covered	130
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $15,934
Total amount of fees paid to insurance company	USD $4,200
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $14,160
Insurance broker organization code?	3
Amount paid for insurance broker fees	4200
Additional information about fees paid to insurance broker	TPA FEES

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

132379

Policy instance

Insurance contract or identification number	132379
Number of Individuals Covered	133
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $17,626
Total amount of fees paid to insurance company	USD $1,450
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $15,663
Insurance broker organization code?	3
Amount paid for insurance broker fees	1450
Additional information about fees paid to insurance broker	TPA FEES

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

132379

Policy instance

Insurance contract or identification number	132379
Number of Individuals Covered	134
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $14,098
Total amount of fees paid to insurance company	USD $2,625
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $12,527
Insurance broker organization code?	3
Amount paid for insurance broker fees	2625
Additional information about fees paid to insurance broker	TPA FEES

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

132379

Policy instance

Insurance contract or identification number	132379
Number of Individuals Covered	129
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $16,391
Total amount of fees paid to insurance company	USD $500
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $14,331
Insurance broker organization code?	3
Amount paid for insurance broker fees	500
Additional information about fees paid to insurance broker	TPA FEES

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

132379

Policy instance

Insurance contract or identification number	132379
Number of Individuals Covered	133
Insurance policy start date	2018-01-12
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $30,782
Total amount of fees paid to insurance company	USD $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 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
Commission paid to Insurance Broker	USD $15,007
Insurance broker organization code?	5

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G37385

Policy instance

Insurance contract or identification number	G37385
Number of Individuals Covered	0
Insurance policy start date	2018-01-01
Insurance policy end date	2018-02-21
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?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G37385

Policy instance

Insurance contract or identification number	G37385
Number of Individuals Covered	111
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?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G37385

Policy instance

Insurance contract or identification number	G37385
Number of Individuals Covered	139
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?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

DELTA DENTAL PLAN OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 56154 )

Policy contract number

154

Policy instance

Insurance contract or identification number	154
Number of Individuals Covered	0
Insurance policy start date	2014-01-01
Insurance policy end date	2014-05-31
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?	Yes
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

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G37385

Policy instance

Insurance contract or identification number	G37385
Number of Individuals Covered	159
Insurance policy start date	2014-04-01
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?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

DELTA DENTAL PLAN OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 56154 )

Policy contract number

154

Policy instance

Insurance contract or identification number	154
Number of Individuals Covered	72
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?	Yes
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

DELTA DENTAL PLAN OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 56154 )

Policy contract number

154

Policy instance

Insurance contract or identification number	154
Number of Individuals Covered	75
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
Are there contracts with allocated funds for individual policies?	Yes
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

DELTA DENTAL PLAN OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 56154 )

Policy contract number

154

Policy instance

Insurance contract or identification number	154
Number of Individuals Covered	89
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
Are there contracts with allocated funds for individual policies?	Yes

DELTA DENTAL PLAN OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 56154 )

Policy contract number

Policy instance

Number of Individuals Covered	108
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 $0
Are there contracts with allocated funds for individual policies?	Yes
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

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Company Name:	SHERIDAN COMMUNITY HOSPITAL
Employer identification number (EIN):	381369796
NAIC Classification:	622000
NAIC Description:	Hospitals