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MCPHERSON HOSPITAL, INC. EMPLOYEE BENEFIT TRUST 401k Plan overview

Plan NameMCPHERSON HOSPITAL, INC. EMPLOYEE BENEFIT TRUST
Plan identification number 502

MCPHERSON HOSPITAL, INC. EMPLOYEE BENEFIT TRUST Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental

401k Sponsoring company profile

MCPHERSON HOSPITAL INC. has sponsored the creation of one or more 401k plans.

Company Name:MCPHERSON HOSPITAL INC.
Employer identification number (EIN):480799105
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MCPHERSON HOSPITAL, INC. EMPLOYEE BENEFIT TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022019-01-01
5022018-01-01
5022017-01-01TERRI GEHRING TERRI GEHRING2018-10-03
5022016-01-01TERRI GEHRING TERRI GEHRING2017-08-31
5022015-08-01ROBERT MONICAL ROBERT MONICAL2016-10-05
5022014-08-01ROBERT MONICAL ROBERT MONICAL2016-05-11
5022013-08-01ROBERT MONICAL ROBERT MONICAL2014-12-10
5022012-08-01ROBERT MONICAL ROBERT MONICAL2013-12-03
5022011-08-01ROBERT MONICAL ROBERT MONICAL2012-12-13
5022009-08-01JAMES R CHROMIK JAMES R CHROMIK2010-12-06

Plan Statistics for MCPHERSON HOSPITAL, INC. EMPLOYEE BENEFIT TRUST

401k plan membership statisitcs for MCPHERSON HOSPITAL, INC. EMPLOYEE BENEFIT TRUST

Measure Date Value
2019: MCPHERSON HOSPITAL, INC. EMPLOYEE BENEFIT TRUST 2019 401k membership
Total participants, beginning-of-year2019-01-01173
Total number of active participants reported on line 7a of the Form 55002019-01-010
Total of all active and inactive participants2019-01-010
2018: MCPHERSON HOSPITAL, INC. EMPLOYEE BENEFIT TRUST 2018 401k membership
Total participants, beginning-of-year2018-01-01172
Total number of active participants reported on line 7a of the Form 55002018-01-01173
Total of all active and inactive participants2018-01-01173
2017: MCPHERSON HOSPITAL, INC. EMPLOYEE BENEFIT TRUST 2017 401k membership
Total participants, beginning-of-year2017-01-01166
Total number of active participants reported on line 7a of the Form 55002017-01-01172
Total of all active and inactive participants2017-01-01172
2016: MCPHERSON HOSPITAL, INC. EMPLOYEE BENEFIT TRUST 2016 401k membership
Total participants, beginning-of-year2016-01-01138
Total number of active participants reported on line 7a of the Form 55002016-01-01166
Total of all active and inactive participants2016-01-01166
2015: MCPHERSON HOSPITAL, INC. EMPLOYEE BENEFIT TRUST 2015 401k membership
Total participants, beginning-of-year2015-08-01128
Total number of active participants reported on line 7a of the Form 55002015-08-01138
Total of all active and inactive participants2015-08-01138
2014: MCPHERSON HOSPITAL, INC. EMPLOYEE BENEFIT TRUST 2014 401k membership
Total participants, beginning-of-year2014-08-01119
Total number of active participants reported on line 7a of the Form 55002014-08-01128
Total of all active and inactive participants2014-08-01128
2013: MCPHERSON HOSPITAL, INC. EMPLOYEE BENEFIT TRUST 2013 401k membership
Total participants, beginning-of-year2013-08-01120
Total number of active participants reported on line 7a of the Form 55002013-08-01119
Total of all active and inactive participants2013-08-01119
2012: MCPHERSON HOSPITAL, INC. EMPLOYEE BENEFIT TRUST 2012 401k membership
Total participants, beginning-of-year2012-08-01139
Total number of active participants reported on line 7a of the Form 55002012-08-01120
Total of all active and inactive participants2012-08-01120
2011: MCPHERSON HOSPITAL, INC. EMPLOYEE BENEFIT TRUST 2011 401k membership
Total participants, beginning-of-year2011-08-01147
Total number of active participants reported on line 7a of the Form 55002011-08-01139
Total of all active and inactive participants2011-08-01139
2009: MCPHERSON HOSPITAL, INC. EMPLOYEE BENEFIT TRUST 2009 401k membership
Total participants, beginning-of-year2009-08-01330
Total number of active participants reported on line 7a of the Form 55002009-08-01340
Total of all active and inactive participants2009-08-01340

