401k Plan data: THREE RIVERS HEALTH SYSTEM, INC. EMPLOYEE SAVINGS plan

THREE RIVERS HEALTH SYSTEM, INC. EMPLOYEE SAVINGS 401k Plan overview

Plan Name	THREE RIVERS HEALTH SYSTEM, INC. EMPLOYEE SAVINGS
Plan identification number	001

THREE RIVERS HEALTH SYSTEM, INC. EMPLOYEE SAVINGS 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).
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.

401k Sponsoring company profile

THREE RIVERS HEALTH SYSTEM, INC. has sponsored the creation of one or more 401k plans.

Company Name: THREE RIVERS HEALTH SYSTEM, INC.

Employer identification number (EIN): 451257972

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THREE RIVERS HEALTH SYSTEM, INC. EMPLOYEE SAVINGS

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01
001 2021-01-01
001 2020-01-01
001 2019-01-01
001 2018-01-01
001 2017-01-01 STEVE ANDREWS STEVE ANDREWS 2018-10-12
001 2016-01-01 STEVE ANDREWS
001 2015-01-01 STEVE ANDREWS STEVE ANDREWS 2016-09-27
001 2014-01-01 STEVE ANDREWS STEVE ANDREWS 2015-10-14
001 2013-04-01 STEVE ANDREWS

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2022-01-01
001	2021-01-01
001	2020-01-01
001	2019-01-01
001	2018-01-01
001	2017-01-01	STEVE ANDREWS	STEVE ANDREWS	2018-10-12
001	2016-01-01	STEVE ANDREWS
001	2015-01-01	STEVE ANDREWS	STEVE ANDREWS	2016-09-27
001	2014-01-01	STEVE ANDREWS	STEVE ANDREWS	2015-10-14
001	2013-04-01	STEVE ANDREWS

Plan Statistics for THREE RIVERS HEALTH SYSTEM, INC. EMPLOYEE SAVINGS

401k plan membership statisitcs for THREE RIVERS HEALTH SYSTEM, INC. EMPLOYEE SAVINGS

