401k Plan data: DCHS MEDICAL FOUNDATION BARGAINING UNIT EMPLOYEES plan

DCHS MEDICAL FOUNDATION BARGAINING UNIT EMPLOYEES 401k Plan overview

Plan Name	DCHS MEDICAL FOUNDATION BARGAINING UNIT EMPLOYEES
Plan identification number	003

DCHS MEDICAL FOUNDATION BARGAINING UNIT EMPLOYEES 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.
Participant-directed brokerage accounts provided as an investment option under the plan.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

DAUGHTERS OF CHARITY HEALTH SYSTEMS MEDICAL FOUNDATION has sponsored the creation of one or more 401k plans.

Company Name: DAUGHTERS OF CHARITY HEALTH SYSTEMS MEDICAL FOUNDATION

Employer identification number (EIN): 453691852

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DCHS MEDICAL FOUNDATION BARGAINING UNIT EMPLOYEES

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
003 2019-01-01
003 2018-01-01
003 2017-01-01 STEVE SHARRER
003 2016-01-01 STEVESHARRER
003 2015-12-14 CHANTELLE WENZ
003 2015-06-17 ERICA LUNA
003 2012-01-01 CARL KETTLER CARL KETTLER 2013-10-15

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
003	2019-01-01
003	2018-01-01
003	2017-01-01	STEVE SHARRER
003	2016-01-01	STEVESHARRER
003	2015-12-14	CHANTELLE WENZ
003	2015-06-17	ERICA LUNA
003	2012-01-01	CARL KETTLER	CARL KETTLER	2013-10-15

Plan Statistics for DCHS MEDICAL FOUNDATION BARGAINING UNIT EMPLOYEES

401k plan membership statisitcs for DCHS MEDICAL FOUNDATION BARGAINING UNIT EMPLOYEES

Measure Date Value
2019: DCHS MEDICAL FOUNDATION BARGAINING UNIT EMPLOYEES 2019 401k membership
Total participants, beginning-of-year 2019-01-01 315
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 0
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 0
Total of all active and inactive participants 2019-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 0
Number of participants with account balances 2019-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: DCHS MEDICAL FOUNDATION BARGAINING UNIT EMPLOYEES 2018 401k membership
Total participants, beginning-of-year 2018-01-01 329
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 171
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 144
Total of all active and inactive participants 2018-01-01 315
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 315
Number of participants with account balances 2018-01-01 315
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 7
2017: DCHS MEDICAL FOUNDATION BARGAINING UNIT EMPLOYEES 2017 401k membership
Total participants, beginning-of-year 2017-01-01 351
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 197
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 132
Total of all active and inactive participants 2017-01-01 329
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 329
Number of participants with account balances 2017-01-01 326
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 4
2016: DCHS MEDICAL FOUNDATION BARGAINING UNIT EMPLOYEES 2016 401k membership
Total participants, beginning-of-year 2016-01-01 344
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 232
Number of retired or separated participants receiving benefits 2016-01-01 1
Number of other retired or separated participants entitled to future benefits 2016-01-01 110
Total of all active and inactive participants 2016-01-01 343
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 343
Number of participants with account balances 2016-01-01 303
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 6
2015: DCHS MEDICAL FOUNDATION BARGAINING UNIT EMPLOYEES 2015 401k membership
Total participants, beginning-of-year 2015-12-14 320
Total number of active participants reported on line 7a of the Form 5500 2015-12-14 223
Number of retired or separated participants receiving benefits 2015-12-14 1
Number of other retired or separated participants entitled to future benefits 2015-12-14 105
Total of all active and inactive participants 2015-12-14 329
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-12-14 0
Total participants 2015-12-14 329
Number of participants with account balances 2015-12-14 296
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-12-14 6
Total participants, beginning-of-year 2015-06-17 323
Total number of active participants reported on line 7a of the Form 5500 2015-06-17 223
Number of retired or separated participants receiving benefits 2015-06-17 1
Number of other retired or separated participants entitled to future benefits 2015-06-17 105
Total of all active and inactive participants 2015-06-17 329
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-06-17 0
Total participants 2015-06-17 329
Number of participants with account balances 2015-06-17 296
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-06-17 6
2012: DCHS MEDICAL FOUNDATION BARGAINING UNIT EMPLOYEES 2012 401k membership
Total participants, beginning-of-year 2012-01-01 313
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 241
Number of retired or separated participants receiving benefits 2012-01-01 1
Number of other retired or separated participants entitled to future benefits 2012-01-01 76
Total of all active and inactive participants 2012-01-01 318
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 318
Number of participants with account balances 2012-01-01 304
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 2

