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SIOUX FALLS SPECIALTY HOSPITAL 401(K) RETIREMENT PLAN 401k Plan overview

Plan NameSIOUX FALLS SPECIALTY HOSPITAL 401(K) RETIREMENT PLAN
Plan identification number 002

SIOUX FALLS SPECIALTY HOSPITAL 401(K) RETIREMENT PLAN Benefits

401k Plan TypeDefined 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.
  • 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

SIOUX FALLS SPECIALTY HOSPITAL has sponsored the creation of one or more 401k plans.

Company Name:SIOUX FALLS SPECIALTY HOSPITAL
Employer identification number (EIN):460382492
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SIOUX FALLS SPECIALTY HOSPITAL 401(K) RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022022-01-01MARTY APPELHOF2023-10-11 MARTY APPELHOF2023-10-11
0022021-01-01
0022020-01-01
0022019-01-01
0022018-01-01JENNIFER RUSK2019-10-04 JENNIFER RUSK2019-10-04
0022017-01-01
0022016-01-01JENNIFER RUSK
0022015-01-01JENNIFER RUSK
0022014-01-01JENNIFER RUSK
0022013-01-01JENNIFER RUSK
0022012-03-15JENNIFER RUSK

Plan Statistics for SIOUX FALLS SPECIALTY HOSPITAL 401(K) RETIREMENT PLAN

401k plan membership statisitcs for SIOUX FALLS SPECIALTY HOSPITAL 401(K) RETIREMENT PLAN

Measure Date Value
2022: SIOUX FALLS SPECIALTY HOSPITAL 401(K) RETIREMENT PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01370
Total number of active participants reported on line 7a of the Form 55002022-01-01352
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-0157
Total of all active and inactive participants2022-01-01409
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01409
Number of participants with account balances2022-01-01391
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-0132
2021: SIOUX FALLS SPECIALTY HOSPITAL 401(K) RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01363
Total number of active participants reported on line 7a of the Form 55002021-01-01324
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-0144
Total of all active and inactive participants2021-01-01368
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01368
Number of participants with account balances2021-01-01354
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-0120
2020: SIOUX FALLS SPECIALTY HOSPITAL 401(K) RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01351
Total number of active participants reported on line 7a of the Form 55002020-01-01325
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-0131
Total of all active and inactive participants2020-01-01356
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01356
Number of participants with account balances2020-01-01342
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-016
2019: SIOUX FALLS SPECIALTY HOSPITAL 401(K) RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01291
Total number of active participants reported on line 7a of the Form 55002019-01-01263
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-0128
Total of all active and inactive participants2019-01-01291
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01291
Number of participants with account balances2019-01-01271
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: SIOUX FALLS SPECIALTY HOSPITAL 401(K) RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01274
Total number of active participants reported on line 7a of the Form 55002018-01-01255
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-0119
Total of all active and inactive participants2018-01-01274
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01274
Number of participants with account balances2018-01-01256
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: SIOUX FALLS SPECIALTY HOSPITAL 401(K) RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01264
Total number of active participants reported on line 7a of the Form 55002017-01-01245
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-0121
Total of all active and inactive participants2017-01-01266
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-01266
Number of participants with account balances2017-01-01261
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: SIOUX FALLS SPECIALTY HOSPITAL 401(K) RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01243
Total number of active participants reported on line 7a of the Form 55002016-01-01239
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-0123
Total of all active and inactive participants2016-01-01262
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-01262
Number of participants with account balances2016-01-01256
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-017
2015: SIOUX FALLS SPECIALTY HOSPITAL 401(K) RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01214
Total number of active participants reported on line 7a of the Form 55002015-01-01215
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-0111
Total of all active and inactive participants2015-01-01226
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-01226
Number of participants with account balances2015-01-01206
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-019
2014: SIOUX FALLS SPECIALTY HOSPITAL 401(K) RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01201
Total number of active participants reported on line 7a of the Form 55002014-01-01194
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-0120
Total of all active and inactive participants2014-01-01214
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-01214
Number of participants with account balances2014-01-01197
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: SIOUX FALLS SPECIALTY HOSPITAL 401(K) RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01190
Total number of active participants reported on line 7a of the Form 55002013-01-01187