Measure Date Value
2022: THREE RIVERS HEALTH SYSTEM, INC. EMPLOYEE SAVINGS 2022 401k membership
Total participants, beginning-of-year 2022-01-01 566
Total number of active participants reported on line 7a of the Form 5500 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: THREE RIVERS HEALTH SYSTEM, INC. EMPLOYEE SAVINGS 2021 401k membership
Total participants, beginning-of-year 2021-01-01 547
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 481
Number of retired or separated participants receiving benefits 2021-01-01 3
Number of other retired or separated participants entitled to future benefits 2021-01-01 82
Total of all active and inactive participants 2021-01-01 566
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 566
Number of participants with account balances 2021-01-01 404
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: THREE RIVERS HEALTH SYSTEM, INC. EMPLOYEE SAVINGS 2020 401k membership
Total participants, beginning-of-year 2020-01-01 574
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 493
Number of retired or separated participants receiving benefits 2020-01-01 2
Number of other retired or separated participants entitled to future benefits 2020-01-01 52
Total of all active and inactive participants 2020-01-01 547
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 547
Number of participants with account balances 2020-01-01 379
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: THREE RIVERS HEALTH SYSTEM, INC. EMPLOYEE SAVINGS 2019 401k membership
Total participants, beginning-of-year 2019-01-01 546
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 495
Number of retired or separated participants receiving benefits 2019-01-01 2
Number of other retired or separated participants entitled to future benefits 2019-01-01 77
Total of all active and inactive participants 2019-01-01 574
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 574
Number of participants with account balances 2019-01-01 409
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: THREE RIVERS HEALTH SYSTEM, INC. EMPLOYEE SAVINGS 2018 401k membership
Total participants, beginning-of-year 2018-01-01 542
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 481
Number of retired or separated participants receiving benefits 2018-01-01 2
Number of other retired or separated participants entitled to future benefits 2018-01-01 63
Total of all active and inactive participants 2018-01-01 546
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 546
Number of participants with account balances 2018-01-01 371
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: THREE RIVERS HEALTH SYSTEM, INC. EMPLOYEE SAVINGS 2017 401k membership
Total participants, beginning-of-year 2017-01-01 542
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 472
Number of retired or separated participants receiving benefits 2017-01-01 1
Number of other retired or separated participants entitled to future benefits 2017-01-01 69
Total of all active and inactive participants 2017-01-01 542
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 542
Number of participants with account balances 2017-01-01 368
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: THREE RIVERS HEALTH SYSTEM, INC. EMPLOYEE SAVINGS 2016 401k membership
Total participants, beginning-of-year 2016-01-01 542
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 494
Number of retired or separated participants receiving benefits 2016-01-01 18
Number of other retired or separated participants entitled to future benefits 2016-01-01 37
Total of all active and inactive participants 2016-01-01 549
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 549
Number of participants with account balances 2016-01-01 343
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: THREE RIVERS HEALTH SYSTEM, INC. EMPLOYEE SAVINGS 2015 401k membership
Total participants, beginning-of-year 2015-01-01 524
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 490
Number of retired or separated participants receiving benefits 2015-01-01 17
Number of other retired or separated participants entitled to future benefits 2015-01-01 35
Total of all active and inactive participants 2015-01-01 542
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 542
Number of participants with account balances 2015-01-01 343
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: THREE RIVERS HEALTH SYSTEM, INC. EMPLOYEE SAVINGS 2014 401k membership
Total participants, beginning-of-year 2014-01-01 546
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 477
Number of retired or separated participants receiving benefits 2014-01-01 17
Number of other retired or separated participants entitled to future benefits 2014-01-01 30
Total of all active and inactive participants 2014-01-01 524
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 524
Number of participants with account balances 2014-01-01 341
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: THREE RIVERS HEALTH SYSTEM, INC. EMPLOYEE SAVINGS 2013 401k membership
Total participants, beginning-of-year 2013-04-01 558
Total number of active participants reported on line 7a of the Form 5500 2013-04-01 492
Number of retired or separated participants receiving benefits 2013-04-01 17
Number of other retired or separated participants entitled to future benefits 2013-04-01 37
Total of all active and inactive participants 2013-04-01 546
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-04-01 0
Total participants 2013-04-01 546
Number of participants with account balances 2013-04-01 357
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-04-01 0

