401k Plan data: CUYUNA REGIONAL MEDICAL CENTER plan

CUYUNA REGIONAL MEDICAL CENTER 401k Plan overview

Plan Name	CUYUNA REGIONAL MEDICAL CENTER
Plan identification number	002

CUYUNA REGIONAL MEDICAL CENTER Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
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.
U.S.-based plan that covers residents of Puerto Rico and is qualified under both Code section 401 and section 1165 of the Puerto Rico Code.

401k Sponsoring company profile

CUYUNA REGIONAL MEDICAL CENTER has sponsored the creation of one or more 401k plans.

Company Name: CUYUNA REGIONAL MEDICAL CENTER

Employer identification number (EIN): 411724637

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CUYUNA REGIONAL MEDICAL CENTER

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2022-01-01
002 2021-01-01
002 2020-01-01
002 2019-01-01
002 2019-01-01
002 2018-01-01
002 2017-01-01 JENNIFER LOIDOLT
002 2017-01-01 JENNIFER LOIDOLT
002 2016-08-01 JENNIFER LOIDOLT
002 2016-08-01
002 2016-08-01

Plan Statistics for CUYUNA REGIONAL MEDICAL CENTER

401k plan membership statisitcs for CUYUNA REGIONAL MEDICAL CENTER

Measure Date Value
2022: CUYUNA REGIONAL MEDICAL CENTER 2022 401k membership
Total participants, beginning-of-year 2022-01-01 1,477
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 0
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 0
Total of all active and inactive participants 2022-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 0
Number of participants with account balances 2022-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: CUYUNA REGIONAL MEDICAL CENTER 2021 401k membership
Total participants, beginning-of-year 2021-01-01 1,338
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 1,035
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 451
Total of all active and inactive participants 2021-01-01 1,486
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 1,486
Number of participants with account balances 2021-01-01 1,379
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 48
2020: CUYUNA REGIONAL MEDICAL CENTER 2020 401k membership
Total participants, beginning-of-year 2020-01-01 1,220
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 998
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 331
Total of all active and inactive participants 2020-01-01 1,329
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 1,329
Number of participants with account balances 2020-01-01 1,221
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 40
2019: CUYUNA REGIONAL MEDICAL CENTER 2019 401k membership
Total participants, beginning-of-year 2019-01-01 1,112
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 952
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 243
Total of all active and inactive participants 2019-01-01 1,195
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 1,195
Number of participants with account balances 2019-01-01 1,046
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 44
2018: CUYUNA REGIONAL MEDICAL CENTER 2018 401k membership
Total participants, beginning-of-year 2018-01-01 1,063
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 925
Number of retired or separated participants receiving benefits 2018-01-01 36
Number of other retired or separated participants entitled to future benefits 2018-01-01 152
Total of all active and inactive participants 2018-01-01 1,113
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 1,113
Number of participants with account balances 2018-01-01 905
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 53
2017: CUYUNA REGIONAL MEDICAL CENTER 2017 401k membership
Total participants, beginning-of-year 2017-01-01 937
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 944
Number of retired or separated participants receiving benefits 2017-01-01 29
Number of other retired or separated participants entitled to future benefits 2017-01-01 104
Total of all active and inactive participants 2017-01-01 1,077
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 1,077
Number of participants with account balances 2017-01-01 822
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 36
2016: CUYUNA REGIONAL MEDICAL CENTER 2016 401k membership
Total participants, beginning-of-year 2016-08-01 328
Total number of active participants reported on line 7a of the Form 5500 2016-08-01 279
Number of retired or separated participants receiving benefits 2016-08-01 9
Number of other retired or separated participants entitled to future benefits 2016-08-01 41
Total of all active and inactive participants 2016-08-01 329
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-08-01 0
Total participants 2016-08-01 329
Number of participants with account balances 2016-08-01 329
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-08-01 7

