401k Plan data: KERSHAWHEALTH 403B RETIREMENT PLAN plan

KERSHAWHEALTH 403B RETIREMENT PLAN 401k Plan overview

Plan Name	KERSHAWHEALTH 403B RETIREMENT PLAN
Plan identification number	002

KERSHAWHEALTH 403B RETIREMENT 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)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
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.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Plan not intended to be qualified - A plan not intended to be qualified under Code sections 401, 403, or 408.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

KERSHAWHEALTH has sponsored the creation of one or more 401k plans.

Company Name: KERSHAWHEALTH

Employer identification number (EIN): 576005963

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan KERSHAWHEALTH 403B RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2022-01-01
002 2021-01-01
002 2020-01-01
002 2019-01-01
002 2018-01-01
002 2017-01-01 MARC A. QUIGLEY
002 2016-01-01 MARC A. QUIGLEY MARC A. QUIGLEY 2017-10-16
002 2015-01-01 MARC A. QUIGLEY MARC A. QUIGLEY 2016-10-17
002 2014-01-01 ANGELA NETTLES ANGELA NETTLES 2015-09-30
002 2013-01-01 ANGELA NETTLES ANGELA NETTLES 2015-03-23
002 2012-01-01 ANGELA NETTLES ANGELA NETTLES 2015-03-23
002 2011-01-01 ANGELA NETTLES ANGELA NETTLES 2015-03-23
002 2010-01-01 ANGELA NETTLES ANGELA NETTLES 2011-10-10
002 2009-01-01 ANGELA NETTLES ANGELA NETTLES 2010-10-04
002 2009-01-01 ANGELA NETTLES ANGELA NETTLES 2011-08-02

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
002	2022-01-01
002	2021-01-01
002	2020-01-01
002	2019-01-01
002	2018-01-01
002	2017-01-01	MARC A. QUIGLEY
002	2016-01-01	MARC A. QUIGLEY	MARC A. QUIGLEY	2017-10-16
002	2015-01-01	MARC A. QUIGLEY	MARC A. QUIGLEY	2016-10-17
002	2014-01-01	ANGELA NETTLES	ANGELA NETTLES	2015-09-30
002	2013-01-01	ANGELA NETTLES	ANGELA NETTLES	2015-03-23
002	2012-01-01	ANGELA NETTLES	ANGELA NETTLES	2015-03-23
002	2011-01-01	ANGELA NETTLES	ANGELA NETTLES	2015-03-23
002	2010-01-01	ANGELA NETTLES	ANGELA NETTLES	2011-10-10
002	2009-01-01	ANGELA NETTLES	ANGELA NETTLES	2010-10-04
002	2009-01-01	ANGELA NETTLES	ANGELA NETTLES	2011-08-02

