401k Plan data: COLUMBUS HOSPICE, INC. 403(B) TAX DEFERRED ANNUITY PROGRAM plan

COLUMBUS HOSPICE, INC. 403(B) TAX DEFERRED ANNUITY PROGRAM 401k Plan overview

Plan Name	COLUMBUS HOSPICE, INC. 403(B) TAX DEFERRED ANNUITY PROGRAM
Plan identification number	001

COLUMBUS HOSPICE, INC. 403(B) TAX DEFERRED ANNUITY PROGRAM Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
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.
Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

COLUMBUS HOSPICE, INC. has sponsored the creation of one or more 401k plans.

Company Name: COLUMBUS HOSPICE, INC.

Employer identification number (EIN): 581385395

NAIC Classification: 621900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COLUMBUS HOSPICE, INC. 403(B) TAX DEFERRED ANNUITY PROGRAM

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01
001 2021-01-01
001 2020-01-01
001 2019-01-01
001 2018-01-01
001 2017-01-01 JOANN MOORE JOANN MOORE 2018-10-15
001 2016-01-01 JOANN MOORE JOANN MOORE 2017-10-18
001 2015-01-01 JOANN MOORE 2016-10-19
001 2014-01-01 JOANN MOORE
001 2013-01-01 AMIE PRATHER
001 2012-01-01 AMIE PRATHER
001 2011-01-01 AMIE PRATHER
001 2009-01-01 JANICE BECKMAN

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2022-01-01
001	2021-01-01
001	2020-01-01
001	2019-01-01
001	2018-01-01
001	2017-01-01	JOANN MOORE	JOANN MOORE	2018-10-15
001	2016-01-01	JOANN MOORE	JOANN MOORE	2017-10-18
001	2015-01-01		JOANN MOORE	2016-10-19
001	2014-01-01	JOANN MOORE
001	2013-01-01	AMIE PRATHER
001	2012-01-01	AMIE PRATHER
001	2011-01-01	AMIE PRATHER
001	2009-01-01	JANICE BECKMAN

Plan Statistics for COLUMBUS HOSPICE, INC. 403(B) TAX DEFERRED ANNUITY PROGRAM

401k plan membership statisitcs for COLUMBUS HOSPICE, INC. 403(B) TAX DEFERRED ANNUITY PROGRAM

Measure Date Value
2022: COLUMBUS HOSPICE, INC. 403(B) TAX DEFERRED ANNUITY PROGRAM 2022 401k membership
Total participants, beginning-of-year 2022-01-01 203
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 141
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 80
Total of all active and inactive participants 2022-01-01 221
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 221
Number of participants with account balances 2022-01-01 197
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 9
2021: COLUMBUS HOSPICE, INC. 403(B) TAX DEFERRED ANNUITY PROGRAM 2021 401k membership
Total participants, beginning-of-year 2021-01-01 193
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 135
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 65
Total of all active and inactive participants 2021-01-01 200
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 3
Total participants 2021-01-01 203
Number of participants with account balances 2021-01-01 197
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 29
2020: COLUMBUS HOSPICE, INC. 403(B) TAX DEFERRED ANNUITY PROGRAM 2020 401k membership
Total participants, beginning-of-year 2020-01-01 177
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 157
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 36
Total of all active and inactive participants 2020-01-01 193
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 193
Number of participants with account balances 2020-01-01 186
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 20
2019: COLUMBUS HOSPICE, INC. 403(B) TAX DEFERRED ANNUITY PROGRAM 2019 401k membership
Total participants, beginning-of-year 2019-01-01 174
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 153
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 24
Total of all active and inactive participants 2019-01-01 177
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 177
Number of participants with account balances 2019-01-01 164
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 7
2018: COLUMBUS HOSPICE, INC. 403(B) TAX DEFERRED ANNUITY PROGRAM 2018 401k membership
Total participants, beginning-of-year 2018-01-01 155
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 142
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 31
Total of all active and inactive participants 2018-01-01 173
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 173
Number of participants with account balances 2018-01-01 151
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 3
2017: COLUMBUS HOSPICE, INC. 403(B) TAX DEFERRED ANNUITY PROGRAM 2017 401k membership
Total participants, beginning-of-year 2017-01-01 165
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 130
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 28
Total of all active and inactive participants 2017-01-01 158
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 158
Number of participants with account balances 2017-01-01 145
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 8
2016: COLUMBUS HOSPICE, INC. 403(B) TAX DEFERRED ANNUITY PROGRAM 2016 401k membership
Total participants, beginning-of-year 2016-01-01 181
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 145
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 23
Total of all active and inactive participants 2016-01-01 168
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 168
Number of participants with account balances 2016-01-01 160
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 4
2015: COLUMBUS HOSPICE, INC. 403(B) TAX DEFERRED ANNUITY PROGRAM 2015 401k membership
Total participants, beginning-of-year 2015-01-01 202
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 159
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 20
Total of all active and inactive participants 2015-01-01 179
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 179
Number of participants with account balances 2015-01-01 168
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 12
2014: COLUMBUS HOSPICE, INC. 403(B) TAX DEFERRED ANNUITY PROGRAM 2014 401k membership
Total participants, beginning-of-year 2014-01-01 293
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 202
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 65
Total of all active and inactive participants 2014-01-01 267
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 267
Number of participants with account balances 2014-01-01 227
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: COLUMBUS HOSPICE, INC. 403(B) TAX DEFERRED ANNUITY PROGRAM 2013 401k membership
Total participants, beginning-of-year 2013-01-01 262
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 226
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 67
Total of all active and inactive participants 2013-01-01 293
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 293
Number of participants with account balances 2013-01-01 233
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: COLUMBUS HOSPICE, INC. 403(B) TAX DEFERRED ANNUITY PROGRAM 2012 401k membership
Total participants, beginning-of-year 2012-01-01 280
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 204
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 58
Total of all active and inactive participants 2012-01-01 262
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 262
Number of participants with account balances 2012-01-01 221
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: COLUMBUS HOSPICE, INC. 403(B) TAX DEFERRED ANNUITY PROGRAM 2011 401k membership
Total participants, beginning-of-year 2011-01-01 261
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 231
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 48
Total of all active and inactive participants 2011-01-01 279
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 279
Number of participants with account balances 2011-01-01 214
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: COLUMBUS HOSPICE, INC. 403(B) TAX DEFERRED ANNUITY PROGRAM 2009 401k membership
Total participants, beginning-of-year 2009-01-01 236
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 216
Number of retired or separated participants receiving benefits 2009-01-01 30
Number of other retired or separated participants entitled to future benefits 2009-01-01 0
Total of all active and inactive participants 2009-01-01 246
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 246
Number of participants with account balances 2009-01-01 184
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 2

