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DOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 401k Plan overview

Plan NameDOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN
Plan identification number 002

DOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
  • Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.
  • Participant-directed brokerage accounts provided as an investment option under the plan.
  • 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

DOOR COUNTY MEMORIAL HOSPITAL DBA DOOR COUNTY MEDICAL CENTER has sponsored the creation of one or more 401k plans.

Company Name:DOOR COUNTY MEMORIAL HOSPITAL DBA DOOR COUNTY MEDICAL CENTER
Employer identification number (EIN):390806324
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022022-01-01
0022021-01-01
0022021-01-01
0022020-01-01
0022019-01-01
0022018-01-01
0022017-01-01KELLI BOWLING
0022016-01-01KELLI BOWLING
0022015-01-01KELLI BOWLING
0022014-01-01KELLI BOWLING
0022013-01-01KELLI BOWLING
0022012-01-01ROBERT C. SCIESZINSKI ROBERT C. SCIESZINSKI2013-10-15
0022011-01-01ROBERT C. SCIESZINSKI
0022010-01-01ROBERT C. SCIESZINSKI
0022009-01-01ROBERT C. SCIESZINSKI
0022008-01-01
0022008-01-01

Plan Statistics for DOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN

401k plan membership statisitcs for DOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN

Measure Date Value
2022: DOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01987
Total number of active participants reported on line 7a of the Form 55002022-01-01715
Number of retired or separated participants receiving benefits2022-01-0155
Number of other retired or separated participants entitled to future benefits2022-01-01238
Total of all active and inactive participants2022-01-011,008
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-011,008
Number of participants with account balances2022-01-01990
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010
2021: DOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01965
Total number of active participants reported on line 7a of the Form 55002021-01-01690
Number of retired or separated participants receiving benefits2021-01-0152
Number of other retired or separated participants entitled to future benefits2021-01-01245
Total of all active and inactive participants2021-01-01987
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01987
Number of participants with account balances2021-01-01963
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: DOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01935
Total number of active participants reported on line 7a of the Form 55002020-01-01707
Number of retired or separated participants receiving benefits2020-01-0149
Number of other retired or separated participants entitled to future benefits2020-01-01209
Total of all active and inactive participants2020-01-01965
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01965
Number of participants with account balances2020-01-01936
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: DOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01986
Total number of active participants reported on line 7a of the Form 55002019-01-01674
Number of retired or separated participants receiving benefits2019-01-0149
Number of other retired or separated participants entitled to future benefits2019-01-01212
Total of all active and inactive participants2019-01-01935
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01935
Number of participants with account balances2019-01-01897
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: DOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01945
Total number of active participants reported on line 7a of the Form 55002018-01-01685
Number of retired or separated participants receiving benefits2018-01-0151
Number of other retired or separated participants entitled to future benefits2018-01-01250
Total of all active and inactive participants2018-01-01986
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01986
Number of participants with account balances2018-01-01906
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: DOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01920
Total number of active participants reported on line 7a of the Form 55002017-01-01662
Number of retired or separated participants receiving benefits2017-01-0124
Number of other retired or separated participants entitled to future benefits2017-01-01256
Total of all active and inactive participants2017-01-01942
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-013
Total participants2017-01-01945
Number of participants with account balances2017-01-01854
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: DOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01867
Total number of active participants reported on line 7a of the Form 55002016-01-01665
Number of retired or separated participants receiving benefits2016-01-0116
Number of other retired or separated participants entitled to future benefits2016-01-01237
Total of all active and inactive participants2016-01-01918
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-012
Total participants2016-01-01920
Number of participants with account balances2016-01-01838
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: DOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01808
Total number of active participants reported on line 7a of the Form 55002015-01-01645
Number of retired or separated participants receiving benefits2015-01-0116
Number of other retired or separated participants entitled to future benefits2015-01-01205
Total of all active and inactive participants2015-01-01866
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-01866
Number of participants with account balances2015-01-01824
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: DOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01905
Total number of active participants reported on line 7a of the Form 55002014-01-01642
Number of retired or separated participants receiving benefits2014-01-0113
Number of other retired or separated participants entitled to future benefits2014-01-01152
Total of all active and inactive participants2014-01-01807
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-01807
Number of participants with account balances2014-01-01793