Measure	Date	Value
2022: CUYUNA REGIONAL MEDICAL CENTER 2022 401k membership
Total participants, beginning-of-year	2022-01-01	1,477
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	0
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	0
Total of all active and inactive participants	2022-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	0
Number of participants with account balances	2022-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: CUYUNA REGIONAL MEDICAL CENTER 2021 401k membership
Total participants, beginning-of-year	2021-01-01	1,338
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	1,035
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	451
Total of all active and inactive participants	2021-01-01	1,486
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	1,486
Number of participants with account balances	2021-01-01	1,379
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	48
2020: CUYUNA REGIONAL MEDICAL CENTER 2020 401k membership
Total participants, beginning-of-year	2020-01-01	1,220
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	998
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	331
Total of all active and inactive participants	2020-01-01	1,329
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	1,329
Number of participants with account balances	2020-01-01	1,221
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	40
2019: CUYUNA REGIONAL MEDICAL CENTER 2019 401k membership
Total participants, beginning-of-year	2019-01-01	1,112
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	952
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	243
Total of all active and inactive participants	2019-01-01	1,195
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	1,195
Number of participants with account balances	2019-01-01	1,046
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	44
2018: CUYUNA REGIONAL MEDICAL CENTER 2018 401k membership
Total participants, beginning-of-year	2018-01-01	1,063
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	925
Number of retired or separated participants receiving benefits	2018-01-01	36
Number of other retired or separated participants entitled to future benefits	2018-01-01	152
Total of all active and inactive participants	2018-01-01	1,113
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	1,113
Number of participants with account balances	2018-01-01	905
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	53
2017: CUYUNA REGIONAL MEDICAL CENTER 2017 401k membership
Total participants, beginning-of-year	2017-01-01	937
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	944
Number of retired or separated participants receiving benefits	2017-01-01	29
Number of other retired or separated participants entitled to future benefits	2017-01-01	104
Total of all active and inactive participants	2017-01-01	1,077
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	1,077
Number of participants with account balances	2017-01-01	822
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	36
2016: CUYUNA REGIONAL MEDICAL CENTER 2016 401k membership
Total participants, beginning-of-year	2016-08-01	328
Total number of active participants reported on line 7a of the Form 5500	2016-08-01	279
Number of retired or separated participants receiving benefits	2016-08-01	9
Number of other retired or separated participants entitled to future benefits	2016-08-01	41
Total of all active and inactive participants	2016-08-01	329
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-08-01	0
Total participants	2016-08-01	329
Number of participants with account balances	2016-08-01	329
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-08-01	7

