401k Plan data: NEW LONDON FAMILY MEDICAL CENTER TAX DEFERRED ANNUITY PLAN plan

NEW LONDON FAMILY MEDICAL CENTER TAX DEFERRED ANNUITY PLAN 401k Plan overview

Plan Name	NEW LONDON FAMILY MEDICAL CENTER TAX DEFERRED ANNUITY PLAN
Plan identification number	002

NEW LONDON FAMILY MEDICAL CENTER 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.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

THEDACARE has sponsored the creation of one or more 401k plans.

Company Name: THEDACARE

Employer identification number (EIN): 391509362

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NEW LONDON FAMILY MEDICAL CENTER TAX DEFERRED ANNUITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2016-07-01 KAREN GARVEY 2017-07-26
002 2015-07-01 KAREN GARVEY 2016-12-19
002 2014-07-01 KAREN GARVEY 2016-01-20
002 2014-01-01 TERRI LICK
002 2013-07-01 KAREN GARVEY 2014-12-18
002 2012-07-01 KAREN GARVEY 2014-01-23
002 2011-07-01 KAREN GARVEY 2013-01-10 KAREN GARVEY 2013-01-10
002 2010-07-01 SUSAN FREDERICKSON
002 2009-07-01 SUSAN FREDERICKSON

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2016-07-01	KAREN GARVEY	2017-07-26
002	2015-07-01	KAREN GARVEY	2016-12-19
002	2014-07-01	KAREN GARVEY	2016-01-20
002	2014-01-01	TERRI LICK
002	2013-07-01	KAREN GARVEY	2014-12-18
002	2012-07-01	KAREN GARVEY	2014-01-23
002	2011-07-01	KAREN GARVEY	2013-01-10	KAREN GARVEY	2013-01-10
002	2010-07-01	SUSAN FREDERICKSON
002	2009-07-01	SUSAN FREDERICKSON

Plan Statistics for NEW LONDON FAMILY MEDICAL CENTER TAX DEFERRED ANNUITY PLAN

401k plan membership statisitcs for NEW LONDON FAMILY MEDICAL CENTER TAX DEFERRED ANNUITY PLAN

Measure Date Value
2014: NEW LONDON FAMILY MEDICAL CENTER TAX DEFERRED ANNUITY PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 871
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 684
Number of retired or separated participants receiving benefits 2014-01-01 10
Number of other retired or separated participants entitled to future benefits 2014-01-01 204
Total of all active and inactive participants 2014-01-01 898
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 898
Number of participants with account balances 2014-01-01 636
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2010: NEW LONDON FAMILY MEDICAL CENTER TAX DEFERRED ANNUITY PLAN 2010 401k membership
Total participants, beginning-of-year 2010-07-01 110
Total number of active participants reported on line 7a of the Form 5500 2010-07-01 0
Number of retired or separated participants receiving benefits 2010-07-01 0
Number of other retired or separated participants entitled to future benefits 2010-07-01 99
Total of all active and inactive participants 2010-07-01 99
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-07-01 0
Total participants 2010-07-01 99
Number of participants with account balances 2010-07-01 99
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-07-01 0
2009: NEW LONDON FAMILY MEDICAL CENTER TAX DEFERRED ANNUITY PLAN 2009 401k membership
Total participants, beginning-of-year 2009-07-01 114
Total number of active participants reported on line 7a of the Form 5500 2009-07-01 60
Number of retired or separated participants receiving benefits 2009-07-01 0
Number of other retired or separated participants entitled to future benefits 2009-07-01 50
Total of all active and inactive participants 2009-07-01 110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-07-01 0
Total participants 2009-07-01 110
Number of participants with account balances 2009-07-01 110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-07-01 0

Measure	Date	Value
2014: NEW LONDON FAMILY MEDICAL CENTER TAX DEFERRED ANNUITY PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	871
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	684
Number of retired or separated participants receiving benefits	2014-01-01	10
Number of other retired or separated participants entitled to future benefits	2014-01-01	204
Total of all active and inactive participants	2014-01-01	898
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	898
Number of participants with account balances	2014-01-01	636
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2010: NEW LONDON FAMILY MEDICAL CENTER TAX DEFERRED ANNUITY PLAN 2010 401k membership
Total participants, beginning-of-year	2010-07-01	110
Total number of active participants reported on line 7a of the Form 5500	2010-07-01	0
Number of retired or separated participants receiving benefits	2010-07-01	0
Number of other retired or separated participants entitled to future benefits	2010-07-01	99
Total of all active and inactive participants	2010-07-01	99
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-07-01	0
Total participants	2010-07-01	99
Number of participants with account balances	2010-07-01	99
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-07-01	0
2009: NEW LONDON FAMILY MEDICAL CENTER TAX DEFERRED ANNUITY PLAN 2009 401k membership
Total participants, beginning-of-year	2009-07-01	114
Total number of active participants reported on line 7a of the Form 5500	2009-07-01	60
Number of retired or separated participants receiving benefits	2009-07-01	0
Number of other retired or separated participants entitled to future benefits	2009-07-01	50
Total of all active and inactive participants	2009-07-01	110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-07-01	0
Total participants	2009-07-01	110
Number of participants with account balances	2009-07-01	110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-07-01	0

