401k Plan data: THE MARTHA JEFFERSON HOSPITAL 403(B) SAVINGS PLAN plan

THE MARTHA JEFFERSON HOSPITAL 403(B) SAVINGS PLAN 401k Plan overview

Plan Name	THE MARTHA JEFFERSON HOSPITAL 403(B) SAVINGS PLAN
Plan identification number	002

THE MARTHA JEFFERSON HOSPITAL 403(B) SAVINGS PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.
Participant-directed brokerage accounts provided as an investment option under the plan.
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.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

MARTHA JEFFERSON HOSPITAL has sponsored the creation of one or more 401k plans.

Company Name: MARTHA JEFFERSON HOSPITAL

Employer identification number (EIN): 540261840

NAIC Classification: 622000
NAIC Description: Hospitals

Additional information about MARTHA JEFFERSON HOSPITAL

Jurisdiction of Incorporation: Virginia Secretary of State

Incorporation Date: 1929-12-16

Company Identification Number: 0035022

Legal Registered Office Address: MARTHA JEFFERSON HOSPITAL

CHARLOTTESVILLE
United States of America (USA)
22911

More information about MARTHA JEFFERSON HOSPITAL

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE MARTHA JEFFERSON HOSPITAL 403(B) SAVINGS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2016-01-01 TAMARA L MEARS
002 2015-01-01 TAMARA L MEARS
002 2014-01-01 TAMARA L MEARS
002 2013-01-01 TAMARA MEARS
002 2012-01-01 SUSAN CABELL MAINS
002 2011-01-01 SUSAN CABELL MAINS
002 2009-01-01 SUSAN CABELL MAINS

Plan id#	Filing Submission Date	Name of Administrator
002	2016-01-01	TAMARA L MEARS
002	2015-01-01	TAMARA L MEARS
002	2014-01-01	TAMARA L MEARS
002	2013-01-01	TAMARA MEARS
002	2012-01-01	SUSAN CABELL MAINS
002	2011-01-01	SUSAN CABELL MAINS
002	2009-01-01	SUSAN CABELL MAINS

Plan Statistics for THE MARTHA JEFFERSON HOSPITAL 403(B) SAVINGS PLAN

401k plan membership statisitcs for THE MARTHA JEFFERSON HOSPITAL 403(B) SAVINGS PLAN

Measure Date Value
2016: THE MARTHA JEFFERSON HOSPITAL 403(B) SAVINGS PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 399
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 0
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 0
Total participants 2016-01-01 0
Number of participants with account balances 2016-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: THE MARTHA JEFFERSON HOSPITAL 403(B) SAVINGS PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 434
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 194
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 205
Total of all active and inactive participants 2015-01-01 399
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 399
Number of participants with account balances 2015-01-01 399
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: THE MARTHA JEFFERSON HOSPITAL 403(B) SAVINGS PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 2,094
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 224
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 209
Total of all active and inactive participants 2014-01-01 433
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 1
Total participants 2014-01-01 434
Number of participants with account balances 2014-01-01 434
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: THE MARTHA JEFFERSON HOSPITAL 403(B) SAVINGS PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 1,967
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 1,719
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 375
Total of all active and inactive participants 2013-01-01 2,094
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 2,094
Number of participants with account balances 2013-01-01 1,538
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: THE MARTHA JEFFERSON HOSPITAL 403(B) SAVINGS PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 1,838
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 1,693
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 324
Total of all active and inactive participants 2012-01-01 2,017
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 2,017
Number of participants with account balances 2012-01-01 1,442
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: THE MARTHA JEFFERSON HOSPITAL 403(B) SAVINGS PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 1,737
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 1,617
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 282
Total of all active and inactive participants 2011-01-01 1,899
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 1,899
Number of participants with account balances 2011-01-01 1,286
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: THE MARTHA JEFFERSON HOSPITAL 403(B) SAVINGS PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 1,619
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 1,585
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 186
Total of all active and inactive participants 2009-01-01 1,771
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 1,771
Number of participants with account balances 2009-01-01 1,039
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 4