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: DOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01815
Total number of active participants reported on line 7a of the Form 55002013-01-01726
Number of retired or separated participants receiving benefits2013-01-0114
Number of other retired or separated participants entitled to future benefits2013-01-01165
Total of all active and inactive participants2013-01-01905
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-01905
Number of participants with account balances2013-01-01783
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: DOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01927
Total number of active participants reported on line 7a of the Form 55002012-01-01645
Number of retired or separated participants receiving benefits2012-01-0111
Number of other retired or separated participants entitled to future benefits2012-01-01159
Total of all active and inactive participants2012-01-01815
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-01815
Number of participants with account balances2012-01-01783
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: DOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01906
Total number of active participants reported on line 7a of the Form 55002011-01-01683
Number of retired or separated participants receiving benefits2011-01-014
Number of other retired or separated participants entitled to future benefits2011-01-01240
Total of all active and inactive participants2011-01-01927
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-01927
Number of participants with account balances2011-01-01845
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2010: DOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01889
Total number of active participants reported on line 7a of the Form 55002010-01-01672
Number of retired or separated participants receiving benefits2010-01-011
Number of other retired or separated participants entitled to future benefits2010-01-01233
Total of all active and inactive participants2010-01-01906
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-01906
Number of participants with account balances2010-01-01812
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-010
2009: DOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01728
Total number of active participants reported on line 7a of the Form 55002009-01-01656
Number of retired or separated participants receiving benefits2009-01-011
Number of other retired or separated participants entitled to future benefits2009-01-01232
Total of all active and inactive participants2009-01-01889
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-01889
Number of participants with account balances2009-01-01790
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on DOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN

Measure Date Value
2022 : DOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total income from all sources (including contributions)2022-12-31$-6,362,730
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$8,299,664
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$8,128,430
Expenses. Certain deemed distributions of participant loans2022-12-31$5,214
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$6,501,198
Value of total assets at end of year2022-12-31$97,668,054
Value of total assets at beginning of year2022-12-31$112,330,448
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$166,020
Total interest from all sources2022-12-31$803,693
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$2,578,607
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-12-31$2,578,607
Administrative expenses professional fees incurred2022-12-31$77,500
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$3,000,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$3,814,997
Participant contributions at end of year2022-12-31$411,408
Participant contributions at beginning of year2022-12-31$365,715
Assets. Other investments not covered elsewhere at end of year2022-12-31$1,424,232
Assets. Other investments not covered elsewhere at beginning of year2022-12-31$1,818,894
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$207,906
Other income not declared elsewhere2022-12-31$-96,484
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Income. Non cash contributions2022-12-31$0
Value of net income/loss2022-12-31$-14,662,394
Value of net assets at end of year (total assets less liabilities)2022-12-31$97,668,054
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$112,330,448
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$69,579,356
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$82,587,787
Interest on participant loans2022-12-31$19,424
Interest earned on other investments2022-12-31$784,269
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$26,253,058
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$27,558,052
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-16,149,744
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$2,478,295
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$8,128,430
Contract administrator fees2022-12-31$88,520
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31WIPFLI, LLP
Accountancy firm EIN2022-12-31390758449
2021 : DOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total income from all sources (including contributions)2021-12-31$17,107,264
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$4,450,200
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$4,260,639
Expenses. Certain deemed distributions of participant loans2021-12-31$16,081
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$5,997,032
Value of total assets at end of year2021-12-31$112,330,448
Value of total assets at beginning of year2021-12-31$99,673,384
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$173,480
Total interest from all sources2021-12-31$843,161
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$3,955,643
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2021-12-31$3,955,643
Administrative expenses professional fees incurred2021-12-31$80,000
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$3,000,000
If this is an individual account plan, was there a blackout period2021-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$3,374,843
