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RIVERSIDE MEDICAL CENTER 403(B) TAX DEFERRED ANNUITY PLAN 401k Plan overview

Plan NameRIVERSIDE MEDICAL CENTER 403(B) TAX DEFERRED ANNUITY PLAN
Plan identification number 006

RIVERSIDE MEDICAL CENTER 403(B) 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.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.

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 RIVERSIDE MEDICAL CENTER 403(B) TAX DEFERRED ANNUITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0062018-07-01
0062017-07-01KAREN GARVEY
0062016-07-01KAREN GARVEY
0062015-07-01KAREN GARVEY
0062014-07-01KAREN GARVEY
0062013-07-01KAREN GARVEY
0062012-07-01KAREN GARVEY
0062011-07-01KAREN GARVEY KAREN GARVEY2013-03-08
0062010-07-01SUSAN FREDERICKSON
0062009-07-01SUSAN FREDERICKSON

Plan Statistics for RIVERSIDE MEDICAL CENTER 403(B) TAX DEFERRED ANNUITY PLAN

401k plan membership statisitcs for RIVERSIDE MEDICAL CENTER 403(B) TAX DEFERRED ANNUITY PLAN

Measure Date Value
2018: RIVERSIDE MEDICAL CENTER 403(B) TAX DEFERRED ANNUITY PLAN 2018 401k membership
Total participants, beginning-of-year2018-07-01112
Total number of active participants reported on line 7a of the Form 55002018-07-010
Number of retired or separated participants receiving benefits2018-07-010
Number of other retired or separated participants entitled to future benefits2018-07-010
Total of all active and inactive participants2018-07-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-07-010
Total participants2018-07-010
Number of participants with account balances2018-07-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-07-010
2017: RIVERSIDE MEDICAL CENTER 403(B) TAX DEFERRED ANNUITY PLAN 2017 401k membership
Total participants, beginning-of-year2017-07-01124
Total number of active participants reported on line 7a of the Form 55002017-07-010
Number of retired or separated participants receiving benefits2017-07-010
Number of other retired or separated participants entitled to future benefits2017-07-01112
Total of all active and inactive participants2017-07-01112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-07-010
Total participants2017-07-01112
Number of participants with account balances2017-07-01112
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-07-010
2016: RIVERSIDE MEDICAL CENTER 403(B) TAX DEFERRED ANNUITY PLAN 2016 401k membership
Total participants, beginning-of-year2016-07-01138
Total number of active participants reported on line 7a of the Form 55002016-07-010
Number of retired or separated participants receiving benefits2016-07-010
Number of other retired or separated participants entitled to future benefits2016-07-01124
Total of all active and inactive participants2016-07-01124
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-07-010
Total participants2016-07-01124
Number of participants with account balances2016-07-01124
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-07-010
2015: RIVERSIDE MEDICAL CENTER 403(B) TAX DEFERRED ANNUITY PLAN 2015 401k membership
Total participants, beginning-of-year2015-07-01151
Total number of active participants reported on line 7a of the Form 55002015-07-010
Number of retired or separated participants receiving benefits2015-07-010
Number of other retired or separated participants entitled to future benefits2015-07-01138
Total of all active and inactive participants2015-07-01138
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-07-010
Total participants2015-07-01138
Number of participants with account balances2015-07-01138
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-07-010
2014: RIVERSIDE MEDICAL CENTER 403(B) TAX DEFERRED ANNUITY PLAN 2014 401k membership
Total participants, beginning-of-year2014-07-01161
Total number of active participants reported on line 7a of the Form 55002014-07-010
Number of retired or separated participants receiving benefits2014-07-010
Number of other retired or separated participants entitled to future benefits2014-07-01151
Total of all active and inactive participants2014-07-01151
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-07-010
Total participants2014-07-01151
Number of participants with account balances2014-07-01151
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-07-010
2013: RIVERSIDE MEDICAL CENTER 403(B) TAX DEFERRED ANNUITY PLAN 2013 401k membership
Total participants, beginning-of-year2013-07-01173
Total number of active participants reported on line 7a of the Form 55002013-07-010
Number of retired or separated participants receiving benefits2013-07-010
Number of other retired or separated participants entitled to future benefits2013-07-01161
Total of all active and inactive participants2013-07-01161
Total participants2013-07-01161
Number of participants with account balances2013-07-01161
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-07-010
2012: RIVERSIDE MEDICAL CENTER 403(B) TAX DEFERRED ANNUITY PLAN 2012 401k membership
Total participants, beginning-of-year2012-07-01189
Total number of active participants reported on line 7a of the Form 55002012-07-010
Number of retired or separated participants receiving benefits2012-07-010