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-017
Total of all active and inactive participants2013-01-01194
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-01194
Number of participants with account balances2013-01-01176
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: SIOUX FALLS SPECIALTY HOSPITAL 401(K) RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year2012-03-15197
Total number of active participants reported on line 7a of the Form 55002012-03-15172
Number of retired or separated participants receiving benefits2012-03-150
Number of other retired or separated participants entitled to future benefits2012-03-159
Total of all active and inactive participants2012-03-15181
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-03-150
Total participants2012-03-15181
Number of participants with account balances2012-03-15164
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-03-155

Financial Data on SIOUX FALLS SPECIALTY HOSPITAL 401(K) RETIREMENT PLAN

Measure Date Value
2022 : SIOUX FALLS SPECIALTY HOSPITAL 401(K) RETIREMENT PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
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$0
Total income from all sources (including contributions)2022-12-31$-1,472,146
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$3,266,085
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$3,169,214
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$2,985,890
Value of total assets at end of year2022-12-31$21,209,205
Value of total assets at beginning of year2022-12-31$25,947,436
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$96,871
Total interest from all sources2022-12-31$21,439
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$76,658
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-12-31$76,658
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$500,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$1,574,164
Participant contributions at end of year2022-12-31$211,442
Participant contributions at beginning of year2022-12-31$146,470
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$482,590
Other income not declared elsewhere2022-12-31$1,073
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-4,738,231
Value of net assets at end of year (total assets less liabilities)2022-12-31$21,209,205
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$25,947,436
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$5,665,776
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$7,087,497
Interest on participant loans2022-12-31$10,545
Interest earned on other investments2022-12-31$10,894
Value of interest in common/collective trusts at end of year2022-12-31$14,644,395
Value of interest in common/collective trusts at beginning of year2022-12-31$18,053,571
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$687,592
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$659,898
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-1,420,808
Net investment gain or loss from common/collective trusts2022-12-31$-3,136,398
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$929,136
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$3,169,214
Contract administrator fees2022-12-31$96,871
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31EIDE BAILLY LLP
Accountancy firm EIN2022-12-31450250958
2021 : SIOUX FALLS SPECIALTY HOSPITAL 401(K) RETIREMENT PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$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$5,867,133
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$599,998
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$501,094
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$2,535,131
Value of total assets at end of year2021-12-31$25,947,436
Value of total assets at beginning of year2021-12-31$20,680,301
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$98,904
Total interest from all sources2021-12-31$16,425
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$81,952
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2021-12-31$81,952
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$500,000
If this is an individual account plan, was there a blackout period2021-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$1,428,857
Participant contributions at end of year2021-12-31$146,470
Participant contributions at beginning of year2021-12-31$143,776
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$274,044
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$5,267,135
Value of net assets at end of year (total assets less liabilities)2021-12-31$25,947,436
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$20,680,301
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$7,087,497
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$5,889,268
Interest on participant loans2021-12-31$9,260
Interest earned on other investments2021-12-31$7,165
Value of interest in common/collective trusts at end of year2021-12-31$18,053,571
Value of interest in common/collective trusts at beginning of year2021-12-31$14,252,541
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$659,898
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$391,336
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$933,570
Net investment gain or loss from common/collective trusts2021-12-31$2,300,055
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$832,230
Employer contributions (assets) at end of year2021-12-31$0
Employer contributions (assets) at beginning of year2021-12-31$3,380
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$501,094
Contract administrator fees2021-12-31$98,904
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31EIDE BAILLY LLP
Accountancy firm EIN2021-12-31450250958
