401k Plan data: DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN plan

DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 401k Plan overview

Plan Name	DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN
Plan identification number	002

DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.

401k Sponsoring company profile

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

Company Name: DEKALB MEDICAL

Employer identification number (EIN): 581966795

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2020-01-01 CATHY HARDIN 2020-10-15
002 2019-01-01
002 2018-01-01
002 2017-01-01 CATHY HARDIN
002 2016-01-01 CATHY HARDIN
002 2015-01-01 LEROY WALKER
002 2014-01-01 LEROY WALKER
002 2013-01-01 LEROY WALKER LEROY WALKER 2014-10-15
002 2012-01-01 LEROY WALKER LEROY WALKER 2013-10-14
002 2011-01-01 LEROY WALKER LEROY WALKER 2013-12-31
002 2010-01-01 LEROY WALKER LEROY WALKER 2013-12-31
002 2009-01-01 LEROY WALKER LEROY WALKER 2013-12-31
002 2009-01-01 TOM CRAWFORD TOM CRAWFORD 2010-10-15

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2020-01-01	CATHY HARDIN	2020-10-15
002	2019-01-01
002	2018-01-01
002	2017-01-01	CATHY HARDIN
002	2016-01-01	CATHY HARDIN
002	2015-01-01	LEROY WALKER
002	2014-01-01	LEROY WALKER
002	2013-01-01	LEROY WALKER		LEROY WALKER	2014-10-15
002	2012-01-01	LEROY WALKER		LEROY WALKER	2013-10-14
002	2011-01-01	LEROY WALKER		LEROY WALKER	2013-12-31
002	2010-01-01	LEROY WALKER		LEROY WALKER	2013-12-31
002	2009-01-01	LEROY WALKER		LEROY WALKER	2013-12-31
002	2009-01-01	TOM CRAWFORD		TOM CRAWFORD	2010-10-15

Plan Statistics for DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN

401k plan membership statisitcs for DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN

Measure Date Value
2019: DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 3,025
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 0
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 1
Total of all active and inactive participants 2019-01-01 1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 1
Number of participants with account balances 2019-01-01 1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 6,285
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 4,140
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 1,791
Total of all active and inactive participants 2018-01-01 5,931
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 5,931
Number of participants with account balances 2018-01-01 3,203
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 6,079
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 4,275
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 2,028
Total of all active and inactive participants 2017-01-01 6,303
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 6,303
Number of participants with account balances 2017-01-01 4,301
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 116
2016: DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 5,813
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 4,137
Number of other retired or separated participants entitled to future benefits 2016-01-01 1,920
Total of all active and inactive participants 2016-01-01 6,057
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 6,057
Number of participants with account balances 2016-01-01 4,239
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 124
2015: DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 5,600
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 4,063
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 1,769
Total of all active and inactive participants 2015-01-01 5,832
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 5,832
Number of participants with account balances 2015-01-01 4,091
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 139
2014: DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 5,393
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 4,127
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 1,408
Total of all active and inactive participants 2014-01-01 5,535
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 5,535
Number of participants with account balances 2014-01-01 3,922
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 4,838
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 4,003
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 1,447
Total of all active and inactive participants 2013-01-01 5,450
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 5,450
Number of participants with account balances 2013-01-01 3,797
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 3,602
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 3,805
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 1,287
Total of all active and inactive participants 2012-01-01 5,092
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 5,092
Number of participants with account balances 2012-01-01 3,851
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 33
2011: DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 4,406
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 3,800
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 1,208
Total of all active and inactive participants 2011-01-01 5,008
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 5,008
Number of participants with account balances 2011-01-01 4,070
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 4,245
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 3,772
Number of retired or separated participants receiving benefits 2010-01-01 89
Number of other retired or separated participants entitled to future benefits 2010-01-01 545
Total of all active and inactive participants 2010-01-01 4,406
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 4,406
Number of participants with account balances 2010-01-01 4,022
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 2
2009: DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 4,204
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 3,738
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 507
Total of all active and inactive participants 2009-01-01 4,245
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 4,245
Number of participants with account balances 2009-01-01 2,014
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 65

