401k Plan data: WINONA HEALTH EMPLOYEES' 403(B) RETIREMENT PLAN plan

WINONA HEALTH EMPLOYEES' 403(B) RETIREMENT PLAN 401k Plan overview

Plan Name	WINONA HEALTH EMPLOYEES' 403(B) RETIREMENT PLAN
Plan identification number	001

WINONA HEALTH EMPLOYEES' 403(B) RETIREMENT PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
Profit-sharing
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 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
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.
Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).
Other welfare benefit cover

401k Sponsoring company profile

WINONA HEALTH SERVICES has sponsored the creation of one or more 401k plans.

Company Name: WINONA HEALTH SERVICES

Employer identification number (EIN): 410713914

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WINONA HEALTH EMPLOYEES' 403(B) RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01
001 2022-01-01
001 2021-01-01
001 2020-01-01
001 2019-01-01
001 2019-01-01
001 2018-01-01

Plan Statistics for WINONA HEALTH EMPLOYEES' 403(B) RETIREMENT PLAN

401k plan membership statisitcs for WINONA HEALTH EMPLOYEES' 403(B) RETIREMENT PLAN

Measure Date Value
2022: WINONA HEALTH EMPLOYEES' 403(B) RETIREMENT PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 1,886
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 960
Number of retired or separated participants receiving benefits 2022-01-01 10
Number of other retired or separated participants entitled to future benefits 2022-01-01 907
Total of all active and inactive participants 2022-01-01 1,877
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 4
Total participants 2022-01-01 1,881
Number of participants with account balances 2022-01-01 1,832
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 9
2021: WINONA HEALTH EMPLOYEES' 403(B) RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 1,701
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 1,242
Number of retired or separated participants receiving benefits 2021-01-01 8
Number of other retired or separated participants entitled to future benefits 2021-01-01 635
Total of all active and inactive participants 2021-01-01 1,885
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 1
Total participants 2021-01-01 1,886
Number of participants with account balances 2021-01-01 1,792
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 17
2020: WINONA HEALTH EMPLOYEES' 403(B) RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 1,669
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 1,152
Number of retired or separated participants receiving benefits 2020-01-01 9
Number of other retired or separated participants entitled to future benefits 2020-01-01 540
Total of all active and inactive participants 2020-01-01 1,701
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 1,701
Number of participants with account balances 2020-01-01 1,647
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 21
2019: WINONA HEALTH EMPLOYEES' 403(B) RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 1,624
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 1,221
Number of retired or separated participants receiving benefits 2019-01-01 8
Number of other retired or separated participants entitled to future benefits 2019-01-01 440
Total of all active and inactive participants 2019-01-01 1,669
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 1,669
Number of participants with account balances 2019-01-01 1,497
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 93
2018: WINONA HEALTH EMPLOYEES' 403(B) RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 1,615
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 1,139
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 485
Total of all active and inactive participants 2018-01-01 1,624
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 1,624
Number of participants with account balances 2018-01-01 1,169
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 85