Participant contributions at end of year2021-12-31$365,715
Participant contributions at beginning of year2021-12-31$453,619
Assets. Other investments not covered elsewhere at end of year2021-12-31$1,818,894
Assets. Other investments not covered elsewhere at beginning of year2021-12-31$1,383,130
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$307,216
Other income not declared elsewhere2021-12-31$132,479
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Income. Non cash contributions2021-12-31$0
Value of net income/loss2021-12-31$12,657,064
Value of net assets at end of year (total assets less liabilities)2021-12-31$112,330,448
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$99,673,384
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$82,587,787
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$70,354,409
Interest on participant loans2021-12-31$23,079
Interest earned on other investments2021-12-31$820,082
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$27,558,052
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$27,482,226
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$6,178,949
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$2,314,973
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$4,260,639
Contract administrator fees2021-12-31$93,480
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Disclaimer
Accountancy firm name2021-12-31WIPFLI, LLP
Accountancy firm EIN2021-12-31390758449
2020 : DOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$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$16,590,992
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$3,560,719
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$3,398,775
Expenses. Certain deemed distributions of participant loans2020-12-31$-5,418
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$5,754,876
Value of total assets at end of year2020-12-31$99,673,384
Value of total assets at beginning of year2020-12-31$86,643,111
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$167,362
Total interest from all sources2020-12-31$793,808
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$2,255,073
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2020-12-31$2,255,073
Administrative expenses professional fees incurred2020-12-31$80,000
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$3,000,000
If this is an individual account plan, was there a blackout period2020-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$3,197,722
Participant contributions at end of year2020-12-31$453,619
Participant contributions at beginning of year2020-12-31$438,678
Assets. Other investments not covered elsewhere at end of year2020-12-31$1,383,130
Assets. Other investments not covered elsewhere at beginning of year2020-12-31$1,186,426
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$289,779
Other income not declared elsewhere2020-12-31$202,540
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$13,030,273
Value of net assets at end of year (total assets less liabilities)2020-12-31$99,673,384
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$86,643,111
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$70,354,409
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$60,840,306
Interest on participant loans2020-12-31$26,085
Interest earned on other investments2020-12-31$767,723
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$27,482,226
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$24,177,701
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$7,584,695
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$2,267,375
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$3,398,775
Contract administrator fees2020-12-31$87,362
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Disclaimer
Accountancy firm name2020-12-31WIPFLI, LLP
Accountancy firm EIN2020-12-31390758449
2019 : DOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total income from all sources (including contributions)2019-12-31$18,288,250
Total income from all sources (including contributions)2019-12-31$18,288,250
Total loss/gain on sale of assets2019-12-31$0
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$6,544,893
Total of all expenses incurred2019-12-31$6,544,893
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$6,391,349
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$6,391,349
Expenses. Certain deemed distributions of participant loans2019-12-31$-10,887
Expenses. Certain deemed distributions of participant loans2019-12-31$-10,887
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$5,697,973
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$5,697,973
Value of total assets at end of year2019-12-31$86,643,111
Value of total assets at end of year2019-12-31$86,643,111
Value of total assets at beginning of year2019-12-31$74,899,754
Value of total assets at beginning of year2019-12-31$74,899,754
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$164,431
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$164,431
Total interest from all sources2019-12-31$780,555
Total interest from all sources2019-12-31$780,555
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$2,161,535
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$2,161,535
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$2,161,535
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$2,161,535
Administrative expenses professional fees incurred2019-12-31$80,000
Administrative expenses professional fees incurred2019-12-31$80,000
Was this plan covered by a fidelity bond2019-12-31Yes
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$3,000,000
Value of fidelity bond cover2019-12-31$3,000,000
If this is an individual account plan, was there a blackout period2019-12-31Yes
If this is an individual account plan, was there a blackout period2019-12-31Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$3,010,751
Contributions received from participants2019-12-31$3,010,751
Participant contributions at end of year2019-12-31$438,678
Participant contributions at end of year2019-12-31$438,678
Participant contributions at beginning of year2019-12-31$228,545
Participant contributions at beginning of year2019-12-31$228,545
Assets. Other investments not covered elsewhere at end of year2019-12-31$1,186,426