Plan Statistics for KERSHAWHEALTH 403B RETIREMENT PLAN

401k plan membership statisitcs for KERSHAWHEALTH 403B RETIREMENT PLAN

Measure Date Value
2022: KERSHAWHEALTH 403B RETIREMENT PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 149
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 1
Number of retired or separated participants receiving benefits 2022-01-01 18
Number of other retired or separated participants entitled to future benefits 2022-01-01 119
Total of all active and inactive participants 2022-01-01 138
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 138
Number of participants with account balances 2022-01-01 138
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: KERSHAWHEALTH 403B RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 160
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 1
Number of retired or separated participants receiving benefits 2021-01-01 15
Number of other retired or separated participants entitled to future benefits 2021-01-01 133
Total of all active and inactive participants 2021-01-01 149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 149
Number of participants with account balances 2021-01-01 149
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: KERSHAWHEALTH 403B RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 172
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 1
Number of retired or separated participants receiving benefits 2020-01-01 16
Number of other retired or separated participants entitled to future benefits 2020-01-01 143
Total of all active and inactive participants 2020-01-01 160
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 160
Number of participants with account balances 2020-01-01 160
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: KERSHAWHEALTH 403B RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 196
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 1
Number of retired or separated participants receiving benefits 2019-01-01 16
Number of other retired or separated participants entitled to future benefits 2019-01-01 155
Total of all active and inactive participants 2019-01-01 172
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 172
Number of participants with account balances 2019-01-01 172
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: KERSHAWHEALTH 403B RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 219
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 1
Number of retired or separated participants receiving benefits 2018-01-01 18
Number of other retired or separated participants entitled to future benefits 2018-01-01 177
Total of all active and inactive participants 2018-01-01 196
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 196
Number of participants with account balances 2018-01-01 196
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: KERSHAWHEALTH 403B RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 258
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 0
Number of retired or separated participants receiving benefits 2017-01-01 20
Number of other retired or separated participants entitled to future benefits 2017-01-01 198
Total of all active and inactive participants 2017-01-01 218
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 218
Number of participants with account balances 2017-01-01 218
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: KERSHAWHEALTH 403B RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 344
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 20
Number of other retired or separated participants entitled to future benefits 2016-01-01 238
Total of all active and inactive participants 2016-01-01 258
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 258
Number of participants with account balances 2016-01-01 258
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: KERSHAWHEALTH 403B RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 1,151
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 1
Number of retired or separated participants receiving benefits 2015-01-01 19
Number of other retired or separated participants entitled to future benefits 2015-01-01 324
Total of all active and inactive participants 2015-01-01 344
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 344
Number of participants with account balances 2015-01-01 343
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 2
2014: KERSHAWHEALTH 403B RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 1,174
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 987
Number of retired or separated participants receiving benefits 2014-01-01 17
Number of other retired or separated participants entitled to future benefits 2014-01-01 145
Total of all active and inactive participants 2014-01-01 1,149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 1,149
Number of participants with account balances 2014-01-01 706
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 16
2013: KERSHAWHEALTH 403B RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 1,173
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 1,023
Number of retired or separated participants receiving benefits 2013-01-01 12
Number of other retired or separated participants entitled to future benefits 2013-01-01 138
Total of all active and inactive participants 2013-01-01 1,173
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 1
Total participants 2013-01-01 1,174
Number of participants with account balances 2013-01-01 705
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 13
2012: KERSHAWHEALTH 403B RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 1,139
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 996
Number of other retired or separated participants entitled to future benefits 2012-01-01 164
Total of all active and inactive participants 2012-01-01 1,160
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 1
Total participants 2012-01-01 1,161
Number of participants with account balances 2012-01-01 712
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 8
2011: KERSHAWHEALTH 403B RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 1,199
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 993
Number of retired or separated participants receiving benefits 2011-01-01 12
Number of other retired or separated participants entitled to future benefits 2011-01-01 131
Total of all active and inactive participants 2011-01-01 1,136
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 1,136
Number of participants with account balances 2011-01-01 724
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 19
2010: KERSHAWHEALTH 403B RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 1,214
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 1,140
Number of retired or separated participants receiving benefits 2010-01-01 10
Number of other retired or separated participants entitled to future benefits 2010-01-01 88
Total of all active and inactive participants 2010-01-01 1,238
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 1,238
Number of participants with account balances 2010-01-01 716
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 14
2009: KERSHAWHEALTH 403B RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 1,116
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 1,131
Number of other retired or separated participants entitled to future benefits 2009-01-01 83
Total of all active and inactive participants 2009-01-01 1,214
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 1,214
Number of participants with account balances 2009-01-01 681
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 13

