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WILD ROSE COMMUNITY MEMORIAL HOSPITAL, INC. 403 (B) TDA PLAN 401k Plan overview

Plan NameWILD ROSE COMMUNITY MEMORIAL HOSPITAL, INC. 403 (B) TDA PLAN
Plan identification number 010

WILD ROSE COMMUNITY MEMORIAL HOSPITAL, INC. 403 (B) TDA 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 WILD ROSE COMMUNITY MEMORIAL HOSPITAL, INC. 403 (B) TDA PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0102018-07-01JESSICA PIRIE2019-10-17
0102017-07-01KAREN GARVEY2018-12-18
0102016-07-01KAREN GARVEY
0102015-07-01KAREN GARVEY
0102014-07-01KAREN GARVEY

Plan Statistics for WILD ROSE COMMUNITY MEMORIAL HOSPITAL, INC. 403 (B) TDA PLAN

401k plan membership statisitcs for WILD ROSE COMMUNITY MEMORIAL HOSPITAL, INC. 403 (B) TDA PLAN

Measure Date Value
2016: WILD ROSE COMMUNITY MEMORIAL HOSPITAL, INC. 403 (B) TDA PLAN 2016 401k membership
Total participants, beginning-of-year2016-07-01117
Total number of active participants reported on line 7a of the Form 55002016-07-0155
Number of retired or separated participants receiving benefits2016-07-010
Number of other retired or separated participants entitled to future benefits2016-07-0142
Total of all active and inactive participants2016-07-0197
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-07-010
Total participants2016-07-0197
Number of participants with account balances2016-07-0197
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-07-010
2015: WILD ROSE COMMUNITY MEMORIAL HOSPITAL, INC. 403 (B) TDA PLAN 2015 401k membership
Total participants, beginning-of-year2015-07-01192
Total number of active participants reported on line 7a of the Form 55002015-07-0179
Number of retired or separated participants receiving benefits2015-07-010
Number of other retired or separated participants entitled to future benefits2015-07-0138
Total of all active and inactive participants2015-07-01117
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-07-010
Total participants2015-07-01117
Number of participants with account balances2015-07-01117
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-07-010
2014: WILD ROSE COMMUNITY MEMORIAL HOSPITAL, INC. 403 (B) TDA PLAN 2014 401k membership
Total participants, beginning-of-year2014-07-01191
Total number of active participants reported on line 7a of the Form 55002014-07-01157
Number of retired or separated participants receiving benefits2014-07-010
Number of other retired or separated participants entitled to future benefits2014-07-0135
Total of all active and inactive participants2014-07-01192
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-07-010
Total participants2014-07-01192
Number of participants with account balances2014-07-01142
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-07-010