Assets. Other investments not covered elsewhere at end of year2019-12-31$1,186,426
Assets. Other investments not covered elsewhere at beginning of year2019-12-31$994,861
Assets. Other investments not covered elsewhere at beginning of year2019-12-31$994,861
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$460,803
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$460,803
Other income not declared elsewhere2019-12-31$185,428
Other income not declared elsewhere2019-12-31$185,428
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Income. Non cash contributions2019-12-31$0
Income. Non cash contributions2019-12-31$0
Value of net income/loss2019-12-31$11,743,357
Value of net income/loss2019-12-31$11,743,357
Value of net assets at end of year (total assets less liabilities)2019-12-31$86,643,111
Value of net assets at end of year (total assets less liabilities)2019-12-31$86,643,111
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$74,899,754
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$74,899,754
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$60,840,306
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$60,840,306
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$47,412,912
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$47,412,912
Interest on participant loans2019-12-31$17,662
Interest on participant loans2019-12-31$17,662
Interest earned on other investments2019-12-31$762,893
Interest earned on other investments2019-12-31$762,893
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$24,177,701
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$24,177,701
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$26,263,436
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$26,263,436
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$9,462,759
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$9,462,759
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$2,226,419
Contributions received in cash from employer2019-12-31$2,226,419
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$6,391,349
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$6,391,349
Contract administrator fees2019-12-31$84,431
Contract administrator fees2019-12-31$84,431
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32019-12-31Yes
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32019-12-31Yes
Did the plan have assets held for investment2019-12-31Yes
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31WIPFLI LLP
Accountancy firm name2019-12-31WIPFLI LLP
Accountancy firm EIN2019-12-31390758449
Accountancy firm EIN2019-12-31390758449
2018 : DOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total income from all sources (including contributions)2018-12-31$2,484,951
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$4,238,552
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$4,096,601
Expenses. Certain deemed distributions of participant loans2018-12-31$-8,900
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$5,263,254
Value of total assets at end of year2018-12-31$74,899,754
Value of total assets at beginning of year2018-12-31$76,653,355
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$150,851
Total interest from all sources2018-12-31$779,308
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$2,535,479
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2018-12-31$2,535,479
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$3,000,000
If this is an individual account plan, was there a blackout period2018-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$2,718,520
Participant contributions at end of year2018-12-31$228,545
Participant contributions at beginning of year2018-12-31$179,215
Assets. Other investments not covered elsewhere at end of year2018-12-31$994,861
Assets. Other investments not covered elsewhere at beginning of year2018-12-31$884,062
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$486,835
Other income not declared elsewhere2018-12-31$67,237
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Income. Non cash contributions2018-12-31$0
Value of net income/loss2018-12-31$-1,753,601
Value of net assets at end of year (total assets less liabilities)2018-12-31$74,899,754
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$76,653,355
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Investment advisory and management fees2018-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$47,412,912
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$50,771,495
Interest on participant loans2018-12-31$11,857
Interest earned on other investments2018-12-31$767,451
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$26,263,436
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$24,818,583
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-6,160,327
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$2,057,899
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$4,096,601
Contract administrator fees2018-12-31$150,851
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31WIPFLI LLP
Accountancy firm EIN2018-12-31390758449
2017 : DOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total income from all sources (including contributions)2017-12-31$13,792,246
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$2,588,576
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$2,449,080
Expenses. Certain deemed distributions of participant loans2017-12-31$39,759
Value of total corrective distributions2017-12-31$753
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$5,036,793
Value of total assets at end of year2017-12-31$76,653,355
Value of total assets at beginning of year2017-12-31$65,449,685
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$98,984
Total interest from all sources2017-12-31$715,312
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$2,078,634
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2017-12-31$2,078,634
Administrative expenses professional fees incurred2017-12-31$95,878
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$3,000,000
If this is an individual account plan, was there a blackout period2017-12-31Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$2,606,078
Participant contributions at end of year2017-12-31$179,215