Measure	Date	Value
2019: DCHS MEDICAL FOUNDATION BARGAINING UNIT EMPLOYEES 2019 401k membership
Total participants, beginning-of-year	2019-01-01	315
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	0
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	0
Total of all active and inactive participants	2019-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	0
Number of participants with account balances	2019-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: DCHS MEDICAL FOUNDATION BARGAINING UNIT EMPLOYEES 2018 401k membership
Total participants, beginning-of-year	2018-01-01	329
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	171
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	144
Total of all active and inactive participants	2018-01-01	315
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	315
Number of participants with account balances	2018-01-01	315
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	7
2017: DCHS MEDICAL FOUNDATION BARGAINING UNIT EMPLOYEES 2017 401k membership
Total participants, beginning-of-year	2017-01-01	351
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	197
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	132
Total of all active and inactive participants	2017-01-01	329
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	329
Number of participants with account balances	2017-01-01	326
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	4
2016: DCHS MEDICAL FOUNDATION BARGAINING UNIT EMPLOYEES 2016 401k membership
Total participants, beginning-of-year	2016-01-01	344
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	232
Number of retired or separated participants receiving benefits	2016-01-01	1
Number of other retired or separated participants entitled to future benefits	2016-01-01	110
Total of all active and inactive participants	2016-01-01	343
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	343
Number of participants with account balances	2016-01-01	303
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	6
2015: DCHS MEDICAL FOUNDATION BARGAINING UNIT EMPLOYEES 2015 401k membership
Total participants, beginning-of-year	2015-12-14	320
Total number of active participants reported on line 7a of the Form 5500	2015-12-14	223
Number of retired or separated participants receiving benefits	2015-12-14	1
Number of other retired or separated participants entitled to future benefits	2015-12-14	105
Total of all active and inactive participants	2015-12-14	329
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-12-14	0
Total participants	2015-12-14	329
Number of participants with account balances	2015-12-14	296
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-12-14	6
Total participants, beginning-of-year	2015-06-17	323
Total number of active participants reported on line 7a of the Form 5500	2015-06-17	223
Number of retired or separated participants receiving benefits	2015-06-17	1
Number of other retired or separated participants entitled to future benefits	2015-06-17	105
Total of all active and inactive participants	2015-06-17	329
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-06-17	0
Total participants	2015-06-17	329
Number of participants with account balances	2015-06-17	296
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-06-17	6
2012: DCHS MEDICAL FOUNDATION BARGAINING UNIT EMPLOYEES 2012 401k membership
Total participants, beginning-of-year	2012-01-01	313
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	241
Number of retired or separated participants receiving benefits	2012-01-01	1
Number of other retired or separated participants entitled to future benefits	2012-01-01	76
Total of all active and inactive participants	2012-01-01	318
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	318
Number of participants with account balances	2012-01-01	304
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	2