Number of other retired or separated participants entitled to future benefits2012-07-01173
Total of all active and inactive participants2012-07-01173
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-07-010
Total participants2012-07-01173
Number of participants with account balances2012-07-01173
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-07-010
2011: RIVERSIDE MEDICAL CENTER 403(B) TAX DEFERRED ANNUITY PLAN 2011 401k membership
Total participants, beginning-of-year2011-07-01206
Total number of active participants reported on line 7a of the Form 55002011-07-010
Number of retired or separated participants receiving benefits2011-07-010
Number of other retired or separated participants entitled to future benefits2011-07-01189
Total of all active and inactive participants2011-07-01189
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-07-010
Total participants2011-07-01189
Number of participants with account balances2011-07-01189
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-07-010
2010: RIVERSIDE MEDICAL CENTER 403(B) TAX DEFERRED ANNUITY PLAN 2010 401k membership
Total participants, beginning-of-year2010-07-01232
Total number of active participants reported on line 7a of the Form 55002010-07-01206
Number of retired or separated participants receiving benefits2010-07-010
Number of other retired or separated participants entitled to future benefits2010-07-010
Total of all active and inactive participants2010-07-01206
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-07-010
Total participants2010-07-01206
Number of participants with account balances2010-07-01206
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-07-010
2009: RIVERSIDE MEDICAL CENTER 403(B) TAX DEFERRED ANNUITY PLAN 2009 401k membership
Total participants, beginning-of-year2009-07-01232
Total number of active participants reported on line 7a of the Form 55002009-07-01232
Number of retired or separated participants receiving benefits2009-07-010
Number of other retired or separated participants entitled to future benefits2009-07-010
Total of all active and inactive participants2009-07-01232
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-07-010
Total participants2009-07-01232
Number of participants with account balances2009-07-01232
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-07-010

Financial Data on RIVERSIDE MEDICAL CENTER 403(B) TAX DEFERRED ANNUITY PLAN

Measure Date Value
2019 : RIVERSIDE MEDICAL CENTER 403(B) TAX DEFERRED ANNUITY PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-03-01$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-03-01$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-03-01$0
Total income from all sources (including contributions)2019-03-01$-39,332
Total loss/gain on sale of assets2019-03-01$0
Total of all expenses incurred2019-03-01$6,229,397
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-03-01$6,226,772
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-03-01$0
Value of total assets at end of year2019-03-01$0
Value of total assets at beginning of year2019-03-01$6,268,729
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-03-01$2,625
Total interest from all sources2019-03-01$19,199
Total dividends received (eg from common stock, registered investment company shares)2019-03-01$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-03-01Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan2019-03-01$0
Was this plan covered by a fidelity bond2019-03-01Yes
Value of fidelity bond cover2019-03-01$500,000
If this is an individual account plan, was there a blackout period2019-03-01No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-03-01$0
Were there any nonexempt tranactions with any party-in-interest2019-03-01No
Participant contributions at end of year2019-03-01$0
Participant contributions at beginning of year2019-03-01$20,961
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-03-01No
Value of net income/loss2019-03-01$-6,268,729
Value of net assets at end of year (total assets less liabilities)2019-03-01$0
Value of net assets at beginning of year (total assets less liabilities)2019-03-01$6,268,729
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-03-01No
Were any loans by the plan or fixed income obligations due to the plan in default2019-03-01No
Were any leases to which the plan was party in default or uncollectible2019-03-01No
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-03-01$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-03-01$5,495,982
Interest earned on other investments2019-03-01$19,199
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-03-01$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-03-01$751,786
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-03-01$-58,531
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-03-01No
Was there a failure to transmit to the plan any participant contributions2019-03-01No
Has the plan failed to provide any benefit when due under the plan2019-03-01No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-03-01$6,226,772
Contract administrator fees2019-03-01$2,625