Measure	Date	Value
2022: COLUMBUS HOSPICE, INC. 403(B) TAX DEFERRED ANNUITY PROGRAM 2022 401k membership
Total participants, beginning-of-year	2022-01-01	203
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	141
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	80
Total of all active and inactive participants	2022-01-01	221
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	221
Number of participants with account balances	2022-01-01	197
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	9
2021: COLUMBUS HOSPICE, INC. 403(B) TAX DEFERRED ANNUITY PROGRAM 2021 401k membership
Total participants, beginning-of-year	2021-01-01	193
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	135
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	65
Total of all active and inactive participants	2021-01-01	200
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	3
Total participants	2021-01-01	203
Number of participants with account balances	2021-01-01	197
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	29
2020: COLUMBUS HOSPICE, INC. 403(B) TAX DEFERRED ANNUITY PROGRAM 2020 401k membership
Total participants, beginning-of-year	2020-01-01	177
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	157
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	36
Total of all active and inactive participants	2020-01-01	193
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	193
Number of participants with account balances	2020-01-01	186
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	20
2019: COLUMBUS HOSPICE, INC. 403(B) TAX DEFERRED ANNUITY PROGRAM 2019 401k membership
Total participants, beginning-of-year	2019-01-01	174
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	153
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	24
Total of all active and inactive participants	2019-01-01	177
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	177
Number of participants with account balances	2019-01-01	164
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	7
2018: COLUMBUS HOSPICE, INC. 403(B) TAX DEFERRED ANNUITY PROGRAM 2018 401k membership
Total participants, beginning-of-year	2018-01-01	155
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	142
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	31
Total of all active and inactive participants	2018-01-01	173
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	173
Number of participants with account balances	2018-01-01	151
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	3
2017: COLUMBUS HOSPICE, INC. 403(B) TAX DEFERRED ANNUITY PROGRAM 2017 401k membership
Total participants, beginning-of-year	2017-01-01	165
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	130
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	28
Total of all active and inactive participants	2017-01-01	158
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	158
Number of participants with account balances	2017-01-01	145
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	8
2016: COLUMBUS HOSPICE, INC. 403(B) TAX DEFERRED ANNUITY PROGRAM 2016 401k membership
Total participants, beginning-of-year	2016-01-01	181
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	145
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	23
Total of all active and inactive participants	2016-01-01	168
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	168
Number of participants with account balances	2016-01-01	160
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	4
2015: COLUMBUS HOSPICE, INC. 403(B) TAX DEFERRED ANNUITY PROGRAM 2015 401k membership
Total participants, beginning-of-year	2015-01-01	202
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	159
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	20
Total of all active and inactive participants	2015-01-01	179
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	179
Number of participants with account balances	2015-01-01	168
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	12
2014: COLUMBUS HOSPICE, INC. 403(B) TAX DEFERRED ANNUITY PROGRAM 2014 401k membership
Total participants, beginning-of-year	2014-01-01	293
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	202
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	65
Total of all active and inactive participants	2014-01-01	267
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	267
Number of participants with account balances	2014-01-01	227
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: COLUMBUS HOSPICE, INC. 403(B) TAX DEFERRED ANNUITY PROGRAM 2013 401k membership
Total participants, beginning-of-year	2013-01-01	262
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	226
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	67
Total of all active and inactive participants	2013-01-01	293
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	293
Number of participants with account balances	2013-01-01	233
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: COLUMBUS HOSPICE, INC. 403(B) TAX DEFERRED ANNUITY PROGRAM 2012 401k membership
Total participants, beginning-of-year	2012-01-01	280
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	204
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	58
Total of all active and inactive participants	2012-01-01	262
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	262
Number of participants with account balances	2012-01-01	221
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: COLUMBUS HOSPICE, INC. 403(B) TAX DEFERRED ANNUITY PROGRAM 2011 401k membership
Total participants, beginning-of-year	2011-01-01	261
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	231
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	48
Total of all active and inactive participants	2011-01-01	279
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	279
Number of participants with account balances	2011-01-01	214
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: COLUMBUS HOSPICE, INC. 403(B) TAX DEFERRED ANNUITY PROGRAM 2009 401k membership
Total participants, beginning-of-year	2009-01-01	236
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	216
Number of retired or separated participants receiving benefits	2009-01-01	30
Number of other retired or separated participants entitled to future benefits	2009-01-01	0
Total of all active and inactive participants	2009-01-01	246
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	246
Number of participants with account balances	2009-01-01	184
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	2