Measure	Date	Value
2019: DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	3,025
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	0
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	1
Total of all active and inactive participants	2019-01-01	1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	1
Number of participants with account balances	2019-01-01	1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	6,285
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	4,140
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	1,791
Total of all active and inactive participants	2018-01-01	5,931
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	5,931
Number of participants with account balances	2018-01-01	3,203
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	6,079
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	4,275
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	2,028
Total of all active and inactive participants	2017-01-01	6,303
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	6,303
Number of participants with account balances	2017-01-01	4,301
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	116
2016: DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	5,813
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	4,137
Number of other retired or separated participants entitled to future benefits	2016-01-01	1,920
Total of all active and inactive participants	2016-01-01	6,057
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	6,057
Number of participants with account balances	2016-01-01	4,239
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	124
2015: DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	5,600
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	4,063
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	1,769
Total of all active and inactive participants	2015-01-01	5,832
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	5,832
Number of participants with account balances	2015-01-01	4,091
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	139
2014: DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	5,393
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	4,127
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	1,408
Total of all active and inactive participants	2014-01-01	5,535
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	5,535
Number of participants with account balances	2014-01-01	3,922
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	4,838
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	4,003
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	1,447
Total of all active and inactive participants	2013-01-01	5,450
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	5,450
Number of participants with account balances	2013-01-01	3,797
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	3,602
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	3,805
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	1,287
Total of all active and inactive participants	2012-01-01	5,092
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	5,092
Number of participants with account balances	2012-01-01	3,851
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	33
2011: DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	4,406
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	3,800
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	1,208
Total of all active and inactive participants	2011-01-01	5,008
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	5,008
Number of participants with account balances	2011-01-01	4,070
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	4,245
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	3,772
Number of retired or separated participants receiving benefits	2010-01-01	89
Number of other retired or separated participants entitled to future benefits	2010-01-01	545
Total of all active and inactive participants	2010-01-01	4,406
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	4,406
Number of participants with account balances	2010-01-01	4,022
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	2
2009: DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	4,204
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	3,738
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	507
Total of all active and inactive participants	2009-01-01	4,245
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	4,245
Number of participants with account balances	2009-01-01	2,014
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	65