Did the plan have assets held for investment2019-03-01No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-03-01No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-03-01Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-03-01Yes
Opinion of an independent qualified public accountant for this plan2019-03-01Disclaimer
Accountancy firm name2019-03-01CLIFTONLARSONALLEN LLP
Accountancy firm EIN2019-03-01410746749
2018 : RIVERSIDE MEDICAL CENTER 403(B) TAX DEFERRED ANNUITY PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-06-30$0
Total income from all sources (including contributions)2018-06-30$615,303
Total loss/gain on sale of assets2018-06-30$0
Total of all expenses incurred2018-06-30$1,276,391
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-06-30$1,273,391
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-06-30$0
Value of total assets at end of year2018-06-30$6,268,729
Value of total assets at beginning of year2018-06-30$6,929,817
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-06-30$3,000
Total interest from all sources2018-06-30$28,585
Total dividends received (eg from common stock, registered investment company shares)2018-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-06-30No
Was this plan covered by a fidelity bond2018-06-30Yes
Value of fidelity bond cover2018-06-30$500,000
If this is an individual account plan, was there a blackout period2018-06-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-06-30$0
Were there any nonexempt tranactions with any party-in-interest2018-06-30No
Participant contributions at end of year2018-06-30$20,961
Participant contributions at beginning of year2018-06-30$29,077
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-06-30No
Value of net income/loss2018-06-30$-661,088
Value of net assets at end of year (total assets less liabilities)2018-06-30$6,268,729
Value of net assets at beginning of year (total assets less liabilities)2018-06-30$6,929,817
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2018-06-30No
Were any leases to which the plan was party in default or uncollectible2018-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-06-30$5,495,982
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-06-30$5,449,228
Interest earned on other investments2018-06-30$28,585
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-06-30$751,786
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-06-30$1,451,512
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-06-30$586,718
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-06-30No
Was there a failure to transmit to the plan any participant contributions2018-06-30No
Has the plan failed to provide any benefit when due under the plan2018-06-30No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-06-30$1,273,391
Contract administrator fees2018-06-30$3,000
Did the plan have assets held for investment2018-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-06-30Yes
Opinion of an independent qualified public accountant for this plan2018-06-30Disclaimer
Accountancy firm name2018-06-30SCHENCK SC
Accountancy firm EIN2018-06-30391173131
2017 : RIVERSIDE MEDICAL CENTER 403(B) TAX DEFERRED ANNUITY PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-06-30$0
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$789,580
Total loss/gain on sale of assets2017-06-30$0
Total of all expenses incurred2017-06-30$525,609
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-06-30$522,259
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-06-30$0
Value of total assets at end of year2017-06-30$6,929,817
Value of total assets at beginning of year2017-06-30$6,665,846
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-06-30$3,350
Total interest from all sources2017-06-30$51,879
Total dividends received (eg from common stock, registered investment company shares)2017-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-06-30No
Was this plan covered by a fidelity bond2017-06-30Yes
Value of fidelity bond cover2017-06-30$500,000
If this is an individual account plan, was there a blackout period2017-06-30No
Were there any nonexempt tranactions with any party-in-interest2017-06-30No
Participant contributions at end of year2017-06-30$29,077
Participant contributions at beginning of year2017-06-30$39,697
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-06-30No
Value of net income/loss2017-06-30$263,971
Value of net assets at end of year (total assets less liabilities)2017-06-30$6,929,817
Value of net assets at beginning of year (total assets less liabilities)2017-06-30$6,665,846
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2017-06-30No
Were any leases to which the plan was party in default or uncollectible2017-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-06-30$5,449,228
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-06-30$5,086,678
Interest earned on other investments2017-06-30$51,879
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-06-30$1,451,512
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-06-30$1,539,471
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-06-30$737,701
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-06-30No
Was there a failure to transmit to the plan any participant contributions2017-06-30No