Financial Data on DCHS MEDICAL FOUNDATION BARGAINING UNIT EMPLOYEES

Measure	Date	Value
2019 : DCHS MEDICAL FOUNDATION BARGAINING UNIT EMPLOYEES 2019 401k financial data
Total income from all sources (including contributions)	2019-12-20	$1,542,767
Total of all expenses incurred	2019-12-20	$10,612,590
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-20	$10,564,380
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-20	$141,083
Value of total assets at end of year	2019-12-20	$0
Value of total assets at beginning of year	2019-12-20	$9,069,823
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-20	$48,210
Total interest from all sources	2019-12-20	$23,159
Total dividends received (eg from common stock, registered investment company shares)	2019-12-20	$104,638
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-20	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2019-12-20	$0
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-20	$104,638
Administrative expenses professional fees incurred	2019-12-20	$28,579
Was this plan covered by a fidelity bond	2019-12-20	Yes
Value of fidelity bond cover	2019-12-20	$10,000,000
If this is an individual account plan, was there a blackout period	2019-12-20	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-20	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-20	No
Contributions received from participants	2019-12-20	$106,403
Participant contributions at end of year	2019-12-20	$0
Participant contributions at beginning of year	2019-12-20	$198,265
Assets. Other investments not covered elsewhere at end of year	2019-12-20	$0
Assets. Other investments not covered elsewhere at beginning of year	2019-12-20	$169,371
Value of other receiveables (less allowance for doubtful accounts) at end of year	2019-12-20	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2019-12-20	$181
Other income not declared elsewhere	2019-12-20	$13,756
Administrative expenses (other) incurred	2019-12-20	$18,696
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-20	No
Value of net income/loss	2019-12-20	$-9,069,823
Value of net assets at end of year (total assets less liabilities)	2019-12-20	$0
Value of net assets at beginning of year (total assets less liabilities)	2019-12-20	$9,069,823
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-20	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-20	No
Were any leases to which the plan was party in default or uncollectible	2019-12-20	No
Investment advisory and management fees	2019-12-20	$935
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-20	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-20	$7,368,259
Interest on participant loans	2019-12-20	$4,489
Interest earned on other investments	2019-12-20	$18,670
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-20	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-20	$1,264,106
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-20	$1,260,131
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-20	No
Was there a failure to transmit to the plan any participant contributions	2019-12-20	No
Has the plan failed to provide any benefit when due under the plan	2019-12-20	No
Contributions received in cash from employer	2019-12-20	$34,680
Employer contributions (assets) at end of year	2019-12-20	$0
Employer contributions (assets) at beginning of year	2019-12-20	$69,641
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-20	$10,564,380
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2019-12-20	No
Did the plan have assets held for investment	2019-12-20	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	2019-12-20	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-20	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-20	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-20	Disclaimer
Accountancy firm name	2019-12-20	MOSS ADAMS
Accountancy firm EIN	2019-12-20	910189318
2018 : DCHS MEDICAL FOUNDATION BARGAINING UNIT EMPLOYEES 2018 401k financial data
Total income from all sources (including contributions)	2018-12-31	$59,683
Total of all expenses incurred	2018-12-31	$555,892
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$534,081
Value of total corrective distributions	2018-12-31	$1,564
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$482,826
Value of total assets at end of year	2018-12-31	$9,069,823
Value of total assets at beginning of year	2018-12-31	$9,566,032
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$20,247
Total interest from all sources	2018-12-31	$42,565
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$168,966
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	$168,966
Administrative expenses professional fees incurred	2018-12-31	$3,000
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$10,000,000
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	$321,877
Participant contributions at end of year	2018-12-31	$198,265
Participant contributions at beginning of year	2018-12-31	$227,882
Assets. Other investments not covered elsewhere at end of year	2018-12-31	$169,371
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$24,448
Value of other receiveables (less allowance for doubtful accounts) at end of year	2018-12-31	$181
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2018-12-31	$451
Other income not declared elsewhere	2018-12-31	$-23,408
Administrative expenses (other) incurred	2018-12-31	$16,024
Total non interest bearing cash at beginning of year	2018-12-31	$1,733
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	$-496,209
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$9,069,823
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$9,566,032
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	$1,223
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$7,368,259
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$7,841,729
Interest on participant loans	2018-12-31	$11,230
Interest earned on other investments	2018-12-31	$31,335
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2018-12-31	$20,894
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2018-12-31	$20,894
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$1,264,106
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$1,473,343
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-611,266
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	Yes
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	$136,501
Employer contributions (assets) at end of year	2018-12-31	$69,641
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$534,081
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	2018-12-31	No
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	MOSS ADAMS
Accountancy firm EIN	2018-12-31	910189318
2017 : DCHS MEDICAL FOUNDATION BARGAINING UNIT EMPLOYEES 2017 401k financial data
Total transfer of assets to this plan	2017-12-31	$470,746
Total income from all sources (including contributions)	2017-12-31	$1,703,360
Total of all expenses incurred	2017-12-31	$1,125,433
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$1,081,356
Expenses. Certain deemed distributions of participant loans	2017-12-31	$18,216
Value of total corrective distributions	2017-12-31	$1,690
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$432,780
Value of total assets at end of year	2017-12-31	$9,566,032
Value of total assets at beginning of year	2017-12-31	$8,517,359
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$24,171
Total interest from all sources	2017-12-31	$31,085
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$85,368
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	$85,368
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$10,000,000
If this is an individual account plan, was there a blackout period	2017-12-31	Yes
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	$245,652
Participant contributions at end of year	2017-12-31	$227,882
Participant contributions at beginning of year	2017-12-31	$238,794
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$53,206