2020 : SIOUX FALLS SPECIALTY HOSPITAL 401(K) RETIREMENT PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$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$5,153,565
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$936,477
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$932,063
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$2,482,549
Value of total assets at end of year2020-12-31$20,680,301
Value of total assets at beginning of year2020-12-31$16,463,213
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$4,414
Total interest from all sources2020-12-31$16,024
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$46,181
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2020-12-31$46,181
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$500,000
If this is an individual account plan, was there a blackout period2020-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$1,279,356
Participant contributions at end of year2020-12-31$143,776
Participant contributions at beginning of year2020-12-31$193,765
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$446,652
Other income not declared elsewhere2020-12-31$414
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$4,217,088
Value of net assets at end of year (total assets less liabilities)2020-12-31$20,680,301
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$16,463,213
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$5,889,268
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$4,049,929
Interest on participant loans2020-12-31$10,955
Interest earned on other investments2020-12-31$5,069
Value of interest in common/collective trusts at end of year2020-12-31$14,252,541
Value of interest in common/collective trusts at beginning of year2020-12-31$11,877,391
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$391,336
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$341,958
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$820,355
Net investment gain or loss from common/collective trusts2020-12-31$1,788,042
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$756,541
Employer contributions (assets) at end of year2020-12-31$3,380
Employer contributions (assets) at beginning of year2020-12-31$170
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$932,063
Contract administrator fees2020-12-31$4,414
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Unqualified
Accountancy firm name2020-12-31EIDE BAILLY LLP
Accountancy firm EIN2020-12-31450250958
2019 : SIOUX FALLS SPECIALTY HOSPITAL 401(K) RETIREMENT PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$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$4,556,682
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$674,271
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$670,243
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$1,709,325
Value of total assets at end of year2019-12-31$16,463,213
Value of total assets at beginning of year2019-12-31$12,580,802
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$4,028
Total interest from all sources2019-12-31$16,791
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$41,169
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$41,169
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$500,000
If this is an individual account plan, was there a blackout period2019-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$974,488
Participant contributions at end of year2019-12-31$193,765
Participant contributions at beginning of year2019-12-31$223,191
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$203,352
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$3,882,411
Value of net assets at end of year (total assets less liabilities)2019-12-31$16,463,213
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$12,580,802
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$4,049,929
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$2,924,900
Interest on participant loans2019-12-31$13,108
Interest earned on other investments2019-12-31$3,683
Value of interest in common/collective trusts at end of year2019-12-31$11,877,391
Value of interest in common/collective trusts at beginning of year2019-12-31$9,107,842
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$341,958
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$324,850
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$773,938
Net investment gain or loss from common/collective trusts2019-12-31$2,015,459
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$531,485
Employer contributions (assets) at end of year2019-12-31$170
Employer contributions (assets) at beginning of year2019-12-31$19
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$670,243
Contract administrator fees2019-12-31$4,028
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31EIDE BAILLY LLP
Accountancy firm EIN2019-12-31450250958
2018 : SIOUX FALLS SPECIALTY HOSPITAL 401(K) RETIREMENT PLAN 2018 401k financial data
Unrealized appreciation/depreciation of real estate assets2018-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2018-12-31$-26
Total unrealized appreciation/depreciation of assets2018-12-31$-26
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$520,016
Total loss/gain on sale of assets2018-12-31$2,075
Total of all expenses incurred2018-12-31$1,859,013
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$1,855,427
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$1,581,291
Value of total assets at end of year2018-12-31$12,580,802
Value of total assets at beginning of year2018-12-31$13,919,799
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$3,586
Total income from rents2018-12-31$0
Total interest from all sources2018-12-31$13,377
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$33,928