Financial Data on NEW LONDON FAMILY MEDICAL CENTER TAX DEFERRED ANNUITY PLAN

Measure	Date	Value
2014 : NEW LONDON FAMILY MEDICAL CENTER TAX DEFERRED ANNUITY PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$3,833,504
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$2,312,380
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$2,301,896
Expenses. Certain deemed distributions of participant loans	2014-12-31	$6,871
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$2,155,874
Value of total assets at end of year	2014-12-31	$28,295,221
Value of total assets at beginning of year	2014-12-31	$26,774,097
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$3,613
Total interest from all sources	2014-12-31	$296,256
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$986,370
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$986,370
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$500,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$1,793,579
Participant contributions at end of year	2014-12-31	$121,470
Participant contributions at beginning of year	2014-12-31	$149,157
Participant contributions at end of year	2014-12-31	$0
Participant contributions at beginning of year	2014-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$362,295
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2014-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2014-12-31	$0
Other income not declared elsewhere	2014-12-31	$469
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$1,521,124
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$28,295,221
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$26,774,097
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$18,290,606
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$17,149,537
Interest on participant loans	2014-12-31	$6,202
Interest earned on other investments	2014-12-31	$290,054
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$9,883,145
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$9,475,403
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$394,535
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$2,301,896
Contract administrator fees	2014-12-31	$3,613
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	WIPFLI LLP
Accountancy firm EIN	2014-12-31	390758449
2011 : NEW LONDON FAMILY MEDICAL CENTER 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	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-06-30	$0
Total income from all sources (including contributions)	2011-06-30	$302,284
Total loss/gain on sale of assets	2011-06-30	$0
Total of all expenses incurred	2011-06-30	$102,375
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-06-30	$100,136
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-06-30	$0
Value of total assets at end of year	2011-06-30	$2,144,454
Value of total assets at beginning of year	2011-06-30	$1,944,545
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-06-30	$2,239
Total interest from all sources	2011-06-30	$32,987
Total dividends received (eg from common stock, registered investment company shares)	2011-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-06-30	No
Was this plan covered by a fidelity bond	2011-06-30	Yes
Value of fidelity bond cover	2011-06-30	$6,000,000
If this is an individual account plan, was there a blackout period	2011-06-30	No
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
Participant contributions at end of year	2011-06-30	$32,251
Participant contributions at beginning of year	2011-06-30	$39,453
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	$199,909
Value of net assets at end of year (total assets less liabilities)	2011-06-30	$2,144,454
Value of net assets at beginning of year (total assets less liabilities)	2011-06-30	$1,944,545
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	$1,206,709
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-06-30	$1,002,071
Interest earned on other investments	2011-06-30	$32,987
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-06-30	$905,494
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-06-30	$903,021
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-06-30	$269,297
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	$100,136
Contract administrator fees	2011-06-30	$2,239
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	SCHENCK SC
Accountancy firm EIN	2011-06-30	391173131
2010 : NEW LONDON FAMILY MEDICAL CENTER 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 NEW LONDON FAMILY MEDICAL CENTER TAX DEFERRED ANNUITY PLAN

2014: NEW LONDON FAMILY MEDICAL CENTER TAX DEFERRED ANNUITY PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2010: NEW LONDON FAMILY MEDICAL CENTER TAX DEFERRED ANNUITY PLAN 2010 form 5500 responses
2010-07-01	Type of plan entity	Single employer plan
2010-07-01	Submission has been amended	No
2010-07-01	This submission is the final filing	No
2010-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-07-01	Plan is a collectively bargained plan	No
2010-07-01	Plan funding arrangement – Insurance	Yes
2010-07-01	Plan funding arrangement – Trust	Yes
2010-07-01	Plan benefit arrangement – Insurance	Yes
2010-07-01	Plan benefit arrangement - Trust	Yes
2009: NEW LONDON FAMILY MEDICAL CENTER 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	No
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

GP55347

Policy instance

Insurance contract or identification number	GP55347
Number of Individuals Covered	547
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $13,416
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $13,416
Insurance broker organization code?	4
Insurance broker name	VSR FINANCIAL SERVICES, INC.

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

Policy contract number

CR14859

Policy instance

Insurance contract or identification number	CR14859
Number of Individuals Covered	147
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $9,224
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $9,224
Insurance broker organization code?	4
Insurance broker name	VSR FINANCIAL SERVICES, INC.

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

Policy contract number

CR14640

Policy instance

Insurance contract or identification number	CR14640
Number of Individuals Covered	99
Insurance policy start date	2010-07-01
Insurance policy end date	2011-06-30
Total amount of commissions paid to insurance broker	USD $4,467
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	THEDACARE
Employer identification number (EIN):	391509362
NAIC Classification:	622000
NAIC Description:	Hospitals