Financial Data on MCPHERSON HOSPITAL, INC. EMPLOYEE BENEFIT TRUST

Measure Date Value
2019 : MCPHERSON HOSPITAL, INC. EMPLOYEE BENEFIT TRUST 2019 401k financial data
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$147,791
Total income from all sources (including contributions)2019-12-31$151,381
Total of all expenses incurred2019-12-31$8,561
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$5,118
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$151,378
Value of total assets at end of year2019-12-31$0
Value of total assets at beginning of year2019-12-31$4,971
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$3,443
Total interest from all sources2019-12-31$3
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan2019-12-31$22,483
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$500,000
If this is an individual account plan, was there a blackout period2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$0
Total non interest bearing cash at end of year2019-12-31$0
Total non interest bearing cash at beginning of year2019-12-31$4,971
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$142,820
Value of net assets at end of year (total assets less liabilities)2019-12-31$0
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$-142,820
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$3
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$151,378
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$5,118
Contract administrator fees2019-12-31$3,443
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32019-12-31No
Liabilities. Value of benefit claims payable at end of year2019-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$147,791
Did the plan have assets held for investment2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Accountancy firm name2019-12-31WENDLING NOE NELSON & JOHNSON
Accountancy firm EIN2019-12-31481026809
2018 : MCPHERSON HOSPITAL, INC. EMPLOYEE BENEFIT TRUST 2018 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$147,791
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$198,923
Total income from all sources (including contributions)2018-12-31$1,927,414
Total of all expenses incurred2018-12-31$1,925,985
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$1,836,110
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$1,927,401
Value of total assets at end of year2018-12-31$4,971
Value of total assets at beginning of year2018-12-31$54,674
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$89,875
Total interest from all sources2018-12-31$13
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$500,000
If this is an individual account plan, was there a blackout period2018-12-31No
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$571,063
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-12-31$12,000
Total non interest bearing cash at end of year2018-12-31$4,971
Total non interest bearing cash at beginning of year2018-12-31$54,674
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$1,429
Value of net assets at end of year (total assets less liabilities)2018-12-31$-142,820
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$-144,249
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-12-31$13
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$227,492
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$1,356,338
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$1,608,618
Contract administrator fees2018-12-31$89,875
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32018-12-31No
Liabilities. Value of benefit claims payable at end of year2018-12-31$147,791
Liabilities. Value of benefit claims payable at beginning of year2018-12-31$186,923
Did the plan have assets held for investment2018-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31No
Opinion of an independent qualified public accountant for this plan2018-12-31Unqualified
Accountancy firm name2018-12-31WENDLING NOE NELSON & JOHNSON
Accountancy firm EIN2018-12-31481026809
2017 : MCPHERSON HOSPITAL, INC. EMPLOYEE BENEFIT TRUST 2017 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$198,923
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$96,930
Total income from all sources (including contributions)2017-12-31$1,467,564
Total of all expenses incurred2017-12-31$1,632,843
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$1,578,996
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$1,467,535
Value of total assets at end of year2017-12-31$54,674
Value of total assets at beginning of year2017-12-31$117,960
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$53,847
Total interest from all sources2017-12-31$29
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$500,000
If this is an individual account plan, was there a blackout period2017-12-31No
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$555,102
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2017-12-31$12,000
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-12-31$12,000
Total non interest bearing cash at end of year2017-12-31$54,674
Total non interest bearing cash at beginning of year2017-12-31$117,960
