401k Plan data: HUTCHINSON REGIONAL HEALTHCARE SYSTEM RETIREMENT SAVINGS PLAN plan

HUTCHINSON REGIONAL HEALTHCARE SYSTEM RETIREMENT SAVINGS PLAN 401k Plan overview

Plan Name	HUTCHINSON REGIONAL HEALTHCARE SYSTEM RETIREMENT SAVINGS PLAN
Plan identification number	003

HUTCHINSON REGIONAL HEALTHCARE SYSTEM RETIREMENT SAVINGS 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.
Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
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

HUTCHINSON REGIONAL MEDICAL CENTER, INC. has sponsored the creation of one or more 401k plans.

Company Name: HUTCHINSON REGIONAL MEDICAL CENTER, INC.

Employer identification number (EIN): 480774005

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HUTCHINSON REGIONAL HEALTHCARE SYSTEM RETIREMENT SAVINGS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
003 2020-01-01
003 2019-01-01
003 2018-01-01

Plan Statistics for HUTCHINSON REGIONAL HEALTHCARE SYSTEM RETIREMENT SAVINGS PLAN

401k plan membership statisitcs for HUTCHINSON REGIONAL HEALTHCARE SYSTEM RETIREMENT SAVINGS PLAN

Measure Date Value
2020: HUTCHINSON REGIONAL HEALTHCARE SYSTEM RETIREMENT SAVINGS PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 1,544
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 1,326
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 242
Total of all active and inactive participants 2020-01-01 1,568
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 1,568
Number of participants with account balances 2020-01-01 1,528
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 21
2019: HUTCHINSON REGIONAL HEALTHCARE SYSTEM RETIREMENT SAVINGS PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 1,468
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 1,317
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 207
Total of all active and inactive participants 2019-01-01 1,524
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 1,524
Number of participants with account balances 2019-01-01 1,479
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 18
2018: HUTCHINSON REGIONAL HEALTHCARE SYSTEM RETIREMENT SAVINGS PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 1,407
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 1,272
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 180
Total of all active and inactive participants 2018-01-01 1,452
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 1,452
Number of participants with account balances 2018-01-01 1,394
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 4

Measure	Date	Value
2020: HUTCHINSON REGIONAL HEALTHCARE SYSTEM RETIREMENT SAVINGS PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	1,544
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	1,326
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	242
Total of all active and inactive participants	2020-01-01	1,568
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	1,568
Number of participants with account balances	2020-01-01	1,528
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	21
2019: HUTCHINSON REGIONAL HEALTHCARE SYSTEM RETIREMENT SAVINGS PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	1,468
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	1,317
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	207
Total of all active and inactive participants	2019-01-01	1,524
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	1,524
Number of participants with account balances	2019-01-01	1,479
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	18
2018: HUTCHINSON REGIONAL HEALTHCARE SYSTEM RETIREMENT SAVINGS PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	1,407
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	1,272
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	180
Total of all active and inactive participants	2018-01-01	1,452
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	1,452
Number of participants with account balances	2018-01-01	1,394
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	4