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2018-12-31$32,188
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$500,000
If this is an individual account plan, was there a blackout period2018-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$850,402
Participant contributions at end of year2018-12-31$223,191
Participant contributions at beginning of year2018-12-31$92,455
Participant contributions at end of year2018-12-31$0
Participant contributions at beginning of year2018-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$254,557
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-12-31$0
Other income not declared elsewhere2018-12-31$0
Total non interest bearing cash at end of year2018-12-31$0
Total non interest bearing cash at beginning of year2018-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Income. Non cash contributions2018-12-31$0
Value of net income/loss2018-12-31$-1,338,997
Value of net assets at end of year (total assets less liabilities)2018-12-31$12,580,802
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$13,919,799
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$2,924,900
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$3,274,777
Interest on participant loans2018-12-31$9,912
Interest earned on other investments2018-12-31$3,465
Value of interest in common/collective trusts at end of year2018-12-31$9,107,842
Value of interest in common/collective trusts at beginning of year2018-12-31$10,217,050
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$324,850
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$302,229
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-266,864
Net investment gain/loss from pooled separate accounts2018-12-31$0
Net investment gain or loss from common/collective trusts2018-12-31$-843,765
Net gain/loss from 103.12 investment entities2018-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Assets. Invements in employer securities at end of year2018-12-31$0
Assets. Invements in employer securities at beginning of year2018-12-31$33,227
Contributions received in cash from employer2018-12-31$476,332
Employer contributions (assets) at end of year2018-12-31$19
Employer contributions (assets) at beginning of year2018-12-31$61
Income. Dividends from common stock2018-12-31$1,740
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$1,855,427
Contract administrator fees2018-12-31$3,586
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Aggregate proceeds on sale of assets2018-12-31$40,677
Aggregate carrying amount (costs) on sale of assets2018-12-31$38,602
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31EIDE BAILLY LLP
Accountancy firm EIN2018-12-31450250958
2017 : SIOUX FALLS SPECIALTY HOSPITAL 401(K) RETIREMENT PLAN 2017 401k financial data
Unrealized appreciation/depreciation of real estate assets2017-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2017-12-31$-4,046
Total unrealized appreciation/depreciation of assets2017-12-31$-4,046
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$3,343,176
Total loss/gain on sale of assets2017-12-31$-3,454
Total of all expenses incurred2017-12-31$586,662
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$583,152
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$1,398,518
Value of total assets at end of year2017-12-31$13,919,799
Value of total assets at beginning of year2017-12-31$11,163,285
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$3,510
Total income from rents2017-12-31$0
Total interest from all sources2017-12-31$8,657
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$33,925
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2017-12-31$31,450
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$500,000
If this is an individual account plan, was there a blackout period2017-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$848,102
Participant contributions at end of year2017-12-31$92,455
Participant contributions at beginning of year2017-12-31$96,569
Participant contributions at end of year2017-12-31$0
Participant contributions at beginning of year2017-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$82,411
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-12-31$0
Other income not declared elsewhere2017-12-31$3,351
Total non interest bearing cash at end of year2017-12-31$0
Total non interest bearing cash at beginning of year2017-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$2,756,514
Value of net assets at end of year (total assets less liabilities)2017-12-31$13,919,799
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$11,163,285
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$3,274,777
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$2,445,942
Interest on participant loans2017-12-31$5,604
Interest earned on other investments2017-12-31$3,053
Value of interest in common/collective trusts at end of year2017-12-31$10,217,050
Value of interest in common/collective trusts at beginning of year2017-12-31$8,306,398
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-12-31$302,229
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-12-31$263,357
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-12-31$496,091
Net investment gain or loss from common/collective trusts2017-12-31$1,410,134
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Assets. Invements in employer securities at end of year2017-12-31$33,227
Assets. Invements in employer securities at beginning of year2017-12-31$48,153
Contributions received in cash from employer2017-12-31$468,005
Employer contributions (assets) at end of year2017-12-31$61
Employer contributions (assets) at beginning of year2017-12-31$2,866
Income. Dividends from preferred stock2017-12-31$0