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$-165,279
Value of net assets at end of year (total assets less liabilities)2017-12-31$-144,249
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$21,030
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-12-31$29
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$185,438
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$912,433
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$1,393,558
Contract administrator fees2017-12-31$53,847
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-12-31No
Liabilities. Value of benefit claims payable at end of year2017-12-31$186,923
Liabilities. Value of benefit claims payable at beginning of year2017-12-31$84,930
Did the plan have assets held for investment2017-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31No
Opinion of an independent qualified public accountant for this plan2017-12-31Unqualified
Accountancy firm name2017-12-31WENDLING NOE NELSON & JOHNSON LLC
Accountancy firm EIN2017-12-31481026809
2016 : MCPHERSON HOSPITAL, INC. EMPLOYEE BENEFIT TRUST 2016 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$96,930
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$161,464
Total income from all sources (including contributions)2016-12-31$1,454,916
Total of all expenses incurred2016-12-31$1,436,886
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$1,380,249
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$1,454,855
Value of total assets at end of year2016-12-31$117,960
Value of total assets at beginning of year2016-12-31$164,464
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$56,637
Total interest from all sources2016-12-31$61
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$500,000
If this is an individual account plan, was there a blackout period2016-12-31No
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$553,943
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2016-12-31$12,000
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-12-31$12,000
Total non interest bearing cash at end of year2016-12-31$117,960
Total non interest bearing cash at beginning of year2016-12-31$164,464
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$18,030
Value of net assets at end of year (total assets less liabilities)2016-12-31$21,030
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$3,000
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-12-31$61
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$168,261
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$900,912
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$1,211,988
Contract administrator fees2016-12-31$56,637
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-12-31No
Liabilities. Value of benefit claims payable at end of year2016-12-31$84,930
Liabilities. Value of benefit claims payable at beginning of year2016-12-31$149,464
Did the plan have assets held for investment2016-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31No
Opinion of an independent qualified public accountant for this plan2016-12-31Unqualified
Accountancy firm name2016-12-31WENDLING NOE NELSON & JOHNSON LLC
Accountancy firm EIN2016-12-31481026809
2015 : MCPHERSON HOSPITAL, INC. EMPLOYEE BENEFIT TRUST 2015 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$161,464
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$143,087
Total income from all sources (including contributions)2015-12-31$489,322
Total of all expenses incurred2015-12-31$499,065
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$475,855
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$489,297
Value of total assets at end of year2015-12-31$164,464
Value of total assets at beginning of year2015-12-31$155,830
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$23,210
Total interest from all sources2015-12-31$25
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$500,000
If this is an individual account plan, was there a blackout period2015-12-31No
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$191,760
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2015-12-31$12,000
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2015-12-31$42,000
Total non interest bearing cash at end of year2015-12-31$164,464
Total non interest bearing cash at beginning of year2015-12-31$155,830
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$-9,743
Value of net assets at end of year (total assets less liabilities)2015-12-31$3,000
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$12,743
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-12-31$25
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$55,540
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$297,537
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$420,315
Contract administrator fees2015-12-31$23,210
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32015-12-31No
Liabilities. Value of benefit claims payable at end of year2015-12-31$149,464
Liabilities. Value of benefit claims payable at beginning of year2015-12-31$101,087
Did the plan have assets held for investment2015-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31No