Financial Data on COLUMBUS HOSPICE, INC. 403(B) TAX DEFERRED ANNUITY PROGRAM

Measure	Date	Value
2022 : COLUMBUS HOSPICE, INC. 403(B) TAX DEFERRED ANNUITY PROGRAM 2022 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2022-12-31	$0
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total transfer of assets to this plan	2022-12-31	$0
Total transfer of assets from this plan	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	$-712,019
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$1,060,170
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$1,057,342
Expenses. Certain deemed distributions of participant loans	2022-12-31	$0
Value of total corrective distributions	2022-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$747,793
Value of total assets at end of year	2022-12-31	$9,529,726
Value of total assets at beginning of year	2022-12-31	$11,301,915
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$2,828
Total interest from all sources	2022-12-31	$8,090
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$0
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	$0
Assets. Real estate other than employer real property at end of year	2022-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2022-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2022-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2022-12-31	$0
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	$480,739
Participant contributions at end of year	2022-12-31	$242,154
Participant contributions at beginning of year	2022-12-31	$273,542
Participant contributions at end of year	2022-12-31	$36,831
Participant contributions at beginning of year	2022-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2022-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2022-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$65,021
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2022-12-31	$0
Assets. Loans (other than to participants) at end of year	2022-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2022-12-31	$0
Other income not declared elsewhere	2022-12-31	$0
Administrative expenses (other) incurred	2022-12-31	$2,828
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
Income. Non cash contributions	2022-12-31	$0
Value of net income/loss	2022-12-31	$-1,772,189
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$9,529,726
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$11,301,915
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
Assets. partnership/joint venture interests at end of year	2022-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2022-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$7,643,060
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$9,588,445
Value of interest in pooled separate accounts at end of year	2022-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2022-12-31	$0
Interest on participant loans	2022-12-31	$8,090
Income. Interest from loans (other than to participants)	2022-12-31	$0
Interest earned on other investments	2022-12-31	$0
Income. Interest from US Government securities	2022-12-31	$0
Income. Interest from corporate debt instruments	2022-12-31	$0
Value of interest in master investment trust accounts at end of year	2022-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2022-12-31	$0
Value of interest in common/collective trusts at end of year	2022-12-31	$0
Value of interest in common/collective trusts at beginning of year	2022-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2022-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2022-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2022-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2022-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2022-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2022-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$1,591,971
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$1,439,928
Expenses. Payments to insurance carriers foe the provision of benefits	2022-12-31	$0
Asset value of US Government securities at end of year	2022-12-31	$0
Asset value of US Government securities at beginning of year	2022-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$0
Net investment gain/loss from pooled separate accounts	2022-12-31	$-1,467,902
Net investment gain or loss from common/collective trusts	2022-12-31	$0
Net gain/loss from 103.12 investment entities	2022-12-31	$0
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	$202,033
Employer contributions (assets) at end of year	2022-12-31	$15,710
Employer contributions (assets) at beginning of year	2022-12-31	$0
Income. Dividends from preferred stock	2022-12-31	$0
Income. Dividends from common stock	2022-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$1,057,342
Asset. Corporate debt instrument preferred debt at end of year	2022-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2022-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2022-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2022-12-31	$0
Assets. Corporate common stocks other than exployer securities at end of year	2022-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2022-12-31	$0
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
Aggregate proceeds on sale of assets	2022-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2022-12-31	$0
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	ROBINSON, GRIMES & COMPANY, P.C.
Accountancy firm EIN	2022-12-31	581374304
2021 : COLUMBUS HOSPICE, INC. 403(B) TAX DEFERRED ANNUITY PROGRAM 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	$1,994,812
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$587,095
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$583,908
Expenses. Certain deemed distributions of participant loans	2021-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$752,594
Value of total assets at end of year	2021-12-31	$11,301,915
Value of total assets at beginning of year	2021-12-31	$9,894,198
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$3,187
Total interest from all sources	2021-12-31	$11,519
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$37,214
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	$37,214
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
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$489,873
Participant contributions at end of year	2021-12-31	$273,542
Participant contributions at beginning of year	2021-12-31	$335,091
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$41,162
Other income not declared elsewhere	2021-12-31	$0
Administrative expenses (other) incurred	2021-12-31	$3,187
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	$1,407,717
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$11,301,915
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$9,894,198
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	$9,588,445
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$7,784,414
Interest on participant loans	2021-12-31	$0
Interest earned on other investments	2021-12-31	$11,519
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$1,439,928
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$1,774,693
Expenses. Payments to insurance carriers foe the provision of benefits	2021-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$1,193,485
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	$221,559
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$583,908
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	ROBINSON, GRIMED & COMPANY
Accountancy firm EIN	2021-12-31	581374304
2020 : COLUMBUS HOSPICE, INC. 403(B) TAX DEFERRED ANNUITY PROGRAM 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	$1,536,934
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$875,233
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$861,651
Expenses. Certain deemed distributions of participant loans	2020-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$980,150
Value of total assets at end of year	2020-12-31	$9,894,198
Value of total assets at beginning of year	2020-12-31	$9,232,497
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$13,582
Total interest from all sources	2020-12-31	$12,850
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$47,470
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	$47,470
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	$472,998
Participant contributions at end of year	2020-12-31	$335,091
