401k Plan data: ASPIRUS LANGLADE HOSPITAL TAX DEFERRED ANNUITY PLAN plan

ASPIRUS LANGLADE HOSPITAL TAX DEFERRED ANNUITY PLAN 401k Plan overview

Plan Name	ASPIRUS LANGLADE HOSPITAL TAX DEFERRED ANNUITY PLAN
Plan identification number	002

ASPIRUS LANGLADE HOSPITAL TAX DEFERRED ANNUITY PLAN Benefits

401k Plan Type

Defined 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.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

LANGLADE HOSPITAL, AN ASPIRUS PARTNER DBA ASPIRUS LANGLADE HOSPITAL has sponsored the creation of one or more 401k plans.

Company Name: LANGLADE HOSPITAL, AN ASPIRUS PARTNER DBA ASPIRUS LANGLADE HOSPITAL

Employer identification number (EIN): 390806429

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ASPIRUS LANGLADE HOSPITAL TAX DEFERRED ANNUITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2017-07-01 PAT TINCHER
002 2016-07-01 PAT TINCHER
002 2015-07-01 PAT TINCHER
002 2014-07-01 PAT TINCHER
002 2013-07-01 PAT TINCHER
002 2012-07-01 PAT TINCHER
002 2011-07-01 JANELLE K. MARKGRAF JANELLE K. MARKGRAF 2013-04-05
002 2009-07-01 JANELLE K MARKGRAF PAT TINCHER 2011-04-18

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
002	2017-07-01	PAT TINCHER
002	2016-07-01	PAT TINCHER
002	2015-07-01	PAT TINCHER
002	2014-07-01	PAT TINCHER
002	2013-07-01	PAT TINCHER
002	2012-07-01	PAT TINCHER
002	2011-07-01	JANELLE K. MARKGRAF	JANELLE K. MARKGRAF	2013-04-05
002	2009-07-01	JANELLE K MARKGRAF	PAT TINCHER	2011-04-18

Plan Statistics for ASPIRUS LANGLADE HOSPITAL TAX DEFERRED ANNUITY PLAN

401k plan membership statisitcs for ASPIRUS LANGLADE HOSPITAL TAX DEFERRED ANNUITY PLAN

Measure Date Value
2017: ASPIRUS LANGLADE HOSPITAL TAX DEFERRED ANNUITY PLAN 2017 401k membership
Total participants, beginning-of-year 2017-07-01 664
Total number of active participants reported on line 7a of the Form 5500 2017-07-01 0
Number of retired or separated participants receiving benefits 2017-07-01 0
Number of other retired or separated participants entitled to future benefits 2017-07-01 0
Total of all active and inactive participants 2017-07-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-07-01 0
Total participants 2017-07-01 0
Number of participants with account balances 2017-07-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-07-01 0
2016: ASPIRUS LANGLADE HOSPITAL TAX DEFERRED ANNUITY PLAN 2016 401k membership
Total participants, beginning-of-year 2016-07-01 655
Total number of active participants reported on line 7a of the Form 5500 2016-07-01 503
Number of retired or separated participants receiving benefits 2016-07-01 14
Number of other retired or separated participants entitled to future benefits 2016-07-01 146
Total of all active and inactive participants 2016-07-01 663
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-07-01 1
Total participants 2016-07-01 664
Number of participants with account balances 2016-07-01 580
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-07-01 0
2015: ASPIRUS LANGLADE HOSPITAL TAX DEFERRED ANNUITY PLAN 2015 401k membership
Total participants, beginning-of-year 2015-07-01 715
Total number of active participants reported on line 7a of the Form 5500 2015-07-01 552
Number of retired or separated participants receiving benefits 2015-07-01 15
Number of other retired or separated participants entitled to future benefits 2015-07-01 86
Total of all active and inactive participants 2015-07-01 653
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-07-01 2