Financial Data on HUTCHINSON REGIONAL HEALTHCARE SYSTEM RETIREMENT SAVINGS PLAN

Measure	Date	Value
2020 : HUTCHINSON REGIONAL HEALTHCARE SYSTEM RETIREMENT SAVINGS 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	$38,027
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$40,300
Total income from all sources (including contributions)	2020-12-31	$13,972,765
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$5,514,327
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$5,187,234
Value of total corrective distributions	2020-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$4,803,443
Value of total assets at end of year	2020-12-31	$72,433,563
Value of total assets at beginning of year	2020-12-31	$63,977,398
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$327,093
Total interest from all sources	2020-12-31	$217,636
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$766,854
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	$766,854
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$1,000,000
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
Contributions received from participants	2020-12-31	$3,283,838
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$373,921
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2020-12-31	$38,027
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2020-12-31	$40,300
Other income not declared elsewhere	2020-12-31	$0
Administrative expenses (other) incurred	2020-12-31	$327,093
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	$8,458,438
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$72,395,536
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$63,937,098
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	$59,726,435
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$50,863,754
Interest earned on other investments	2020-12-31	$217,636
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$11,676,403
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$10,239,886
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$8,184,832
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$1,145,684
Employer contributions (assets) at end of year	2020-12-31	$1,030,725
Employer contributions (assets) at beginning of year	2020-12-31	$2,873,758
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$5,187,234
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	BKD, LLP
Accountancy firm EIN	2020-12-31	440160260
2019 : HUTCHINSON REGIONAL HEALTHCARE SYSTEM RETIREMENT SAVINGS PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$40,300
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$34,906
Total income from all sources (including contributions)	2019-12-31	$16,329,246
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$5,519,806
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$5,200,974
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$6,309,169
Value of total assets at end of year	2019-12-31	$63,977,398
Value of total assets at beginning of year	2019-12-31	$53,162,564
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$318,832
Total interest from all sources	2019-12-31	$209,135
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$1,265,062
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	$1,265,062
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$3,011,214
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$290,275
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2019-12-31	$40,300
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2019-12-31	$34,906
Administrative expenses (other) incurred	2019-12-31	$318,832
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	$10,809,440
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$63,937,098
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$53,127,658
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$50,863,754
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$41,134,897
Interest earned on other investments	2019-12-31	$209,135
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$10,239,886
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$9,126,250
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$8,545,880
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$3,007,680
Employer contributions (assets) at end of year	2019-12-31	$2,873,758
Employer contributions (assets) at beginning of year	2019-12-31	$2,901,417
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$5,200,974
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	BKD, LLP
Accountancy firm EIN	2019-12-31	440160260
2018 : HUTCHINSON REGIONAL HEALTHCARE SYSTEM RETIREMENT SAVINGS 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	$34,906
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	$16,878,531
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$4,930,306
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$4,685,623
Value of total corrective distributions	2018-12-31	$2,538
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$20,214,881
Value of total assets at end of year	2018-12-31	$53,162,564
Value of total assets at beginning of year	2018-12-31	$41,179,433
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$242,145
Total interest from all sources	2018-12-31	$133,248
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$811,390
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	$811,390
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$500,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$2,738,808
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$14,460,472
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2018-12-31	$34,906
Other income not declared elsewhere	2018-12-31	$0
Administrative expenses (other) incurred	2018-12-31	$242,145
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	$11,948,225
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$53,127,658
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$41,179,433
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	$41,134,897
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$32,203,549
Interest earned on other investments	2018-12-31	$133,238
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2018-12-31	$10
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$9,126,250
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$6,682,576
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-4,280,988
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	$3,015,601
Employer contributions (assets) at end of year	2018-12-31	$2,901,417
Employer contributions (assets) at beginning of year	2018-12-31	$2,293,308
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$4,685,623
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	BKD, LLP
Accountancy firm EIN	2018-12-31	440160260

Form 5500 Responses for HUTCHINSON REGIONAL HEALTHCARE SYSTEM RETIREMENT SAVINGS PLAN

2020: HUTCHINSON REGIONAL HEALTHCARE SYSTEM RETIREMENT SAVINGS 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: HUTCHINSON REGIONAL HEALTHCARE SYSTEM RETIREMENT SAVINGS 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: HUTCHINSON REGIONAL HEALTHCARE SYSTEM RETIREMENT SAVINGS 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

Insurance Providers Used on plan

PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )

Policy contract number

074214

Policy instance

Insurance contract or identification number	074214
Number of Individuals Covered	1568
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	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

PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )

Policy contract number

074214

Policy instance

Insurance contract or identification number	074214
Number of Individuals Covered	1524
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	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

PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )

Policy contract number

074214

Policy instance

Insurance contract or identification number	074214
Number of Individuals Covered	1452
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	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

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Company Name:	HUTCHINSON REGIONAL MEDICAL CENTER, INC.
Employer identification number (EIN):	480774005
NAIC Classification:	622000
NAIC Description:	Hospitals