Participant contributions at beginning of year	2020-12-31	$411,628
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$298,563
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2020-12-31	$0
Other income not declared elsewhere	2020-12-31	$0
Administrative expenses (other) incurred	2020-12-31	$13,582
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	$661,701
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$9,894,198
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$9,232,497
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	$7,784,414
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$7,744,727
Interest on participant loans	2020-12-31	$12,850
Interest earned on other investments	2020-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$1,774,693
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$1,076,142
Expenses. Payments to insurance carriers foe the provision of benefits	2020-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$496,464
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	$208,589
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$861,651
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	ROBINSON, GRIMES & COMPANY
Accountancy firm EIN	2020-12-31	581374304
2019 : COLUMBUS HOSPICE, INC. 403(B) TAX DEFERRED ANNUITY PROGRAM 2019 401k financial data
Unrealized appreciation/depreciation of real estate assets	2019-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2019-12-31	$0
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total transfer of assets to this plan	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
Expenses. Interest paid	2019-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$2,090,801
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$846,062
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$804,133
Expenses. Certain deemed distributions of participant loans	2019-12-31	$0
Value of total corrective distributions	2019-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$633,543
Value of total assets at end of year	2019-12-31	$9,232,497
Value of total assets at beginning of year	2019-12-31	$7,987,758
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$41,929
Total income from rents	2019-12-31	$0
Total interest from all sources	2019-12-31	$23,332
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$115,157
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	$115,157
Administrative expenses professional fees incurred	2019-12-31	$0
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
Amount of non-exempt transactions with any party-in-interest	2019-12-31	$0
Contributions received from participants	2019-12-31	$387,181
Participant contributions at end of year	2019-12-31	$411,628
Participant contributions at beginning of year	2019-12-31	$504,151
Participant contributions at end of year	2019-12-31	$0
Participant contributions at beginning of year	2019-12-31	$25,993
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$83,211
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2019-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2019-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2019-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2019-12-31	$0
Other income not declared elsewhere	2019-12-31	$32,972
Administrative expenses (other) incurred	2019-12-31	$2,284
Liabilities. Value of operating payables at beginning of year	2019-12-31	$0
Total non interest bearing cash at end of year	2019-12-31	$0
Total non interest bearing cash at beginning of year	2019-12-31	$0
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
Income. Non cash contributions	2019-12-31	$0
Value of net income/loss	2019-12-31	$1,244,739
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$9,232,497
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$7,987,758
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
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year	2019-12-31	$0
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year	2019-12-31	$0
Investment advisory and management fees	2019-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$7,744,727
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$6,123,153
Interest on participant loans	2019-12-31	$14,714
Income. Interest from loans (other than to participants)	2019-12-31	$0
Interest earned on other investments	2019-12-31	$8,618
Income. Interest from US Government securities	2019-12-31	$0
Income. Interest from corporate debt instruments	2019-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$1,076,142
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$1,326,638
Expenses. Payments to insurance carriers foe the provision of benefits	2019-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$1,285,797
Net investment gain/loss from pooled separate accounts	2019-12-31	$0
Net investment gain or loss from common/collective trusts	2019-12-31	$0
Net gain/loss from 103.12 investment entities	2019-12-31	$0
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	Yes
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	$163,151
Employer contributions (assets) at end of year	2019-12-31	$0
Employer contributions (assets) at beginning of year	2019-12-31	$7,823
Income. Dividends from preferred stock	2019-12-31	$0
Income. Dividends from common stock	2019-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$804,133
Contract administrator fees	2019-12-31	$39,645
Liabilities. Value of benefit claims payable at beginning of year	2019-12-31	$0
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
Aggregate proceeds on sale of assets	2019-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2019-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2019-12-31	$0
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	ROBINSON, GRIMES & COMPANY, P.C.
Accountancy firm EIN	2019-12-31	581374304
2018 : COLUMBUS HOSPICE, INC. 403(B) TAX DEFERRED ANNUITY PROGRAM 2018 401k financial data
Unrealized appreciation/depreciation of real estate assets	2018-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2018-12-31	$0
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total transfer of assets to this plan	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Expenses. Interest paid	2018-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$146,323
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$1,775,514
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$1,737,113
Expenses. Certain deemed distributions of participant loans	2018-12-31	$0
Value of total corrective distributions	2018-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$538,201
Value of total assets at end of year	2018-12-31	$7,987,758
Value of total assets at beginning of year	2018-12-31	$9,616,949
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$38,401
Total income from rents	2018-12-31	$0
Total interest from all sources	2018-12-31	$66,923
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$398,759
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	$398,759
Administrative expenses professional fees incurred	2018-12-31	$0
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
Amount of non-exempt transactions with any party-in-interest	2018-12-31	$0
Contributions received from participants	2018-12-31	$375,947
Participant contributions at end of year	2018-12-31	$504,151
Participant contributions at beginning of year	2018-12-31	$498,406
Participant contributions at end of year	2018-12-31	$25,993
Participant contributions at beginning of year	2018-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$8,314
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2018-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2018-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2018-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2018-12-31	$0
Other income not declared elsewhere	2018-12-31	$12,768
Administrative expenses (other) incurred	2018-12-31	$0
Liabilities. Value of operating payables at beginning of year	2018-12-31	$0
Total non interest bearing cash at end of year	2018-12-31	$0
Total non interest bearing cash at beginning of year	2018-12-31	$0
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
Income. Non cash contributions	2018-12-31	$0
Value of net income/loss	2018-12-31	$-1,629,191
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$7,987,758
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$9,616,949