Income. Dividends from common stock2017-12-31$2,475
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$583,152
Contract administrator fees2017-12-31$3,510
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Aggregate proceeds on sale of assets2017-12-31$18,977
Aggregate carrying amount (costs) on sale of assets2017-12-31$22,431
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31EIDE BAILLY LLP
Accountancy firm EIN2017-12-31450250958
2016 : SIOUX FALLS SPECIALTY HOSPITAL 401(K) RETIREMENT PLAN 2016 401k financial data
Unrealized appreciation/depreciation of real estate assets2016-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2016-12-31$5,692
Total unrealized appreciation/depreciation of assets2016-12-31$5,692
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$2,105,056
Total loss/gain on sale of assets2016-12-31$61
Total of all expenses incurred2016-12-31$774,390
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$771,820
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$1,270,945
Value of total assets at end of year2016-12-31$11,163,285
Value of total assets at beginning of year2016-12-31$9,832,619
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$2,570
Total interest from all sources2016-12-31$9,036
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$25,816
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2016-12-31$23,835
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$500,000
If this is an individual account plan, was there a blackout period2016-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$731,104
Participant contributions at end of year2016-12-31$96,569
Participant contributions at beginning of year2016-12-31$139,050
Participant contributions at end of year2016-12-31$0
Participant contributions at beginning of year2016-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$130,288
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-12-31$0
Other income not declared elsewhere2016-12-31$1,015
Total non interest bearing cash at end of year2016-12-31$0
Total non interest bearing cash at beginning of year2016-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$1,330,666
Value of net assets at end of year (total assets less liabilities)2016-12-31$11,163,285
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$9,832,619
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-31$2,445,942
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$1,914,164
Interest on participant loans2016-12-31$5,898
Interest earned on other investments2016-12-31$3,138
Value of interest in common/collective trusts at end of year2016-12-31$8,306,398
Value of interest in common/collective trusts at beginning of year2016-12-31$7,497,991
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-12-31$263,357
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-12-31$253,256
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-12-31$199,636
Net investment gain or loss from common/collective trusts2016-12-31$592,855
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Assets. Invements in employer securities at end of year2016-12-31$48,153
Assets. Invements in employer securities at beginning of year2016-12-31$28,158
Contributions received in cash from employer2016-12-31$409,553
Employer contributions (assets) at end of year2016-12-31$2,866
Employer contributions (assets) at beginning of year2016-12-31$0
Income. Dividends from preferred stock2016-12-31$0
Income. Dividends from common stock2016-12-31$1,981
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$771,820
Contract administrator fees2016-12-31$2,570
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Aggregate proceeds on sale of assets2016-12-31$1,303
Aggregate carrying amount (costs) on sale of assets2016-12-31$1,242
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31EIDE BAILLY LLP
Accountancy firm EIN2016-12-31450250958
2015 : SIOUX FALLS SPECIALTY HOSPITAL 401(K) RETIREMENT PLAN 2015 401k financial data
Unrealized appreciation/depreciation of real estate assets2015-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2015-12-31$-12,265
Total unrealized appreciation/depreciation of assets2015-12-31$-12,265
Total transfer of assets to this plan2015-12-31$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$1,173,025
Total loss/gain on sale of assets2015-12-31$-6,722
Total of all expenses incurred2015-12-31$341,767
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$339,071
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$1,321,451
Value of total assets at end of year2015-12-31$9,832,619
Value of total assets at beginning of year2015-12-31$9,001,361
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$2,696
Total interest from all sources2015-12-31$10,436
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$20,369
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2015-12-31$17,754
Administrative expenses professional fees incurred2015-12-31$0
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$500,000
If this is an individual account plan, was there a blackout period2015-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$661,675
Participant contributions at end of year2015-12-31$139,050
Participant contributions at beginning of year2015-12-31$178,058
Participant contributions at end of year2015-12-31$0
Participant contributions at beginning of year2015-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$279,132
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2015-12-31$437
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-12-31$0
Other income not declared elsewhere2015-12-31$0
Administrative expenses (other) incurred2015-12-31$0
Total non interest bearing cash at end of year2015-12-31$0