Opinion of an independent qualified public accountant for this plan2015-12-31Unqualified
Accountancy firm name2015-12-31WENDLING NOE NELSON & JOHNSON LLC
Accountancy firm EIN2015-12-31481026809
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-07-31$143,087
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-07-31$162,782
Total income from all sources (including contributions)2015-07-31$1,071,408
Total of all expenses incurred2015-07-31$1,072,730
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-07-31$1,025,876
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-07-31$1,071,346
Value of total assets at end of year2015-07-31$155,830
Value of total assets at beginning of year2015-07-31$176,847
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-07-31$46,854
Total interest from all sources2015-07-31$62
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-07-31No
Was this plan covered by a fidelity bond2015-07-31Yes
Value of fidelity bond cover2015-07-31$500,000
If this is an individual account plan, was there a blackout period2015-07-31No
Were there any nonexempt tranactions with any party-in-interest2015-07-31No
Contributions received from participants2015-07-31$449,468
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2015-07-31$42,000
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2015-07-31$59,000
Total non interest bearing cash at end of year2015-07-31$155,830
Total non interest bearing cash at beginning of year2015-07-31$176,847
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-07-31No
Value of net income/loss2015-07-31$-1,322
Value of net assets at end of year (total assets less liabilities)2015-07-31$12,743
Value of net assets at beginning of year (total assets less liabilities)2015-07-31$14,065
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-07-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-07-31No
Were any leases to which the plan was party in default or uncollectible2015-07-31No
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-07-31$62
Expenses. Payments to insurance carriers foe the provision of benefits2015-07-31$120,403
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-07-31No
Was there a failure to transmit to the plan any participant contributions2015-07-31No
Has the plan failed to provide any benefit when due under the plan2015-07-31No
Contributions received in cash from employer2015-07-31$621,878
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-07-31$905,473
Contract administrator fees2015-07-31$46,854
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32015-07-31No
Liabilities. Value of benefit claims payable at end of year2015-07-31$101,087
Liabilities. Value of benefit claims payable at beginning of year2015-07-31$103,782
Did the plan have assets held for investment2015-07-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-07-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-07-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-07-31No
Opinion of an independent qualified public accountant for this plan2015-07-31Unqualified
Accountancy firm name2015-07-31WENDLING NOE NELSON & JOHNSON LLC
Accountancy firm EIN2015-07-31481026809
2014 : MCPHERSON HOSPITAL, INC. EMPLOYEE BENEFIT TRUST 2014 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-07-31$162,782
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-07-31$190,562
Total income from all sources (including contributions)2014-07-31$945,733
Total of all expenses incurred2014-07-31$968,764
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-07-31$934,547
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-07-31$945,713
Value of total assets at end of year2014-07-31$176,847
Value of total assets at beginning of year2014-07-31$227,658
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-07-31$34,217
Total interest from all sources2014-07-31$20
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-07-31No
Was this plan covered by a fidelity bond2014-07-31Yes
Value of fidelity bond cover2014-07-31$500,000
If this is an individual account plan, was there a blackout period2014-07-31No
Were there any nonexempt tranactions with any party-in-interest2014-07-31No
Contributions received from participants2014-07-31$434,039
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2014-07-31$59,000
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2014-07-31$40,000
Total non interest bearing cash at end of year2014-07-31$176,847
Total non interest bearing cash at beginning of year2014-07-31$227,658
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-07-31No
Value of net income/loss2014-07-31$-23,031
Value of net assets at end of year (total assets less liabilities)2014-07-31$14,065
Value of net assets at beginning of year (total assets less liabilities)2014-07-31$37,096
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-07-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-07-31No
Were any leases to which the plan was party in default or uncollectible2014-07-31No
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-07-31$20