Measure	Date	Value
2022: KERSHAWHEALTH 403B RETIREMENT PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	149
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	1
Number of retired or separated participants receiving benefits	2022-01-01	18
Number of other retired or separated participants entitled to future benefits	2022-01-01	119
Total of all active and inactive participants	2022-01-01	138
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	138
Number of participants with account balances	2022-01-01	138
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: KERSHAWHEALTH 403B RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	160
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	1
Number of retired or separated participants receiving benefits	2021-01-01	15
Number of other retired or separated participants entitled to future benefits	2021-01-01	133
Total of all active and inactive participants	2021-01-01	149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	149
Number of participants with account balances	2021-01-01	149
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: KERSHAWHEALTH 403B RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	172
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	1
Number of retired or separated participants receiving benefits	2020-01-01	16
Number of other retired or separated participants entitled to future benefits	2020-01-01	143
Total of all active and inactive participants	2020-01-01	160
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	160
Number of participants with account balances	2020-01-01	160
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: KERSHAWHEALTH 403B RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	196
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	1
Number of retired or separated participants receiving benefits	2019-01-01	16
Number of other retired or separated participants entitled to future benefits	2019-01-01	155
Total of all active and inactive participants	2019-01-01	172
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	172
Number of participants with account balances	2019-01-01	172
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: KERSHAWHEALTH 403B RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	219
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	1
Number of retired or separated participants receiving benefits	2018-01-01	18
Number of other retired or separated participants entitled to future benefits	2018-01-01	177
Total of all active and inactive participants	2018-01-01	196
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	196
Number of participants with account balances	2018-01-01	196
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: KERSHAWHEALTH 403B RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	258
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	0
Number of retired or separated participants receiving benefits	2017-01-01	20
Number of other retired or separated participants entitled to future benefits	2017-01-01	198
Total of all active and inactive participants	2017-01-01	218
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	218
Number of participants with account balances	2017-01-01	218
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: KERSHAWHEALTH 403B RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	344
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	20
Number of other retired or separated participants entitled to future benefits	2016-01-01	238
Total of all active and inactive participants	2016-01-01	258
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	258
Number of participants with account balances	2016-01-01	258
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: KERSHAWHEALTH 403B RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	1,151
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	1
Number of retired or separated participants receiving benefits	2015-01-01	19
Number of other retired or separated participants entitled to future benefits	2015-01-01	324
Total of all active and inactive participants	2015-01-01	344
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	344
Number of participants with account balances	2015-01-01	343
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	2
2014: KERSHAWHEALTH 403B RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	1,174
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	987
Number of retired or separated participants receiving benefits	2014-01-01	17
Number of other retired or separated participants entitled to future benefits	2014-01-01	145
Total of all active and inactive participants	2014-01-01	1,149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	1,149
Number of participants with account balances	2014-01-01	706
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	16
2013: KERSHAWHEALTH 403B RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	1,173
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	1,023
Number of retired or separated participants receiving benefits	2013-01-01	12
Number of other retired or separated participants entitled to future benefits	2013-01-01	138
Total of all active and inactive participants	2013-01-01	1,173
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	1
Total participants	2013-01-01	1,174
Number of participants with account balances	2013-01-01	705
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	13
2012: KERSHAWHEALTH 403B RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	1,139
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	996
Number of other retired or separated participants entitled to future benefits	2012-01-01	164
Total of all active and inactive participants	2012-01-01	1,160
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	1
Total participants	2012-01-01	1,161
Number of participants with account balances	2012-01-01	712
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	8
2011: KERSHAWHEALTH 403B RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	1,199
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	993
Number of retired or separated participants receiving benefits	2011-01-01	12
Number of other retired or separated participants entitled to future benefits	2011-01-01	131
Total of all active and inactive participants	2011-01-01	1,136
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	1,136
Number of participants with account balances	2011-01-01	724
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	19
2010: KERSHAWHEALTH 403B RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	1,214
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	1,140
Number of retired or separated participants receiving benefits	2010-01-01	10
Number of other retired or separated participants entitled to future benefits	2010-01-01	88
Total of all active and inactive participants	2010-01-01	1,238
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	1,238
Number of participants with account balances	2010-01-01	716
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	14
2009: KERSHAWHEALTH 403B RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	1,116
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	1,131
Number of other retired or separated participants entitled to future benefits	2009-01-01	83
Total of all active and inactive participants	2009-01-01	1,214
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	1,214
Number of participants with account balances	2009-01-01	681
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	13