Has the plan failed to provide any benefit when due under the plan2017-06-30No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-06-30$522,259
Contract administrator fees2017-06-30$3,350
Did the plan have assets held for investment2017-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-06-30Yes
Opinion of an independent qualified public accountant for this plan2017-06-30Disclaimer
Accountancy firm name2017-06-30SCHENCK SC
Accountancy firm EIN2017-06-30391173131
2016 : RIVERSIDE MEDICAL CENTER 403(B) TAX DEFERRED ANNUITY PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-06-30$0
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$0
Total income from all sources (including contributions)2016-06-30$-83,735
Total loss/gain on sale of assets2016-06-30$0
Total of all expenses incurred2016-06-30$626,543
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-06-30$622,876
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-06-30$0
Value of total assets at end of year2016-06-30$6,665,846
Value of total assets at beginning of year2016-06-30$7,376,124
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-06-30$3,667
Total interest from all sources2016-06-30$56,525
Total dividends received (eg from common stock, registered investment company shares)2016-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-06-30No
Was this plan covered by a fidelity bond2016-06-30Yes
Value of fidelity bond cover2016-06-30$500,000
If this is an individual account plan, was there a blackout period2016-06-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-06-30$0
Were there any nonexempt tranactions with any party-in-interest2016-06-30No
Participant contributions at end of year2016-06-30$39,697
Participant contributions at beginning of year2016-06-30$28,582
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-06-30No
Value of net income/loss2016-06-30$-710,278
Value of net assets at end of year (total assets less liabilities)2016-06-30$6,665,846
Value of net assets at beginning of year (total assets less liabilities)2016-06-30$7,376,124
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2016-06-30No
Were any leases to which the plan was party in default or uncollectible2016-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-06-30$5,086,678
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-06-30$5,741,123
Interest earned on other investments2016-06-30$56,525
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-06-30$1,539,471
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-06-30$1,606,419
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-06-30$-140,260
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-06-30No
Was there a failure to transmit to the plan any participant contributions2016-06-30No
Has the plan failed to provide any benefit when due under the plan2016-06-30No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-06-30$622,876
Contract administrator fees2016-06-30$3,667
Did the plan have assets held for investment2016-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-06-30Yes
Opinion of an independent qualified public accountant for this plan2016-06-30Disclaimer
Accountancy firm name2016-06-30SCHENCK SC
Accountancy firm EIN2016-06-30391173131
2015 : RIVERSIDE MEDICAL CENTER 403(B) TAX DEFERRED ANNUITY PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-06-30$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$297,772
Total loss/gain on sale of assets2015-06-30$0
Total of all expenses incurred2015-06-30$561,143
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-06-30$557,218
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-06-30$0
Value of total assets at end of year2015-06-30$7,376,124
Value of total assets at beginning of year2015-06-30$7,639,495
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-06-30$3,925
Total interest from all sources2015-06-30$61,718
Total dividends received (eg from common stock, registered investment company shares)2015-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-06-30No
Was this plan covered by a fidelity bond2015-06-30Yes
Value of fidelity bond cover2015-06-30$10,000,000
If this is an individual account plan, was there a blackout period2015-06-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-06-30$0
Were there any nonexempt tranactions with any party-in-interest2015-06-30No
Participant contributions at end of year2015-06-30$28,582
Participant contributions at beginning of year2015-06-30$43,672
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-06-30No
Value of net income/loss2015-06-30$-263,371
Value of net assets at end of year (total assets less liabilities)2015-06-30$7,376,124
Value of net assets at beginning of year (total assets less liabilities)2015-06-30$7,639,495
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2015-06-30No
Were any leases to which the plan was party in default or uncollectible2015-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-06-30$5,741,123
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-06-30$5,920,759
Interest earned on other investments2015-06-30$61,718
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-06-30$1,606,419