Expenses. Payments to insurance carriers foe the provision of benefits2014-07-31$111,534
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-07-31No
Was there a failure to transmit to the plan any participant contributions2014-07-31No
Has the plan failed to provide any benefit when due under the plan2014-07-31No
Contributions received in cash from employer2014-07-31$511,674
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-07-31$823,013
Contract administrator fees2014-07-31$34,217
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32014-07-31No
Liabilities. Value of benefit claims payable at end of year2014-07-31$103,782
Liabilities. Value of benefit claims payable at beginning of year2014-07-31$150,562
Did the plan have assets held for investment2014-07-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-07-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-07-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-07-31No
Opinion of an independent qualified public accountant for this plan2014-07-31Unqualified
Accountancy firm name2014-07-31WENDLING NOE NELSON & JOHNSON LLC
Accountancy firm EIN2014-07-31481026809
2013 : MCPHERSON HOSPITAL, INC. EMPLOYEE BENEFIT TRUST 2013 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-07-31$190,562
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-07-31$299,786
Total income from all sources (including contributions)2013-07-31$1,157,294
Total of all expenses incurred2013-07-31$1,003,107
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-07-31$963,203
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-07-31$1,157,277
Value of total assets at end of year2013-07-31$227,658
Value of total assets at beginning of year2013-07-31$182,695
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-07-31$39,904
Total interest from all sources2013-07-31$17
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-07-31No
Was this plan covered by a fidelity bond2013-07-31Yes
Value of fidelity bond cover2013-07-31$500,000
If this is an individual account plan, was there a blackout period2013-07-31No
Were there any nonexempt tranactions with any party-in-interest2013-07-31No
Contributions received from participants2013-07-31$520,673
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2013-07-31$40,000
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2013-07-31$40,000
Total non interest bearing cash at end of year2013-07-31$227,658
Total non interest bearing cash at beginning of year2013-07-31$182,695
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-07-31No
Value of net income/loss2013-07-31$154,187
Value of net assets at end of year (total assets less liabilities)2013-07-31$37,096
Value of net assets at beginning of year (total assets less liabilities)2013-07-31$-117,091
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-07-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-07-31No
Were any leases to which the plan was party in default or uncollectible2013-07-31No
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-07-31$17
Expenses. Payments to insurance carriers foe the provision of benefits2013-07-31$116,059
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-07-31No
Was there a failure to transmit to the plan any participant contributions2013-07-31No
Has the plan failed to provide any benefit when due under the plan2013-07-31No
Contributions received in cash from employer2013-07-31$636,604
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-07-31$847,144
Contract administrator fees2013-07-31$39,904
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32013-07-31No
Liabilities. Value of benefit claims payable at end of year2013-07-31$150,562
Liabilities. Value of benefit claims payable at beginning of year2013-07-31$259,786
Did the plan have assets held for investment2013-07-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-07-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-07-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-07-31No
Opinion of an independent qualified public accountant for this plan2013-07-31Unqualified
Accountancy firm name2013-07-31WENDLING NOE NELSON & JOHNSON LLC
Accountancy firm EIN2013-07-31481026809
2012 : MCPHERSON HOSPITAL, INC. EMPLOYEE BENEFIT TRUST 2012 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-07-31$299,786
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-07-31$148,060
Total income from all sources (including contributions)2012-07-31$1,481,809
Total of all expenses incurred2012-07-31$1,586,814
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-07-31$1,550,858
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-07-31$1,481,799
Value of total assets at end of year2012-07-31$182,695
Value of total assets at beginning of year2012-07-31$135,974
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-07-31$35,956
Total interest from all sources2012-07-31$10
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-07-31No
Was this plan covered by a fidelity bond2012-07-31Yes
Value of fidelity bond cover2012-07-31$500,000
If this is an individual account plan, was there a blackout period2012-07-31No