Total non interest bearing cash at beginning of year2015-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$831,258
Value of net assets at end of year (total assets less liabilities)2015-12-31$9,832,619
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$9,001,361
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Investment advisory and management fees2015-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$1,914,164
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$1,646,557
Interest on participant loans2015-12-31$7,650
Income. Interest from loans (other than to participants)2015-12-31$0
Interest earned on other investments2015-12-31$2,786
Income. Interest from US Government securities2015-12-31$0
Income. Interest from corporate debt instruments2015-12-31$0
Value of interest in common/collective trusts at end of year2015-12-31$7,497,991
Value of interest in common/collective trusts at beginning of year2015-12-31$6,915,344
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-12-31$253,256
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-12-31$198,144
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$-52,116
Net investment gain/loss from pooled separate accounts2015-12-31$0
Net investment gain or loss from common/collective trusts2015-12-31$-108,128
Net gain/loss from 103.12 investment entities2015-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Assets. Invements in employer securities at end of year2015-12-31$28,158
Assets. Invements in employer securities at beginning of year2015-12-31$63,258
Contributions received in cash from employer2015-12-31$380,644
Employer contributions (assets) at end of year2015-12-31$0
Employer contributions (assets) at beginning of year2015-12-31$0
Income. Dividends from preferred stock2015-12-31$0
Income. Dividends from common stock2015-12-31$2,615
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$338,634
Contract administrator fees2015-12-31$2,696
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Aggregate proceeds on sale of assets2015-12-31$28,099
Aggregate carrying amount (costs) on sale of assets2015-12-31$34,821
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31EIDE BAILLY LLP
Accountancy firm EIN2015-12-31450250958
2014 : SIOUX FALLS SPECIALTY HOSPITAL 401(K) RETIREMENT PLAN 2014 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2014-12-31$-10,534
Total unrealized appreciation/depreciation of assets2014-12-31$-10,534
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$1,683,200
Total loss/gain on sale of assets2014-12-31$-813
Total of all expenses incurred2014-12-31$1,354,839
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$1,351,367
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$1,145,470
Value of total assets at end of year2014-12-31$9,001,361
Value of total assets at beginning of year2014-12-31$8,673,000
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$3,472
Total interest from all sources2014-12-31$13,480
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$18,115
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2014-12-31$16,193
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$500,000
If this is an individual account plan, was there a blackout period2014-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$673,371
Participant contributions at end of year2014-12-31$178,058
Participant contributions at beginning of year2014-12-31$209,561
Income. Received or receivable in cash from other sources (including rollovers)2014-12-31$94,854
Administrative expenses (other) incurred2014-12-31$4
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$328,361
Value of net assets at end of year (total assets less liabilities)2014-12-31$9,001,361
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$8,673,000
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$1,646,557
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$1,165,028
Interest on participant loans2014-12-31$10,850
Interest earned on other investments2014-12-31$2,630
Value of interest in common/collective trusts at end of year2014-12-31$6,915,344
Value of interest in common/collective trusts at beginning of year2014-12-31$7,053,661
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-12-31$198,144
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-12-31$244,750
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-12-31$86,500
Net investment gain or loss from common/collective trusts2014-12-31$430,982
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Assets. Invements in employer securities at end of year2014-12-31$63,258
Assets. Invements in employer securities at beginning of year2014-12-31$0
Contributions received in cash from employer2014-12-31$377,245
Income. Dividends from common stock2014-12-31$1,922
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$1,351,367
Contract administrator fees2014-12-31$3,468
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Aggregate proceeds on sale of assets2014-12-31$13,784
Aggregate carrying amount (costs) on sale of assets2014-12-31$14,597
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31EIDE BAILLY LLP
Accountancy firm EIN2014-12-31450250958
2013 : SIOUX FALLS SPECIALTY HOSPITAL 401(K) RETIREMENT PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-12-31$0
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$54
Total income from all sources (including contributions)2013-12-31$2,188,212
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$1,035,877
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$1,032,903
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$987,464
Value of total assets at end of year2013-12-31$8,673,000
Value of total assets at beginning of year2013-12-31$7,520,719
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$2,974