Measure	Date	Value
2022: WINONA HEALTH EMPLOYEES' 403(B) RETIREMENT PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	1,886
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	960
Number of retired or separated participants receiving benefits	2022-01-01	10
Number of other retired or separated participants entitled to future benefits	2022-01-01	907
Total of all active and inactive participants	2022-01-01	1,877
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	4
Total participants	2022-01-01	1,881
Number of participants with account balances	2022-01-01	1,832
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	9
2021: WINONA HEALTH EMPLOYEES' 403(B) RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	1,701
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	1,242
Number of retired or separated participants receiving benefits	2021-01-01	8
Number of other retired or separated participants entitled to future benefits	2021-01-01	635
Total of all active and inactive participants	2021-01-01	1,885
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	1
Total participants	2021-01-01	1,886
Number of participants with account balances	2021-01-01	1,792
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	17
2020: WINONA HEALTH EMPLOYEES' 403(B) RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	1,669
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	1,152
Number of retired or separated participants receiving benefits	2020-01-01	9
Number of other retired or separated participants entitled to future benefits	2020-01-01	540
Total of all active and inactive participants	2020-01-01	1,701
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	1,701
Number of participants with account balances	2020-01-01	1,647
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	21
2019: WINONA HEALTH EMPLOYEES' 403(B) RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	1,624
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	1,221
Number of retired or separated participants receiving benefits	2019-01-01	8
Number of other retired or separated participants entitled to future benefits	2019-01-01	440
Total of all active and inactive participants	2019-01-01	1,669
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	1,669
Number of participants with account balances	2019-01-01	1,497
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	93
2018: WINONA HEALTH EMPLOYEES' 403(B) RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	1,615
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	1,139
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	485
Total of all active and inactive participants	2018-01-01	1,624
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	1,624
Number of participants with account balances	2018-01-01	1,169
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	85