Measure	Date	Value
2022: THREE RIVERS HEALTH SYSTEM, INC. EMPLOYEE SAVINGS 2022 401k membership
Total participants, beginning-of-year	2022-01-01	566
Total number of active participants reported on line 7a of the Form 5500	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: THREE RIVERS HEALTH SYSTEM, INC. EMPLOYEE SAVINGS 2021 401k membership
Total participants, beginning-of-year	2021-01-01	547
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	481
Number of retired or separated participants receiving benefits	2021-01-01	3
Number of other retired or separated participants entitled to future benefits	2021-01-01	82
Total of all active and inactive participants	2021-01-01	566
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	566
Number of participants with account balances	2021-01-01	404
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: THREE RIVERS HEALTH SYSTEM, INC. EMPLOYEE SAVINGS 2020 401k membership
Total participants, beginning-of-year	2020-01-01	574
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	493
Number of retired or separated participants receiving benefits	2020-01-01	2
Number of other retired or separated participants entitled to future benefits	2020-01-01	52
Total of all active and inactive participants	2020-01-01	547
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	547
Number of participants with account balances	2020-01-01	379
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: THREE RIVERS HEALTH SYSTEM, INC. EMPLOYEE SAVINGS 2019 401k membership
Total participants, beginning-of-year	2019-01-01	546
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	495
Number of retired or separated participants receiving benefits	2019-01-01	2
Number of other retired or separated participants entitled to future benefits	2019-01-01	77
Total of all active and inactive participants	2019-01-01	574
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	574
Number of participants with account balances	2019-01-01	409
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: THREE RIVERS HEALTH SYSTEM, INC. EMPLOYEE SAVINGS 2018 401k membership
Total participants, beginning-of-year	2018-01-01	542
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	481
Number of retired or separated participants receiving benefits	2018-01-01	2
Number of other retired or separated participants entitled to future benefits	2018-01-01	63
Total of all active and inactive participants	2018-01-01	546
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	546
Number of participants with account balances	2018-01-01	371
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: THREE RIVERS HEALTH SYSTEM, INC. EMPLOYEE SAVINGS 2017 401k membership
Total participants, beginning-of-year	2017-01-01	542
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	472
Number of retired or separated participants receiving benefits	2017-01-01	1
Number of other retired or separated participants entitled to future benefits	2017-01-01	69
Total of all active and inactive participants	2017-01-01	542
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	542
Number of participants with account balances	2017-01-01	368
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: THREE RIVERS HEALTH SYSTEM, INC. EMPLOYEE SAVINGS 2016 401k membership
Total participants, beginning-of-year	2016-01-01	542
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	494
Number of retired or separated participants receiving benefits	2016-01-01	18
Number of other retired or separated participants entitled to future benefits	2016-01-01	37
Total of all active and inactive participants	2016-01-01	549
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	549
Number of participants with account balances	2016-01-01	343
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: THREE RIVERS HEALTH SYSTEM, INC. EMPLOYEE SAVINGS 2015 401k membership
Total participants, beginning-of-year	2015-01-01	524
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	490
Number of retired or separated participants receiving benefits	2015-01-01	17
Number of other retired or separated participants entitled to future benefits	2015-01-01	35
Total of all active and inactive participants	2015-01-01	542
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	542
Number of participants with account balances	2015-01-01	343
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: THREE RIVERS HEALTH SYSTEM, INC. EMPLOYEE SAVINGS 2014 401k membership
Total participants, beginning-of-year	2014-01-01	546
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	477
Number of retired or separated participants receiving benefits	2014-01-01	17
Number of other retired or separated participants entitled to future benefits	2014-01-01	30
Total of all active and inactive participants	2014-01-01	524
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	524
Number of participants with account balances	2014-01-01	341
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: THREE RIVERS HEALTH SYSTEM, INC. EMPLOYEE SAVINGS 2013 401k membership
Total participants, beginning-of-year	2013-04-01	558
Total number of active participants reported on line 7a of the Form 5500	2013-04-01	492
Number of retired or separated participants receiving benefits	2013-04-01	17
Number of other retired or separated participants entitled to future benefits	2013-04-01	37
Total of all active and inactive participants	2013-04-01	546
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-04-01	0
Total participants	2013-04-01	546
Number of participants with account balances	2013-04-01	357
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-04-01	0

