401k Plan data: GALICHIA HOSPITAL GROUP, LLC 401(K) PLAN plan

GALICHIA HOSPITAL GROUP, LLC 401(K) PLAN 401k Plan overview

Plan Name	GALICHIA HOSPITAL GROUP, LLC 401(K) PLAN
Plan identification number	001

GALICHIA HOSPITAL GROUP, LLC 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
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.

401k Sponsoring company profile

GALICHIA HOSPITAL GROUP, LLC has sponsored the creation of one or more 401k plans.

Company Name: GALICHIA HOSPITAL GROUP, LLC

Employer identification number (EIN): 461534182

NAIC Classification: 621111
NAIC Description: Offices of Physicians (except Mental Health Specialists)

Additional information about GALICHIA HOSPITAL GROUP, LLC

Jurisdiction of Incorporation: Indiana Secretary of State

Incorporation Date:

Company Identification Number: 013122300006

More information about GALICHIA HOSPITAL GROUP, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GALICHIA HOSPITAL GROUP, LLC 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2019-01-01
001 2018-01-01
001 2017-01-01 LAURA WOOD
001 2016-01-01 ROBERT AUGUSTUS
001 2015-01-01 ROBERT AUGUSTUS

Plan Statistics for GALICHIA HOSPITAL GROUP, LLC 401(K) PLAN

401k plan membership statisitcs for GALICHIA HOSPITAL GROUP, LLC 401(K) PLAN

Measure Date Value
2019: GALICHIA HOSPITAL GROUP, LLC 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 222
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 0
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 0
Total of all active and inactive participants 2019-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 0
Number of participants with account balances 2019-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: GALICHIA HOSPITAL GROUP, LLC 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 206
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 195
Number of retired or separated participants receiving benefits 2018-01-01 4
Number of other retired or separated participants entitled to future benefits 2018-01-01 12
Total of all active and inactive participants 2018-01-01 211
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 211
Number of participants with account balances 2018-01-01 116
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: GALICHIA HOSPITAL GROUP, LLC 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 186
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 185
Number of retired or separated participants receiving benefits 2017-01-01 5
Number of other retired or separated participants entitled to future benefits 2017-01-01 11
Total of all active and inactive participants 2017-01-01 201
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 201
Number of participants with account balances 2017-01-01 105
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: GALICHIA HOSPITAL GROUP, LLC 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 154
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 174
Number of retired or separated participants receiving benefits 2016-01-01 5
Number of other retired or separated participants entitled to future benefits 2016-01-01 7
Total of all active and inactive participants 2016-01-01 186
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 186
Number of participants with account balances 2016-01-01 97
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: GALICHIA HOSPITAL GROUP, LLC 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 99
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 141
Number of retired or separated participants receiving benefits 2015-01-01 2
Number of other retired or separated participants entitled to future benefits 2015-01-01 7
Total of all active and inactive participants 2015-01-01 150
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 150
Number of participants with account balances 2015-01-01 90
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0

Measure	Date	Value
2019: GALICHIA HOSPITAL GROUP, LLC 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	222
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	0
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	0
Total of all active and inactive participants	2019-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	0
Number of participants with account balances	2019-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: GALICHIA HOSPITAL GROUP, LLC 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	206
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	195
Number of retired or separated participants receiving benefits	2018-01-01	4
Number of other retired or separated participants entitled to future benefits	2018-01-01	12
Total of all active and inactive participants	2018-01-01	211
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	211
Number of participants with account balances	2018-01-01	116
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: GALICHIA HOSPITAL GROUP, LLC 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	186
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	185
Number of retired or separated participants receiving benefits	2017-01-01	5
Number of other retired or separated participants entitled to future benefits	2017-01-01	11
Total of all active and inactive participants	2017-01-01	201
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	201
Number of participants with account balances	2017-01-01	105
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: GALICHIA HOSPITAL GROUP, LLC 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	154
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	174
Number of retired or separated participants receiving benefits	2016-01-01	5
Number of other retired or separated participants entitled to future benefits	2016-01-01	7
Total of all active and inactive participants	2016-01-01	186
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	186
Number of participants with account balances	2016-01-01	97
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: GALICHIA HOSPITAL GROUP, LLC 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	99
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	141
Number of retired or separated participants receiving benefits	2015-01-01	2
Number of other retired or separated participants entitled to future benefits	2015-01-01	7
Total of all active and inactive participants	2015-01-01	150
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	150
Number of participants with account balances	2015-01-01	90
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0