Financial Data on KERSHAWHEALTH 403B RETIREMENT PLAN

Measure	Date	Value
2022 : KERSHAWHEALTH 403B RETIREMENT PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total income from all sources (including contributions)	2022-12-31	$-1,499,285
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$760,313
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$725,692
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$7,026
Value of total assets at end of year	2022-12-31	$7,472,162
Value of total assets at beginning of year	2022-12-31	$9,731,760
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$34,621
Total interest from all sources	2022-12-31	$137
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$231,043
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-12-31	$231,043
Administrative expenses professional fees incurred	2022-12-31	$17,430
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$500,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$3,513
Other income not declared elsewhere	2022-12-31	$9,089
Total non interest bearing cash at end of year	2022-12-31	$14,585
Total non interest bearing cash at beginning of year	2022-12-31	$30,201
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$-2,259,598
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$7,472,162
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$9,731,760
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$6,902,355
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$9,078,393
Value of interest in pooled separate accounts at end of year	2022-12-31	$457,629
Value of interest in pooled separate accounts at beginning of year	2022-12-31	$528,368
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2022-12-31	$137
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$97,593
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$94,798
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-1,680,655
Net investment gain or loss from common/collective trusts	2022-12-31	$-65,925
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$3,513
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$725,692
Contract administrator fees	2022-12-31	$17,191
Did the plan have assets held for investment	2022-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	FORVIS, LLP
Accountancy firm EIN	2022-12-31	440160260
2021 : KERSHAWHEALTH 403B RETIREMENT PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$1,198,979
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$1,322,375
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$1,284,352
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$6,614
Value of total assets at end of year	2021-12-31	$9,731,760
Value of total assets at beginning of year	2021-12-31	$9,855,156
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$38,023
Total interest from all sources	2021-12-31	$2,761
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$274,497
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2021-12-31	$274,497
Administrative expenses professional fees incurred	2021-12-31	$34,078
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$3,307
Other income not declared elsewhere	2021-12-31	$9,782
Administrative expenses (other) incurred	2021-12-31	$3,945
Total non interest bearing cash at end of year	2021-12-31	$30,201
Total non interest bearing cash at beginning of year	2021-12-31	$49,063
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$-123,396
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$9,731,760
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$9,855,156
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$9,078,393
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$9,243,281
Value of interest in pooled separate accounts at end of year	2021-12-31	$528,368
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$483,246
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2021-12-31	$2,761
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$94,798
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$79,566
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$838,236
Net investment gain or loss from common/collective trusts	2021-12-31	$67,089
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$3,307
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$1,284,352
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	FORVIS, LLP
Accountancy firm EIN	2021-12-31	440160260
2020 : KERSHAWHEALTH 403B RETIREMENT PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$1,291,685
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$1,364,625
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$1,338,308
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$6,320
Value of total assets at end of year	2020-12-31	$9,855,156
Value of total assets at beginning of year	2020-12-31	$9,928,096
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$26,317
Total interest from all sources	2020-12-31	$136
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$236,113
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-31	$236,113
Administrative expenses professional fees incurred	2020-12-31	$22,409
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$3,160
Other income not declared elsewhere	2020-12-31	$8,220
Administrative expenses (other) incurred	2020-12-31	$3,908
Total non interest bearing cash at end of year	2020-12-31	$49,063
Total non interest bearing cash at beginning of year	2020-12-31	$48,481
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$-72,940
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$9,855,156
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$9,928,096
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$9,243,281
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$9,279,630
Value of interest in pooled separate accounts at end of year	2020-12-31	$483,246
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$509,399
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2020-12-31	$136
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$79,566
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$90,586
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$990,868
Net investment gain or loss from common/collective trusts	2020-12-31	$50,028
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$3,160
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$1,338,308
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	DIXON HUGHES GOODMAN LLP
Accountancy firm EIN	2020-12-31	560747981
2019 : KERSHAWHEALTH 403B RETIREMENT PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$1,688,277
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$601,867
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$591,819
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$6,130
Value of total assets at end of year	2019-12-31	$9,928,096
Value of total assets at beginning of year	2019-12-31	$8,841,686
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$10,048
Total interest from all sources	2019-12-31	$137
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$262,583
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$262,583
Administrative expenses professional fees incurred	2019-12-31	$10,048
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$3,065
Other income not declared elsewhere	2019-12-31	$8,545
Total non interest bearing cash at end of year	2019-12-31	$48,481
Total non interest bearing cash at beginning of year	2019-12-31	$28,547