Were there any nonexempt tranactions with any party-in-interest2012-07-31No
Contributions received from participants2012-07-31$548,573
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2012-07-31$40,000
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-07-31$20,000
Total non interest bearing cash at end of year2012-07-31$182,695
Total non interest bearing cash at beginning of year2012-07-31$135,974
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-07-31No
Value of net income/loss2012-07-31$-105,005
Value of net assets at end of year (total assets less liabilities)2012-07-31$-117,091
Value of net assets at beginning of year (total assets less liabilities)2012-07-31$-12,086
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-07-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-07-31No
Were any leases to which the plan was party in default or uncollectible2012-07-31No
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-07-31$10
Expenses. Payments to insurance carriers foe the provision of benefits2012-07-31$127,370
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-07-31No
Was there a failure to transmit to the plan any participant contributions2012-07-31No
Has the plan failed to provide any benefit when due under the plan2012-07-31No
Contributions received in cash from employer2012-07-31$933,226
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-07-31$1,423,488
Contract administrator fees2012-07-31$35,956
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32012-07-31No
Liabilities. Value of benefit claims payable at end of year2012-07-31$259,786
Liabilities. Value of benefit claims payable at beginning of year2012-07-31$128,060
Did the plan have assets held for investment2012-07-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-07-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-07-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-07-31No
Opinion of an independent qualified public accountant for this plan2012-07-31Unqualified
Accountancy firm name2012-07-31WENDLING NOE NELSON & JOHNSON LLC
Accountancy firm EIN2012-07-31481026809
2011 : MCPHERSON HOSPITAL, INC. EMPLOYEE BENEFIT TRUST 2011 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-07-31$148,060
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-07-31$72,500
Total income from all sources (including contributions)2011-07-31$1,596,805
Total of all expenses incurred2011-07-31$1,663,806
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-07-31$1,620,887
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-07-31$1,596,798
Value of total assets at end of year2011-07-31$135,974
Value of total assets at beginning of year2011-07-31$127,415
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-07-31$42,919
Total interest from all sources2011-07-31$7
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-07-31No
Was this plan covered by a fidelity bond2011-07-31Yes
Value of fidelity bond cover2011-07-31$500,000
If this is an individual account plan, was there a blackout period2011-07-31No
Were there any nonexempt tranactions with any party-in-interest2011-07-31No
Contributions received from participants2011-07-31$549,180
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2011-07-31$20,000
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2011-07-31$20,000
Total non interest bearing cash at end of year2011-07-31$135,974
Total non interest bearing cash at beginning of year2011-07-31$127,415
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-07-31No
Value of net income/loss2011-07-31$-67,001
Value of net assets at end of year (total assets less liabilities)2011-07-31$-12,086
Value of net assets at beginning of year (total assets less liabilities)2011-07-31$54,915
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-07-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-07-31No
Were any leases to which the plan was party in default or uncollectible2011-07-31No
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-07-31$7
Expenses. Payments to insurance carriers foe the provision of benefits2011-07-31$149,173
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-07-31No
Was there a failure to transmit to the plan any participant contributions2011-07-31No
Has the plan failed to provide any benefit when due under the plan2011-07-31No
Contributions received in cash from employer2011-07-31$1,047,618
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-07-31$1,471,714
Contract administrator fees2011-07-31$42,919
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32011-07-31No
Liabilities. Value of benefit claims payable at end of year2011-07-31$128,060
Liabilities. Value of benefit claims payable at beginning of year2011-07-31$52,500
Did the plan have assets held for investment2011-07-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-07-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-07-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-07-31No
Opinion of an independent qualified public accountant for this plan2011-07-31Unqualified
Accountancy firm name2011-07-31WENDLING NOE NELSON & JOHNSON LLC
Accountancy firm EIN2011-07-31481026809