Total participants 2015-07-01 655
Number of participants with account balances 2015-07-01 571
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-07-01 0
2014: ASPIRUS LANGLADE HOSPITAL TAX DEFERRED ANNUITY PLAN 2014 401k membership
Total participants, beginning-of-year 2014-07-01 716
Total number of active participants reported on line 7a of the Form 5500 2014-07-01 624
Number of retired or separated participants receiving benefits 2014-07-01 11
Number of other retired or separated participants entitled to future benefits 2014-07-01 79
Total of all active and inactive participants 2014-07-01 714
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-07-01 1
Total participants 2014-07-01 715
Number of participants with account balances 2014-07-01 591
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-07-01 0
2013: ASPIRUS LANGLADE HOSPITAL TAX DEFERRED ANNUITY PLAN 2013 401k membership
Total participants, beginning-of-year 2013-07-01 677
Total number of active participants reported on line 7a of the Form 5500 2013-07-01 601
Number of retired or separated participants receiving benefits 2013-07-01 13
Number of other retired or separated participants entitled to future benefits 2013-07-01 102
Total of all active and inactive participants 2013-07-01 716
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-07-01 0
Total participants 2013-07-01 716
Number of participants with account balances 2013-07-01 594
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-07-01 0
2012: ASPIRUS LANGLADE HOSPITAL TAX DEFERRED ANNUITY PLAN 2012 401k membership
Total participants, beginning-of-year 2012-07-01 673
Total number of active participants reported on line 7a of the Form 5500 2012-07-01 567
Number of retired or separated participants receiving benefits 2012-07-01 11
Number of other retired or separated participants entitled to future benefits 2012-07-01 95
Total of all active and inactive participants 2012-07-01 673
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-07-01 0
Total participants 2012-07-01 673
Number of participants with account balances 2012-07-01 574
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-07-01 0
2011: ASPIRUS LANGLADE HOSPITAL TAX DEFERRED ANNUITY PLAN 2011 401k membership
Total participants, beginning-of-year 2011-07-01 631
Total number of active participants reported on line 7a of the Form 5500 2011-07-01 538
Number of retired or separated participants receiving benefits 2011-07-01 10
Number of other retired or separated participants entitled to future benefits 2011-07-01 125
Total of all active and inactive participants 2011-07-01 673
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-07-01 0
Total participants 2011-07-01 673
Number of participants with account balances 2011-07-01 612
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-07-01 0
2009: ASPIRUS LANGLADE HOSPITAL TAX DEFERRED ANNUITY PLAN 2009 401k membership
Total participants, beginning-of-year 2009-07-01 525
Total number of active participants reported on line 7a of the Form 5500 2009-07-01 419
Number of retired or separated participants receiving benefits 2009-07-01 7
Number of other retired or separated participants entitled to future benefits 2009-07-01 91
Total of all active and inactive participants 2009-07-01 517
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-07-01 0
Total participants 2009-07-01 517
Number of participants with account balances 2009-07-01 462
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-07-01 0