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
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year	2018-12-31	$0
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year	2018-12-31	$0
Investment advisory and management fees	2018-12-31	$2,575
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$6,123,153
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$7,127,662
Interest on participant loans	2018-12-31	$23,985
Income. Interest from loans (other than to participants)	2018-12-31	$0
Interest earned on other investments	2018-12-31	$42,938
Income. Interest from US Government securities	2018-12-31	$0
Income. Interest from corporate debt instruments	2018-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2018-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$1,326,638
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$1,983,913
Expenses. Payments to insurance carriers foe the provision of benefits	2018-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-870,328
Net investment gain/loss from pooled separate accounts	2018-12-31	$0
Net investment gain or loss from common/collective trusts	2018-12-31	$0
Net gain/loss from 103.12 investment entities	2018-12-31	$0
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	$153,940
Employer contributions (assets) at end of year	2018-12-31	$7,823
Employer contributions (assets) at beginning of year	2018-12-31	$6,968
Income. Dividends from preferred stock	2018-12-31	$0
Income. Dividends from common stock	2018-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$1,737,113
Contract administrator fees	2018-12-31	$35,826
Liabilities. Value of benefit claims payable at beginning of year	2018-12-31	$0
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
Aggregate proceeds on sale of assets	2018-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2018-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2018-12-31	$0
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	ROBINSON, GRIMES & COMPANY, P.C.
Accountancy firm EIN	2018-12-31	581374304
2017 : COLUMBUS HOSPICE, INC. 403(B) TAX DEFERRED ANNUITY PROGRAM 2017 401k financial data
Unrealized appreciation/depreciation of real estate assets	2017-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2017-12-31	$0
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total transfer of assets to this plan	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Expenses. Interest paid	2017-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$1,858,195
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$1,186,910
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$1,152,640
Expenses. Certain deemed distributions of participant loans	2017-12-31	$0
Value of total corrective distributions	2017-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$943,790
Value of total assets at end of year	2017-12-31	$9,271,455
Value of total assets at beginning of year	2017-12-31	$8,600,170
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$34,270
Total income from rents	2017-12-31	$0
Total interest from all sources	2017-12-31	$16,505
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$124,145
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	$124,145
Administrative expenses professional fees incurred	2017-12-31	$0
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
Amount of non-exempt transactions with any party-in-interest	2017-12-31	$0
Contributions received from participants	2017-12-31	$377,063
Participant contributions at end of year	2017-12-31	$498,684
Participant contributions at beginning of year	2017-12-31	$545,176
Participant contributions at end of year	2017-12-31	$0
Participant contributions at beginning of year	2017-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$341,994
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2017-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2017-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2017-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2017-12-31	$0
Other income not declared elsewhere	2017-12-31	$0
Administrative expenses (other) incurred	2017-12-31	$1
Liabilities. Value of operating payables at beginning of year	2017-12-31	$0
Total non interest bearing cash at end of year	2017-12-31	$0
Total non interest bearing cash at beginning of year	2017-12-31	$0
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
Income. Non cash contributions	2017-12-31	$0
Value of net income/loss	2017-12-31	$671,285
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$9,271,455
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$8,600,170
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
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year	2017-12-31	$0
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year	2017-12-31	$0
Investment advisory and management fees	2017-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$6,719,968
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$5,986,451
Interest on participant loans	2017-12-31	$15,015
Income. Interest from loans (other than to participants)	2017-12-31	$0
Interest earned on other investments	2017-12-31	$1,490
Income. Interest from US Government securities	2017-12-31	$0
Income. Interest from corporate debt instruments	2017-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2017-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$2,045,835
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$2,059,482
Expenses. Payments to insurance carriers foe the provision of benefits	2017-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$773,755
Net investment gain/loss from pooled separate accounts	2017-12-31	$0
Net investment gain or loss from common/collective trusts	2017-12-31	$0
Net gain/loss from 103.12 investment entities	2017-12-31	$0
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
Contributions received in cash from employer	2017-12-31	$224,733
Employer contributions (assets) at end of year	2017-12-31	$6,968
Employer contributions (assets) at beginning of year	2017-12-31	$9,061
Income. Dividends from preferred stock	2017-12-31	$0
Income. Dividends from common stock	2017-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$1,152,640
Contract administrator fees	2017-12-31	$34,269
Liabilities. Value of benefit claims payable at beginning of year	2017-12-31	$0
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
Aggregate proceeds on sale of assets	2017-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2017-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2017-12-31	$0
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	BRAN CLEMENTS
Accountancy firm EIN	2017-12-31	582211147
2016 : COLUMBUS HOSPICE, INC. 403(B) TAX DEFERRED ANNUITY PROGRAM 2016 401k financial data
Unrealized appreciation/depreciation of real estate assets	2016-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2016-12-31	$0
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total transfer of assets to this plan	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Expenses. Interest paid	2016-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$1,325,168
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$1,489,199
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$1,365,183
Expenses. Certain deemed distributions of participant loans	2016-12-31	$91,468
Value of total corrective distributions	2016-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$846,104
Value of total assets at end of year	2016-12-31	$8,600,170
Value of total assets at beginning of year	2016-12-31	$8,764,201
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$32,548
Total income from rents	2016-12-31	$0
Total interest from all sources	2016-12-31	$8,621
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$152,229
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	$152,229
Administrative expenses professional fees incurred	2016-12-31	$0
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
Amount of non-exempt transactions with any party-in-interest	2016-12-31	$0
Contributions received from participants	2016-12-31	$419,144
Participant contributions at end of year	2016-12-31	$545,176
Participant contributions at beginning of year	2016-12-31	$585,542
Participant contributions at end of year	2016-12-31	$0
Participant contributions at beginning of year	2016-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$104,053