Participant contributions at beginning of year2017-12-31$148,117
Assets. Other investments not covered elsewhere at end of year2017-12-31$884,062
Assets. Other investments not covered elsewhere at beginning of year2017-12-31$763,238
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$480,882
Other income not declared elsewhere2017-12-31$115,002
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Income. Non cash contributions2017-12-31$0
Value of net income/loss2017-12-31$11,203,670
Value of net assets at end of year (total assets less liabilities)2017-12-31$76,653,355
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$65,449,685
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$50,771,495
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$41,721,638
Interest on participant loans2017-12-31$7,464
Interest earned on other investments2017-12-31$707,848
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-12-31$24,818,583
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-12-31$22,816,692
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-12-31$5,846,505
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$1,949,833
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$2,449,080
Contract administrator fees2017-12-31$3,106
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-12-31Yes
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31WIPFLI LLP
Accountancy firm EIN2017-12-31390758449
2016 : DOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total income from all sources (including contributions)2016-12-31$9,718,604
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$1,757,380
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$1,743,740
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$6,118,968
Value of total assets at end of year2016-12-31$65,449,685
Value of total assets at beginning of year2016-12-31$57,488,461
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$13,640
Total interest from all sources2016-12-31$647,555
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$2,068,900
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2016-12-31$2,068,900
Administrative expenses professional fees incurred2016-12-31$10,521
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$3,000,000
If this is an individual account plan, was there a blackout period2016-12-31Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$2,398,318
Participant contributions at end of year2016-12-31$148,117
Participant contributions at beginning of year2016-12-31$185,767
Assets. Other investments not covered elsewhere at end of year2016-12-31$763,238
Assets. Other investments not covered elsewhere at beginning of year2016-12-31$661,304
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$1,910,982
Other income not declared elsewhere2016-12-31$36,858
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$7,961,224
Value of net assets at end of year (total assets less liabilities)2016-12-31$65,449,685
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$57,488,461
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-31$41,721,638
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$37,397,773
Interest on participant loans2016-12-31$7,047
Interest earned on other investments2016-12-31$640,508
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-12-31$22,816,692
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-12-31$19,243,617
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-12-31$846,323
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$1,809,668
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$1,743,740
Contract administrator fees2016-12-31$3,119
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-12-31Yes
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31WIPFLI LLP
Accountancy firm EIN2016-12-31390758449
2015 : DOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total income from all sources (including contributions)2015-12-31$4,632,490
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$3,507,500
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$3,495,864
Expenses. Certain deemed distributions of participant loans2015-12-31$-2,083
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$4,529,328
Value of total assets at end of year2015-12-31$57,488,461
Value of total assets at beginning of year2015-12-31$56,363,471
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$13,719
Total interest from all sources2015-12-31$558,903
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$2,918,108
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2015-12-31$2,918,108
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$500,000
If this is an individual account plan, was there a blackout period2015-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$2,216,040
Participant contributions at end of year2015-12-31$185,767
Participant contributions at beginning of year2015-12-31$129,217
Assets. Other investments not covered elsewhere at end of year2015-12-31$661,304
Assets. Other investments not covered elsewhere at beginning of year2015-12-31$750,854
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$632,949
Other income not declared elsewhere2015-12-31$3,943
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Income. Non cash contributions2015-12-31$0
Value of net income/loss2015-12-31$1,124,990
Value of net assets at end of year (total assets less liabilities)2015-12-31$57,488,461
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$56,363,471
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$37,397,773
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$37,303,890
Interest on participant loans2015-12-31$6,058
Interest earned on other investments2015-12-31$552,845
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-12-31$19,243,617
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-12-31$18,179,510
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$-3,377,792
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$1,680,339
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$3,495,864
Contract administrator fees2015-12-31$13,719
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31WIPFLI LLP
Accountancy firm EIN2015-12-31390758449
2014 : DOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total income from all sources (including contributions)2014-12-31$7,229,976