Form 5500 Responses for MCPHERSON HOSPITAL, INC. EMPLOYEE BENEFIT TRUST

2019: MCPHERSON HOSPITAL, INC. EMPLOYEE BENEFIT TRUST 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01This submission is the final filingYes
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: MCPHERSON HOSPITAL, INC. EMPLOYEE BENEFIT TRUST 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: MCPHERSON HOSPITAL, INC. EMPLOYEE BENEFIT TRUST 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: MCPHERSON HOSPITAL, INC. EMPLOYEE BENEFIT TRUST 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: MCPHERSON HOSPITAL, INC. EMPLOYEE BENEFIT TRUST 2015 form 5500 responses
2015-08-01Type of plan entitySingle employer plan
2015-08-01This return/report is a short plan year return/report (less than 12 months)Yes
2015-08-01Plan funding arrangement – InsuranceYes
2015-08-01Plan funding arrangement – TrustYes
2015-08-01Plan benefit arrangement – InsuranceYes
2015-08-01Plan benefit arrangement - TrustYes
2014: MCPHERSON HOSPITAL, INC. EMPLOYEE BENEFIT TRUST 2014 form 5500 responses
2014-08-01Type of plan entitySingle employer plan
2014-08-01Plan funding arrangement – InsuranceYes
2014-08-01Plan funding arrangement – TrustYes
2014-08-01Plan benefit arrangement – InsuranceYes
2014-08-01Plan benefit arrangement - TrustYes
2013: MCPHERSON HOSPITAL, INC. EMPLOYEE BENEFIT TRUST 2013 form 5500 responses
2013-08-01Type of plan entitySingle employer plan
2013-08-01Plan funding arrangement – InsuranceYes
2013-08-01Plan funding arrangement – TrustYes
2013-08-01Plan benefit arrangement – InsuranceYes
2013-08-01Plan benefit arrangement - TrustYes
2012: MCPHERSON HOSPITAL, INC. EMPLOYEE BENEFIT TRUST 2012 form 5500 responses
2012-08-01Type of plan entitySingle employer plan
2012-08-01Plan funding arrangement – InsuranceYes
2012-08-01Plan funding arrangement – TrustYes
2012-08-01Plan benefit arrangement – InsuranceYes
2012-08-01Plan benefit arrangement - TrustYes
2011: MCPHERSON HOSPITAL, INC. EMPLOYEE BENEFIT TRUST 2011 form 5500 responses
2011-08-01Type of plan entitySingle employer plan
2011-08-01Plan funding arrangement – InsuranceYes
2011-08-01Plan funding arrangement – TrustYes
2011-08-01Plan benefit arrangement – InsuranceYes
2011-08-01Plan benefit arrangement - TrustYes
2009: MCPHERSON HOSPITAL, INC. EMPLOYEE BENEFIT TRUST 2009 form 5500 responses
2009-08-01Type of plan entitySingle employer plan
2009-08-01This submission is the final filingNo
2009-08-01Plan funding arrangement – InsuranceYes
2009-08-01Plan funding arrangement – TrustYes
2009-08-01Plan benefit arrangement – InsuranceYes
2009-08-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

QBE A&H (National Association of Insurance Commissioners NAIC id number: 10219 )
Policy contract numberLGS00595-18
Policy instance 1
Insurance contract or identification numberLGS00595-18
Number of Individuals Covered0
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
QBE A&H (National Association of Insurance Commissioners NAIC id number: 10219 )
Policy contract numberLGS00595-17
Policy instance 1
Insurance contract or identification numberLGS00595-17
Number of Individuals Covered172
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
QBE A&H (National Association of Insurance Commissioners NAIC id number: 10219 )
Policy contract numberLGS00595-14
Policy instance 1
Insurance contract or identification numberLGS00595-14
Number of Individuals Covered138
Insurance policy start date2015-08-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
QBE A&H (National Association of Insurance Commissioners NAIC id number: 10219 )
Policy contract numberLGS00595-14
Policy instance 1
Insurance contract or identification numberLGS00595-14
Number of Individuals Covered128
Insurance policy start date2014-08-01
Insurance policy end date2015-07-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
QBE/SLG BENEFITS (National Association of Insurance Commissioners NAIC id number: 39217 )
Policy contract numberLGS00595-13
Policy instance 1
Insurance contract or identification numberLGS00595-13
Number of Individuals Covered119
Insurance policy start date2013-08-01
Insurance policy end date2014-07-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
QBE/SLG BENEFITS (National Association of Insurance Commissioners NAIC id number: 39217 )
Policy contract numberLGS00595-13
Policy instance 1
Insurance contract or identification numberLGS00595-13
Number of Individuals Covered120
Insurance policy start date2012-08-01
Insurance policy end date2013-07-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
QBE/SLG BENEFITS (National Association of Insurance Commissioners NAIC id number: 39217 )
Policy contract numberLGS00595-10
Policy instance 1
Insurance contract or identification numberLGS00595-10
Number of Individuals Covered139
Insurance policy start date2011-08-01
Insurance policy end date2012-07-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
QBE/SLG BENEFITS (National Association of Insurance Commissioners NAIC id number: 39217 )
Policy contract numberLGS00595-10
Policy instance 1
Insurance contract or identification numberLGS00595-10
Number of Individuals Covered147
Insurance policy start date2010-08-01
Insurance policy end date2011-07-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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