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-06-30$1,675,064
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-06-30$236,054
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-06-30No
Was there a failure to transmit to the plan any participant contributions2015-06-30No
Has the plan failed to provide any benefit when due under the plan2015-06-30No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-06-30$557,218
Contract administrator fees2015-06-30$3,925
Did the plan have assets held for investment2015-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-06-30Yes
Opinion of an independent qualified public accountant for this plan2015-06-30Disclaimer
Accountancy firm name2015-06-30SCHENCK SC
Accountancy firm EIN2015-06-30391173131
2014 : RIVERSIDE MEDICAL CENTER 403(B) TAX DEFERRED ANNUITY PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-06-30$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$1,066,168
Total loss/gain on sale of assets2014-06-30$0
Total of all expenses incurred2014-06-30$411,288
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-06-30$407,067
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-06-30$0
Value of total assets at end of year2014-06-30$7,639,495
Value of total assets at beginning of year2014-06-30$6,984,615
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-06-30$4,221
Total interest from all sources2014-06-30$55,058
Total dividends received (eg from common stock, registered investment company shares)2014-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-06-30No
Was this plan covered by a fidelity bond2014-06-30Yes
Value of fidelity bond cover2014-06-30$10,000,000
If this is an individual account plan, was there a blackout period2014-06-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-06-30$0
Were there any nonexempt tranactions with any party-in-interest2014-06-30No
Participant contributions at end of year2014-06-30$43,672
Participant contributions at beginning of year2014-06-30$32,284
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-06-30No
Value of net income/loss2014-06-30$654,880
Value of net assets at end of year (total assets less liabilities)2014-06-30$7,639,495
Value of net assets at beginning of year (total assets less liabilities)2014-06-30$6,984,615
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2014-06-30No
Were any leases to which the plan was party in default or uncollectible2014-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-06-30$5,920,759
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-06-30$5,437,858
Interest earned on other investments2014-06-30$55,058
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-06-30$1,675,064
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-06-30$1,514,473
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-06-30$1,011,110
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-06-30No
Was there a failure to transmit to the plan any participant contributions2014-06-30No
Has the plan failed to provide any benefit when due under the plan2014-06-30No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-06-30$407,067
Contract administrator fees2014-06-30$4,221
Did the plan have assets held for investment2014-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-06-30Yes
Opinion of an independent qualified public accountant for this plan2014-06-30Disclaimer
Accountancy firm name2014-06-30SCHENCK SC
Accountancy firm EIN2014-06-30391173131
2013 : RIVERSIDE MEDICAL CENTER 403(B) TAX DEFERRED ANNUITY PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-06-30$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$0
Total income from all sources (including contributions)2013-06-30$798,581
Total loss/gain on sale of assets2013-06-30$0
Total of all expenses incurred2013-06-30$684,174
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-06-30$659,159
Expenses. Certain deemed distributions of participant loans2013-06-30$14,456
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-06-30$0
Value of total assets at end of year2013-06-30$6,984,615
Value of total assets at beginning of year2013-06-30$6,870,208
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-06-30$10,559
Total interest from all sources2013-06-30$53,847
Total dividends received (eg from common stock, registered investment company shares)2013-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-06-30No
Was this plan covered by a fidelity bond2013-06-30Yes
Value of fidelity bond cover2013-06-30$10,000,000
If this is an individual account plan, was there a blackout period2013-06-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-06-30$0
Were there any nonexempt tranactions with any party-in-interest2013-06-30No
Participant contributions at end of year2013-06-30$32,284
Participant contributions at beginning of year2013-06-30$63,344
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-06-30No
Value of net income/loss2013-06-30$114,407
Value of net assets at end of year (total assets less liabilities)2013-06-30$6,984,615
Value of net assets at beginning of year (total assets less liabilities)2013-06-30$6,870,208
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2013-06-30No