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2016-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2016-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2016-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2016-12-31	$0
Other income not declared elsewhere	2016-12-31	$145
Administrative expenses (other) incurred	2016-12-31	$0
Liabilities. Value of operating payables at beginning of year	2016-12-31	$0
Total non interest bearing cash at end of year	2016-12-31	$0
Total non interest bearing cash at beginning of year	2016-12-31	$0
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
Income. Non cash contributions	2016-12-31	$0
Value of net income/loss	2016-12-31	$-164,031
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$8,600,170
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$8,764,201
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
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year	2016-12-31	$0
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year	2016-12-31	$0
Investment advisory and management fees	2016-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$5,986,451
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$5,960,690
Interest on participant loans	2016-12-31	$7,437
Income. Interest from loans (other than to participants)	2016-12-31	$0
Interest earned on other investments	2016-12-31	$1,184
Income. Interest from US Government securities	2016-12-31	$0
Income. Interest from corporate debt instruments	2016-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2016-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$2,059,482
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$2,203,986
Expenses. Payments to insurance carriers foe the provision of benefits	2016-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$318,069
Net investment gain/loss from pooled separate accounts	2016-12-31	$0
Net investment gain or loss from common/collective trusts	2016-12-31	$0
Net gain/loss from 103.12 investment entities	2016-12-31	$0
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	Yes
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$322,907
Employer contributions (assets) at end of year	2016-12-31	$9,061
Employer contributions (assets) at beginning of year	2016-12-31	$13,983
Income. Dividends from preferred stock	2016-12-31	$0
Income. Dividends from common stock	2016-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$1,365,183
Contract administrator fees	2016-12-31	$32,548
Liabilities. Value of benefit claims payable at beginning of year	2016-12-31	$0
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Aggregate proceeds on sale of assets	2016-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2016-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2016-12-31	$0
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	AJK, LLC
Accountancy firm EIN	2016-12-31	582211147
2015 : COLUMBUS HOSPICE, INC. 403(B) TAX DEFERRED ANNUITY PROGRAM 2015 401k financial data
Unrealized appreciation/depreciation of real estate assets	2015-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2015-12-31	$0
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total transfer of assets to this plan	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Expenses. Interest paid	2015-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$1,311,377
Total loss/gain on sale of assets	2015-12-31	$-49,235
Total of all expenses incurred	2015-12-31	$2,204,923
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$2,150,972
Expenses. Certain deemed distributions of participant loans	2015-12-31	$17,493
Value of total corrective distributions	2015-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$1,349,351
Value of total assets at end of year	2015-12-31	$8,764,201
Value of total assets at beginning of year	2015-12-31	$9,657,747
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$36,458
Total income from rents	2015-12-31	$0
Total interest from all sources	2015-12-31	$101,875
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$53,821
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	$53,821
Administrative expenses professional fees incurred	2015-12-31	$0
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	Yes
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Amount of non-exempt transactions with any party-in-interest	2015-12-31	$0
Contributions received from participants	2015-12-31	$562,638
Participant contributions at end of year	2015-12-31	$585,542
Participant contributions at beginning of year	2015-12-31	$697,134
Participant contributions at end of year	2015-12-31	$0
Participant contributions at beginning of year	2015-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$327,020
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2015-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2015-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2015-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2015-12-31	$0
Other income not declared elsewhere	2015-12-31	$49,235
Administrative expenses (other) incurred	2015-12-31	$0
Liabilities. Value of operating payables at beginning of year	2015-12-31	$0
Total non interest bearing cash at end of year	2015-12-31	$0
Total non interest bearing cash at beginning of year	2015-12-31	$0
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
Income. Non cash contributions	2015-12-31	$0
Value of net income/loss	2015-12-31	$-893,546
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$8,764,201
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$9,657,747
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
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year	2015-12-31	$0
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year	2015-12-31	$0
Investment advisory and management fees	2015-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$5,960,690
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$4,733,522
Interest on participant loans	2015-12-31	$1,370
Income. Interest from loans (other than to participants)	2015-12-31	$0
Interest earned on other investments	2015-12-31	$100,505
Income. Interest from US Government securities	2015-12-31	$0
Income. Interest from corporate debt instruments	2015-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2015-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$2,203,986
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$4,227,091
Expenses. Payments to insurance carriers foe the provision of benefits	2015-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-193,670
Net investment gain/loss from pooled separate accounts	2015-12-31	$0
Net investment gain or loss from common/collective trusts	2015-12-31	$0
Net gain/loss from 103.12 investment entities	2015-12-31	$0
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	$459,693
Employer contributions (assets) at end of year	2015-12-31	$13,983
Employer contributions (assets) at beginning of year	2015-12-31	$0
Income. Dividends from preferred stock	2015-12-31	$0
Income. Dividends from common stock	2015-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$2,150,972
Contract administrator fees	2015-12-31	$36,458
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	2015-12-31	Yes
Liabilities. Value of benefit claims payable at beginning of year	2015-12-31	$0
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
Aggregate proceeds on sale of assets	2015-12-31	$7,709,922
Aggregate carrying amount (costs) on sale of assets	2015-12-31	$7,759,157
Liabilities. Value of acquisition indebtedness at beginning of year	2015-12-31	$0
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	Adverse
Accountancy firm name	2015-12-31	BRAD CLEMENTS
Accountancy firm EIN	2015-12-31	582211147
2014 : COLUMBUS HOSPICE, INC. 403(B) TAX DEFERRED ANNUITY PROGRAM 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$1,395,147
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$592,144
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$585,611
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$981,027
Value of total assets at end of year	2014-12-31	$9,657,747
Value of total assets at beginning of year	2014-12-31	$8,854,744
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$6,533
Total interest from all sources	2014-12-31	$139,501
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
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	$560,289
Participant contributions at end of year	2014-12-31	$697,134