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$1,086,410
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$9,928,096
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$8,841,686
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$9,279,630
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$8,278,853
Value of interest in pooled separate accounts at end of year	2019-12-31	$509,399
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$435,844
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-31	$137
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$90,586
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$87,364
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$1,325,751
Net investment gain or loss from common/collective trusts	2019-12-31	$85,131
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$3,065
Employer contributions (assets) at beginning of year	2019-12-31	$11,078
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$591,819
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	DIXON HUGHES GOODMAN LLP
Accountancy firm EIN	2019-12-31	560747981
2018 : KERSHAWHEALTH 403B RETIREMENT PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$7,487
Total income from all sources (including contributions)	2018-12-31	$-364,689
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$1,023,020
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$1,002,906
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$13,164
Value of total assets at end of year	2018-12-31	$8,841,686
Value of total assets at beginning of year	2018-12-31	$10,236,882
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$20,114
Total interest from all sources	2018-12-31	$124
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$736,625
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2018-12-31	$736,625
Administrative expenses professional fees incurred	2018-12-31	$20,114
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$500,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$1,043
Other income not declared elsewhere	2018-12-31	$11,538
Total non interest bearing cash at end of year	2018-12-31	$28,547
Total non interest bearing cash at beginning of year	2018-12-31	$21,856
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$-1,387,709
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$8,841,686
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$10,229,395
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$8,278,853
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$9,413,343
Value of interest in pooled separate accounts at end of year	2018-12-31	$435,844
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$716,421
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2018-12-31	$124
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$87,364
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$85,262
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-1,091,154
Net investment gain or loss from common/collective trusts	2018-12-31	$-34,986
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$12,121
Employer contributions (assets) at end of year	2018-12-31	$11,078
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$1,002,906
Liabilities. Value of benefit claims payable at beginning of year	2018-12-31	$7,487
Did the plan have assets held for investment	2018-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	DIXON HUGHES GOODMAN LLP
Accountancy firm EIN	2018-12-31	560747981
2017 : KERSHAWHEALTH 403B RETIREMENT PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$7,487
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$12,041
Total income from all sources (including contributions)	2017-12-31	$1,405,941
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$1,218,188
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$1,184,901
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$0
Value of total assets at end of year	2017-12-31	$10,236,882
Value of total assets at beginning of year	2017-12-31	$10,053,683
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$33,287
Total interest from all sources	2017-12-31	$122
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$347,904
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$347,904
Administrative expenses professional fees incurred	2017-12-31	$33,252
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$500,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Other income not declared elsewhere	2017-12-31	$10,667
Administrative expenses (other) incurred	2017-12-31	$35
Liabilities. Value of operating payables at beginning of year	2017-12-31	$4,764
Total non interest bearing cash at end of year	2017-12-31	$21,856
Total non interest bearing cash at beginning of year	2017-12-31	$23,697
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$187,753
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$10,229,395
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$10,041,642
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$9,413,343
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$9,308,380
Value of interest in pooled separate accounts at end of year	2017-12-31	$716,421
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$622,766
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2017-12-31	$122
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$85,262
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$98,840
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$953,558
Net investment gain or loss from common/collective trusts	2017-12-31	$93,690
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$1,184,901
Liabilities. Value of benefit claims payable at end of year	2017-12-31	$7,487
Liabilities. Value of benefit claims payable at beginning of year	2017-12-31	$7,277
Did the plan have assets held for investment	2017-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	DIXON HUGHES GOODMAN LLP
Accountancy firm EIN	2017-12-31	560747981
2016 : KERSHAWHEALTH 403B RETIREMENT PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$12,041
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$6,000
Total income from all sources (including contributions)	2016-12-31	$692,277
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$2,461,832
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$2,444,905
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$0
Value of total assets at end of year	2016-12-31	$10,053,683
Value of total assets at beginning of year	2016-12-31	$11,817,197
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$16,927
Total interest from all sources	2016-12-31	$394
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$214,561
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	$214,561
Administrative expenses professional fees incurred	2016-12-31	$16,889
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$500,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Participant contributions at beginning of year	2016-12-31	$34,704
Other income not declared elsewhere	2016-12-31	$16,584
Administrative expenses (other) incurred	2016-12-31	$38
Liabilities. Value of operating payables at end of year	2016-12-31	$4,764
Total non interest bearing cash at end of year	2016-12-31	$23,697
Total non interest bearing cash at beginning of year	2016-12-31	$42,176
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	$-1,769,555
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$10,041,642
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$11,811,197