Measure	Date	Value
2016: THE MARTHA JEFFERSON HOSPITAL 403(B) SAVINGS PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	399
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	0
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	0
Total participants	2016-01-01	0
Number of participants with account balances	2016-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: THE MARTHA JEFFERSON HOSPITAL 403(B) SAVINGS PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	434
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	194
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	205
Total of all active and inactive participants	2015-01-01	399
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	399
Number of participants with account balances	2015-01-01	399
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: THE MARTHA JEFFERSON HOSPITAL 403(B) SAVINGS PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	2,094
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	224
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	209
Total of all active and inactive participants	2014-01-01	433
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	1
Total participants	2014-01-01	434
Number of participants with account balances	2014-01-01	434
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: THE MARTHA JEFFERSON HOSPITAL 403(B) SAVINGS PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	1,967
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	1,719
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	375
Total of all active and inactive participants	2013-01-01	2,094
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	2,094
Number of participants with account balances	2013-01-01	1,538
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: THE MARTHA JEFFERSON HOSPITAL 403(B) SAVINGS PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	1,838
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	1,693
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	324
Total of all active and inactive participants	2012-01-01	2,017
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	2,017
Number of participants with account balances	2012-01-01	1,442
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: THE MARTHA JEFFERSON HOSPITAL 403(B) SAVINGS PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	1,737
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	1,617
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	282
Total of all active and inactive participants	2011-01-01	1,899
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	1,899
Number of participants with account balances	2011-01-01	1,286
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: THE MARTHA JEFFERSON HOSPITAL 403(B) SAVINGS PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	1,619
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	1,585
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	186
Total of all active and inactive participants	2009-01-01	1,771
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	1,771
Number of participants with account balances	2009-01-01	1,039
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	4