Participant contributions at beginning of year	2014-12-31	$600,655
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$8,311
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	$803,003
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$9,657,747
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$8,854,744
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	$4,733,522
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$4,287,527
Interest earned on other investments	2014-12-31	$139,501
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$4,227,091
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$3,966,562
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$274,619
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	$412,427
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$585,611
Contract administrator fees	2014-12-31	$6,533
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	ABBOTT,JORDAN & KOON, LLC
Accountancy firm EIN	2014-12-31	058221147
2013 : COLUMBUS HOSPICE, INC. 403(B) TAX DEFERRED ANNUITY PROGRAM 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	$1,881,380
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$469,525
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$462,082
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$962,835
Value of total assets at end of year	2013-12-31	$8,854,744
Value of total assets at beginning of year	2013-12-31	$7,442,889
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$7,443
Total interest from all sources	2013-12-31	$133,632
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
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	$505,753
Participant contributions at end of year	2013-12-31	$600,655
Participant contributions at beginning of year	2013-12-31	$512,899
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$48,934
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	$1,411,855
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$8,854,744
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$7,442,889
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	$4,287,527
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$3,340,505
Interest earned on other investments	2013-12-31	$133,632
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$3,966,562
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$3,589,485
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$784,913
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	$408,148
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$462,082
Contract administrator fees	2013-12-31	$7,443
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	ABBOTT,JORDAN & KOON, LLC
Accountancy firm EIN	2013-12-31	058221147
2012 : COLUMBUS HOSPICE, INC. 403(B) TAX DEFERRED ANNUITY PROGRAM 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	$1,404,209
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$507,089
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$500,785
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$931,252
Value of total assets at end of year	2012-12-31	$7,442,889
Value of total assets at beginning of year	2012-12-31	$6,545,769
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$6,304
Total interest from all sources	2012-12-31	$123,154
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
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
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$460,310
Participant contributions at end of year	2012-12-31	$512,899
Participant contributions at beginning of year	2012-12-31	$499,637
Participant contributions at beginning of year	2012-12-31	$18,569
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$94,863
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	$897,120
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$7,442,889
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$6,545,769
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	$3,340,505
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$2,931,056
Interest earned on other investments	2012-12-31	$123,154
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$3,589,485
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$3,088,566
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$349,803
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	$376,079
Employer contributions (assets) at beginning of year	2012-12-31	$7,941
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$500,785
Contract administrator fees	2012-12-31	$6,304
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	AJK, LLC
Accountancy firm EIN	2012-12-31	058221147
2011 : COLUMBUS HOSPICE, INC. 403(B) TAX DEFERRED ANNUITY PROGRAM 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	$861,033
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$388,224
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$382,020
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$778,610
Value of total assets at end of year	2011-12-31	$6,545,769
Value of total assets at beginning of year	2011-12-31	$6,072,960
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$6,204
Total interest from all sources	2011-12-31	$114,058
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
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$466,388
Participant contributions at end of year	2011-12-31	$499,637
Participant contributions at beginning of year	2011-12-31	$434,241
Participant contributions at end of year	2011-12-31	$18,569
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$54,395
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	$472,809
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$6,545,769
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$6,072,960
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	$2,931,056
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$2,933,839
Interest earned on other investments	2011-12-31	$114,058
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$3,088,566
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$2,704,880
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-31,635
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	$257,827
Employer contributions (assets) at end of year	2011-12-31	$7,941
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$382,020
Contract administrator fees	2011-12-31	$6,204
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	DRAFFIN & TUCKER, LLP/CPA
Accountancy firm EIN	2011-12-31	580914992
2010 : COLUMBUS HOSPICE, INC. 403(B) TAX DEFERRED ANNUITY PROGRAM 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	$1,456,279
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$287,747
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$282,864
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$993,123
Value of total assets at end of year	2010-12-31	$6,072,960
Value of total assets at beginning of year	2010-12-31	$4,904,428
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$4,883
Total interest from all sources	2010-12-31	$104,301
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
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
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$528,112
Participant contributions at end of year	2010-12-31	$434,241
Participant contributions at beginning of year	2010-12-31	$324,261
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$140,702
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	$1,168,532
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$6,072,960
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$4,904,428
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	$2,933,839
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$2,309,440
Interest earned on other investments	2010-12-31	$104,301
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$2,704,880
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$2,270,727
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$358,855
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	$324,309
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$282,864
Contract administrator fees	2010-12-31	$4,883
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	DRAFFIN & TUCKER, LLP CPA
Accountancy firm EIN	2010-12-31	580914992
2009 : COLUMBUS HOSPICE, INC. 403(B) TAX DEFERRED ANNUITY PROGRAM 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for COLUMBUS HOSPICE, INC. 403(B) TAX DEFERRED ANNUITY PROGRAM