Were any leases to which the plan was party in default or uncollectible2013-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-06-30$5,437,858
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-06-30$5,243,846
Interest earned on other investments2013-06-30$53,847
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-06-30$1,514,473
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-06-30$1,563,018
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-06-30$744,734
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-06-30No
Was there a failure to transmit to the plan any participant contributions2013-06-30No
Has the plan failed to provide any benefit when due under the plan2013-06-30No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-06-30$659,159
Contract administrator fees2013-06-30$10,559
Did the plan have assets held for investment2013-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-06-30Yes
Opinion of an independent qualified public accountant for this plan2013-06-30Disclaimer
Accountancy firm name2013-06-30SCHENCK SC
Accountancy firm EIN2013-06-30391173131
2012 : RIVERSIDE MEDICAL CENTER 403(B) TAX DEFERRED ANNUITY PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-06-30$0
Total income from all sources (including contributions)2012-06-30$-4,988
Total loss/gain on sale of assets2012-06-30$0
Total of all expenses incurred2012-06-30$423,554
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-06-30$388,417
Expenses. Certain deemed distributions of participant loans2012-06-30$29,149
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-06-30$0
Value of total assets at end of year2012-06-30$6,870,208
Value of total assets at beginning of year2012-06-30$7,298,750
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-06-30$5,988
Total interest from all sources2012-06-30$56,795
Total dividends received (eg from common stock, registered investment company shares)2012-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-06-30No
Was this plan covered by a fidelity bond2012-06-30Yes
Value of fidelity bond cover2012-06-30$6,000,000
If this is an individual account plan, was there a blackout period2012-06-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-06-30$0
Were there any nonexempt tranactions with any party-in-interest2012-06-30No
Participant contributions at end of year2012-06-30$63,344
Participant contributions at beginning of year2012-06-30$65,561
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-06-30No
Value of net income/loss2012-06-30$-428,542
Value of net assets at end of year (total assets less liabilities)2012-06-30$6,870,208
Value of net assets at beginning of year (total assets less liabilities)2012-06-30$7,298,750
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2012-06-30No
Were any leases to which the plan was party in default or uncollectible2012-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-06-30$5,243,846
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-06-30$5,667,742
Interest earned on other investments2012-06-30$56,795
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-06-30$1,563,018
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-06-30$1,565,447
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-06-30$-61,783
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-06-30No
Was there a failure to transmit to the plan any participant contributions2012-06-30No
Has the plan failed to provide any benefit when due under the plan2012-06-30No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-06-30$388,417
Contract administrator fees2012-06-30$5,988
Did the plan have assets held for investment2012-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-06-30Yes
Opinion of an independent qualified public accountant for this plan2012-06-30Disclaimer
Accountancy firm name2012-06-30SCHENCK SC
Accountancy firm EIN2012-06-30391173131
2011 : RIVERSIDE MEDICAL CENTER 403(B) TAX DEFERRED ANNUITY PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-06-30$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$1,450,664
Total loss/gain on sale of assets2011-06-30$0
Total of all expenses incurred2011-06-30$1,131,785
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-06-30$1,104,532
Expenses. Certain deemed distributions of participant loans2011-06-30$21,206
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-06-30$0
Value of total assets at end of year2011-06-30$7,298,750
Value of total assets at beginning of year2011-06-30$6,979,871
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-06-30$6,047
Total interest from all sources2011-06-30$62,033
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 year2011-06-30No
Was this plan covered by a fidelity bond2011-06-30Yes
Value of fidelity bond cover2011-06-30$6,000,000
If this is an individual account plan, was there a blackout period2011-06-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-06-30$0
Were there any nonexempt tranactions with any party-in-interest2011-06-30No
Participant contributions at end of year2011-06-30$65,561
Participant contributions at beginning of year2011-06-30$63,944
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-06-30No