Financial Data on GALICHIA HOSPITAL GROUP, LLC 401(K) PLAN

Measure	Date	Value
2019 : GALICHIA HOSPITAL GROUP, LLC 401(K) PLAN 2019 401k financial data
Total income from all sources (including contributions)	2019-10-31	$386,759
Total of all expenses incurred	2019-10-31	$1,881,418
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-10-31	$1,846,314
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-10-31	$149,464
Value of total assets at end of year	2019-10-31	$0
Value of total assets at beginning of year	2019-10-31	$1,494,659
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-10-31	$35,104
Total interest from all sources	2019-10-31	$1,903
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-10-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2019-10-31	$0
Was this plan covered by a fidelity bond	2019-10-31	No
If this is an individual account plan, was there a blackout period	2019-10-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-10-31	No
Contributions received from participants	2019-10-31	$93,534
Participant contributions at end of year	2019-10-31	$0
Participant contributions at beginning of year	2019-10-31	$62,173
Participant contributions at end of year	2019-10-31	$0
Participant contributions at beginning of year	2019-10-31	$7,181
Value of other receiveables (less allowance for doubtful accounts) at end of year	2019-10-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2019-10-31	$979
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-10-31	No
Value of net income/loss	2019-10-31	$-1,494,659
Value of net assets at end of year (total assets less liabilities)	2019-10-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2019-10-31	$1,494,659
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-10-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-10-31	No
Were any leases to which the plan was party in default or uncollectible	2019-10-31	No
Investment advisory and management fees	2019-10-31	$35,104
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-10-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-10-31	$1,392,000
Interest on participant loans	2019-10-31	$1,903
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-10-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-10-31	$20,019
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-10-31	$235,392
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-10-31	No
Was there a failure to transmit to the plan any participant contributions	2019-10-31	No
Has the plan failed to provide any benefit when due under the plan	2019-10-31	No
Contributions received in cash from employer	2019-10-31	$55,930
Employer contributions (assets) at end of year	2019-10-31	$0
Employer contributions (assets) at beginning of year	2019-10-31	$12,307
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-10-31	$1,846,314
Did the plan have assets held for investment	2019-10-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-10-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-10-31	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-10-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-10-31	Disclaimer
Accountancy firm name	2019-10-31	MONROE SHINE & CO, INC
Accountancy firm EIN	2019-10-31	351515068
2018 : GALICHIA HOSPITAL GROUP, LLC 401(K) PLAN 2018 401k financial data
Total income from all sources (including contributions)	2018-12-31	$381,181
Total of all expenses incurred	2018-12-31	$201,784
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$190,010
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$486,617
Value of total assets at end of year	2018-12-31	$1,494,659
Value of total assets at beginning of year	2018-12-31	$1,315,262
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$11,774
Total interest from all sources	2018-12-31	$3,729
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$123,402
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2018-12-31	$123,402
Was this plan covered by a fidelity bond	2018-12-31	No
If this is an individual account plan, was there a blackout period	2018-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$302,160
Participant contributions at end of year	2018-12-31	$62,173
Participant contributions at beginning of year	2018-12-31	$57,678
Participant contributions at end of year	2018-12-31	$7,181
Participant contributions at beginning of year	2018-12-31	$4,962
Value of other receiveables (less allowance for doubtful accounts) at end of year	2018-12-31	$979
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2018-12-31	$1,177
Administrative expenses (other) incurred	2018-12-31	$11,774
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$179,397
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$1,494,659
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$1,315,262
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$1,392,000
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$1,237,398
Interest on participant loans	2018-12-31	$3,729
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$20,019
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$13,149
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-232,567
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$184,457
Employer contributions (assets) at end of year	2018-12-31	$12,307
Employer contributions (assets) at beginning of year	2018-12-31	$898
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$190,010
Did the plan have assets held for investment	2018-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	MONROE SHINE & CO, INC.
Accountancy firm EIN	2018-12-31	351515068
2017 : GALICHIA HOSPITAL GROUP, LLC 401(K) PLAN 2017 401k financial data
Total income from all sources (including contributions)	2017-12-31	$621,713
Total of all expenses incurred	2017-12-31	$81,542
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$74,235
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$447,280
Value of total assets at end of year	2017-12-31	$1,315,262
Value of total assets at beginning of year	2017-12-31	$775,091
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$7,307
Total interest from all sources	2017-12-31	$2,650
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$64,197
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$64,197
Was this plan covered by a fidelity bond	2017-12-31	No
If this is an individual account plan, was there a blackout period	2017-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$267,640
Participant contributions at end of year	2017-12-31	$57,678
Participant contributions at beginning of year	2017-12-31	$21,879
Participant contributions at end of year	2017-12-31	$4,962
Participant contributions at beginning of year	2017-12-31	$8,866
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$14,467
Value of other receiveables (less allowance for doubtful accounts) at end of year	2017-12-31	$1,177
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2017-12-31	$356
Administrative expenses (other) incurred	2017-12-31	$7,307
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$540,171
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$1,315,262
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$775,091
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$1,237,398
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$730,855
Interest on participant loans	2017-12-31	$2,650
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$13,149
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$7,255
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$107,586
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$165,173
Employer contributions (assets) at end of year	2017-12-31	$898
Employer contributions (assets) at beginning of year	2017-12-31	$5,880
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$74,235
Did the plan have assets held for investment	2017-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	MONROE SHINE & CO, INC.
Accountancy firm EIN	2017-12-31	351515068
2016 : GALICHIA HOSPITAL GROUP, LLC 401(K) PLAN 2016 401k financial data
Total income from all sources (including contributions)	2016-12-31	$499,692
Total of all expenses incurred	2016-12-31	$104,731
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$101,085
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$452,118
Value of total assets at end of year	2016-12-31	$775,091
Value of total assets at beginning of year	2016-12-31	$380,130
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$3,646
Total interest from all sources	2016-12-31	$537
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$30,004
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$30,004
Was this plan covered by a fidelity bond	2016-12-31	No
If this is an individual account plan, was there a blackout period	2016-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$247,516
Participant contributions at end of year	2016-12-31	$21,879
Participant contributions at end of year	2016-12-31	$8,866
Participant contributions at beginning of year	2016-12-31	$10,077
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$42,945
Value of other receiveables (less allowance for doubtful accounts) at end of year	2016-12-31	$356
Administrative expenses (other) incurred	2016-12-31	$3,646
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$394,961
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$775,091
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$380,130
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$730,855
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$362,141
Interest on participant loans	2016-12-31	$432
Interest earned on other investments	2016-12-31	$105
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$7,255
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$1,537
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$17,033
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$161,657
Employer contributions (assets) at end of year	2016-12-31	$5,880
Employer contributions (assets) at beginning of year	2016-12-31	$6,375
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$101,085
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	MONROE SHINE & CO, INC.
Accountancy firm EIN	2016-12-31	351515068
2015 : GALICHIA HOSPITAL GROUP, LLC 401(K) PLAN 2015 401k financial data
Total plan liabilities at end of year	2015-12-31	$0
Total income from all sources	2015-12-31	$383,847
Expenses. Total of all expenses incurred	2015-12-31	$3,717
Benefits paid (including direct rollovers)	2015-12-31	$3,717
Total plan assets at end of year	2015-12-31	$380,130
Total contributions received or receivable from participants	2015-12-31	$229,347
Contributions received from other sources (not participants or employers)	2015-12-31	$22,749
Other income received	2015-12-31	$-11,389
Net income (gross income less expenses)	2015-12-31	$380,130
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$380,130
Total contributions received or receivable from employer(s)	2015-12-31	$143,140