Value of other receiveables (less allowance for doubtful accounts) at end of year	2017-12-31	$451
Other income not declared elsewhere	2017-12-31	$1,285
Administrative expenses (other) incurred	2017-12-31	$24,171
Total non interest bearing cash at end of year	2017-12-31	$1,733
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	$577,927
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$9,566,032
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$8,517,359
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	$7,841,729
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$7,148,669
Interest on participant loans	2017-12-31	$11,953
Interest earned on other investments	2017-12-31	$19,132
Value of interest in common/collective trusts at beginning of year	2017-12-31	$1,129,896
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2017-12-31	$20,894
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$1,473,343
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$1,077,376
Net investment gain or loss from common/collective trusts	2017-12-31	$75,466
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	Yes
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	$133,922
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$1,081,356
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	2017-12-31	Yes
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	MOSS ADAMS
Accountancy firm EIN	2017-12-31	910189318
2016 : DCHS MEDICAL FOUNDATION BARGAINING UNIT EMPLOYEES 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	$1,116,919
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$427,601
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$398,064
Expenses. Certain deemed distributions of participant loans	2016-12-31	$-8
Value of total corrective distributions	2016-12-31	$2,654
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$505,278
Value of total assets at end of year	2016-12-31	$8,517,359
Value of total assets at beginning of year	2016-12-31	$7,828,041
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$26,891
Total interest from all sources	2016-12-31	$13,629
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$81,649
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	$81,649
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$10,000,000
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	$290,641
Participant contributions at end of year	2016-12-31	$238,794
Participant contributions at beginning of year	2016-12-31	$304,952
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$38,889
Other income not declared elsewhere	2016-12-31	$309
Administrative expenses (other) incurred	2016-12-31	$26,891
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	$689,318
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$8,517,359
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$7,828,041
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$7,148,669
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$6,469,305
Interest on participant loans	2016-12-31	$13,629
Value of interest in common/collective trusts at end of year	2016-12-31	$1,129,896
Value of interest in common/collective trusts at beginning of year	2016-12-31	$1,053,784
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$445,100
Net investment gain or loss from common/collective trusts	2016-12-31	$70,954
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	$175,748
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$398,064
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	MOSS ADAMS
Accountancy firm EIN	2016-12-31	910189318
2015 : DCHS MEDICAL FOUNDATION BARGAINING UNIT EMPLOYEES 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	$511,837
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$609,953
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$572,054
Expenses. Certain deemed distributions of participant loans	2015-12-31	$6,777
Value of total corrective distributions	2015-12-31	$2,368
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$476,947
Value of total assets at end of year	2015-12-31	$7,828,050
Value of total assets at beginning of year	2015-12-31	$7,926,166
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$28,754
Total interest from all sources	2015-12-31	$15,561
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$69,918
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$69,918
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	$280,835
Participant contributions at end of year	2015-12-31	$304,952
Participant contributions at beginning of year	2015-12-31	$354,755
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$9,663
Other income not declared elsewhere	2015-12-31	$1,172
Administrative expenses (other) incurred	2015-12-31	$28,754
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	$-98,116
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$7,828,050
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$7,926,166
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$6,469,310
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$6,468,655
Interest on participant loans	2015-12-31	$15,561
Value of interest in common/collective trusts at end of year	2015-12-31	$1,053,788
Value of interest in common/collective trusts at beginning of year	2015-12-31	$1,102,756
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-40,857
Net investment gain or loss from common/collective trusts	2015-12-31	$-10,904
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	$186,449
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$572,054
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
2012 : DCHS MEDICAL FOUNDATION BARGAINING UNIT EMPLOYEES 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total transfer of assets from this plan	2012-12-31	$13,241
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$1,183,508
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$260,383
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$231,699
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$502,354
Value of total assets at end of year	2012-12-31	$6,730,831
Value of total assets at beginning of year	2012-12-31	$5,820,947
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$28,684
Total interest from all sources	2012-12-31	$13,060
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$101,086
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-12-31	$101,086
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$500,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$301,118
Participant contributions at end of year	2012-12-31	$239,902
Participant contributions at beginning of year	2012-12-31	$227,120
Other income not declared elsewhere	2012-12-31	$1,650
Administrative expenses (other) incurred	2012-12-31	$28,684
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$923,125
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$6,730,831
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$5,820,947
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$4,098,911
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$3,618,478
Interest on participant loans	2012-12-31	$13,060
Value of interest in common/collective trusts at end of year	2012-12-31	$1,165,896
Value of interest in common/collective trusts at beginning of year	2012-12-31	$896,712
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-12-31	$1,226,122
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-12-31	$1,078,637
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-12-31	$1,078,637
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$464,602
Net investment gain or loss from common/collective trusts	2012-12-31	$100,756
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$201,236
Employer contributions (assets) at beginning of year	2012-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$231,699
Did the plan have assets held for investment	2012-12-31	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	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	FRANK RIMERMAN & CO LLP
Accountancy firm EIN	2012-12-31	941341042