Financial Data on CUYUNA REGIONAL MEDICAL CENTER

Measure	Date	Value
2022 : CUYUNA REGIONAL MEDICAL CENTER 2022 401k financial data
Total transfer of assets from this plan	2022-01-19	$58,865,434
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-01-19	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-01-19	$1,310
Total income from all sources (including contributions)	2022-01-19	$-1,738,667
Total of all expenses incurred	2022-01-19	$158,444
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-01-19	$134,584
Value of total assets at end of year	2022-01-19	$0
Value of total assets at beginning of year	2022-01-19	$60,763,855
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-01-19	$23,860
Total interest from all sources	2022-01-19	$3,068
Total dividends received (eg from common stock, registered investment company shares)	2022-01-19	$587
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-01-19	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-01-19	$587
Was this plan covered by a fidelity bond	2022-01-19	Yes
Value of fidelity bond cover	2022-01-19	$500,000
If this is an individual account plan, was there a blackout period	2022-01-19	Yes
Were there any nonexempt tranactions with any party-in-interest	2022-01-19	No
Participant contributions at end of year	2022-01-19	$0
Participant contributions at beginning of year	2022-01-19	$771,519
Value of other receiveables (less allowance for doubtful accounts) at end of year	2022-01-19	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2022-01-19	$388
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2022-01-19	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2022-01-19	$1,310
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-01-19	No
Value of net income/loss	2022-01-19	$-1,897,111
Value of net assets at end of year (total assets less liabilities)	2022-01-19	$0
Value of net assets at beginning of year (total assets less liabilities)	2022-01-19	$60,762,545
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-01-19	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-01-19	No
Were any leases to which the plan was party in default or uncollectible	2022-01-19	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-01-19	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-01-19	$54,419,648
Interest on participant loans	2022-01-19	$1,414
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2022-01-19	$1,654
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-01-19	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-01-19	$3,223,179
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-01-19	$-1,742,322
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-01-19	No
Was there a failure to transmit to the plan any participant contributions	2022-01-19	Yes
Has the plan failed to provide any benefit when due under the plan	2022-01-19	No
Employer contributions (assets) at end of year	2022-01-19	$0
Employer contributions (assets) at beginning of year	2022-01-19	$2,349,121
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-01-19	$134,584
Contract administrator fees	2022-01-19	$23,860
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	2022-01-19	Yes
Did the plan have assets held for investment	2022-01-19	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-01-19	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-01-19	Yes
Opinion of an independent qualified public accountant for this plan	2022-01-19	Unqualified
Accountancy firm name	2022-01-19	RSM US LLP
Accountancy firm EIN	2022-01-19	420714325
2021 : CUYUNA REGIONAL MEDICAL CENTER 2021 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$1,310
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$900
Total income from all sources (including contributions)	2021-12-31	$14,293,030
Total of all expenses incurred	2021-12-31	$2,817,435
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$2,670,589
Expenses. Certain deemed distributions of participant loans	2021-12-31	$1,028
Value of total corrective distributions	2021-12-31	$14,463
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$8,248,909
Value of total assets at end of year	2021-12-31	$60,763,855
Value of total assets at beginning of year	2021-12-31	$49,287,850
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$131,355
Total interest from all sources	2021-12-31	$71,175
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$1,842,916
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	$1,842,916
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
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	$3,302,175
Participant contributions at end of year	2021-12-31	$771,519
Participant contributions at beginning of year	2021-12-31	$563,608
Participant contributions at beginning of year	2021-12-31	$94,824
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$2,707,407
Value of other receiveables (less allowance for doubtful accounts) at end of year	2021-12-31	$388
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2021-12-31	$1,310
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2021-12-31	$900
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	$11,475,595
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$60,762,545
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$49,286,950
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$54,419,648
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$42,969,640
Interest on participant loans	2021-12-31	$33,424
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2021-12-31	$37,751
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$3,223,179
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$3,313,476
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$4,130,030
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	Yes
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$2,239,327
Employer contributions (assets) at end of year	2021-12-31	$2,349,121
Employer contributions (assets) at beginning of year	2021-12-31	$2,346,302
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$2,670,589
Contract administrator fees	2021-12-31	$131,355
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
2020 : CUYUNA REGIONAL MEDICAL CENTER 2020 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$900
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	$11,528,599
Total of all expenses incurred	2020-12-31	$3,345,582
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$3,187,196
Expenses. Certain deemed distributions of participant loans	2020-12-31	$28,813
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$5,579,022
Value of total assets at end of year	2020-12-31	$49,287,850
Value of total assets at beginning of year	2020-12-31	$41,103,933
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$129,573
Total interest from all sources	2020-12-31	$77,420
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$1,408,267
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	$1,408,267
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
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	$2,836,236
Participant contributions at end of year	2020-12-31	$563,608
Participant contributions at beginning of year	2020-12-31	$547,945
Participant contributions at end of year	2020-12-31	$94,824
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$394,813
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2020-12-31	$900
Other income not declared elsewhere	2020-12-31	$153
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	$8,183,017
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$49,286,950
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$41,103,933
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	$85,605
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$42,969,640
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$34,979,393
Interest on participant loans	2020-12-31	$32,111
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2020-12-31	$45,309
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$3,313,476
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$3,509,747
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$4,463,737
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$2,347,973
Employer contributions (assets) at end of year	2020-12-31	$2,346,302
Employer contributions (assets) at beginning of year	2020-12-31	$2,066,848
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$3,187,196
Contract administrator fees	2020-12-31	$43,968
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	RSM US LLP
Accountancy firm EIN	2020-12-31	420714325
2019 : CUYUNA REGIONAL MEDICAL CENTER 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
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	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$11,414,368
Total income from all sources (including contributions)	2019-12-31	$11,414,368
Total loss/gain on sale of assets	2019-12-31	$0
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$2,674,127
Total of all expenses incurred	2019-12-31	$2,674,127
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$2,567,190
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$2,567,190
Value of total corrective distributions	2019-12-31	$774
Value of total corrective distributions	2019-12-31	$774
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$5,254,093
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$5,254,093
Value of total assets at end of year	2019-12-31	$41,103,933
Value of total assets at end of year	2019-12-31	$41,103,933
Value of total assets at beginning of year	2019-12-31	$32,363,692
Value of total assets at beginning of year	2019-12-31	$32,363,692
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$106,163
Total interest from all sources	2019-12-31	$27,048
Total interest from all sources	2019-12-31	$27,048
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$938,455
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$938,455
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
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	$938,455
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$938,455
Was this plan covered by a fidelity bond	2019-12-31	Yes
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
Value of fidelity bond cover	2019-12-31	$500,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