Financial Data on THREE RIVERS HEALTH SYSTEM, INC. EMPLOYEE SAVINGS

Measure	Date	Value
2022 : THREE RIVERS HEALTH SYSTEM, INC. EMPLOYEE SAVINGS 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total transfer of assets from this plan	2022-12-31	$17,028,665
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
Total income from all sources (including contributions)	2022-12-31	$-3,351,011
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$5,868,854
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$5,767,399
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$1,633,699
Value of total assets at end of year	2022-12-31	$0
Value of total assets at beginning of year	2022-12-31	$26,248,530
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$101,455
Total interest from all sources	2022-12-31	$12,211
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$17,788
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	$17,788
Administrative expenses professional fees incurred	2022-12-31	$19,924
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	Yes
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$1,375,227
Participant contributions at end of year	2022-12-31	$0
Participant contributions at beginning of year	2022-12-31	$244,643
Participant contributions at beginning of year	2022-12-31	$89
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$1,500
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
Value of net income/loss	2022-12-31	$-9,219,865
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$26,248,530
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$24,556,925
Interest on participant loans	2022-12-31	$12,211
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$1,354,590
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-5,014,709
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	Yes
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$256,972
Employer contributions (assets) at end of year	2022-12-31	$0
Employer contributions (assets) at beginning of year	2022-12-31	$92,283
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$5,767,399
Contract administrator fees	2022-12-31	$81,531
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	2022-12-31	Yes
Did the plan have assets held for investment	2022-12-31	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	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	Yes
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	PLANTE & MORAN, LLC
Accountancy firm EIN	2022-12-31	381357951
2021 : THREE RIVERS HEALTH SYSTEM, INC. EMPLOYEE SAVINGS 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
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	$5,343,551
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$4,076,313
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$3,966,184
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$1,807,759
Value of total assets at end of year	2021-12-31	$26,248,530
Value of total assets at beginning of year	2021-12-31	$24,981,292
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$110,129
Total interest from all sources	2021-12-31	$16,022
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Administrative expenses professional fees incurred	2021-12-31	$13,084
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$750,000
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	$1,412,003
Participant contributions at end of year	2021-12-31	$244,643
Participant contributions at beginning of year	2021-12-31	$353,177
Participant contributions at end of year	2021-12-31	$89
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$56,511
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	$1,267,238
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$26,248,530
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$24,981,292
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	$24,556,925
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$22,628,068
Interest on participant loans	2021-12-31	$16,022
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$1,354,590
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$1,832,197
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$3,519,770
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	$339,245
Employer contributions (assets) at end of year	2021-12-31	$92,283
Employer contributions (assets) at beginning of year	2021-12-31	$167,850
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$3,966,184
Contract administrator fees	2021-12-31	$97,045
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	PLANTE & MORAN, LLC
Accountancy firm EIN	2021-12-31	381357951
2020 : THREE RIVERS HEALTH SYSTEM, INC. EMPLOYEE SAVINGS 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
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	$5,991,455
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$1,873,198
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$1,783,262
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$1,755,588
Value of total assets at end of year	2020-12-31	$24,981,292
Value of total assets at beginning of year	2020-12-31	$20,863,035
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$89,936
Total interest from all sources	2020-12-31	$19,470
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$750,000
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	$1,331,829
Participant contributions at end of year	2020-12-31	$353,177
Participant contributions at beginning of year	2020-12-31	$340,169
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$93,757
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	$4,118,257
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$24,981,292
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$20,863,035
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	$89,936
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$22,628,068
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$18,434,463
Interest on participant loans	2020-12-31	$19,470
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$1,832,197
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$1,929,084
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$4,216,397
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	No
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	$330,002
Employer contributions (assets) at end of year	2020-12-31	$167,850
Employer contributions (assets) at beginning of year	2020-12-31	$159,319
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$1,783,262
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	PLANTE & MORAN, LLC
Accountancy firm EIN	2020-12-31	381357951
2019 : THREE RIVERS HEALTH SYSTEM, INC. EMPLOYEE SAVINGS 2019 401k financial data
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 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	$5,969,212
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$1,581,066
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$1,511,962
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$1,752,421
Value of total assets at end of year	2019-12-31	$20,863,035
Value of total assets at beginning of year	2019-12-31	$16,474,889
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$69,104
Total interest from all sources	2019-12-31	$18,505
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$750,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