Form 5500 Responses for GALICHIA HOSPITAL GROUP, LLC 401(K) PLAN

2019: GALICHIA HOSPITAL GROUP, LLC 401(K) PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	This submission is the final filing	Yes
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: GALICHIA HOSPITAL GROUP, LLC 401(K) PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: GALICHIA HOSPITAL GROUP, LLC 401(K) PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: GALICHIA HOSPITAL GROUP, LLC 401(K) PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: GALICHIA HOSPITAL GROUP, LLC 401(K) PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	First time form 5500 has been submitted	Yes
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

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

Policy contract number

871-80078

Policy instance

Insurance contract or identification number	871-80078
Number of Individuals Covered	0
Insurance policy start date	2019-01-01
Insurance policy end date	2019-10-31
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

871-80078

Policy instance

Insurance contract or identification number	871-80078
Number of Individuals Covered	116
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

871-80078

Policy instance

Insurance contract or identification number	871-80078
Number of Individuals Covered	105
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $7
Total amount of fees paid to insurance company	USD $2
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $7
Insurance broker organization code?	3
Amount paid for insurance broker fees	2
Additional information about fees paid to insurance broker	ADMINISTRATIVE COMPENSATION
Insurance broker name	PENSION SOLUTIONS, INC

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

Policy contract number

871-80078

Policy instance

Insurance contract or identification number	871-80078
Number of Individuals Covered	156
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $1
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1
Insurance broker organization code?	3
Insurance broker name	RAYMOND JAMES & ASSOC INC

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Company Name:	GALICHIA HOSPITAL GROUP, LLC
Employer identification number (EIN):	461534182
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)

Jurisdiction of Incorporation:	Indiana Secretary of State
Incorporation Date:
Company Identification Number:	013122300006