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$2,765,582
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$2,751,565
Expenses. Certain deemed distributions of participant loans2014-12-31$567
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$4,460,564
Value of total assets at end of year2014-12-31$56,363,471
Value of total assets at beginning of year2014-12-31$51,899,077
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$13,450
Total interest from all sources2014-12-31$524,714
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$3,005,156
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2014-12-31$3,005,156
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$500,000
If this is an individual account plan, was there a blackout period2014-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$2,017,273
Participant contributions at end of year2014-12-31$129,217
Participant contributions at beginning of year2014-12-31$118,680
Assets. Other investments not covered elsewhere at end of year2014-12-31$750,854
Assets. Other investments not covered elsewhere at beginning of year2014-12-31$710,190
Income. Received or receivable in cash from other sources (including rollovers)2014-12-31$809,366
Other income not declared elsewhere2014-12-31$56,103
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Income. Non cash contributions2014-12-31$0
Value of net income/loss2014-12-31$4,464,394
Value of net assets at end of year (total assets less liabilities)2014-12-31$56,363,471
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$51,899,077
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$37,303,890
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$34,908,571
Interest on participant loans2014-12-31$5,291
Interest earned on other investments2014-12-31$519,423
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-12-31$18,179,510
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-12-31$16,161,636
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-12-31$-816,561
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$1,633,925
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$2,751,565
Contract administrator fees2014-12-31$13,450
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31WIPFLI LLP
Accountancy firm EIN2014-12-31390758449
2013 : DOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total income from all sources (including contributions)2013-12-31$11,162,135
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$1,867,027
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$1,836,112
Expenses. Certain deemed distributions of participant loans2013-12-31$27,521
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$3,977,907
Value of total assets at end of year2013-12-31$51,899,077
Value of total assets at beginning of year2013-12-31$42,603,969
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$3,394
Total interest from all sources2013-12-31$460,443
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$1,599,459
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2013-12-31$1,599,459
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$500,000
If this is an individual account plan, was there a blackout period2013-12-31Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$1,982,083
Participant contributions at end of year2013-12-31$118,680
Participant contributions at beginning of year2013-12-31$148,376
Assets. Other investments not covered elsewhere at end of year2013-12-31$710,190
Assets. Other investments not covered elsewhere at beginning of year2013-12-31$551,117
Income. Received or receivable in cash from other sources (including rollovers)2013-12-31$371,616
Other income not declared elsewhere2013-12-31$-11,459
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$9,295,108
Value of net assets at end of year (total assets less liabilities)2013-12-31$51,899,077
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$42,603,969
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-12-31$34,908,571
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$27,898,763
Interest on participant loans2013-12-31$5,460
Interest earned on other investments2013-12-31$454,983
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-12-31$5,672
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-12-31$5,672
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-12-31$16,161,636
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-12-31$14,000,041
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-12-31$5,135,785
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$1,624,208
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$1,836,112
Contract administrator fees2013-12-31$3,394
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32013-12-31Yes
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31Yes
Opinion of an independent qualified public accountant for this plan2013-12-31Disclaimer
Accountancy firm name2013-12-31WIPFLI LLP
Accountancy firm EIN2013-12-31390758449
2012 : DOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$42,980
Total income from all sources (including contributions)2012-12-31$7,571,360
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$2,535,709
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$2,506,157
Expenses. Certain deemed distributions of participant loans2012-12-31$24,445
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$3,855,289
Value of total assets at end of year2012-12-31$42,603,969
Value of total assets at beginning of year2012-12-31$37,611,298
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$5,107
Total interest from all sources2012-12-31$399,417
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$684,811
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2012-12-31$684,811
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$5,000,000
If this is an individual account plan, was there a blackout period2012-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$1,856,549
Participant contributions at end of year2012-12-31$148,376
Participant contributions at beginning of year2012-12-31$165,115
Assets. Other investments not covered elsewhere at end of year2012-12-31$551,117
Assets. Other investments not covered elsewhere at beginning of year2012-12-31$538,357