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	$9,308,380
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$11,041,138
Value of interest in pooled separate accounts at end of year	2016-12-31	$622,766
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$601,197
Interest on participant loans	2016-12-31	$277
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2016-12-31	$117
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$98,840
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$97,982
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$410,481
Net investment gain or loss from common/collective trusts	2016-12-31	$50,257
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	$2,444,905
Liabilities. Value of benefit claims payable at end of year	2016-12-31	$7,277
Liabilities. Value of benefit claims payable at beginning of year	2016-12-31	$6,000
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	DIXON-HUGHES GOODMAN LLP
Accountancy firm EIN	2016-12-31	560747981
2015 : KERSHAWHEALTH 403B RETIREMENT 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	$6,000
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	$2,214,476
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$18,318,984
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$18,290,224
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$2,315,735
Value of total assets at end of year	2015-12-31	$11,817,197
Value of total assets at beginning of year	2015-12-31	$27,915,705
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$28,760
Total interest from all sources	2015-12-31	$40,203
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$508,835
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	$508,835
Administrative expenses professional fees incurred	2015-12-31	$28,760
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$500,000
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
Contributions received from participants	2015-12-31	$1,390,493
Participant contributions at end of year	2015-12-31	$34,704
Participant contributions at beginning of year	2015-12-31	$1,104,194
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$48,005
Other income not declared elsewhere	2015-12-31	$815
Total non interest bearing cash at end of year	2015-12-31	$42,176
Total non interest bearing cash at beginning of year	2015-12-31	$2,348
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	$-16,104,508
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$11,811,197
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$27,915,705
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	$11,041,138
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$26,043,039
Value of interest in pooled separate accounts at end of year	2015-12-31	$601,197
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$670,023
Interest on participant loans	2015-12-31	$36,882
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2015-12-31	$3,321
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$97,982
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$96,101
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-651,112
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
Contributions received in cash from employer	2015-12-31	$877,237
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$18,290,224
Liabilities. Value of benefit claims payable at end of year	2015-12-31	$6,000
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	DIXON-HUGHES GOODMAN LLP
Accountancy firm EIN	2015-12-31	560747981
2014 : KERSHAWHEALTH 403B RETIREMENT 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	$4,426,842
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$3,402,753
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$3,383,113
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$2,789,854
Value of total assets at end of year	2014-12-31	$27,915,705
Value of total assets at beginning of year	2014-12-31	$26,891,616
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$19,640
Total interest from all sources	2014-12-31	$44,615
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Administrative expenses professional fees incurred	2014-12-31	$19,640
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$500,000
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
Contributions received from participants	2014-12-31	$1,639,704
Participant contributions at end of year	2014-12-31	$1,104,194
Participant contributions at beginning of year	2014-12-31	$1,027,161
Participant contributions at beginning of year	2014-12-31	$190
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$146,498
Other income not declared elsewhere	2014-12-31	$-23,438
Total non interest bearing cash at end of year	2014-12-31	$2,348
Total non interest bearing cash at beginning of year	2014-12-31	$44,372
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	$1,024,089
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$27,915,705
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$26,891,616
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	$26,043,039
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$25,004,618
Value of interest in pooled separate accounts at end of year	2014-12-31	$670,023
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$719,906
Interest on participant loans	2014-12-31	$44,615
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$96,101
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$95,332
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$1,615,811
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
Contributions received in cash from employer	2014-12-31	$1,003,652
Employer contributions (assets) at beginning of year	2014-12-31	$37
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$3,383,113
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	DIXON HUGHES GOODMAN LLP
Accountancy firm EIN	2014-12-31	560747981
2013 : KERSHAWHEALTH 403B RETIREMENT PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
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	$6,166,728
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$2,331,403
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$2,307,469
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$2,797,475
Value of total assets at end of year	2013-12-31	$26,891,616
Value of total assets at beginning of year	2013-12-31	$23,056,291
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$23,934
Total interest from all sources	2013-12-31	$39,450
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Administrative expenses professional fees incurred	2013-12-31	$23,934
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$500,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$1,626,204
Participant contributions at end of year	2013-12-31	$1,027,161
Participant contributions at beginning of year	2013-12-31	$902,374
Participant contributions at end of year	2013-12-31	$190
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$150,007
Other income not declared elsewhere	2013-12-31	$23,295
Total non interest bearing cash at end of year	2013-12-31	$44,372
Total non interest bearing cash at beginning of year	2013-12-31	$19,320
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	$3,835,325
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$26,891,616
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$23,056,291
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	$25,004,618
