401k Plan data: ROCKFORD MEMORIAL HOSPITAL SUPPLEMENTAL PENSION PLAN plan

ROCKFORD MEMORIAL HOSPITAL SUPPLEMENTAL PENSION PLAN 401k Plan overview

Plan Name	ROCKFORD MEMORIAL HOSPITAL SUPPLEMENTAL PENSION PLAN
Plan identification number	002

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

401k Sponsoring company profile

MERCY HEALTH CORPORATION has sponsored the creation of one or more 401k plans.

Company Name: MERCY HEALTH CORPORATION

Employer identification number (EIN): 472158680

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ROCKFORD MEMORIAL HOSPITAL SUPPLEMENTAL PENSION PLAN

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

Plan Statistics for ROCKFORD MEMORIAL HOSPITAL SUPPLEMENTAL PENSION PLAN

401k plan membership statisitcs for ROCKFORD MEMORIAL HOSPITAL SUPPLEMENTAL PENSION PLAN

Measure Date Value
2022: ROCKFORD MEMORIAL HOSPITAL SUPPLEMENTAL PENSION PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 2,744
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 1,458
Number of retired or separated participants receiving benefits 2022-01-01 4
Number of other retired or separated participants entitled to future benefits 2022-01-01 1,084
Total of all active and inactive participants 2022-01-01 2,546
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 13
Total participants 2022-01-01 2,559
Number of participants with account balances 2022-01-01 2,559
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 46
2021: ROCKFORD MEMORIAL HOSPITAL SUPPLEMENTAL PENSION PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 3,056
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 1,585
Number of retired or separated participants receiving benefits 2021-01-01 1
Number of other retired or separated participants entitled to future benefits 2021-01-01 1,147
Total of all active and inactive participants 2021-01-01 2,733
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 11
Total participants 2021-01-01 2,744
Number of participants with account balances 2021-01-01 2,744
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 54
2020: ROCKFORD MEMORIAL HOSPITAL SUPPLEMENTAL PENSION PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 3,350
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 1,828
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 1,220
Total of all active and inactive participants 2020-01-01 3,048
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 8
Total participants 2020-01-01 3,056
Number of participants with account balances 2020-01-01 3,056
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 141
2019: ROCKFORD MEMORIAL HOSPITAL SUPPLEMENTAL PENSION PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 3,733
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 2,162
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 1,182
Total of all active and inactive participants 2019-01-01 3,344
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 6
Total participants 2019-01-01 3,350
Number of participants with account balances 2019-01-01 3,350
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 182
2018: ROCKFORD MEMORIAL HOSPITAL SUPPLEMENTAL PENSION PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 4,286
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 2,342
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 1,386
Total of all active and inactive participants 2018-01-01 3,728
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 5
Total participants 2018-01-01 3,733
Number of participants with account balances 2018-01-01 3,733
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 205
2017: ROCKFORD MEMORIAL HOSPITAL SUPPLEMENTAL PENSION PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 4,865
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 2,495
Number of retired or separated participants receiving benefits 2017-01-01 1
Number of other retired or separated participants entitled to future benefits 2017-01-01 1,790
Total of all active and inactive participants 2017-01-01 4,286
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 4,286
Number of participants with account balances 2017-01-01 4,005
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 262
2016: ROCKFORD MEMORIAL HOSPITAL SUPPLEMENTAL PENSION PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 460
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 257
Number of retired or separated participants receiving benefits 2016-01-01 5
Number of other retired or separated participants entitled to future benefits 2016-01-01 137
Total of all active and inactive participants 2016-01-01 399
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 2
Total participants 2016-01-01 401
Number of participants with account balances 2016-01-01 375
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0