Financial Data on DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN

Measure	Date	Value
2019 : DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2019 401k financial data
Total income from all sources (including contributions)	2019-12-31	$13,013,884
Total income from all sources (including contributions)	2019-12-31	$13,013,884
Total of all expenses incurred	2019-12-31	$139,336,143
Total of all expenses incurred	2019-12-31	$139,336,143
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$139,038,466
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$139,038,466
Expenses. Certain deemed distributions of participant loans	2019-12-31	$5,338
Expenses. Certain deemed distributions of participant loans	2019-12-31	$5,338
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$13,343
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$13,343
Value of total assets at end of year	2019-12-31	$5,888
Value of total assets at beginning of year	2019-12-31	$126,328,147
Value of total assets at beginning of year	2019-12-31	$126,328,147
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$292,339
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$292,339
Total interest from all sources	2019-12-31	$357,437
Total interest from all sources	2019-12-31	$357,437
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$985,113
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$985,113
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	Yes
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2019-12-31	$0
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2019-12-31	$0
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$985,113
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$985,113
Was this plan covered by a fidelity bond	2019-12-31	Yes
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$10,000,000
Value of fidelity bond cover	2019-12-31	$10,000,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
If this is an individual account plan, was there a blackout period	2019-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Participant contributions at beginning of year	2019-12-31	$2,547,156
Participant contributions at beginning of year	2019-12-31	$2,547,156
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
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$-126,322,259
Value of net income/loss	2019-12-31	$-126,322,259
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$5,888
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$5,888
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$126,328,147
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$126,328,147
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$90,934,501
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$90,934,501
Interest on participant loans	2019-12-31	$51,528
Interest on participant loans	2019-12-31	$51,528
Interest earned on other investments	2019-12-31	$305,909
Interest earned on other investments	2019-12-31	$305,909
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$5,888
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$5,888
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$32,846,490
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$32,846,490
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$11,657,991
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$11,657,991
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
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	$13,343
Contributions received in cash from employer	2019-12-31	$13,343
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$139,038,466
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$139,038,466
Contract administrator fees	2019-12-31	$292,339
Contract administrator fees	2019-12-31	$292,339
Did the plan have assets held for investment	2019-12-31	Yes
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
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
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
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
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	WARREN AVERETT
Accountancy firm name	2019-12-31	WARREN AVERETT
Accountancy firm EIN	2019-12-31	454084437
Accountancy firm EIN	2019-12-31	454084437
2018 : DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2018 401k financial data
Total income from all sources (including contributions)	2018-12-31	$6,096,372
Total of all expenses incurred	2018-12-31	$89,696,612
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$88,781,738
Expenses. Certain deemed distributions of participant loans	2018-12-31	$147,484
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$10,853,846
Value of total assets at end of year	2018-12-31	$126,328,147
Value of total assets at beginning of year	2018-12-31	$209,928,387
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$767,390
Total interest from all sources	2018-12-31	$1,064,727
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$5,172,393
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2018-12-31	$0
Total dividends received from registered investment company shares (eg mutual funds)	2018-12-31	$5,172,393
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$10,000,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$8,070,975
Participant contributions at end of year	2018-12-31	$2,547,156
Participant contributions at beginning of year	2018-12-31	$3,877,675
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$244,055
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$-83,600,240
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$126,328,147
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$209,928,387
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$90,934,501
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$157,588,132
Interest on participant loans	2018-12-31	$165,645
Interest earned on other investments	2018-12-31	$899,082
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$32,846,490
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$48,462,580
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-10,994,594
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	$2,538,816
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$88,781,738
Contract administrator fees	2018-12-31	$767,390
Did the plan have assets held for investment	2018-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	WARREN AVERTT, LLC
Accountancy firm EIN	2018-12-31	454084437
2017 : DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2017 401k financial data
Total income from all sources (including contributions)	2017-12-31	$43,150,627
Total of all expenses incurred	2017-12-31	$16,487,571
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$15,433,071
Expenses. Certain deemed distributions of participant loans	2017-12-31	$286,522
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$15,893,941
Value of total assets at end of year	2017-12-31	$209,928,387
Value of total assets at beginning of year	2017-12-31	$183,265,331
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$767,978
Total interest from all sources	2017-12-31	$1,125,194
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$5,008,347
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	$5,008,347
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$10,000,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$10,988,872
Participant contributions at end of year	2017-12-31	$3,877,675
Participant contributions at beginning of year	2017-12-31	$3,689,571
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$1,112,646
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$26,663,056
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$209,928,387
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$183,265,331
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$157,588,132
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$131,651,388
Interest on participant loans	2017-12-31	$152,860
Interest earned on other investments	2017-12-31	$972,334
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$48,462,580
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$47,924,372
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$21,123,145
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	$3,792,423
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$15,433,071
Contract administrator fees	2017-12-31	$767,978
Did the plan have assets held for investment	2017-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	WARREN AVERTT, LLC
Accountancy firm EIN	2017-12-31	454084437
2016 : DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$29,799,546
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$17,272,959
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$16,341,841