Measure	Date	Value
2017: ASPIRUS LANGLADE HOSPITAL TAX DEFERRED ANNUITY PLAN 2017 401k membership
Total participants, beginning-of-year	2017-07-01	664
Total number of active participants reported on line 7a of the Form 5500	2017-07-01	0
Number of retired or separated participants receiving benefits	2017-07-01	0
Number of other retired or separated participants entitled to future benefits	2017-07-01	0
Total of all active and inactive participants	2017-07-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-07-01	0
Total participants	2017-07-01	0
Number of participants with account balances	2017-07-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-07-01	0
2016: ASPIRUS LANGLADE HOSPITAL TAX DEFERRED ANNUITY PLAN 2016 401k membership
Total participants, beginning-of-year	2016-07-01	655
Total number of active participants reported on line 7a of the Form 5500	2016-07-01	503
Number of retired or separated participants receiving benefits	2016-07-01	14
Number of other retired or separated participants entitled to future benefits	2016-07-01	146
Total of all active and inactive participants	2016-07-01	663
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-07-01	1
Total participants	2016-07-01	664
Number of participants with account balances	2016-07-01	580
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-07-01	0
2015: ASPIRUS LANGLADE HOSPITAL TAX DEFERRED ANNUITY PLAN 2015 401k membership
Total participants, beginning-of-year	2015-07-01	715
Total number of active participants reported on line 7a of the Form 5500	2015-07-01	552
Number of retired or separated participants receiving benefits	2015-07-01	15
Number of other retired or separated participants entitled to future benefits	2015-07-01	86
Total of all active and inactive participants	2015-07-01	653
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-07-01	2
Total participants	2015-07-01	655
Number of participants with account balances	2015-07-01	571
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-07-01	0
2014: ASPIRUS LANGLADE HOSPITAL TAX DEFERRED ANNUITY PLAN 2014 401k membership
Total participants, beginning-of-year	2014-07-01	716
Total number of active participants reported on line 7a of the Form 5500	2014-07-01	624
Number of retired or separated participants receiving benefits	2014-07-01	11
Number of other retired or separated participants entitled to future benefits	2014-07-01	79
Total of all active and inactive participants	2014-07-01	714
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-07-01	1
Total participants	2014-07-01	715
Number of participants with account balances	2014-07-01	591
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-07-01	0
2013: ASPIRUS LANGLADE HOSPITAL TAX DEFERRED ANNUITY PLAN 2013 401k membership
Total participants, beginning-of-year	2013-07-01	677
Total number of active participants reported on line 7a of the Form 5500	2013-07-01	601
Number of retired or separated participants receiving benefits	2013-07-01	13
Number of other retired or separated participants entitled to future benefits	2013-07-01	102
Total of all active and inactive participants	2013-07-01	716
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-07-01	0
Total participants	2013-07-01	716
Number of participants with account balances	2013-07-01	594
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-07-01	0
2012: ASPIRUS LANGLADE HOSPITAL TAX DEFERRED ANNUITY PLAN 2012 401k membership
Total participants, beginning-of-year	2012-07-01	673
Total number of active participants reported on line 7a of the Form 5500	2012-07-01	567
Number of retired or separated participants receiving benefits	2012-07-01	11
Number of other retired or separated participants entitled to future benefits	2012-07-01	95
Total of all active and inactive participants	2012-07-01	673
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-07-01	0
Total participants	2012-07-01	673
Number of participants with account balances	2012-07-01	574
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-07-01	0
2011: ASPIRUS LANGLADE HOSPITAL TAX DEFERRED ANNUITY PLAN 2011 401k membership
Total participants, beginning-of-year	2011-07-01	631
Total number of active participants reported on line 7a of the Form 5500	2011-07-01	538
Number of retired or separated participants receiving benefits	2011-07-01	10
Number of other retired or separated participants entitled to future benefits	2011-07-01	125
Total of all active and inactive participants	2011-07-01	673
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-07-01	0
Total participants	2011-07-01	673
Number of participants with account balances	2011-07-01	612
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-07-01	0
2009: ASPIRUS LANGLADE HOSPITAL TAX DEFERRED ANNUITY PLAN 2009 401k membership
Total participants, beginning-of-year	2009-07-01	525
Total number of active participants reported on line 7a of the Form 5500	2009-07-01	419
Number of retired or separated participants receiving benefits	2009-07-01	7
Number of other retired or separated participants entitled to future benefits	2009-07-01	91
Total of all active and inactive participants	2009-07-01	517
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-07-01	0
Total participants	2009-07-01	517
Number of participants with account balances	2009-07-01	462
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-07-01	0