Financial Data on WINONA HEALTH EMPLOYEES' 403(B) RETIREMENT PLAN

Measure	Date	Value
2022 : WINONA HEALTH EMPLOYEES' 403(B) RETIREMENT PLAN 2022 401k financial data
Unrealized appreciation/depreciation of real estate assets	2022-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2022-12-31	$-152
Total unrealized appreciation/depreciation of assets	2022-12-31	$-152
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Expenses. Interest paid	2022-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2022-12-31	$0
Total income from all sources (including contributions)	2022-12-31	$-12,868,096
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$10,195,055
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$9,976,584
Expenses. Certain deemed distributions of participant loans	2022-12-31	$0
Value of total corrective distributions	2022-12-31	$267
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$5,644,563
Value of total assets at end of year	2022-12-31	$75,310,712
Value of total assets at beginning of year	2022-12-31	$98,373,863
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$218,204
Total income from rents	2022-12-31	$0
Total interest from all sources	2022-12-31	$110,056
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$3,354,669
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-12-31	$3,354,669
Assets. Real estate other than employer real property at end of year	2022-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2022-12-31	$0
Administrative expenses professional fees incurred	2022-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2022-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2022-12-31	$0
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$3,506,377
Participant contributions at end of year	2022-12-31	$448,563
Participant contributions at beginning of year	2022-12-31	$476,022
Participant contributions at end of year	2022-12-31	$0
Participant contributions at beginning of year	2022-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2022-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2022-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$391,358
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2022-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2022-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2022-12-31	$0
Assets. Loans (other than to participants) at end of year	2022-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2022-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2022-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2022-12-31	$0
Other income not declared elsewhere	2022-12-31	$27,169
Administrative expenses (other) incurred	2022-12-31	$0
Total non interest bearing cash at end of year	2022-12-31	$0
Total non interest bearing cash at beginning of year	2022-12-31	$2
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Income. Non cash contributions	2022-12-31	$0
Value of net income/loss	2022-12-31	$-23,063,151
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$75,310,712
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$98,373,863
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Assets. partnership/joint venture interests at end of year	2022-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2022-12-31	$0
Investment advisory and management fees	2022-12-31	$165,201
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$70,162,578
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$93,515,524
Interest on participant loans	2022-12-31	$22,502
Income. Interest from loans (other than to participants)	2022-12-31	$0
Interest earned on other investments	2022-12-31	$87,554
Income. Interest from US Government securities	2022-12-31	$0
Income. Interest from corporate debt instruments	2022-12-31	$0
Value of interest in master investment trust accounts at end of year	2022-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2022-12-31	$0
Value of interest in common/collective trusts at end of year	2022-12-31	$0
Value of interest in common/collective trusts at beginning of year	2022-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2022-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2022-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2022-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2022-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2022-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2022-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$4,699,571
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$4,382,315
Expenses. Payments to insurance carriers foe the provision of benefits	2022-12-31	$0
Asset value of US Government securities at end of year	2022-12-31	$0
Asset value of US Government securities at beginning of year	2022-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-22,004,401
Net investment gain/loss from pooled separate accounts	2022-12-31	$0
Net investment gain or loss from common/collective trusts	2022-12-31	$0
Net gain/loss from 103.12 investment entities	2022-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Assets. Invements in employer securities at end of year	2022-12-31	$0
Assets. Invements in employer securities at beginning of year	2022-12-31	$0
Assets. Value of employer real property at end of year	2022-12-31	$0
Assets. Value of employer real property at beginning of year	2022-12-31	$0
Contributions received in cash from employer	2022-12-31	$1,746,828
Employer contributions (assets) at end of year	2022-12-31	$0
Employer contributions (assets) at beginning of year	2022-12-31	$0
Income. Dividends from preferred stock	2022-12-31	$0
Income. Dividends from common stock	2022-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$9,976,584
Asset. Corporate debt instrument preferred debt at end of year	2022-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2022-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2022-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2022-12-31	$0
Contract administrator fees	2022-12-31	$53,003
Assets. Corporate common stocks other than exployer securities at end of year	2022-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2022-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2022-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2022-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2022-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2022-12-31	$0
Did the plan have assets held for investment	2022-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Aggregate proceeds on sale of assets	2022-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2022-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2022-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2022-12-31	$0
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	HAWKINS ASH CPAS, LLP
Accountancy firm EIN	2022-12-31	390312608
2021 : WINONA HEALTH EMPLOYEES' 403(B) RETIREMENT PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total transfer of assets to this plan	2021-12-31	$2,807,678
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$18,776,449
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$9,212,347
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$8,941,955
Expenses. Certain deemed distributions of participant loans	2021-12-31	$0
Value of total corrective distributions	2021-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$5,384,246
Value of total assets at end of year	2021-12-31	$98,373,863
Value of total assets at beginning of year	2021-12-31	$86,002,083
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$270,392
Total interest from all sources	2021-12-31	$79,315
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$4,842,895
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2021-12-31	$4,842,895
Administrative expenses professional fees incurred	2021-12-31	$0
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$3,139,149
Participant contributions at end of year	2021-12-31	$476,022
Participant contributions at beginning of year	2021-12-31	$453,400
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$322,057
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2021-12-31	$0
Other income not declared elsewhere	2021-12-31	$34,454
Administrative expenses (other) incurred	2021-12-31	$0
Total non interest bearing cash at end of year	2021-12-31	$2
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$9,564,102
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$98,373,863
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$86,002,083
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Investment advisory and management fees	2021-12-31	$235,010
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$93,515,524
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$80,948,220
Value of interest in pooled separate accounts at end of year	2021-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$0
Interest on participant loans	2021-12-31	$23,872
Interest earned on other investments	2021-12-31	$55,443
Value of interest in common/collective trusts at end of year	2021-12-31	$0
Value of interest in common/collective trusts at beginning of year	2021-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$4,382,315
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$4,600,463
Expenses. Payments to insurance carriers foe the provision of benefits	2021-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$8,435,539
Net investment gain/loss from pooled separate accounts	2021-12-31	$0
Net investment gain or loss from common/collective trusts	2021-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Assets. Invements in employer securities at end of year	2021-12-31	$0
Assets. Invements in employer securities at beginning of year	2021-12-31	$0
Contributions received in cash from employer	2021-12-31	$1,923,040
Income. Dividends from common stock	2021-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$8,941,955
Contract administrator fees	2021-12-31	$35,382