Measure	Date	Value
2022: ROCKFORD MEMORIAL HOSPITAL SUPPLEMENTAL PENSION PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	2,744
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	1,458
Number of retired or separated participants receiving benefits	2022-01-01	4
Number of other retired or separated participants entitled to future benefits	2022-01-01	1,084
Total of all active and inactive participants	2022-01-01	2,546
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	13
Total participants	2022-01-01	2,559
Number of participants with account balances	2022-01-01	2,559
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	46
2021: ROCKFORD MEMORIAL HOSPITAL SUPPLEMENTAL PENSION PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	3,056
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	1,585
Number of retired or separated participants receiving benefits	2021-01-01	1
Number of other retired or separated participants entitled to future benefits	2021-01-01	1,147
Total of all active and inactive participants	2021-01-01	2,733
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	11
Total participants	2021-01-01	2,744
Number of participants with account balances	2021-01-01	2,744
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	54
2020: ROCKFORD MEMORIAL HOSPITAL SUPPLEMENTAL PENSION PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	3,350
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	1,828
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	1,220
Total of all active and inactive participants	2020-01-01	3,048
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	8
Total participants	2020-01-01	3,056
Number of participants with account balances	2020-01-01	3,056
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	141
2019: ROCKFORD MEMORIAL HOSPITAL SUPPLEMENTAL PENSION PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	3,733
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	2,162
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	1,182
Total of all active and inactive participants	2019-01-01	3,344
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	6
Total participants	2019-01-01	3,350
Number of participants with account balances	2019-01-01	3,350
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	182
2018: ROCKFORD MEMORIAL HOSPITAL SUPPLEMENTAL PENSION PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	4,286
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	2,342
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	1,386
Total of all active and inactive participants	2018-01-01	3,728
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	5
Total participants	2018-01-01	3,733
Number of participants with account balances	2018-01-01	3,733
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	205
2017: ROCKFORD MEMORIAL HOSPITAL SUPPLEMENTAL PENSION PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	4,865
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	2,495
Number of retired or separated participants receiving benefits	2017-01-01	1
Number of other retired or separated participants entitled to future benefits	2017-01-01	1,790
Total of all active and inactive participants	2017-01-01	4,286
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	4,286
Number of participants with account balances	2017-01-01	4,005
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	262
2016: ROCKFORD MEMORIAL HOSPITAL SUPPLEMENTAL PENSION PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	460
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	257
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	137
Total of all active and inactive participants	2016-01-01	399
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	2
Total participants	2016-01-01	401
Number of participants with account balances	2016-01-01	375
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0