Financial Data on ASPIRUS LANGLADE HOSPITAL TAX DEFERRED ANNUITY PLAN

Measure	Date	Value
2017 : ASPIRUS LANGLADE HOSPITAL TAX DEFERRED ANNUITY PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-29	$0
Total transfer of assets from this plan	2017-12-29	$27,412,670
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-29	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-29	$0
Total income from all sources (including contributions)	2017-12-29	$2,372,715
Total loss/gain on sale of assets	2017-12-29	$0
Total of all expenses incurred	2017-12-29	$1,363,406
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-29	$1,322,264
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-29	$889,326
Value of total assets at end of year	2017-12-29	$0
Value of total assets at beginning of year	2017-12-29	$26,403,361
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-29	$41,142
Total interest from all sources	2017-12-29	$69,181
Total dividends received (eg from common stock, registered investment company shares)	2017-12-29	$750,515
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-29	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-29	$750,515
Was this plan covered by a fidelity bond	2017-12-29	Yes
Value of fidelity bond cover	2017-12-29	$500,000
If this is an individual account plan, was there a blackout period	2017-12-29	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-29	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-29	No
Contributions received from participants	2017-12-29	$880,789
Participant contributions at end of year	2017-12-29	$0
Participant contributions at beginning of year	2017-12-29	$175,210
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-29	$8,537
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-29	No
Value of net income/loss	2017-12-29	$1,009,309
Value of net assets at end of year (total assets less liabilities)	2017-12-29	$0
Value of net assets at beginning of year (total assets less liabilities)	2017-12-29	$26,403,361
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-29	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-29	No
Were any leases to which the plan was party in default or uncollectible	2017-12-29	No
Investment advisory and management fees	2017-12-29	$39,711
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-29	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-29	$19,617,794
Interest on participant loans	2017-12-29	$3,313
Interest earned on other investments	2017-12-29	$65,868
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-29	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-29	$6,610,357
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-29	$663,693
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-29	No
Was there a failure to transmit to the plan any participant contributions	2017-12-29	No
Has the plan failed to provide any benefit when due under the plan	2017-12-29	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-29	$1,322,264
Contract administrator fees	2017-12-29	$1,431
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2017-12-29	Yes
Did the plan have assets held for investment	2017-12-29	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-29	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-29	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-29	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-29	Disclaimer
Accountancy firm name	2017-12-29	WIPFLI, LLP
Accountancy firm EIN	2017-12-29	390758449
Total unrealized appreciation/depreciation of assets	2017-06-30	$0
Total transfer of assets to this plan	2017-06-30	$3,016
Total transfer of assets from this plan	2017-06-30	$93,999
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-06-30	$0
Total income from all sources (including contributions)	2017-06-30	$3,789,254
Total loss/gain on sale of assets	2017-06-30	$0
Total of all expenses incurred	2017-06-30	$2,326,430
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-06-30	$2,271,209
Expenses. Certain deemed distributions of participant loans	2017-06-30	$920
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-06-30	$1,666,153
Value of total assets at end of year	2017-06-30	$26,403,361
Value of total assets at beginning of year	2017-06-30	$25,031,520
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-06-30	$54,301
Total interest from all sources	2017-06-30	$141,527
Total dividends received (eg from common stock, registered investment company shares)	2017-06-30	$748,668
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-06-30	$748,668
Was this plan covered by a fidelity bond	2017-06-30	Yes
Value of fidelity bond cover	2017-06-30	$500,000
If this is an individual account plan, was there a blackout period	2017-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2017-06-30	No
Contributions received from participants	2017-06-30	$1,666,153
Participant contributions at end of year	2017-06-30	$175,210
Participant contributions at beginning of year	2017-06-30	$209,297
Income. Received or receivable in cash from other sources (including rollovers)	2017-06-30	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-06-30	No
Value of net income/loss	2017-06-30	$1,462,824
Value of net assets at end of year (total assets less liabilities)	2017-06-30	$26,403,361
Value of net assets at beginning of year (total assets less liabilities)	2017-06-30	$25,031,520
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-06-30	No
Were any leases to which the plan was party in default or uncollectible	2017-06-30	No
Investment advisory and management fees	2017-06-30	$48,542
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-06-30	$19,617,794
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-06-30	$18,093,977
Interest on participant loans	2017-06-30	$5,766
Interest earned on other investments	2017-06-30	$135,761
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-06-30	$6,610,357
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-06-30	$6,728,246
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-06-30	$1,232,906
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-06-30	No
Was there a failure to transmit to the plan any participant contributions	2017-06-30	No
Has the plan failed to provide any benefit when due under the plan	2017-06-30	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-06-30	$2,271,209
Contract administrator fees	2017-06-30	$5,759
Did the plan have assets held for investment	2017-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2017-06-30	Disclaimer
Accountancy firm name	2017-06-30	WIPFLI, LLP
Accountancy firm EIN	2017-06-30	390758449
2016 : ASPIRUS LANGLADE HOSPITAL TAX DEFERRED ANNUITY PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-06-30	$0
Total transfer of assets to this plan	2016-06-30	$36,137