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	HAWKINS ASH CPAS, LLP
Accountancy firm EIN	2021-12-31	390312608
2020 : WINONA HEALTH EMPLOYEES' 403(B) RETIREMENT PLAN 2020 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2020-12-31	$32
Total unrealized appreciation/depreciation of assets	2020-12-31	$32
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$17,420,612
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$8,642,708
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$8,392,981
Expenses. Certain deemed distributions of participant loans	2020-12-31	$6,655
Value of total corrective distributions	2020-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$4,634,081
Value of total assets at end of year	2020-12-31	$86,002,083
Value of total assets at beginning of year	2020-12-31	$77,224,179
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$243,072
Total interest from all sources	2020-12-31	$144,844
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$1,824,458
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-31	$1,824,458
Administrative expenses professional fees incurred	2020-12-31	$0
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$5,000,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$2,858,242
Participant contributions at end of year	2020-12-31	$453,400
Participant contributions at beginning of year	2020-12-31	$474,042
Assets. Other investments not covered elsewhere at beginning of year	2020-12-31	$3,285,343
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$180,133
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2020-12-31	$0
Administrative expenses (other) incurred	2020-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$8,777,904
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$86,002,083
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$77,224,179
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Investment advisory and management fees	2020-12-31	$211,370
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$80,948,220
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$71,294,378
Value of interest in pooled separate accounts at end of year	2020-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$0
Interest on participant loans	2020-12-31	$27,648
Interest earned on other investments	2020-12-31	$117,196
Value of interest in common/collective trusts at end of year	2020-12-31	$0
Value of interest in common/collective trusts at beginning of year	2020-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$4,600,463
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$2,170,416
Expenses. Payments to insurance carriers foe the provision of benefits	2020-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$10,817,197
Net investment gain/loss from pooled separate accounts	2020-12-31	$0
Net investment gain or loss from common/collective trusts	2020-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Assets. Invements in employer securities at end of year	2020-12-31	$0
Assets. Invements in employer securities at beginning of year	2020-12-31	$0
Contributions received in cash from employer	2020-12-31	$1,595,706
Income. Dividends from common stock	2020-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$8,392,981
Contract administrator fees	2020-12-31	$31,702
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	HAWKINS ASH CPAS, LLP
Accountancy firm EIN	2020-12-31	390312608
2019 : WINONA HEALTH EMPLOYEES' 403(B) RETIREMENT PLAN 2019 401k financial data
Unrealized appreciation/depreciation of real estate assets	2019-12-31	$-32
Total unrealized appreciation/depreciation of assets	2019-12-31	$-32
Total transfer of assets to this plan	2019-12-31	$586,085
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$201,020
Total income from all sources (including contributions)	2019-12-31	$21,069,688
Total loss/gain on sale of assets	2019-12-31	$5,234
Total of all expenses incurred	2019-12-31	$6,490,249
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$6,286,860
Expenses. Certain deemed distributions of participant loans	2019-12-31	$794
Value of total corrective distributions	2019-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$5,667,497
Value of total assets at end of year	2019-12-31	$77,224,178
Value of total assets at beginning of year	2019-12-31	$62,259,674
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$202,595
Total interest from all sources	2019-12-31	$134,358
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$2,608,544
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$2,608,544
Administrative expenses professional fees incurred	2019-12-31	$0
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2019-12-31	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$2,915,714
Participant contributions at end of year	2019-12-31	$474,042
Participant contributions at beginning of year	2019-12-31	$419,531
Assets. Other investments not covered elsewhere at beginning of year	2019-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$771,480
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2019-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2019-12-31	$201,020
Other income not declared elsewhere	2019-12-31	$315,121
Administrative expenses (other) incurred	2019-12-31	$0
Total non interest bearing cash at beginning of year	2019-12-31	$201,020
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$14,579,439
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$77,224,178
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$62,058,654
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Investment advisory and management fees	2019-12-31	$133,831
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$71,294,378
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$57,386,408
Value of interest in pooled separate accounts at end of year	2019-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$0
Interest on participant loans	2019-12-31	$25,340
Interest earned on other investments	2019-12-31	$109,018
Value of interest in common/collective trusts at end of year	2019-12-31	$0
Value of interest in common/collective trusts at beginning of year	2019-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$5,455,758
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$4,130,728
Expenses. Payments to insurance carriers foe the provision of benefits	2019-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$12,338,966
Net investment gain/loss from pooled separate accounts	2019-12-31	$0
Net investment gain or loss from common/collective trusts	2019-12-31	$15,087
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Assets. Invements in employer securities at end of year	2019-12-31	$0
Assets. Invements in employer securities at beginning of year	2019-12-31	$0
Contributions received in cash from employer	2019-12-31	$1,980,303
Employer contributions (assets) at beginning of year	2019-12-31	$121,987
Income. Dividends from common stock	2019-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$6,286,860
Contract administrator fees	2019-12-31	$68,764
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2019-12-31	Yes
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Aggregate proceeds on sale of assets	2019-12-31	$5,234
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	HAWKINS ASH CPAS, LLP
Accountancy firm EIN	2019-12-31	390912608
2018 : WINONA HEALTH EMPLOYEES' 403(B) RETIREMENT PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$201,020
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$70,364
Total income from all sources (including contributions)	2018-12-31	$1,240,852
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$6,440,554
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$6,281,516
Expenses. Certain deemed distributions of participant loans	2018-12-31	$794
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$5,220,216
Value of total assets at end of year	2018-12-31	$62,259,674
Value of total assets at beginning of year	2018-12-31	$67,328,720
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$158,244
Total interest from all sources	2018-12-31	$20,007
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$3,138,414
Total dividends received from registered investment company shares (eg mutual funds)	2018-12-31	$3,138,414
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$2,810,272
Participant contributions at end of year	2018-12-31	$419,531
Participant contributions at beginning of year	2018-12-31	$462,860
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$167,829
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2018-12-31	$99,867
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2018-12-31	$201,020
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2018-12-31	$70,364
Other income not declared elsewhere	2018-12-31	$118,181
Total non interest bearing cash at end of year	2018-12-31	$201,020
Total non interest bearing cash at beginning of year	2018-12-31	$117,509
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$-5,199,702
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$62,058,654
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$67,258,356
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$57,386,408
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$62,747,381
Interest on participant loans	2018-12-31	$20,007
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$4,130,728
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$3,897,710
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-7,255,966
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$2,242,115
Employer contributions (assets) at end of year	2018-12-31	$121,987
Employer contributions (assets) at beginning of year	2018-12-31	$3,393
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$6,281,516
Contract administrator fees	2018-12-31	$158,244
Did the plan have assets held for investment	2018-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	HAWKINS ASH CPAS, LLP
Accountancy firm EIN	2018-12-31	390912608