Form 5500 Responses for DCHS MEDICAL FOUNDATION BARGAINING UNIT EMPLOYEES

2019: DCHS MEDICAL FOUNDATION BARGAINING UNIT EMPLOYEES 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	This submission is the final filing	Yes
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2019-01-01	Plan is a collectively bargained plan	Yes
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: DCHS MEDICAL FOUNDATION BARGAINING UNIT EMPLOYEES 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Plan is a collectively bargained plan	Yes
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: DCHS MEDICAL FOUNDATION BARGAINING UNIT EMPLOYEES 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Plan is a collectively bargained plan	Yes
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: DCHS MEDICAL FOUNDATION BARGAINING UNIT EMPLOYEES 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	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: DCHS MEDICAL FOUNDATION BARGAINING UNIT EMPLOYEES 2015 form 5500 responses
2015-12-14	Type of plan entity	Single employer plan
2015-12-14	Submission has been amended	Yes
2015-12-14	This submission is the final filing	No
2015-12-14	This return/report is a short plan year return/report (less than 12 months)	Yes
2015-12-14	Plan is a collectively bargained plan	Yes
2015-12-14	Plan funding arrangement – Trust	Yes
2015-12-14	Plan benefit arrangement - Trust	Yes
2015-06-17	Type of plan entity	Single employer plan
2015-06-17	First time form 5500 has been submitted	Yes
2015-06-17	Submission has been amended	Yes
2015-06-17	This submission is the final filing	No
2015-06-17	This return/report is a short plan year return/report (less than 12 months)	Yes
2015-06-17	Plan is a collectively bargained plan	Yes
2015-06-17	Plan funding arrangement – Trust	Yes
2015-06-17	Plan benefit arrangement - Trust	Yes
2012: DCHS MEDICAL FOUNDATION BARGAINING UNIT EMPLOYEES 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

TA080598

Policy instance

Insurance contract or identification number	TA080598
Number of Individuals Covered	0
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-20
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

TA080598

Policy instance

Insurance contract or identification number	TA080598
Number of Individuals Covered	315
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

TA080598

Policy instance

Insurance contract or identification number	TA080598
Number of Individuals Covered	326
Insurance policy start date	2017-07-01
Insurance policy end date	2017-12-31
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

Potentially related plans

DCHS MEDICAL FOUNDATION BARGAINING UNIT EMPLOYEES 401(K) PLAN [EIN = 941326380]

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Company Name:	DAUGHTERS OF CHARITY HEALTH SYSTEMS MEDICAL FOUNDATION
Employer identification number (EIN):	453691852
NAIC Classification:	622000
NAIC Description:	Hospitals