Total interest from all sources2013-12-31$10,249
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$4,624
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2013-12-31$4,624
Administrative expenses professional fees incurred2013-12-31$2,254
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$500,000
If this is an individual account plan, was there a blackout period2013-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$616,172
Participant contributions at end of year2013-12-31$209,561
Participant contributions at beginning of year2013-12-31$153,813
Income. Received or receivable in cash from other sources (including rollovers)2013-12-31$27,857
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2013-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2013-12-31$54
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$1,152,335
Value of net assets at end of year (total assets less liabilities)2013-12-31$8,673,000
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$7,520,665
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-12-31$1,165,028
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$7,365,449
Interest on participant loans2013-12-31$9,635
Interest earned on other investments2013-12-31$614
Value of interest in common/collective trusts at end of year2013-12-31$7,053,661
Value of interest in common/collective trusts at beginning of year2013-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-12-31$244,750
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-12-31$42,690
Net investment gain/loss from pooled separate accounts2013-12-31$959,533
Net investment gain or loss from common/collective trusts2013-12-31$183,652
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$343,435
Employer contributions (assets) at end of year2013-12-31$0
Employer contributions (assets) at beginning of year2013-12-31$1,457
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$1,032,903
Contract administrator fees2013-12-31$720
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31Yes
Opinion of an independent qualified public accountant for this plan2013-12-31Disclaimer
Accountancy firm name2013-12-31EIDE BAILLY LLP
Accountancy firm EIN2013-12-31450250958
2012 : SIOUX FALLS SPECIALTY HOSPITAL 401(K) RETIREMENT PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-12-31$0
Total transfer of assets to this plan2012-12-31$7,432,381
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$54
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$887,327
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$799,043
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$796,410
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$615,000
Value of total assets at end of year2012-12-31$7,520,719
Value of total assets at beginning of year2012-12-31$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$2,633
Total interest from all sources2012-12-31$7,093
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Administrative expenses professional fees incurred2012-12-31$2,025
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$500,000
If this is an individual account plan, was there a blackout period2012-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$391,975
Participant contributions at end of year2012-12-31$153,813
Participant contributions at beginning of year2012-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2012-12-31$14,011
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2012-12-31$54
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-12-31$0
Administrative expenses (other) incurred2012-12-31$608
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$88,284
Value of net assets at end of year (total assets less liabilities)2012-12-31$7,520,665
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-12-31$7,365,449
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$0
Interest on participant loans2012-12-31$7,093
Net investment gain/loss from pooled separate accounts2012-12-31$265,234
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$209,014
Employer contributions (assets) at end of year2012-12-31$1,457
Employer contributions (assets) at beginning of year2012-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$796,410
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31Yes
Opinion of an independent qualified public accountant for this plan2012-12-31Disclaimer
Accountancy firm name2012-12-31EIDE BAILLY LLP
Accountancy firm EIN2012-12-31450250958

Form 5500 Responses for SIOUX FALLS SPECIALTY HOSPITAL 401(K) RETIREMENT PLAN

2022: SIOUX FALLS SPECIALTY HOSPITAL 401(K) RETIREMENT PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: SIOUX FALLS SPECIALTY HOSPITAL 401(K) RETIREMENT PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: SIOUX FALLS SPECIALTY HOSPITAL 401(K) RETIREMENT PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: SIOUX FALLS SPECIALTY HOSPITAL 401(K) RETIREMENT PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: SIOUX FALLS SPECIALTY HOSPITAL 401(K) RETIREMENT PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: SIOUX FALLS SPECIALTY HOSPITAL 401(K) RETIREMENT PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: SIOUX FALLS SPECIALTY HOSPITAL 401(K) RETIREMENT PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: SIOUX FALLS SPECIALTY HOSPITAL 401(K) RETIREMENT PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: SIOUX FALLS SPECIALTY HOSPITAL 401(K) RETIREMENT PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: SIOUX FALLS SPECIALTY HOSPITAL 401(K) RETIREMENT PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: SIOUX FALLS SPECIALTY HOSPITAL 401(K) RETIREMENT PLAN 2012 form 5500 responses
2012-03-15Type of plan entitySingle employer plan