Income. Received or receivable in cash from other sources (including rollovers)2012-12-31$457,496
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-12-31$42,715
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-12-31$42,980
Other income not declared elsewhere2012-12-31$9,897
Total non interest bearing cash at beginning of year2012-12-31$249
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$5,035,651
Value of net assets at end of year (total assets less liabilities)2012-12-31$42,603,969
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$37,568,318
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-12-31$27,898,763
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$24,375,117
Interest on participant loans2012-12-31$6,353
Interest earned on other investments2012-12-31$393,011
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-12-31$5,672
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-12-31$5,280
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-12-31$5,280
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-12-31$53
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-12-31$14,000,041
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-12-31$12,484,465
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-12-31$2,621,946
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$1,541,244
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$2,506,157
Contract administrator fees2012-12-31$5,107
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31Yes
Opinion of an independent qualified public accountant for this plan2012-12-31Disclaimer
Accountancy firm name2012-12-31WIPFLI LLP
Accountancy firm EIN2012-12-31390758449
2011 : DOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$42,980
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$35,172
Total income from all sources (including contributions)2011-12-31$3,440,882
Total loss/gain on sale of assets2011-12-31$0
Total of all expenses incurred2011-12-31$2,547,270
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$2,541,789
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$3,512,756
Value of total assets at end of year2011-12-31$37,611,298
Value of total assets at beginning of year2011-12-31$36,709,878
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$5,481
Total interest from all sources2011-12-31$351,480
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$527,606
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2011-12-31$527,606
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$5,000,000
If this is an individual account plan, was there a blackout period2011-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$1,832,616
Participant contributions at end of year2011-12-31$165,115
Participant contributions at beginning of year2011-12-31$207,140
Assets. Other investments not covered elsewhere at end of year2011-12-31$538,357
Assets. Other investments not covered elsewhere at beginning of year2011-12-31$531,763
Income. Received or receivable in cash from other sources (including rollovers)2011-12-31$210,973
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-12-31$42,715
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-12-31$34,538
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2011-12-31$42,980
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2011-12-31$35,172
Other income not declared elsewhere2011-12-31$6,643
Administrative expenses (other) incurred2011-12-31$2,231
Total non interest bearing cash at end of year2011-12-31$249
Total non interest bearing cash at beginning of year2011-12-31$249
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$893,612
Value of net assets at end of year (total assets less liabilities)2011-12-31$37,568,318
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$36,674,706
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-12-31$24,375,117
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-12-31$24,961,170
Interest on participant loans2011-12-31$7,793
Interest earned on other investments2011-12-31$343,683
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-12-31$5,280
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-12-31$462,308
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-12-31$462,308
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$4
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-12-31$12,484,465
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-12-31$10,512,710
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-12-31$-957,603
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$1,469,167
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$2,541,789
Contract administrator fees2011-12-31$3,250
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31WIPFLI LLP
Accountancy firm EIN2011-12-31390758449
2010 : DOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets2010-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$35,172
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$34,367
Total income from all sources (including contributions)2010-12-31$6,878,598
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$1,688,136
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$1,682,166
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$3,197,728
Value of total assets at end of year2010-12-31$36,709,878
Value of total assets at beginning of year2010-12-31$31,518,611
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$5,970
Total interest from all sources2010-12-31$312,148
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$413,766
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2010-12-31$413,766
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$500,000
If this is an individual account plan, was there a blackout period2010-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$1,681,687
Participant contributions at end of year2010-12-31$207,140
Participant contributions at beginning of year2010-12-31$181,734
Participant contributions at beginning of year2010-12-31$48,134
Assets. Other investments not covered elsewhere at end of year2010-12-31$531,763
Income. Received or receivable in cash from other sources (including rollovers)2010-12-31$79,201
Value of other receiveables (less allowance for doubtful accounts) at end of year2010-12-31$34,538
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2010-12-31$34,367