If this is an individual account plan, was there a blackout period	2019-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$2,503,585
Contributions received from participants	2019-12-31	$2,503,585
Participant contributions at end of year	2019-12-31	$547,945
Participant contributions at end of year	2019-12-31	$547,945
Participant contributions at beginning of year	2019-12-31	$435,160
Participant contributions at beginning of year	2019-12-31	$435,160
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$683,660
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$683,660
Other income not declared elsewhere	2019-12-31	$-2,092
Other income not declared elsewhere	2019-12-31	$-2,092
Administrative expenses (other) incurred	2019-12-31	$106,163
Administrative expenses (other) incurred	2019-12-31	$106,163
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
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	$8,740,241
Value of net income/loss	2019-12-31	$8,740,241
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$41,103,933
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$41,103,933
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$32,363,692
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$32,363,692
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
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 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
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$34,979,393
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$34,979,393
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$26,332,150
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$26,332,150
Interest on participant loans	2019-12-31	$27,048
Interest on participant loans	2019-12-31	$27,048
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$3,509,747
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$3,509,747
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$3,640,302
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$3,640,302
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$5,196,864
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$5,196,864
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
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
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$2,066,848
Contributions received in cash from employer	2019-12-31	$2,066,848
Employer contributions (assets) at end of year	2019-12-31	$2,066,848
Employer contributions (assets) at end of year	2019-12-31	$2,066,848
Employer contributions (assets) at beginning of year	2019-12-31	$1,956,080
Employer contributions (assets) at beginning of year	2019-12-31	$1,956,080
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$2,567,190
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$2,567,190
Did the plan have assets held for investment	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
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
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
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
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
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	RSM US LLP
Accountancy firm name	2019-12-31	RSM US LLP
Accountancy firm EIN	2019-12-31	420714325
Accountancy firm EIN	2019-12-31	420714325
2018 : CUYUNA REGIONAL MEDICAL CENTER 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	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$2,473,571
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$2,325,150
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$2,212,665
Expenses. Certain deemed distributions of participant loans	2018-12-31	$12,336
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$4,176,838
Value of total assets at end of year	2018-12-31	$32,363,692
Value of total assets at beginning of year	2018-12-31	$32,215,271
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$100,149
Total interest from all sources	2018-12-31	$19,618
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$962,630
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2018-12-31	$962,630
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$500,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$2,104,918
Participant contributions at end of year	2018-12-31	$435,160
Participant contributions at beginning of year	2018-12-31	$366,200
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$115,951
Administrative expenses (other) incurred	2018-12-31	$100,149
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	$148,421
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$32,363,692
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$32,215,271
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	$26,332,150
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$26,234,236
Interest on participant loans	2018-12-31	$19,618
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$3,640,302
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$3,808,009
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-2,685,515
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	$1,955,969
Employer contributions (assets) at end of year	2018-12-31	$1,956,080
Employer contributions (assets) at beginning of year	2018-12-31	$1,806,826
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$2,212,665
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	RSM US LLP
Accountancy firm EIN	2018-12-31	420714325
2017 : CUYUNA REGIONAL MEDICAL CENTER 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total transfer of assets to this plan	2017-12-31	$4,923,072
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$17,525,844
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$1,522,248
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$1,439,340
Expenses. Certain deemed distributions of participant loans	2017-12-31	$1,723
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$14,129,282
Value of total assets at end of year	2017-12-31	$32,215,271
Value of total assets at beginning of year	2017-12-31	$11,288,603
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$81,185
Total interest from all sources	2017-12-31	$16,018
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$696,435
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$696,435
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$500,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$1,902,986
Participant contributions at end of year	2017-12-31	$366,200
Participant contributions at beginning of year	2017-12-31	$230,169
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$10,411,808
Administrative expenses (other) incurred	2017-12-31	$81,185
Total non interest bearing cash at beginning of year	2017-12-31	$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	2017-12-31	No
Value of net income/loss	2017-12-31	$16,003,596
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$32,215,271
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$11,288,603
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$26,234,236
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$7,667,117
Interest on participant loans	2017-12-31	$16,018
Value of interest in common/collective trusts at beginning of year	2017-12-31	$3,201,660
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$3,808,009
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$18,973
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$2,684,109
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$1,814,488
Employer contributions (assets) at end of year	2017-12-31	$1,806,826
Employer contributions (assets) at beginning of year	2017-12-31	$170,684
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$1,439,340
Did the plan have assets held for investment	2017-12-31	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	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	RSM US LLP
Accountancy firm EIN	2017-12-31	420714325
2016 : CUYUNA REGIONAL MEDICAL CENTER 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total transfer of assets to this plan	2016-12-31	$10,420,007
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$122,251
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$1,275,421
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$522,472
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$519,202
Expenses. Certain deemed distributions of participant loans	2016-12-31	$15,038
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$1,103,641
Value of total assets at end of year	2016-12-31	$11,295,207
Value of total assets at beginning of year	2016-12-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$3,270
Total interest from all sources	2016-12-31	$3,921
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$191,935
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$500,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$590,066
Participant contributions at end of year	2016-12-31	$245,245
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2016-12-31	$122,251
Total non interest bearing cash at end of year	2016-12-31	$0
Total non interest bearing cash at beginning of year	2016-12-31	$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	2016-12-31	No
Value of net income/loss	2016-12-31	$752,949
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$11,172,956
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Investment advisory and management fees	2016-12-31	$3,070
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$10,887,750
Value of interest in pooled separate accounts at end of year	2016-12-31	$3,201,660
Interest on participant loans	2016-12-31	$3,921
Value of interest in common/collective trusts at end of year	2016-12-31	$3,201,660
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$18,973
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$167,859
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$513,575
Employer contributions (assets) at end of year	2016-12-31	$162,212
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$519,202
Contract administrator fees	2016-12-31	$200
Did the plan have assets held for investment	2016-12-31	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	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No