Financial Data on ROCKFORD MEMORIAL HOSPITAL SUPPLEMENTAL PENSION PLAN

Measure	Date	Value
2022 : ROCKFORD MEMORIAL HOSPITAL SUPPLEMENTAL PENSION PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$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	$-26,700,923
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$12,343,502
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$12,340,384
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$298,310
Value of total assets at end of year	2022-12-31	$111,853,966
Value of total assets at beginning of year	2022-12-31	$150,898,391
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$3,118
Total interest from all sources	2022-12-31	$432,159
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$6,371,703
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-12-31	$6,371,703
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$10,000,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Participant contributions at end of year	2022-12-31	$466,989
Participant contributions at beginning of year	2022-12-31	$541,125
Assets. Other investments not covered elsewhere at end of year	2022-12-31	$1,915,646
Assets. Other investments not covered elsewhere at beginning of year	2022-12-31	$3,075,713
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$298,310
Other income not declared elsewhere	2022-12-31	$-160,506
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$-39,044,425
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$111,853,966
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$150,898,391
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$93,270,268
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$131,089,612
Interest on participant loans	2022-12-31	$26,179
Interest earned on other investments	2022-12-31	$405,980
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$16,201,063
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$16,191,941
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-33,642,589
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$12,340,384
Contract administrator fees	2022-12-31	$3,118
Did the plan have assets held for investment	2022-12-31	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	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	WIPFLI LLP
Accountancy firm EIN	2022-12-31	390758449
2021 : ROCKFORD MEMORIAL HOSPITAL SUPPLEMENTAL PENSION PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$20,777,549
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$11,396,563
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$11,393,063
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$0
Value of total assets at end of year	2021-12-31	$150,898,391
Value of total assets at beginning of year	2021-12-31	$141,517,405
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$3,500
Total interest from all sources	2021-12-31	$358,232
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$10,832,121
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2021-12-31	$10,832,121
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$10,000,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Participant contributions at end of year	2021-12-31	$541,125
Participant contributions at beginning of year	2021-12-31	$719,444
Assets. Other investments not covered elsewhere at end of year	2021-12-31	$3,075,713
Assets. Other investments not covered elsewhere at beginning of year	2021-12-31	$2,755,823
Other income not declared elsewhere	2021-12-31	$-19,154
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$9,380,986
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$150,898,391
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$141,517,405
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$131,089,612
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$121,049,039
Interest on participant loans	2021-12-31	$31,049
Interest earned on other investments	2021-12-31	$327,183
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$16,191,941
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$16,993,099
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$9,606,350
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$11,393,063
Contract administrator fees	2021-12-31	$3,500
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	WIPFLI LLP
Accountancy firm EIN	2021-12-31	390758449
2020 : ROCKFORD MEMORIAL HOSPITAL SUPPLEMENTAL PENSION PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$23,737,116
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$12,458,182
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$12,456,632
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$0
Value of total assets at end of year	2020-12-31	$141,517,405
Value of total assets at beginning of year	2020-12-31	$130,238,471
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$1,550
Total interest from all sources	2020-12-31	$431,257
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$6,140,997
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-31	$6,140,997
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$10,000,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Participant contributions at end of year	2020-12-31	$719,444
Participant contributions at beginning of year	2020-12-31	$1,094,564
Assets. Other investments not covered elsewhere at end of year	2020-12-31	$2,755,823
Assets. Other investments not covered elsewhere at beginning of year	2020-12-31	$3,106,711
Other income not declared elsewhere	2020-12-31	$-303,101
Administrative expenses (other) incurred	2020-12-31	$1,550
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$11,278,934
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$141,517,405
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$130,238,471
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$121,049,039
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$111,414,787
Interest on participant loans	2020-12-31	$52,960
Interest earned on other investments	2020-12-31	$378,297
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$16,993,099
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$14,622,409
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$17,467,963
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$12,456,632
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Unqualified
Accountancy firm name	2020-12-31	WIPFLI LLP
Accountancy firm EIN	2020-12-31	390758449
2019 : ROCKFORD MEMORIAL HOSPITAL SUPPLEMENTAL PENSION PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$24,647,393
Total loss/gain on sale of assets	2019-12-31	$0
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$8,254,842
Total of all expenses incurred	2019-12-31	$8,254,842
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$8,247,292
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$8,247,292
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$0
Value of total assets at end of year	2019-12-31	$130,238,471
Value of total assets at end of year	2019-12-31	$130,238,471
Value of total assets at beginning of year	2019-12-31	$113,845,920
Value of total assets at beginning of year	2019-12-31	$113,845,920
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$7,550
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$7,550
Total interest from all sources	2019-12-31	$424,068
Total interest from all sources	2019-12-31	$424,068
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$5,317,573
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$5,317,573
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$5,317,573
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$5,317,573
Was this plan covered by a fidelity bond	2019-12-31	Yes
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$10,000,000
Value of fidelity bond cover	2019-12-31	$10,000,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Participant contributions at end of year	2019-12-31	$1,094,564
Participant contributions at end of year	2019-12-31	$1,094,564
Participant contributions at beginning of year	2019-12-31	$936,353
Participant contributions at beginning of year	2019-12-31	$936,353
Administrative expenses (other) incurred	2019-12-31	$7,550
Administrative expenses (other) incurred	2019-12-31	$7,550
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$16,392,551
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$130,238,471
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$130,238,471
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$113,845,920
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$113,845,920
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$114,521,498
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$114,521,498
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$99,680,882
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$99,680,882
Interest on participant loans	2019-12-31	$54,749
Interest on participant loans	2019-12-31	$54,749
Interest earned on other investments	2019-12-31	$369,319
Interest earned on other investments	2019-12-31	$369,319
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$14,622,409
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$14,622,409
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$13,228,685
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$13,228,685
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$18,905,752
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$18,905,752
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$8,247,292
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$8,247,292
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	WIPFLI LLP
Accountancy firm EIN	2019-12-31	390758449
Accountancy firm EIN	2019-12-31	390758449
2018 : ROCKFORD MEMORIAL HOSPITAL SUPPLEMENTAL PENSION PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$-4,283,081
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$9,230,888
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$9,222,438
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$0
Value of total assets at end of year	2018-12-31	$113,845,920
Value of total assets at beginning of year	2018-12-31	$127,359,889
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$8,450
Total interest from all sources	2018-12-31	$339,274
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$5,474,580
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	$5,474,580
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$10,000,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Participant contributions at end of year	2018-12-31	$936,353
Participant contributions at beginning of year	2018-12-31	$716,082
Administrative expenses (other) incurred	2018-12-31	$8,450
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	$-13,513,969
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$113,845,920
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$127,359,889
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	$99,680,882
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$116,961,973
Interest on participant loans	2018-12-31	$41,994
Interest earned on other investments	2018-12-31	$297,280
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$13,228,685
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$9,681,834
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-10,096,935
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$9,222,438
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	WIPFLI LLP
Accountancy firm EIN	2018-12-31	390758449
2017 : ROCKFORD MEMORIAL HOSPITAL SUPPLEMENTAL PENSION PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$23,872,232
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$15,574,543
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$15,564,318
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$0
Value of total assets at end of year	2017-12-31	$128,797,810
Value of total assets at beginning of year	2017-12-31	$120,500,121
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$10,225
Total interest from all sources	2017-12-31	$1,864,160
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$4,260,588
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	$4,260,588
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$10,000,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Participant contributions at end of year	2017-12-31	$716,082
Participant contributions at beginning of year	2017-12-31	$19,216
Administrative expenses (other) incurred	2017-12-31	$10,225
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	$8,297,689
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$128,797,810
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$120,500,121
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	$118,399,894
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$111,238,804
Interest on participant loans	2017-12-31	$15,495
Interest earned on other investments	2017-12-31	$1,847,066
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2017-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2017-12-31	$3,967,869
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2017-12-31	$3,967,869
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2017-12-31	$1,599
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$9,681,834
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$2,681,353
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$17,747,484
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
Employer contributions (assets) at end of year	2017-12-31	$0
Employer contributions (assets) at beginning of year	2017-12-31	$2,592,879
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$15,564,318
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	WIPFLI LLP
Accountancy firm EIN	2017-12-31	390758449
2016 : ROCKFORD MEMORIAL HOSPITAL SUPPLEMENTAL PENSION PLAN 2016 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2016-12-31	$102
Total unrealized appreciation/depreciation of assets	2016-12-31	$102
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	$785,147
Total loss/gain on sale of assets	2016-12-31	$-294
Total of all expenses incurred	2016-12-31	$3,038,818
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$3,039,023
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$0
Value of total assets at end of year	2016-12-31	$12,470,713
Value of total assets at beginning of year	2016-12-31	$14,724,384
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$-205
Total interest from all sources	2016-12-31	$6,414
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$444,035
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	$443,943
Administrative expenses professional fees incurred	2016-12-31	$-205
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$10,000,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Participant contributions at end of year	2016-12-31	$40,126
Participant contributions at beginning of year	2016-12-31	$40,424
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	$-2,253,671
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$12,470,713
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$14,724,384
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	$10,723,822
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$12,543,175
Interest on participant loans	2016-12-31	$1,734
Interest earned on other investments	2016-12-31	$3,881
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2016-12-31	$1,364,860
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2016-12-31	$1,796,305
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2016-12-31	$1,796,305
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2016-12-31	$799
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$336,774
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$337,638
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$334,890
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
Income. Dividends from common stock	2016-12-31	$92
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$3,039,023
Assets. Corporate common stocks other than exployer securities at end of year	2016-12-31	$5,131
Assets. Corporate common stocks other than exployer securities at beginning of year	2016-12-31	$6,842
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
Aggregate proceeds on sale of assets	2016-12-31	$6,617
Aggregate carrying amount (costs) on sale of assets	2016-12-31	$6,911
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	WIPFLI LLP
Accountancy firm EIN	2016-12-31	390758449