Total transfer of assets from this plan	2016-06-30	$207,137
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-06-30	$0
Total income from all sources (including contributions)	2016-06-30	$1,818,959
Total loss/gain on sale of assets	2016-06-30	$0
Total of all expenses incurred	2016-06-30	$1,834,471
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-06-30	$1,801,276
Expenses. Certain deemed distributions of participant loans	2016-06-30	$14,827
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-06-30	$1,770,956
Value of total assets at end of year	2016-06-30	$25,031,520
Value of total assets at beginning of year	2016-06-30	$25,218,032
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-06-30	$18,368
Total interest from all sources	2016-06-30	$180,158
Total dividends received (eg from common stock, registered investment company shares)	2016-06-30	$790,882
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-06-30	$790,882
Was this plan covered by a fidelity bond	2016-06-30	Yes
Value of fidelity bond cover	2016-06-30	$500,000
If this is an individual account plan, was there a blackout period	2016-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2016-06-30	No
Contributions received from participants	2016-06-30	$1,676,050
Participant contributions at end of year	2016-06-30	$209,297
Participant contributions at beginning of year	2016-06-30	$298,563
Income. Received or receivable in cash from other sources (including rollovers)	2016-06-30	$94,906
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-06-30	No
Value of net income/loss	2016-06-30	$-15,512
Value of net assets at end of year (total assets less liabilities)	2016-06-30	$25,031,520
Value of net assets at beginning of year (total assets less liabilities)	2016-06-30	$25,218,032
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-06-30	No
Were any leases to which the plan was party in default or uncollectible	2016-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-06-30	$18,093,977
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-06-30	$18,150,782
Interest on participant loans	2016-06-30	$7,228
Interest earned on other investments	2016-06-30	$172,930
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-06-30	$6,728,246
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-06-30	$6,768,687
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-06-30	$-923,037
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-06-30	No
Was there a failure to transmit to the plan any participant contributions	2016-06-30	No
Has the plan failed to provide any benefit when due under the plan	2016-06-30	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-06-30	$1,801,276
Contract administrator fees	2016-06-30	$18,368
Did the plan have assets held for investment	2016-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2016-06-30	Disclaimer
Accountancy firm name	2016-06-30	WIPFLI, LLP
Accountancy firm EIN	2016-06-30	390758449
2015 : ASPIRUS LANGLADE HOSPITAL TAX DEFERRED ANNUITY PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-06-30	$0
Total income from all sources (including contributions)	2015-06-30	$2,965,346
Total loss/gain on sale of assets	2015-06-30	$0
Total of all expenses incurred	2015-06-30	$1,395,049
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-06-30	$1,365,242
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-06-30	$2,054,054
Value of total assets at end of year	2015-06-30	$25,218,032
Value of total assets at beginning of year	2015-06-30	$23,647,735
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-06-30	$29,807
Total interest from all sources	2015-06-30	$229,650
Total dividends received (eg from common stock, registered investment company shares)	2015-06-30	$1,270,843
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-06-30	$1,270,843
Was this plan covered by a fidelity bond	2015-06-30	Yes
Value of fidelity bond cover	2015-06-30	$500,000
If this is an individual account plan, was there a blackout period	2015-06-30	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2015-06-30	No
Contributions received from participants	2015-06-30	$1,605,786
Participant contributions at end of year	2015-06-30	$298,563
Participant contributions at beginning of year	2015-06-30	$421,331
Income. Received or receivable in cash from other sources (including rollovers)	2015-06-30	$448,268
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-06-30	No
Value of net income/loss	2015-06-30	$1,570,297
Value of net assets at end of year (total assets less liabilities)	2015-06-30	$25,218,032
Value of net assets at beginning of year (total assets less liabilities)	2015-06-30	$23,647,735
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-06-30	No
Were any leases to which the plan was party in default or uncollectible	2015-06-30	No
Investment advisory and management fees	2015-06-30	$3,867
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-06-30	$18,150,782
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-06-30	$16,033,144
Interest on participant loans	2015-06-30	$7,980
Interest earned on other investments	2015-06-30	$221,670
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-06-30	$6,768,687
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-06-30	$7,193,260
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-06-30	$-589,201
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-06-30	No
Was there a failure to transmit to the plan any participant contributions	2015-06-30	No
Has the plan failed to provide any benefit when due under the plan	2015-06-30	No
Contributions received in cash from employer	2015-06-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-06-30	$1,365,242
Contract administrator fees	2015-06-30	$25,940
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2015-06-30	Yes
Did the plan have assets held for investment	2015-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2015-06-30	Disclaimer
Accountancy firm name	2015-06-30	WIPFLI, LLP
Accountancy firm EIN	2015-06-30	390758449
2014 : ASPIRUS LANGLADE HOSPITAL TAX DEFERRED ANNUITY PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-06-30	$0
Total income from all sources (including contributions)	2014-06-30	$4,339,385
Total loss/gain on sale of assets	2014-06-30	$0
Total of all expenses incurred	2014-06-30	$978,946
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-06-30	$955,371
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-06-30	$1,636,982
Value of total assets at end of year	2014-06-30	$23,647,735
Value of total assets at beginning of year	2014-06-30	$20,287,296
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-06-30	$23,575
Total interest from all sources	2014-06-30	$173,179
Total dividends received (eg from common stock, registered investment company shares)	2014-06-30	$568,649