Form 5500 Responses for WINONA HEALTH EMPLOYEES' 403(B) RETIREMENT PLAN

2022: WINONA HEALTH EMPLOYEES' 403(B) RETIREMENT PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: WINONA HEALTH EMPLOYEES' 403(B) RETIREMENT PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: WINONA HEALTH EMPLOYEES' 403(B) RETIREMENT PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: WINONA HEALTH EMPLOYEES' 403(B) RETIREMENT PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: WINONA HEALTH EMPLOYEES' 403(B) RETIREMENT PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	Yes
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

743473-01

Policy instance

Insurance contract or identification number	743473-01
Number of Individuals Covered	312
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

MR 63036

Policy instance

Insurance contract or identification number	MR 63036
Number of Individuals Covered	1886
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

MR 63036

Policy instance

Insurance contract or identification number	MR 63036
Number of Individuals Covered	1701
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

MR 63036

Policy instance

Insurance contract or identification number	MR 63036
Number of Individuals Covered	1669
Insurance policy start date	2019-02-21
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

809035

Policy instance

Insurance contract or identification number	809035
Number of Individuals Covered	108
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No

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Company Name:	WINONA HEALTH SERVICES
Employer identification number (EIN):	410713914
NAIC Classification:	622000
NAIC Description:	Hospitals