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	$1,313,948
Participant contributions at end of year	2019-12-31	$340,169
Participant contributions at beginning of year	2019-12-31	$330,703
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$123,836
Administrative expenses (other) incurred	2019-12-31	$10,253
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	$4,388,146
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$20,863,035
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$16,474,889
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	$1,717
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$18,434,463
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$13,836,781
Interest on participant loans	2019-12-31	$18,505
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$1,929,084
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$2,091,714
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$4,198,286
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
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	$314,637
Employer contributions (assets) at end of year	2019-12-31	$159,319
Employer contributions (assets) at beginning of year	2019-12-31	$215,691
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$1,511,962
Contract administrator fees	2019-12-31	$57,134
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
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	PLANTE & MORAN, LLC
Accountancy firm EIN	2019-12-31	381357951
2018 : THREE RIVERS HEALTH SYSTEM, INC. EMPLOYEE SAVINGS 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	$957,391
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$2,038,062
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$1,954,767
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$1,516,262
Value of total assets at end of year	2018-12-31	$16,474,889
Value of total assets at beginning of year	2018-12-31	$17,555,560
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$83,295
Total interest from all sources	2018-12-31	$18,167
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
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	$1,155,703
Participant contributions at end of year	2018-12-31	$330,703
Participant contributions at beginning of year	2018-12-31	$411,764
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$80,389
Administrative expenses (other) incurred	2018-12-31	$9,881
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
Income. Non cash contributions	2018-12-31	$0
Value of net income/loss	2018-12-31	$-1,080,671
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$16,474,889
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$17,555,560
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
Investment advisory and management fees	2018-12-31	$40,968
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$13,836,781
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$14,947,479
Interest on participant loans	2018-12-31	$18,167
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$2,091,714
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$2,066,489
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-577,038
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	$280,170
Employer contributions (assets) at end of year	2018-12-31	$215,691
Employer contributions (assets) at beginning of year	2018-12-31	$129,828
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$1,954,767
Contract administrator fees	2018-12-31	$32,446
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	PLANTE & MORAN, PLLC
Accountancy firm EIN	2018-12-31	381357951
2017 : THREE RIVERS HEALTH SYSTEM, INC. EMPLOYEE SAVINGS 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
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	$3,971,495
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$3,098,983
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$3,015,695
Expenses. Certain deemed distributions of participant loans	2017-12-31	$3,020
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$1,352,926
Value of total assets at end of year	2017-12-31	$17,555,560
Value of total assets at beginning of year	2017-12-31	$16,683,048
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$80,268
Total interest from all sources	2017-12-31	$16,325
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$46,252
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	$46,252
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	$1,012,785
Participant contributions at end of year	2017-12-31	$411,764
Participant contributions at beginning of year	2017-12-31	$378,098
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$81,260
Administrative expenses (other) incurred	2017-12-31	$11,634
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	$872,512
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$17,555,560
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$16,683,048
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
Investment advisory and management fees	2017-12-31	$29,918
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$14,947,479
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$14,221,423
Interest on participant loans	2017-12-31	$16,325
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$2,066,489
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$1,952,737
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$2,555,992
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	$258,881
Employer contributions (assets) at end of year	2017-12-31	$129,828
Employer contributions (assets) at beginning of year	2017-12-31	$130,790
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$3,015,695
Contract administrator fees	2017-12-31	$38,716
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	PLANTE & MORAN, PLLC
Accountancy firm EIN	2017-12-31	381357951
2016 : THREE RIVERS HEALTH SYSTEM, INC. EMPLOYEE SAVINGS 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
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	$2,389,543
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$1,496,584
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$1,409,706
Expenses. Certain deemed distributions of participant loans	2016-12-31	$882
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$1,171,981
Value of total assets at end of year	2016-12-31	$16,683,048
Value of total assets at beginning of year	2016-12-31	$15,790,089
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$85,996
Total interest from all sources	2016-12-31	$17,138
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
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	$927,792
Participant contributions at end of year	2016-12-31	$378,098
Participant contributions at beginning of year	2016-12-31	$387,443
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$1,683
Administrative expenses (other) incurred	2016-12-31	$10,684
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	$892,959
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$16,683,048
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$15,790,089
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	$36,983
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$14,221,423
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$14,420,044
Income. Interest from loans (other than to participants)	2016-12-31	$17,138