Form 5500 Responses for CUYUNA REGIONAL MEDICAL CENTER

2022: CUYUNA REGIONAL MEDICAL CENTER 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	Yes
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
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: CUYUNA REGIONAL MEDICAL CENTER 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: CUYUNA REGIONAL MEDICAL CENTER 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: CUYUNA REGIONAL MEDICAL CENTER 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: CUYUNA REGIONAL MEDICAL CENTER 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	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: CUYUNA REGIONAL MEDICAL CENTER 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: CUYUNA REGIONAL MEDICAL CENTER 2016 form 5500 responses
2016-08-01	Type of plan entity	Single employer plan
2016-08-01	First time form 5500 has been submitted	Yes
2016-08-01	Submission has been amended	No
2016-08-01	This submission is the final filing	No
2016-08-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2016-08-01	Plan is a collectively bargained plan	No
2016-08-01	Plan funding arrangement – Insurance	Yes
2016-08-01	Plan funding arrangement – Trust	Yes
2016-08-01	Plan benefit arrangement – Insurance	Yes
2016-08-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

95871-01

Policy instance

Insurance contract or identification number	95871-01
Number of Individuals Covered	0
Insurance policy start date	2022-01-01
Insurance policy end date	2022-01-01
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

95871-01

Policy instance

Insurance contract or identification number	95871-01
Number of Individuals Covered	223
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 unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

95871-01

Policy instance

Insurance contract or identification number	95871-01
Number of Individuals Covered	239
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

95871-01

Policy instance

Insurance contract or identification number	95871-01
Number of Individuals Covered	251
Insurance policy start date	2019-01-01
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 unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

95871-01

Policy instance

Insurance contract or identification number	95871-01
Number of Individuals Covered	274
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	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

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

95871-01

Policy instance

Insurance contract or identification number	95871-01
Number of Individuals Covered	290
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
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?	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:	CUYUNA REGIONAL MEDICAL CENTER
Employer identification number (EIN):	411724637
NAIC Classification:	622000
NAIC Description:	Hospitals