Financial Data on THE MARTHA JEFFERSON HOSPITAL 403(B) SAVINGS PLAN

Measure	Date	Value
2016 : THE MARTHA JEFFERSON HOSPITAL 403(B) SAVINGS PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total transfer of assets from this plan	2016-12-31	$15,093,609
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	$1,296,829
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$1,604,394
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$1,598,824
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$21,603
Value of total assets at end of year	2016-12-31	$0
Value of total assets at beginning of year	2016-12-31	$15,401,174
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$5,570
Total interest from all sources	2016-12-31	$83,762
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$32,356
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	$32,356
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$5,000,000
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
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$21,603
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	$-307,565
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$15,401,174
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	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$13,026,350
Interest earned on other investments	2016-12-31	$83,762
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$2,374,824
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$1,159,108
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$1,598,824
Contract administrator fees	2016-12-31	$5,570
Did the plan have assets held for investment	2016-12-31	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	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	Yes
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	CHARLES W SNADER, PC
Accountancy firm EIN	2016-12-31	541873714
2015 : THE MARTHA JEFFERSON HOSPITAL 403(B) SAVINGS PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$-131,045
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$2,329,163
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$2,323,128
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$25,375
Value of total assets at end of year	2015-12-31	$15,401,174
Value of total assets at beginning of year	2015-12-31	$17,861,382
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$6,035
Total interest from all sources	2015-12-31	$88,739
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$20,350
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$20,350
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$5,000,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$25,375
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$-2,460,208
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$15,401,174
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$17,861,382
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$13,026,350
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$15,328,894
Interest earned on other investments	2015-12-31	$88,739
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$2,374,824
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$2,532,488
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-265,509
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$2,323,128
Contract administrator fees	2015-12-31	$6,035
Did the plan have assets held for investment	2015-12-31	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	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	CHARLES W SNADER, PC
Accountancy firm EIN	2015-12-31	541873714
2014 : THE MARTHA JEFFERSON HOSPITAL 403(B) SAVINGS PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$1,519,186
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$2,724,673
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$2,717,612
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$268,547
Value of total assets at end of year	2014-12-31	$17,861,382
Value of total assets at beginning of year	2014-12-31	$19,066,869
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$7,061
Total interest from all sources	2014-12-31	$92,869
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$24,485
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$24,485
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$4,000,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$268,547
Administrative expenses (other) incurred	2014-12-31	$191
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$-1,205,487
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$17,861,382
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$19,066,869
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$15,328,894
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$16,179,978
Interest earned on other investments	2014-12-31	$92,869
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$2,532,488
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$2,886,891
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$1,133,285
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$2,717,612
Contract administrator fees	2014-12-31	$6,870
Did the plan have assets held for investment	2014-12-31	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	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	CHARLES W SNADER, PC
Accountancy firm EIN	2014-12-31	541873714
2013 : THE MARTHA JEFFERSON HOSPITAL 403(B) SAVINGS PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total transfer of assets from this plan	2013-12-31	$47,152,876
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$15,639,423
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$5,046,724
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$4,909,098
Expenses. Certain deemed distributions of participant loans	2013-12-31	$10,912
Value of total corrective distributions	2013-12-31	$6,638
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$4,801,649
Value of total assets at end of year	2013-12-31	$19,066,869
Value of total assets at beginning of year	2013-12-31	$55,627,046
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$120,076
Total interest from all sources	2013-12-31	$220,483
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$1,081,601
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-12-31	$1,081,601
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$4,000,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$4,692,447
Participant contributions at end of year	2013-12-31	$0
Participant contributions at beginning of year	2013-12-31	$421,710
Assets. Other investments not covered elsewhere at end of year	2013-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2013-12-31	$776,557
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$109,202
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$10,592,699
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$19,066,869
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$55,627,046
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$16,179,978
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$47,387,625
Interest on participant loans	2013-12-31	$20,581
Interest earned on other investments	2013-12-31	$199,902
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2013-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2013-12-31	$21,048
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2013-12-31	$21,048
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$2,886,891
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$7,020,106
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$9,535,690
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$4,909,098
Contract administrator fees	2013-12-31	$120,076
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2013-12-31	No
Did the plan have assets held for investment	2013-12-31	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	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	HANTZMON WIEBEL, LLP
Accountancy firm EIN	2013-12-31	540618213
2012 : THE MARTHA JEFFERSON HOSPITAL 403(B) SAVINGS PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$11,338,914
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$3,377,248
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$3,279,020
Expenses. Certain deemed distributions of participant loans	2012-12-31	$-3,945
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$5,580,143
Value of total assets at end of year	2012-12-31	$55,627,046
Value of total assets at beginning of year	2012-12-31	$47,665,380
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$102,173
Total interest from all sources	2012-12-31	$214,122
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$954,855
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-12-31	$954,855
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$3,000,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$4,573,457
Participant contributions at end of year	2012-12-31	$421,710
Participant contributions at beginning of year	2012-12-31	$322,953
Assets. Other investments not covered elsewhere at end of year	2012-12-31	$776,557
Assets. Other investments not covered elsewhere at beginning of year	2012-12-31	$525,385
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$1,003,878
Administrative expenses (other) incurred	2012-12-31	$63
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$7,961,666
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$55,627,046
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$47,665,380
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$47,387,625
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$40,565,713
Interest on participant loans	2012-12-31	$15,439
Interest earned on other investments	2012-12-31	$198,683
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-12-31	$21,048
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-12-31	$24,213
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-12-31	$24,213
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$7,020,106
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$6,227,116
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$4,589,794
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$2,808
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$3,279,020
Contract administrator fees	2012-12-31	$102,110
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2012-12-31	No
Did the plan have assets held for investment	2012-12-31	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	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	HANTZMON WIEBEL LLP
Accountancy firm EIN	2012-12-31	540618213
2011 : THE MARTHA JEFFERSON HOSPITAL 403(B) SAVINGS PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$4,590,533
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$2,625,372
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$2,510,602
Expenses. Certain deemed distributions of participant loans	2011-12-31	$27,002
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$4,881,170
Value of total assets at end of year	2011-12-31	$47,665,380
Value of total assets at beginning of year	2011-12-31	$45,700,219
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$87,768
Total interest from all sources	2011-12-31	$218,633
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$750,649
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2011-12-31	$750,649
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$3,000,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$4,015,825
Assets. Other investments not covered elsewhere at end of year	2011-12-31	$525,385
Assets. Other investments not covered elsewhere at beginning of year	2011-12-31	$459,749
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$865,345
Assets. Loans (other than to participants) at end of year	2011-12-31	$322,953
Assets. Loans (other than to participants) at beginning of year	2011-12-31	$262,249
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2011-12-31	$0
Administrative expenses (other) incurred	2011-12-31	$4
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$1,965,161
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$47,665,380
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$45,700,219
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$40,565,713
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$39,211,165
Interest on participant loans	2011-12-31	$13,071
Interest earned on other investments	2011-12-31	$205,562
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-12-31	$24,213
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-12-31	$436
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-12-31	$436
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$6,227,116
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$5,766,620
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-1,259,919
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$2,510,602
Contract administrator fees	2011-12-31	$87,764
Did the plan have assets held for investment	2011-12-31	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	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	HANTZMON WIEBEL LLP
Accountancy firm EIN	2011-12-31	540618213
2010 : THE MARTHA JEFFERSON HOSPITAL 403(B) SAVINGS PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$18,468
Total income from all sources (including contributions)	2010-12-31	$9,838,047
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$2,209,028
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$1,987,239
Expenses. Certain deemed distributions of participant loans	2010-12-31	$46,909
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$4,409,271
Value of total assets at end of year	2010-12-31	$45,700,219
Value of total assets at beginning of year	2010-12-31	$38,089,668
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$174,880
Total interest from all sources	2010-12-31	$203,918
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$556,839
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2010-12-31	$556,839
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$3,000,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$3,794,348
Assets. Other investments not covered elsewhere at end of year	2010-12-31	$459,749
Assets. Other investments not covered elsewhere at beginning of year	2010-12-31	$408,415
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$614,923
Assets. Loans (other than to participants) at end of year	2010-12-31	$262,249
Assets. Loans (other than to participants) at beginning of year	2010-12-31	$178,696
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2010-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2010-12-31	$18,468
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$7,629,019
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$45,700,219
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$38,071,200
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Investment advisory and management fees	2010-12-31	$11,612
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$39,211,165
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$32,373,506
Interest on participant loans	2010-12-31	$9,101
Interest earned on other investments	2010-12-31	$194,817
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2010-12-31	$436
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2010-12-31	$29,151
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2010-12-31	$29,151
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$5,766,620
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$5,099,900
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$4,668,019
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$1,987,239
Contract administrator fees	2010-12-31	$163,268
Did the plan have assets held for investment	2010-12-31	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	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	HANTZMON WIEBEL LLP
Accountancy firm EIN	2010-12-31	540618213