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$1,952,737
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$921,083
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$1,200,424
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	$242,506
Employer contributions (assets) at end of year	2016-12-31	$130,790
Employer contributions (assets) at beginning of year	2016-12-31	$61,519
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$1,409,706
Contract administrator fees	2016-12-31	$38,329
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
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	PLANTE & MORAN, PLLC
Accountancy firm EIN	2016-12-31	381357951
2015 : THREE RIVERS HEALTH SYSTEM, INC. EMPLOYEE SAVINGS 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$2,313,292
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$1,001,643
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$918,009
Expenses. Certain deemed distributions of participant loans	2015-12-31	$9,245
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$2,075,802
Value of total assets at end of year	2015-12-31	$15,790,089
Value of total assets at beginning of year	2015-12-31	$14,478,440
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$74,389
Total interest from all sources	2015-12-31	$15,496
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$500,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$879,304
Participant contributions at end of year	2015-12-31	$387,443
Participant contributions at beginning of year	2015-12-31	$340,129
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$966,790
Administrative expenses (other) incurred	2015-12-31	$36,176
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$1,311,649
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$15,790,089
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$14,478,440
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Investment advisory and management fees	2015-12-31	$14,561
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$14,420,044
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$13,043,768
Interest on participant loans	2015-12-31	$15,496
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$921,083
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$997,568
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$221,994
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$229,708
Employer contributions (assets) at end of year	2015-12-31	$61,519
Employer contributions (assets) at beginning of year	2015-12-31	$96,975
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$918,009
Contract administrator fees	2015-12-31	$23,652
Did the plan have assets held for investment	2015-12-31	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	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	PLANTE & MORAN, PLLC
Accountancy firm EIN	2015-12-31	381357951
2014 : THREE RIVERS HEALTH SYSTEM, INC. EMPLOYEE SAVINGS 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$1,635,660
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$1,676,528
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$1,613,220
Expenses. Certain deemed distributions of participant loans	2014-12-31	$10,525
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$1,012,263
Value of total assets at end of year	2014-12-31	$14,478,440
Value of total assets at beginning of year	2014-12-31	$14,519,308
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$52,783
Total interest from all sources	2014-12-31	$13,982
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$500,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$742,855
Participant contributions at end of year	2014-12-31	$340,129
Participant contributions at beginning of year	2014-12-31	$430,743
Assets. Other investments not covered elsewhere at beginning of year	2014-12-31	$5,793
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$79,517
Administrative expenses (other) incurred	2014-12-31	$15,000
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$-40,868
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$14,478,440
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$14,519,308
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Investment advisory and management fees	2014-12-31	$33,904
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$13,043,768
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$13,081,333
Interest on participant loans	2014-12-31	$13,982
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$997,568
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$960,660
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$609,415
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$189,891
Employer contributions (assets) at end of year	2014-12-31	$96,975
Employer contributions (assets) at beginning of year	2014-12-31	$40,779
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$1,613,220
Contract administrator fees	2014-12-31	$3,879
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	PLANTE & MORAN, PLLC
Accountancy firm EIN	2014-12-31	381357951
2013 : THREE RIVERS HEALTH SYSTEM, INC. EMPLOYEE SAVINGS 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total transfer of assets to this plan	2013-12-31	$13,115,251
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$2,576,769
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$1,172,712
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$1,141,199
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$690,138
Value of total assets at end of year	2013-12-31	$14,519,308
Value of total assets at beginning of year	2013-12-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$31,513
Total interest from all sources	2013-12-31	$15,022
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$500,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$528,378
Participant contributions at end of year	2013-12-31	$430,743
Participant contributions at beginning of year	2013-12-31	$0
Participant contributions at beginning of year	2013-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2013-12-31	$5,793
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$26,542
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2013-12-31	$0
Administrative expenses (other) incurred	2013-12-31	$5,330
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$1,404,057
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$14,519,308
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Investment advisory and management fees	2013-12-31	$8,377
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$13,081,333
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$0
Interest on participant loans	2013-12-31	$15,022
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$960,660
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$1,871,609
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$135,218
Employer contributions (assets) at end of year	2013-12-31	$40,779
Employer contributions (assets) at beginning of year	2013-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$1,141,199
Contract administrator fees	2013-12-31	$17,806
Did the plan have assets held for investment	2013-12-31	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	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	PLANTE & MORAN, PLLC
Accountancy firm EIN	2013-12-31	381357951