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-06-30	$568,649
Was this plan covered by a fidelity bond	2014-06-30	Yes
Value of fidelity bond cover	2014-06-30	$500,000
If this is an individual account plan, was there a blackout period	2014-06-30	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2014-06-30	No
Contributions received from participants	2014-06-30	$1,560,109
Participant contributions at end of year	2014-06-30	$421,331
Participant contributions at beginning of year	2014-06-30	$389,883
Income. Received or receivable in cash from other sources (including rollovers)	2014-06-30	$76,873
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-06-30	No
Value of net income/loss	2014-06-30	$3,360,439
Value of net assets at end of year (total assets less liabilities)	2014-06-30	$23,647,735
Value of net assets at beginning of year (total assets less liabilities)	2014-06-30	$20,287,296
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-06-30	No
Were any leases to which the plan was party in default or uncollectible	2014-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-06-30	$16,033,144
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-06-30	$13,632,332
Interest on participant loans	2014-06-30	$8,049
Interest earned on other investments	2014-06-30	$165,130
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-06-30	$7,193,260
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-06-30	$6,265,081
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-06-30	$1,960,575
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-06-30	No
Was there a failure to transmit to the plan any participant contributions	2014-06-30	No
Has the plan failed to provide any benefit when due under the plan	2014-06-30	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-06-30	$955,371
Contract administrator fees	2014-06-30	$23,575
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2014-06-30	Yes
Did the plan have assets held for investment	2014-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2014-06-30	Disclaimer
Accountancy firm name	2014-06-30	WIPFLI, LLP
Accountancy firm EIN	2014-06-30	390758449
2013 : ASPIRUS LANGLADE HOSPITAL TAX DEFERRED ANNUITY PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-06-30	$40,770
Total income from all sources (including contributions)	2013-06-30	$3,955,908
Total loss/gain on sale of assets	2013-06-30	$0
Total of all expenses incurred	2013-06-30	$1,278,753
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-06-30	$1,250,280
Expenses. Certain deemed distributions of participant loans	2013-06-30	$7,762
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-06-30	$1,910,845
Value of total assets at end of year	2013-06-30	$20,287,296
Value of total assets at beginning of year	2013-06-30	$17,650,911
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-06-30	$20,711
Total interest from all sources	2013-06-30	$228,864
Total dividends received (eg from common stock, registered investment company shares)	2013-06-30	$476,030
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-06-30	$476,030
Was this plan covered by a fidelity bond	2013-06-30	Yes
Value of fidelity bond cover	2013-06-30	$500,000
If this is an individual account plan, was there a blackout period	2013-06-30	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2013-06-30	No
Contributions received from participants	2013-06-30	$1,462,945
Participant contributions at end of year	2013-06-30	$389,883
Participant contributions at beginning of year	2013-06-30	$210,970
Income. Received or receivable in cash from other sources (including rollovers)	2013-06-30	$447,900
Value of other receiveables (less allowance for doubtful accounts) at end of year	2013-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2013-06-30	$20,772
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2013-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2013-06-30	$40,770
Total non interest bearing cash at end of year	2013-06-30	$0
Total non interest bearing cash at beginning of year	2013-06-30	$23
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-06-30	No
Value of net income/loss	2013-06-30	$2,677,155
Value of net assets at end of year (total assets less liabilities)	2013-06-30	$20,287,296
Value of net assets at beginning of year (total assets less liabilities)	2013-06-30	$17,610,141
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-06-30	No
Were any leases to which the plan was party in default or uncollectible	2013-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-06-30	$13,632,332
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-06-30	$11,699,253
Interest on participant loans	2013-06-30	$9,336
Interest earned on other investments	2013-06-30	$219,528
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2013-06-30	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2013-06-30	$29,042
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2013-06-30	$29,042
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-06-30	$6,265,081
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-06-30	$5,690,851
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-06-30	$1,340,169
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-06-30	No
Was there a failure to transmit to the plan any participant contributions	2013-06-30	No
Has the plan failed to provide any benefit when due under the plan	2013-06-30	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-06-30	$1,250,280
Contract administrator fees	2013-06-30	$20,711
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2013-06-30	Yes
Did the plan have assets held for investment	2013-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2013-06-30	Disclaimer
Accountancy firm name	2013-06-30	WIPFLI, LLP
Accountancy firm EIN	2013-06-30	390758449
2012 : ASPIRUS LANGLADE HOSPITAL TAX DEFERRED ANNUITY PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-06-30	$40,770
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-06-30	$18,854
Total income from all sources (including contributions)	2012-06-30	$2,237,509
Total loss/gain on sale of assets	2012-06-30	$0
Total of all expenses incurred	2012-06-30	$837,560
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-06-30	$815,761
Value of total corrective distributions	2012-06-30	$4,759
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-06-30	$1,892,126
Value of total assets at end of year	2012-06-30	$17,650,911
Value of total assets at beginning of year	2012-06-30	$16,229,046
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-06-30	$17,040
Total interest from all sources	2012-06-30	$172,279
Total dividends received (eg from common stock, registered investment company shares)	2012-06-30	$337,390