Financial Data on WILD ROSE COMMUNITY MEMORIAL HOSPITAL, INC. 403 (B) TDA PLAN

Measure Date Value
2017 : WILD ROSE COMMUNITY MEMORIAL HOSPITAL, INC. 403 (B) TDA 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$328,183
Total loss/gain on sale of assets2017-06-30$0
Total of all expenses incurred2017-06-30$379,032
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-06-30$374,819
Value of total corrective distributions2017-06-30$0
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$2,931,349
Value of total assets at beginning of year2017-06-30$2,982,198
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-06-30$4,213
Total interest from all sources2017-06-30$25,658
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
Administrative expenses professional fees incurred2017-06-30$0
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
Contributions received from participants2017-06-30$0
Participant contributions at end of year2017-06-30$0
Participant contributions at beginning of year2017-06-30$0
Participant contributions at end of year2017-06-30$0
Participant contributions at beginning of year2017-06-30$0
Income. Received or receivable in cash from other sources (including rollovers)2017-06-30$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-06-30No
Value of net income/loss2017-06-30$-50,849
Value of net assets at end of year (total assets less liabilities)2017-06-30$2,931,349
Value of net assets at beginning of year (total assets less liabilities)2017-06-30$2,982,198
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$2,208,341
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-06-30$2,209,929
Interest earned on other investments2017-06-30$25,658
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-06-30$723,008
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-06-30$772,269
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-06-30$302,525
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
Contributions received in cash from employer2017-06-30$0
Employer contributions (assets) at end of year2017-06-30$0
Employer contributions (assets) at beginning of year2017-06-30$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-06-30$374,819
Contract administrator fees2017-06-30$4,213
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 : WILD ROSE COMMUNITY MEMORIAL HOSPITAL, INC. 403 (B) TDA 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$0
Total income from all sources (including contributions)2016-06-30$-25,759
Total loss/gain on sale of assets2016-06-30$0
Total of all expenses incurred2016-06-30$158,292
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-06-30$153,182
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-06-30$753
Value of total assets at end of year2016-06-30$2,982,198
Value of total assets at beginning of year2016-06-30$3,166,249
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-06-30$5,110
Total interest from all sources2016-06-30$26,979
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$0
Participant contributions at beginning of year2016-06-30$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-06-30No
Value of net income/loss2016-06-30$-184,051
Value of net assets at end of year (total assets less liabilities)2016-06-30$2,982,198
Value of net assets at beginning of year (total assets less liabilities)2016-06-30$3,166,249
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$2,209,929
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-06-30$2,347,197
Interest earned on other investments2016-06-30$26,979
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-06-30$772,269
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-06-30$819,052
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-06-30$-53,491
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
Contributions received in cash from employer2016-06-30$753
Employer contributions (assets) at end of year2016-06-30$0
Employer contributions (assets) at beginning of year2016-06-30$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-06-30$153,182
Contract administrator fees2016-06-30$5,110
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 : WILD ROSE COMMUNITY MEMORIAL HOSPITAL, INC. 403 (B) TDA 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$349,702
Total loss/gain on sale of assets2015-06-30$0
Total of all expenses incurred2015-06-30$635,678
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-06-30$626,789
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-06-30$242,701
Value of total assets at end of year2015-06-30$3,166,249
Value of total assets at beginning of year2015-06-30$3,452,225
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-06-30$8,889
Total interest from all sources2015-06-30$30,864
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$500,000
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
Contributions received from participants2015-06-30$81,688
Participant contributions at end of year2015-06-30$0
Participant contributions at beginning of year2015-06-30$6,584
Income. Received or receivable in cash from other sources (including rollovers)2015-06-30$91,373
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-06-30No
Value of net income/loss2015-06-30$-285,976
Value of net assets at end of year (total assets less liabilities)2015-06-30$3,166,249
Value of net assets at beginning of year (total assets less liabilities)2015-06-30$3,452,225
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$2,347,197
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-06-30$2,482,261
Interest earned on other investments2015-06-30$30,864
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-06-30$819,052
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-06-30$954,825
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-06-30$76,137
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
Contributions received in cash from employer2015-06-30$69,640
Employer contributions (assets) at end of year2015-06-30$0
Employer contributions (assets) at beginning of year2015-06-30$8,555
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-06-30$626,789
Contract administrator fees2015-06-30$8,889
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

Form 5500 Responses for WILD ROSE COMMUNITY MEMORIAL HOSPITAL, INC. 403 (B) TDA PLAN

2016: WILD ROSE COMMUNITY MEMORIAL HOSPITAL, INC. 403 (B) TDA 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: WILD ROSE COMMUNITY MEMORIAL HOSPITAL, INC. 403 (B) TDA 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: WILD ROSE COMMUNITY MEMORIAL HOSPITAL, INC. 403 (B) TDA 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

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberCR 15041
Policy instance 1
Insurance contract or identification numberCR 15041
Number of Individuals Covered117
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Total amount of commissions paid to insurance brokerUSD $3,080
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 $3,080
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 numberCR 15041
Policy instance 1
Insurance contract or identification numberCR 15041
Number of Individuals Covered142
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $12,056
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 $12,056
Insurance broker organization code?4
Insurance broker name

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