Form 5500 Responses for THREE RIVERS HEALTH SYSTEM, INC. EMPLOYEE SAVINGS

2022: THREE RIVERS HEALTH SYSTEM, INC. EMPLOYEE SAVINGS 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)	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: THREE RIVERS HEALTH SYSTEM, INC. EMPLOYEE SAVINGS 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: THREE RIVERS HEALTH SYSTEM, INC. EMPLOYEE SAVINGS 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: THREE RIVERS HEALTH SYSTEM, INC. EMPLOYEE SAVINGS 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: THREE RIVERS HEALTH SYSTEM, INC. EMPLOYEE SAVINGS 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: THREE RIVERS HEALTH SYSTEM, INC. EMPLOYEE SAVINGS 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: THREE RIVERS HEALTH SYSTEM, INC. EMPLOYEE SAVINGS 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: THREE RIVERS HEALTH SYSTEM, INC. EMPLOYEE SAVINGS 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: THREE RIVERS HEALTH SYSTEM, INC. EMPLOYEE SAVINGS 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: THREE RIVERS HEALTH SYSTEM, INC. EMPLOYEE SAVINGS 2013 form 5500 responses
2013-04-01	Type of plan entity	Single employer plan
2013-04-01	First time form 5500 has been submitted	Yes
2013-04-01	Submission has been amended	No
2013-04-01	This submission is the final filing	No
2013-04-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2013-04-01	Plan is a collectively bargained plan	No
2013-04-01	Plan funding arrangement – Insurance	Yes
2013-04-01	Plan funding arrangement – Trust	Yes
2013-04-01	Plan benefit arrangement – Insurance	Yes
2013-04-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

395-80071

Policy instance

Insurance contract or identification number	395-80071
Number of Individuals Covered	0
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $3,138
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?	Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,138
Insurance broker organization code?	3

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

395-80071

Policy instance

Insurance contract or identification number	395-80071
Number of Individuals Covered	411
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $3,990
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?	Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,990
Insurance broker organization code?	3

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

395-80071

Policy instance

Insurance contract or identification number	395-80071
Number of Individuals Covered	406
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $4,035
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?	Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,035
Insurance broker organization code?	3

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

395-80071

Policy instance

Insurance contract or identification number	395-80071
Number of Individuals Covered	417
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $4,193
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?	Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,193
Insurance broker organization code?	3

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

395-80071

Policy instance

Insurance contract or identification number	395-80071
Number of Individuals Covered	375
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?	Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

395-80071

Policy instance

Insurance contract or identification number	395-80071
Number of Individuals Covered	370
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?	Yes
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

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

39585138

Policy instance

Insurance contract or identification number	39585138
Number of Individuals Covered	0
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
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?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	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

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

395-80071

Policy instance

Insurance contract or identification number	395-80071
Number of Individuals Covered	357
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
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?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
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

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

39585138

Policy instance

Insurance contract or identification number	39585138
Number of Individuals Covered	353
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
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?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	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

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

39585138

Policy instance

Insurance contract or identification number	39585138
Number of Individuals Covered	546
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $2,011
Total amount of fees paid to insurance company	USD $503
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	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
Commission paid to Insurance Broker	USD $2,011
Insurance broker organization code?	3
Amount paid for insurance broker fees	503
Additional information about fees paid to insurance broker	FEES
Insurance broker name	NANCY J SABOLISH

Potentially related plans

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Company Name:	THREE RIVERS HEALTH SYSTEM, INC.
Employer identification number (EIN):	451257972
NAIC Classification:	622000
NAIC Description:	Hospitals