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-06-30	$337,390
Was this plan covered by a fidelity bond	2012-06-30	Yes
Value of fidelity bond cover	2012-06-30	$1,000,000
If this is an individual account plan, was there a blackout period	2012-06-30	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2012-06-30	No
Contributions received from participants	2012-06-30	$1,441,566
Participant contributions at end of year	2012-06-30	$210,970
Participant contributions at beginning of year	2012-06-30	$163,332
Income. Received or receivable in cash from other sources (including rollovers)	2012-06-30	$450,560
Value of other receiveables (less allowance for doubtful accounts) at end of year	2012-06-30	$20,772
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2012-06-30	$18,854
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2012-06-30	$40,770
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2012-06-30	$18,854
Other income not declared elsewhere	2012-06-30	$32,698
Total non interest bearing cash at end of year	2012-06-30	$23
Total non interest bearing cash at beginning of year	2012-06-30	$23
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-06-30	No
Value of net income/loss	2012-06-30	$1,399,949
Value of net assets at end of year (total assets less liabilities)	2012-06-30	$17,610,141
Value of net assets at beginning of year (total assets less liabilities)	2012-06-30	$16,210,192
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-06-30	No
Were any leases to which the plan was party in default or uncollectible	2012-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-06-30	$11,699,253
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-06-30	$10,975,790
Interest on participant loans	2012-06-30	$7,336
Interest earned on other investments	2012-06-30	$164,939
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-06-30	$29,042
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-06-30	$22,570
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-06-30	$22,570
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-06-30	$4
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-06-30	$5,690,851
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-06-30	$5,048,477
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-06-30	$-196,984
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-06-30	No
Was there a failure to transmit to the plan any participant contributions	2012-06-30	No
Has the plan failed to provide any benefit when due under the plan	2012-06-30	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-06-30	$815,761
Contract administrator fees	2012-06-30	$17,040
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2012-06-30	Yes
Did the plan have assets held for investment	2012-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2012-06-30	Disclaimer
Accountancy firm name	2012-06-30	WIPFLI, LLP
Accountancy firm EIN	2012-06-30	390758449
2011 : ASPIRUS LANGLADE HOSPITAL TAX DEFERRED ANNUITY PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-06-30	$18,854
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-06-30	$65,122
Total income from all sources (including contributions)	2011-06-30	$3,794,918
Total loss/gain on sale of assets	2011-06-30	$0
Total of all expenses incurred	2011-06-30	$879,916
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-06-30	$864,696
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-06-30	$1,405,690
Value of total assets at end of year	2011-06-30	$16,229,046
Value of total assets at beginning of year	2011-06-30	$13,360,312
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-06-30	$15,220
Total interest from all sources	2011-06-30	$149,827
Total dividends received (eg from common stock, registered investment company shares)	2011-06-30	$223,290
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2011-06-30	$223,290
Was this plan covered by a fidelity bond	2011-06-30	Yes
Value of fidelity bond cover	2011-06-30	$1,000,000
If this is an individual account plan, was there a blackout period	2011-06-30	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2011-06-30	No
Contributions received from participants	2011-06-30	$1,221,822
Participant contributions at end of year	2011-06-30	$163,332
Participant contributions at beginning of year	2011-06-30	$159,041
Participant contributions at beginning of year	2011-06-30	$48,567
Income. Received or receivable in cash from other sources (including rollovers)	2011-06-30	$183,868
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-06-30	$18,854
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-06-30	$17,505
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2011-06-30	$18,854
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2011-06-30	$65,122
Total non interest bearing cash at end of year	2011-06-30	$23
Total non interest bearing cash at beginning of year	2011-06-30	$23
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-06-30	No
Value of net income/loss	2011-06-30	$2,915,002
Value of net assets at end of year (total assets less liabilities)	2011-06-30	$16,210,192
Value of net assets at beginning of year (total assets less liabilities)	2011-06-30	$13,295,190
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-06-30	No
Were any leases to which the plan was party in default or uncollectible	2011-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-06-30	$10,975,790
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-06-30	$8,697,501
Interest on participant loans	2011-06-30	$6,450
Interest earned on other investments	2011-06-30	$143,375
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-06-30	$22,570
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-06-30	$58,298
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-06-30	$58,298
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-06-30	$2
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-06-30	$5,048,477
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-06-30	$4,379,377
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-06-30	$2,016,111
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-06-30	No
Was there a failure to transmit to the plan any participant contributions	2011-06-30	No
Has the plan failed to provide any benefit when due under the plan	2011-06-30	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-06-30	$864,696
Contract administrator fees	2011-06-30	$15,220
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2011-06-30	Yes
Did the plan have assets held for investment	2011-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2011-06-30	Disclaimer
Accountancy firm name	2011-06-30	WIPFLI, LLP
Accountancy firm EIN	2011-06-30	390758449
2010 : ASPIRUS LANGLADE HOSPITAL TAX DEFERRED ANNUITY PLAN 2010 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-06-30	$0