Expenses. Certain deemed distributions of participant loans	2016-12-31	$246,484
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$19,472,912
Value of total assets at end of year	2016-12-31	$183,265,331
Value of total assets at beginning of year	2016-12-31	$170,738,744
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$684,634
Total interest from all sources	2016-12-31	$1,129,843
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$3,229,845
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	$3,229,845
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$10,000,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$11,130,258
Participant contributions at end of year	2016-12-31	$3,689,571
Participant contributions at beginning of year	2016-12-31	$3,763,315
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$1,426,580
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$12,526,587
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$183,265,331
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$170,738,744
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$131,651,388
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$122,032,745
Interest on participant loans	2016-12-31	$141,082
Interest earned on other investments	2016-12-31	$988,761
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$47,924,372
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$44,942,684
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$5,966,946
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$6,916,074
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$16,341,841
Contract administrator fees	2016-12-31	$684,634
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	WARREN AVERETT, LLC.
Accountancy firm EIN	2016-12-31	454084437
2015 : DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$19,720,273
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$16,701,449
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$15,882,856
Expenses. Certain deemed distributions of participant loans	2015-12-31	$157,276
Value of total corrective distributions	2015-12-31	$588
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$18,192,677
Value of total assets at end of year	2015-12-31	$170,738,744
Value of total assets at beginning of year	2015-12-31	$167,719,920
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$660,729
Total interest from all sources	2015-12-31	$1,201,055
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$4,112,368
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	$4,112,368
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$10,000,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$10,379,146
Participant contributions at end of year	2015-12-31	$3,763,315
Participant contributions at beginning of year	2015-12-31	$3,105,320
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$1,323,182
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$3,018,824
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$170,738,744
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$167,719,920
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$122,032,745
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$120,712,806
Interest on participant loans	2015-12-31	$131,266
Interest earned on other investments	2015-12-31	$1,069,789
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$44,942,684
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$43,901,794
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-3,785,827
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	$6,490,349
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$15,882,856
Contract administrator fees	2015-12-31	$660,729
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	WARREN AVERETT, LLC
Accountancy firm EIN	2015-12-31	454084437
2014 : DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$27,460,541
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$14,687,004
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$13,897,775
Expenses. Certain deemed distributions of participant loans	2014-12-31	$239,627
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$17,318,289
Value of total assets at end of year	2014-12-31	$167,719,920
Value of total assets at beginning of year	2014-12-31	$154,946,383
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$549,602
Total interest from all sources	2014-12-31	$1,208,520
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$4,655,629
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$4,655,629
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$10,000,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$9,618,477
Participant contributions at end of year	2014-12-31	$3,105,320
Participant contributions at beginning of year	2014-12-31	$2,671,545
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$1,479,372
Administrative expenses (other) incurred	2014-12-31	$4
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$12,773,537
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$167,719,920
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$154,946,383
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	$120,712,806
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$108,759,166
Interest on participant loans	2014-12-31	$114,105
Interest earned on other investments	2014-12-31	$1,094,415
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$43,901,794
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$43,515,672
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$4,278,103
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	$6,220,440
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$13,897,775
Contract administrator fees	2014-12-31	$549,598
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	WARREN AVERETT, LLC
Accountancy firm EIN	2014-12-31	454084437
2013 : DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$39,997,235
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$12,178,200
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$11,620,572
Expenses. Certain deemed distributions of participant loans	2013-12-31	$88,972
Value of total corrective distributions	2013-12-31	$7,423
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$17,150,453
Value of total assets at end of year	2013-12-31	$154,946,383
Value of total assets at beginning of year	2013-12-31	$127,127,348
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$461,233
Total interest from all sources	2013-12-31	$1,146,119
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$2,677,446
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-12-31	$2,677,446
Was this plan covered by a fidelity bond	2013-12-31	No
If this is an individual account plan, was there a blackout period	2013-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$9,325,059
Participant contributions at end of year	2013-12-31	$2,671,545
Participant contributions at beginning of year	2013-12-31	$2,525,748
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$1,855,545
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	$27,819,035
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$154,946,383
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$127,127,348
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	$108,759,166
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$83,922,088
Interest on participant loans	2013-12-31	$99,053
Interest earned on other investments	2013-12-31	$1,047,066
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$43,515,672
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$40,679,512
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$19,023,217
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	$5,969,849
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$11,620,572
Contract administrator fees	2013-12-31	$461,233
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2013-12-31	No
Did the plan have assets held for investment	2013-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	WARREN AVERETT, LLC
Accountancy firm EIN	2013-12-31	454084437
2012 : DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$27,877,679
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$10,374,139
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$9,949,305
Expenses. Certain deemed distributions of participant loans	2012-12-31	$19,148
Value of total corrective distributions	2012-12-31	$1,913
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$15,892,269
Value of total assets at end of year	2012-12-31	$127,127,348
Value of total assets at beginning of year	2012-12-31	$109,623,808
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$403,773
Total interest from all sources	2012-12-31	$1,220,007
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$1,838,215
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-12-31	$1,838,215