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$21,429,545
Value of interest in pooled separate accounts at end of year	2013-12-31	$719,906
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$612,111
Interest on participant loans	2013-12-31	$39,450
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$95,332
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$92,941
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$3,306,508
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
Contributions received in cash from employer	2013-12-31	$1,021,264
Employer contributions (assets) at end of year	2013-12-31	$37
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$2,307,469
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	DIXON HUGHES GOODMAN LLP
Accountancy firm EIN	2013-12-31	560747981
2012 : KERSHAWHEALTH 403B RETIREMENT 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	$5,140,801
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$2,504,218
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$2,493,924
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$2,883,884
Value of total assets at end of year	2012-12-31	$23,056,291
Value of total assets at beginning of year	2012-12-31	$20,419,708
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$10,294
Total interest from all sources	2012-12-31	$31,823
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Administrative expenses professional fees incurred	2012-12-31	$10,294
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$500,000
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	$1,627,585
Participant contributions at end of year	2012-12-31	$902,374
Participant contributions at beginning of year	2012-12-31	$781,405
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$223,204
Other income not declared elsewhere	2012-12-31	$138
Total non interest bearing cash at end of year	2012-12-31	$19,320
Total non interest bearing cash at beginning of year	2012-12-31	$27,591
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	$2,636,583
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$23,056,291
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$20,419,708
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	$21,429,545
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$18,923,045
Value of interest in pooled separate accounts at end of year	2012-12-31	$612,111
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$579,389
Interest on participant loans	2012-12-31	$31,823
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$92,941
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$108,278
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$2,224,956
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	$1,033,095
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$2,493,924
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	DIXON HUGHES GOLDMAN LLP
Accountancy firm EIN	2012-12-31	560747981
2011 : KERSHAWHEALTH 403B RETIREMENT 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	$2,599,563
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$963,041
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$955,435
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$2,941,202
Value of total assets at end of year	2011-12-31	$20,419,708
Value of total assets at beginning of year	2011-12-31	$18,783,186
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$7,606
Total interest from all sources	2011-12-31	$32,570
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$500,000
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	$1,778,503
Participant contributions at end of year	2011-12-31	$781,405
Participant contributions at beginning of year	2011-12-31	$782,452
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$56,833
Administrative expenses (other) incurred	2011-12-31	$7,606
Total non interest bearing cash at end of year	2011-12-31	$27,591
Total non interest bearing cash at beginning of year	2011-12-31	$138,542
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	$1,636,522
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$20,419,708
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$18,783,186
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	$18,923,045
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$17,084,936
Value of interest in pooled separate accounts at end of year	2011-12-31	$579,389
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$665,683
Interest on participant loans	2011-12-31	$32,570
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$108,278
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$111,573
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-374,209
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
Contributions received in cash from employer	2011-12-31	$1,105,866
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$955,435
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	2011-12-31	No
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	DIXON HUGHES GOODMAN LLP
Accountancy firm EIN	2011-12-31	560747981
2010 : KERSHAWHEALTH 403B RETIREMENT 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	$0
Total income from all sources (including contributions)	2010-12-31	$4,895,330
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$788,319
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$774,999
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$2,938,801
Value of total assets at end of year	2010-12-31	$18,783,186
Value of total assets at beginning of year	2010-12-31	$14,676,175
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$13,320
Total interest from all sources	2010-12-31	$30,926
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Administrative expenses professional fees incurred	2010-12-31	$13,320
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$500,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$1,770,416
Participant contributions at end of year	2010-12-31	$782,452
Participant contributions at beginning of year	2010-12-31	$521,950
Participant contributions at beginning of year	2010-12-31	$60,412
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$48,906
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2010-12-31	$0
Total non interest bearing cash at end of year	2010-12-31	$138,542
Total non interest bearing cash at beginning of year	2010-12-31	$14,036
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	$4,107,011
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$18,783,186
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$14,676,175
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$17,084,936
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$14,036,141
Value of interest in pooled separate accounts at end of year	2010-12-31	$665,683
Interest on participant loans	2010-12-31	$30,926
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$111,573
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$1,846,749
Net investment gain/loss from pooled separate accounts	2010-12-31	$78,854
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
Contributions received in cash from employer	2010-12-31	$1,119,479
Employer contributions (assets) at beginning of year	2010-12-31	$43,636
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$774,999
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	2010-12-31	No
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	DIXON HUGHES GOODMAN LLP
Accountancy firm EIN	2010-12-31	560747981