Form 5500 Responses for ASPIRUS LANGLADE HOSPITAL TAX DEFERRED ANNUITY PLAN

2017: ASPIRUS LANGLADE HOSPITAL TAX DEFERRED ANNUITY PLAN 2017 form 5500 responses
2017-07-01	Type of plan entity	Single employer plan
2017-07-01	Submission has been amended	No
2017-07-01	This submission is the final filing	Yes
2017-07-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2017-07-01	Plan is a collectively bargained plan	Yes
2017-07-01	Plan funding arrangement – Insurance	Yes
2017-07-01	Plan funding arrangement – Trust	Yes
2017-07-01	Plan benefit arrangement – Insurance	Yes
2017-07-01	Plan benefit arrangement - Trust	Yes
2016: ASPIRUS LANGLADE HOSPITAL TAX DEFERRED ANNUITY PLAN 2016 form 5500 responses
2016-07-01	Type of plan entity	Single employer plan
2016-07-01	Submission has been amended	No
2016-07-01	This submission is the final filing	No
2016-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-07-01	Plan is a collectively bargained plan	Yes
2016-07-01	Plan funding arrangement – Insurance	Yes
2016-07-01	Plan funding arrangement – Trust	Yes
2016-07-01	Plan benefit arrangement – Insurance	Yes
2016-07-01	Plan benefit arrangement - Trust	Yes
2015: ASPIRUS LANGLADE HOSPITAL TAX DEFERRED ANNUITY PLAN 2015 form 5500 responses
2015-07-01	Type of plan entity	Single employer plan
2015-07-01	Submission has been amended	No
2015-07-01	This submission is the final filing	No
2015-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-07-01	Plan is a collectively bargained plan	Yes
2015-07-01	Plan funding arrangement – Insurance	Yes
2015-07-01	Plan funding arrangement – Trust	Yes
2015-07-01	Plan benefit arrangement – Insurance	Yes
2015-07-01	Plan benefit arrangement - Trust	Yes
2014: ASPIRUS LANGLADE HOSPITAL TAX DEFERRED ANNUITY PLAN 2014 form 5500 responses
2014-07-01	Type of plan entity	Single employer plan
2014-07-01	Submission has been amended	No
2014-07-01	This submission is the final filing	No
2014-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-07-01	Plan is a collectively bargained plan	Yes
2014-07-01	Plan funding arrangement – Insurance	Yes
2014-07-01	Plan funding arrangement – Trust	Yes
2014-07-01	Plan benefit arrangement – Insurance	Yes
2014-07-01	Plan benefit arrangement - Trust	Yes
2013: ASPIRUS LANGLADE HOSPITAL TAX DEFERRED ANNUITY PLAN 2013 form 5500 responses
2013-07-01	Type of plan entity	Single employer plan
2013-07-01	Submission has been amended	No
2013-07-01	This submission is the final filing	No
2013-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-07-01	Plan is a collectively bargained plan	Yes
2013-07-01	Plan funding arrangement – Insurance	Yes
2013-07-01	Plan funding arrangement – Trust	Yes
2013-07-01	Plan benefit arrangement – Insurance	Yes
2013-07-01	Plan benefit arrangement - Trust	Yes
2012: ASPIRUS LANGLADE HOSPITAL TAX DEFERRED ANNUITY PLAN 2012 form 5500 responses
2012-07-01	Type of plan entity	Single employer plan
2012-07-01	Submission has been amended	No
2012-07-01	This submission is the final filing	No
2012-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-07-01	Plan is a collectively bargained plan	Yes
2012-07-01	Plan funding arrangement – Insurance	Yes
2012-07-01	Plan funding arrangement – Trust	Yes
2012-07-01	Plan benefit arrangement – Insurance	Yes
2012-07-01	Plan benefit arrangement - Trust	Yes
2011: ASPIRUS LANGLADE HOSPITAL TAX DEFERRED ANNUITY PLAN 2011 form 5500 responses
2011-07-01	Type of plan entity	Single employer plan
2011-07-01	Submission has been amended	No
2011-07-01	This submission is the final filing	No
2011-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-07-01	Plan is a collectively bargained plan	Yes
2011-07-01	Plan funding arrangement – Insurance	Yes
2011-07-01	Plan funding arrangement – Trust	Yes
2011-07-01	Plan benefit arrangement – Insurance	Yes
2011-07-01	Plan benefit arrangement - Trust	Yes
2009: ASPIRUS LANGLADE HOSPITAL TAX DEFERRED ANNUITY PLAN 2009 form 5500 responses
2009-07-01	Type of plan entity	Single employer plan
2009-07-01	Submission has been amended	No
2009-07-01	This submission is the final filing	No
2009-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-07-01	Plan is a collectively bargained plan	Yes
2009-07-01	Plan funding arrangement – Insurance	Yes
2009-07-01	Plan funding arrangement – Trust	Yes
2009-07-01	Plan benefit arrangement – Insurance	Yes
2009-07-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

CR 15004

Policy instance

Insurance contract or identification number	CR 15004
Number of Individuals Covered	0
Insurance policy start date	2017-07-01
Insurance policy end date	2017-12-29
Total amount of commissions paid to insurance broker	USD $300
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $300
Insurance broker organization code?	4
Insurance broker name	LPL FINANCIAL CORPORATION

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

GP 55291

Policy instance

Insurance contract or identification number	GP 55291
Number of Individuals Covered	0
Insurance policy start date	2017-07-01
Insurance policy end date	2017-12-29
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	LANGLADE HOSPITAL, AN ASPIRUS PARTNER DBA ASPIRUS LANGLADE HOSPITAL
Employer identification number (EIN):	390806429
NAIC Classification:	622000
NAIC Description:	Hospitals