Form 5500 Responses for THE MARTHA JEFFERSON HOSPITAL 403(B) SAVINGS PLAN

2016: THE MARTHA JEFFERSON HOSPITAL 403(B) SAVINGS 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	Yes
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
2015: THE MARTHA JEFFERSON HOSPITAL 403(B) SAVINGS PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: THE MARTHA JEFFERSON HOSPITAL 403(B) SAVINGS PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: THE MARTHA JEFFERSON HOSPITAL 403(B) SAVINGS PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: THE MARTHA JEFFERSON HOSPITAL 403(B) SAVINGS PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: THE MARTHA JEFFERSON HOSPITAL 403(B) SAVINGS PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: THE MARTHA JEFFERSON HOSPITAL 403(B) SAVINGS PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

CR24908

Policy instance

Insurance contract or identification number	CR24908
Number of Individuals Covered	384
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $19,943
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $19,943
Insurance broker organization code?	4
Insurance broker name	LINCOLN FINANCIAL ADVISORS

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

CR24908

Policy instance

Insurance contract or identification number	CR24908
Number of Individuals Covered	419
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $42,917
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $42,917
Insurance broker organization code?	4
Insurance broker name	LINCOLN FINANCIAL ADVISORS

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )

Policy contract number

67977

Policy instance

Insurance contract or identification number	67977
Number of Individuals Covered	1549
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
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?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare 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

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

CR24908

Policy instance

Insurance contract or identification number	CR24908
Number of Individuals Covered	462
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $44,445
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $44,445
Insurance broker organization code?	4
Insurance broker name	LINCOLN FINANCIAL ADVISORS

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

CR32433

Policy instance

Insurance contract or identification number	CR32433
Number of Individuals Covered	396
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $4,662
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $4,662
Insurance broker organization code?	4
Insurance broker name	LINCOLN FINANCIAL ADVISORS

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )

Policy contract number

67977

Policy instance

Insurance contract or identification number	67977
Number of Individuals Covered	1450
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
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?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare 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

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

CR32433

Policy instance

Insurance contract or identification number	CR32433
Number of Individuals Covered	424
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $3,698
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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
Commission paid to Insurance Broker	USD $3,698
Insurance broker organization code?	4
Insurance broker name	LINCOLN FINANCIAL ADVISORS

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

CR24908

Policy instance

Insurance contract or identification number	CR24908
Number of Individuals Covered	494
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $41,777
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $41,777
Insurance broker organization code?	4
Insurance broker name	LINCOLN FINANCIAL ADVISORS

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

CR24908

Policy instance

Insurance contract or identification number	CR24908
Number of Individuals Covered	528
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $33,131
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare 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

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

CR32433

Policy instance

Insurance contract or identification number	CR32433
Number of Individuals Covered	447
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $139
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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?	No
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

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )

Policy contract number

67977

Policy instance

Insurance contract or identification number	67977
Number of Individuals Covered	1279
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
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?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare 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

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

CR24908

Policy instance

Insurance contract or identification number	CR24908
Number of Individuals Covered	560
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $24,584
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare 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 $24,584
Insurance broker organization code?	4
Insurance broker name	LINCOLN FINANCIAL ADVISORS

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

CR32433

Policy instance

Insurance contract or identification number	CR32433
Number of Individuals Covered	468
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
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?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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?	No
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

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )

Policy contract number

67977

Policy instance

Insurance contract or identification number	67977
Number of Individuals Covered	1124
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
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?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare 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:	MARTHA JEFFERSON HOSPITAL
Employer identification number (EIN):	540261840
NAIC Classification:	622000
NAIC Description:	Hospitals

Jurisdiction of Incorporation:	Virginia Secretary of State
Incorporation Date:	1929-12-16
Company Identification Number:	0035022
Legal Registered Office Address:	MARTHA JEFFERSON HOSPITAL CHARLOTTESVILLE United States of America (USA) 22911