Form 5500 Responses for KERSHAWHEALTH 403B RETIREMENT PLAN

2022: KERSHAWHEALTH 403B RETIREMENT PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: KERSHAWHEALTH 403B RETIREMENT PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: KERSHAWHEALTH 403B RETIREMENT PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: KERSHAWHEALTH 403B RETIREMENT PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: KERSHAWHEALTH 403B RETIREMENT PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: KERSHAWHEALTH 403B RETIREMENT PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: KERSHAWHEALTH 403B RETIREMENT PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: KERSHAWHEALTH 403B RETIREMENT 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: KERSHAWHEALTH 403B RETIREMENT 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: KERSHAWHEALTH 403B RETIREMENT PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	Yes
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: KERSHAWHEALTH 403B RETIREMENT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	Yes
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: KERSHAWHEALTH 403B RETIREMENT PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	Yes
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
2010: KERSHAWHEALTH 403B RETIREMENT PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: KERSHAWHEALTH 403B RETIREMENT PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	Yes
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 – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

95782-01

Policy instance

Insurance contract or identification number	95782-01
Number of Individuals Covered	45
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	Yes
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

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

95782-01

Policy instance

Insurance contract or identification number	95782-01
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	Yes
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

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

95782-01

Policy instance

Insurance contract or identification number	95782-01
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	Yes
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

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

95782-01

Policy instance

Insurance contract or identification number	95782-01
Number of Individuals Covered	53
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	Yes
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

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

95782-01

Policy instance

Insurance contract or identification number	95782-01
Number of Individuals Covered	55
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	Yes
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

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

95782-01

Policy instance

Insurance contract or identification number	95782-01
Number of Individuals Covered	57
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	Yes
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

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

95782-01

Policy instance

Insurance contract or identification number	95782-01
Number of Individuals Covered	62
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
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?	Yes
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

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

9578201

Policy instance

Insurance contract or identification number	9578201
Number of Individuals Covered	69
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
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?	Yes
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

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

9578201

Policy instance

Insurance contract or identification number	9578201
Number of Individuals Covered	73
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?	Yes
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

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

9578201

Policy instance

Insurance contract or identification number	9578201
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?	Yes
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?	Yes
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

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

9578201

Policy instance

Insurance contract or identification number	9578201
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?	Yes
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

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

9578201

Policy instance

Insurance contract or identification number	9578201
Number of Individuals Covered	103
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?	Yes
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

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Company Name:	KERSHAWHEALTH
Employer identification number (EIN):	576005963
NAIC Classification:	622000
NAIC Description:	Hospitals