Value of net income/loss2011-06-30$318,879
Value of net assets at end of year (total assets less liabilities)2011-06-30$7,298,750
Value of net assets at beginning of year (total assets less liabilities)2011-06-30$6,979,871
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2011-06-30No
Were any leases to which the plan was party in default or uncollectible2011-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-06-30$5,667,742
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-06-30$5,186,294
Interest earned on other investments2011-06-30$62,033
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-06-30$1,565,447
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-06-30$1,729,633
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-06-30$1,388,631
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-06-30No
Was there a failure to transmit to the plan any participant contributions2011-06-30No
Has the plan failed to provide any benefit when due under the plan2011-06-30No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-06-30$1,104,532
Contract administrator fees2011-06-30$6,047
Did the plan have assets held for investment2011-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-06-30Yes
Opinion of an independent qualified public accountant for this plan2011-06-30Disclaimer
Accountancy firm name2011-06-30SCHENCK SC
Accountancy firm EIN2011-06-30391173131
2010 : RIVERSIDE MEDICAL CENTER 403(B) 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 securities2010-06-30$0

Form 5500 Responses for RIVERSIDE MEDICAL CENTER 403(B) TAX DEFERRED ANNUITY PLAN

2018: RIVERSIDE MEDICAL CENTER 403(B) TAX DEFERRED ANNUITY PLAN 2018 form 5500 responses
2018-07-01Type of plan entitySingle employer plan
2018-07-01Submission has been amendedNo
2018-07-01This submission is the final filingYes
2018-07-01This return/report is a short plan year return/report (less than 12 months)Yes
2018-07-01Plan is a collectively bargained planNo
2018-07-01Plan funding arrangement – InsuranceYes
2018-07-01Plan funding arrangement – TrustYes
2018-07-01Plan benefit arrangement – InsuranceYes
2018-07-01Plan benefit arrangement - TrustYes
2017: RIVERSIDE MEDICAL CENTER 403(B) TAX DEFERRED ANNUITY PLAN 2017 form 5500 responses
2017-07-01Type of plan entitySingle employer plan
2017-07-01Submission has been amendedNo
2017-07-01This submission is the final filingNo
2017-07-01This return/report is a short plan year return/report (less than 12 months)No
2017-07-01Plan is a collectively bargained planNo
2017-07-01Plan funding arrangement – InsuranceYes
2017-07-01Plan funding arrangement – TrustYes
2017-07-01Plan benefit arrangement – InsuranceYes
2017-07-01Plan benefit arrangement - TrustYes
2016: RIVERSIDE MEDICAL CENTER 403(B) TAX DEFERRED ANNUITY PLAN 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01Submission has been amendedNo
2016-07-01This submission is the final filingNo
2016-07-01This return/report is a short plan year return/report (less than 12 months)No
2016-07-01Plan is a collectively bargained planNo
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan funding arrangement – TrustYes
2016-07-01Plan benefit arrangement – InsuranceYes
2016-07-01Plan benefit arrangement - TrustYes
2015: RIVERSIDE MEDICAL CENTER 403(B) TAX DEFERRED ANNUITY PLAN 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01Submission has been amendedNo
2015-07-01This submission is the final filingNo
2015-07-01This return/report is a short plan year return/report (less than 12 months)No
2015-07-01Plan is a collectively bargained planNo
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan funding arrangement – TrustYes
2015-07-01Plan benefit arrangement – InsuranceYes
2015-07-01Plan benefit arrangement - TrustYes
2014: RIVERSIDE MEDICAL CENTER 403(B) TAX DEFERRED ANNUITY PLAN 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01Submission has been amendedNo
2014-07-01This submission is the final filingNo
2014-07-01This return/report is a short plan year return/report (less than 12 months)No
2014-07-01Plan is a collectively bargained planNo
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan funding arrangement – TrustYes
2014-07-01Plan benefit arrangement – InsuranceYes
2014-07-01Plan benefit arrangement - TrustYes
2013: RIVERSIDE MEDICAL CENTER 403(B) TAX DEFERRED ANNUITY PLAN 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01Submission has been amendedNo
2013-07-01This submission is the final filingNo
2013-07-01This return/report is a short plan year return/report (less than 12 months)No
2013-07-01Plan is a collectively bargained planNo
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan funding arrangement – TrustYes
2013-07-01Plan benefit arrangement – InsuranceYes
2013-07-01Plan benefit arrangement - TrustYes
2012: RIVERSIDE MEDICAL CENTER 403(B) TAX DEFERRED ANNUITY PLAN 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01Submission has been amendedNo
2012-07-01This submission is the final filingNo
2012-07-01This return/report is a short plan year return/report (less than 12 months)No
2012-07-01Plan is a collectively bargained planNo