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2010-12-31$35,172
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2010-12-31$34,367
Other income not declared elsewhere2010-12-31$2,859
Total non interest bearing cash at end of year2010-12-31$249
Total non interest bearing cash at beginning of year2010-12-31$151
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$5,190,462
Value of net assets at end of year (total assets less liabilities)2010-12-31$36,674,706
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$31,484,244
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2010-12-31$24,961,170
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$21,515,902
Interest on participant loans2010-12-31$10,706
Interest earned on other investments2010-12-31$301,438
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2010-12-31$462,308
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2010-12-31$459,657
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2010-12-31$459,657
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$4
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$10,512,710
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$9,219,746
Net investment gain/loss from registered investment companies (e.g. mutual funds)2010-12-31$2,952,097
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$1,436,840
Employer contributions (assets) at beginning of year2010-12-31$58,920
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$1,682,166
Contract administrator fees2010-12-31$5,970
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31WIPFLI LLP
Accountancy firm EIN2010-12-31390758449
2009 : DOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2009-12-31$0

Form 5500 Responses for DOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN

2022: DOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: DOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: DOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: DOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: DOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: DOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: DOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: DOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: DOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: DOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: DOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: DOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2010: DOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedYes
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes
2009: DOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes
2008: DOOR COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2008 form 5500 responses
2008-01-01Type of plan entitySingle employer plan
2008-01-01Submission has been amendedNo
2008-01-01This submission is the final filingNo
2008-01-01This return/report is a short plan year return/report (less than 12 months)No
2008-01-01Plan is a collectively bargained planNo

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberCR15657
Policy instance 2
Insurance contract or identification numberCR15657
Number of Individuals Covered106
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $9,983
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,983
Insurance broker organization code?4
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberGP55543
Policy instance 1
Insurance contract or identification numberGP55543
Number of Individuals Covered747
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberCR15657
Policy instance 2
Insurance contract or identification numberCR15657
Number of Individuals Covered114
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $8,752
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,752
Insurance broker organization code?4
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberGP55543
Policy instance 1
Insurance contract or identification numberGP55543
Number of Individuals Covered630
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberCR15657
Policy instance 2
Insurance contract or identification numberCR15657
Number of Individuals Covered123
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $9,284
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,284
Insurance broker organization code?4
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberGP55543
Policy instance 1
Insurance contract or identification numberGP55543
Number of Individuals Covered629
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberCR15657
Policy instance 2
Insurance contract or identification numberCR15657
Number of Individuals Covered124
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $9,589
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,589
Insurance broker organization code?4
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberGP55543
Policy instance 1
Insurance contract or identification numberGP55543
Number of Individuals Covered618
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberCR15657
Policy instance 2
Insurance contract or identification numberCR15657
Number of Individuals Covered135
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $11,702
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,702
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerSALES AND BASE COMMISSIONS
Insurance broker organization code?4
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberGP55543
Policy instance 1
Insurance contract or identification numberGP55543
Number of Individuals Covered780
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberCR15657
Policy instance 2
Insurance contract or identification numberCR15657
Number of Individuals Covered142
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $9,408
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,408
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerSALES AND BASE COMMISSIONS
Insurance broker organization code?4
Insurance broker nameLPL FINANCIAL CORPORATION
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberGP55543
Policy instance 1
Insurance contract or identification numberGP55543
Number of Individuals Covered725
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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