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

Insurance Providers Used on plan

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

062206

Policy instance

Insurance contract or identification number	062206
Number of Individuals Covered	0
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 $2,276
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	2276
Additional information about fees paid to insurance broker	INCENTIVE COMPENSATION
Insurance broker organization code?	3

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

Policy contract number

CR15763

Policy instance

Insurance contract or identification number	CR15763
Number of Individuals Covered	61
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $3,638
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,638
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	SALES AND BASE COMMISSIONS
Insurance broker organization code?	4

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

Policy contract number

613953

Policy instance

Insurance contract or identification number	613953
Number of Individuals Covered	0
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?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

062206K

Policy instance

Insurance contract or identification number	062206K
Number of Individuals Covered	203
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?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

613953

Policy instance

Insurance contract or identification number	613953
Number of Individuals Covered	6
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

062206K

Policy instance

Insurance contract or identification number	062206K
Number of Individuals Covered	193
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

CR15763

Policy instance

Insurance contract or identification number	CR15763
Number of Individuals Covered	76
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $5,120
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,120
Amount paid for insurance broker fees	0
Insurance broker organization code?	6

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

Policy contract number

613953

Policy instance

Insurance contract or identification number	613953
Number of Individuals Covered	177
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $127
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $127
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

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

Policy contract number

CR15763

Policy instance

Insurance contract or identification number	CR15763
Number of Individuals Covered	173
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
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

613953

Policy instance

Insurance contract or identification number	613953
Number of Individuals Covered	173
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $307
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $176
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

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

Policy contract number

CR15763

Policy instance

Insurance contract or identification number	CR15763
Number of Individuals Covered	0
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
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

613953

Policy instance

Insurance contract or identification number	613953
Number of Individuals Covered	158
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $309
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $309
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	MORGAN STANLEY SMITH BARNEY LLC

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Company Name:	COLUMBUS HOSPICE, INC.
Employer identification number (EIN):	581385395
NAIC Classification:	621900