2012-03-15First time form 5500 has been submittedYes
2012-03-15Submission has been amendedNo
2012-03-15This submission is the final filingNo
2012-03-15This return/report is a short plan year return/report (less than 12 months)Yes
2012-03-15Plan is a collectively bargained planNo
2012-03-15Plan funding arrangement – InsuranceYes
2012-03-15Plan funding arrangement – TrustYes
2012-03-15Plan benefit arrangement – InsuranceYes
2012-03-15Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number613953
Policy instance 1
Insurance contract or identification number613953
Number of Individuals Covered391
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $335
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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees335
Additional information about fees paid to insurance brokerREFERRAL/SERVICE FEE
Insurance broker organization code?5
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number613953
Policy instance 1
Insurance contract or identification number613953
Number of Individuals Covered354
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $198
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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees198
Additional information about fees paid to insurance brokerREFERRAL/SERVICE FEE
Insurance broker organization code?5
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number613953
Policy instance 1
Insurance contract or identification number613953
Number of Individuals Covered342
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $216
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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees216
Additional information about fees paid to insurance brokerREFERRAL/SERVICE FEE
Insurance broker organization code?5
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number613953
Policy instance 1
Insurance contract or identification number613953
Number of Individuals Covered271
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $163
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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees163
Additional information about fees paid to insurance brokerREFERRAL/SERVICE FEE
Insurance broker organization code?5
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number613953
Policy instance 1
Insurance contract or identification number613953
Number of Individuals Covered256
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $153
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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees153
Additional information about fees paid to insurance brokerREFERRAL/SERVICE FEE
Insurance broker organization code?5
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number613953
Policy instance 1
Insurance contract or identification number613953
Number of Individuals Covered261
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $264
Total amount of fees paid to insurance companyUSD $140
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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $264
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerBROKER COMMISSION
Insurance broker organization code?3
Insurance broker nameQUALIFIED PLAN CONSULTANTS LLC
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number613953
Policy instance 1
Insurance contract or identification number613953
Number of Individuals Covered206
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $414
Total amount of fees paid to insurance companyUSD $106
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $414
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerBROKER COMMISSION
Insurance broker organization code?3
Insurance broker nameQUALIFIED PLAN CONSULTANTS LLC
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number613953
Policy instance 1
Insurance contract or identification number613953
Number of Individuals Covered209
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $369
Total amount of fees paid to insurance companyUSD $99
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $369
Insurance broker organization code?3
Amount paid for insurance broker fees99
Additional information about fees paid to insurance brokerREFERRAL/SERVICE FEE
Insurance broker nameQUALIFIED PLAN CONSULTANTS LLC
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number613953
Policy instance 2
Insurance contract or identification number613953
Number of Individuals Covered211
Insurance policy start date2013-10-15
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number105060
Policy instance 1
Insurance contract or identification number105060
Number of Individuals Covered0
Insurance policy start date2013-01-01
Insurance policy end date2013-10-28
Total amount of commissions paid to insurance brokerUSD $16,877
Total amount of fees paid to insurance companyUSD $3,447
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,103
Insurance broker organization code?3
Amount paid for insurance broker fees3447
Additional information about fees paid to insurance brokerTPA COMPENSATION
Insurance broker nameEDWARD D. JONES & COMAPNY
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number105060
Policy instance 1
Insurance contract or identification number105060
Number of Individuals Covered173
Insurance policy start date2012-03-15
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $13,589
Total amount of fees paid to insurance companyUSD $2,834
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,589
Insurance broker organization code?3
Amount paid for insurance broker fees2834
Additional information about fees paid to insurance brokerTPA COMPENSATION
Insurance broker nameQUALIFIED PLAN CONSULTANTS, LLC

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