Form 5500 Responses for ROCKFORD MEMORIAL HOSPITAL SUPPLEMENTAL PENSION PLAN

2022: ROCKFORD MEMORIAL HOSPITAL SUPPLEMENTAL PENSION PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: ROCKFORD MEMORIAL HOSPITAL SUPPLEMENTAL PENSION PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: ROCKFORD MEMORIAL HOSPITAL SUPPLEMENTAL PENSION PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: ROCKFORD MEMORIAL HOSPITAL SUPPLEMENTAL PENSION PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: ROCKFORD MEMORIAL HOSPITAL SUPPLEMENTAL PENSION PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: ROCKFORD MEMORIAL HOSPITAL SUPPLEMENTAL PENSION PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: ROCKFORD MEMORIAL HOSPITAL SUPPLEMENTAL PENSION PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

664137

Policy instance

Insurance contract or identification number	664137
Number of Individuals Covered	2571
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $258,630
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $258,630
Insurance broker organization code?	3

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

664137

Policy instance

Insurance contract or identification number	664137
Number of Individuals Covered	2748
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $36,497
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $36,497
Insurance broker organization code?	3

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

450829/806623

Policy instance

Insurance contract or identification number	450829/806623
Number of Individuals Covered	0
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

664137

Policy instance

Insurance contract or identification number	664137
Number of Individuals Covered	3062
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $31,447
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $31,447
Insurance broker organization code?	3

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

664137

Policy instance

Insurance contract or identification number	664137
Number of Individuals Covered	3354
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $28,373
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $28,373
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	ALLOCATED NON-CASH COMP
Insurance broker organization code?	3

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

450829/806623

Policy instance

Insurance contract or identification number	450829/806623
Number of Individuals Covered	41
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

450829/806623

Policy instance

Insurance contract or identification number	450829/806623
Number of Individuals Covered	49
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

664137

Policy instance

Insurance contract or identification number	664137
Number of Individuals Covered	3739
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $272,154
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $272,154
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	ALLOCATED NON-CASH COMP
Insurance broker organization code?	3

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

664137

Policy instance

Insurance contract or identification number	664137
Number of Individuals Covered	4022
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $45,154
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $45,154
Insurance broker organization code?	3
Insurance broker name	REGULUS ADVISORS, LLC

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

450829/806623

Policy instance

Insurance contract or identification number	450829/806623
Number of Individuals Covered	56
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $1,676
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	1676
Additional information about fees paid to insurance broker	REFERRAL/SERVICE FEE
Insurance broker organization code?	3
Insurance broker name	FIDELITY INVESTMENTS TAX-EXEMPT SVC

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Company Name:	MERCY HEALTH CORPORATION
Employer identification number (EIN):	472158680
NAIC Classification:	622000
NAIC Description:	Hospitals