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan funding arrangement – TrustYes
2012-07-01Plan benefit arrangement – InsuranceYes
2012-07-01Plan benefit arrangement - TrustYes
2011: RIVERSIDE MEDICAL CENTER 403(B) TAX DEFERRED ANNUITY PLAN 2011 form 5500 responses
2011-07-01Type of plan entitySingle employer plan
2011-07-01Submission has been amendedNo
2011-07-01This submission is the final filingNo
2011-07-01This return/report is a short plan year return/report (less than 12 months)No
2011-07-01Plan is a collectively bargained planNo
2011-07-01Plan funding arrangement – InsuranceYes
2011-07-01Plan funding arrangement – TrustYes
2011-07-01Plan benefit arrangement – InsuranceYes
2011-07-01Plan benefit arrangement - TrustYes
2010: RIVERSIDE MEDICAL CENTER 403(B) TAX DEFERRED ANNUITY PLAN 2010 form 5500 responses
2010-07-01Type of plan entitySingle employer plan
2010-07-01Submission has been amendedNo
2010-07-01This submission is the final filingNo
2010-07-01This return/report is a short plan year return/report (less than 12 months)No
2010-07-01Plan is a collectively bargained planNo
2010-07-01Plan funding arrangement – InsuranceYes
2010-07-01Plan funding arrangement – TrustYes
2010-07-01Plan benefit arrangement – InsuranceYes
2010-07-01Plan benefit arrangement - TrustYes
2009: RIVERSIDE MEDICAL CENTER 403(B) TAX DEFERRED ANNUITY PLAN 2009 form 5500 responses
2009-07-01Type of plan entitySingle employer plan
2009-07-01Submission has been amendedNo
2009-07-01This submission is the final filingNo
2009-07-01This return/report is a short plan year return/report (less than 12 months)No
2009-07-01Plan is a collectively bargained planNo
2009-07-01Plan funding arrangement – InsuranceYes
2009-07-01Plan funding arrangement – TrustYes
2009-07-01Plan benefit arrangement – InsuranceYes
2009-07-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberCR16503
Policy instance 1
Insurance contract or identification numberCR16503
Number of Individuals Covered0
Insurance policy start date2018-07-01
Insurance policy end date2019-03-01
Total amount of commissions paid to insurance brokerUSD $7,997
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 $7,997
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 numberCR16503
Policy instance 1
Insurance contract or identification numberCR16503
Number of Individuals Covered112
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $12,584
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 $12,584
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 numberCR16503
Policy instance 1
Insurance contract or identification numberCR16503
Number of Individuals Covered138
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Total amount of commissions paid to insurance brokerUSD $11,657
Total amount of fees paid to insurance companyUSD $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 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 $11,657
Insurance broker organization code?4
Insurance broker nameVSR FINANCIAL SERVICES INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberCR16503
Policy instance 1
Insurance contract or identification numberCR16503
Number of Individuals Covered151
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $11,846
Total amount of fees paid to insurance companyUSD $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 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 $11,846
Insurance broker organization code?4
Insurance broker nameVSR FINANCIAL SERVICES INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberCR16503
Policy instance 1
Insurance contract or identification numberCR16503
Number of Individuals Covered161
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $15,520
Total amount of fees paid to insurance companyUSD $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 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 $15,520
Insurance broker organization code?4
Insurance broker nameVSR FINANCIAL SERVICES INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberCR16503
Policy instance 1
Insurance contract or identification numberCR16503
Number of Individuals Covered173
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $14,675
Total amount of fees paid to insurance companyUSD $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 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 $14,675
Insurance broker organization code?4
Insurance broker nameVSR FINANCIAL SERVICES INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberCR16503
Policy instance 1
Insurance contract or identification numberCR16503
Number of Individuals Covered189
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $8,019
Total amount of fees paid to insurance companyUSD $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 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 numberCR16503
Policy instance 1
Insurance contract or identification numberCR16503
Number of Individuals Covered206
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $9,125
Total amount of fees paid to insurance companyUSD $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 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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