Was this plan covered by a fidelity bond	2012-12-31	No
If this is an individual account plan, was there a blackout period	2012-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$8,246,423
Participant contributions at end of year	2012-12-31	$2,525,748
Participant contributions at beginning of year	2012-12-31	$2,439,814
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$1,445,388
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2012-12-31	$2
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2012-12-31	$0
Administrative expenses (other) incurred	2012-12-31	$23
Total non interest bearing cash at beginning of year	2012-12-31	$77
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	$17,503,540
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$127,127,348
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$109,623,808
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	$83,922,088
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$70,538,899
Interest on participant loans	2012-12-31	$97,358
Interest earned on other investments	2012-12-31	$1,122,649
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$40,679,512
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$36,645,016
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$8,927,188
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	$6,200,458
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$9,949,305
Contract administrator fees	2012-12-31	$403,750
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2012-12-31	No
Did the plan have assets held for investment	2012-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	WARREN AVERETT, LLC
Accountancy firm EIN	2012-12-31	454084437
2011 : DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$190,677
Total income from all sources (including contributions)	2011-12-31	$14,913,563
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$9,997,570
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$9,573,665
Expenses. Certain deemed distributions of participant loans	2011-12-31	$142,759
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$15,314,979
Value of total assets at end of year	2011-12-31	$107,542,038
Value of total assets at beginning of year	2011-12-31	$102,816,722
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$281,146
Total interest from all sources	2011-12-31	$850,449
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$1,300,923
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2011-12-31	$1,300,923
Was this plan covered by a fidelity bond	2011-12-31	No
If this is an individual account plan, was there a blackout period	2011-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$8,174,466
Participant contributions at end of year	2011-12-31	$2,334,252
Participant contributions at beginning of year	2011-12-31	$1,842,413
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$971,107
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-12-31	$2
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-12-31	$78,095
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2011-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2011-12-31	$190,677
Other income not declared elsewhere	2011-12-31	$283,925
Administrative expenses (other) incurred	2011-12-31	$1
Total non interest bearing cash at end of year	2011-12-31	$77
Total non interest bearing cash at beginning of year	2011-12-31	$2,092
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	$4,915,993
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$107,542,038
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$102,626,045
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	$68,843,998
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$67,836,569
Interest on participant loans	2011-12-31	$71,779
Interest earned on other investments	2011-12-31	$778,670
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-12-31	$115,825
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-12-31	$115,825
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$36,363,709
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$32,941,728
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-2,836,713
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	$6,169,406
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$9,573,665
Contract administrator fees	2011-12-31	$281,145
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2011-12-31	No
Did the plan have assets held for investment	2011-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	WARREN AVERETT, LLC
Accountancy firm EIN	2011-12-31	454084437
2010 : DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$190,677
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$33,077
Total income from all sources (including contributions)	2010-12-31	$23,595,298
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$8,730,641
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$8,462,576
Expenses. Certain deemed distributions of participant loans	2010-12-31	$29,845
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$14,048,167
Value of total assets at end of year	2010-12-31	$102,816,722
Value of total assets at beginning of year	2010-12-31	$87,794,465
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$238,220
Total interest from all sources	2010-12-31	$792,083
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$1,423,965
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2010-12-31	$1,423,965
Was this plan covered by a fidelity bond	2010-12-31	No
If this is an individual account plan, was there a blackout period	2010-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$7,401,833
Participant contributions at end of year	2010-12-31	$1,842,413
Participant contributions at beginning of year	2010-12-31	$1,935,127
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$1,014,822
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2010-12-31	$236,026
Value of other receiveables (less allowance for doubtful accounts) at end of year	2010-12-31	$78,095
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2010-12-31	$33,077
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2010-12-31	$190,677
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2010-12-31	$33,077
Other income not declared elsewhere	2010-12-31	$277,740
Total non interest bearing cash at end of year	2010-12-31	$2,092
Total non interest bearing cash at beginning of year	2010-12-31	$4,340
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	$14,864,657
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$102,626,045
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$87,761,388
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	$67,836,569
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$56,333,412
Interest on participant loans	2010-12-31	$92,008
Interest earned on other investments	2010-12-31	$700,075
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2010-12-31	$115,825
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2010-12-31	$8,060
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2010-12-31	$8,060
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$32,941,728
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$29,480,449
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$7,053,343
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	$5,631,512
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$8,226,550
Contract administrator fees	2010-12-31	$238,220
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2010-12-31	No
Did the plan have assets held for investment	2010-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	WARREN, AVERETT, KIMBROUGH & MARINO
Accountancy firm EIN	2010-12-31	631239684

Form 5500 Responses for DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN

2019: DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
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: DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
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: DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
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: DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	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: DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	Yes
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	Yes
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	Yes
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: DEKALB REGIONAL HEALTH SYSTEM INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	Yes
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

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

Policy contract number

CR30524

Policy instance

Insurance contract or identification number	CR30524
Number of Individuals Covered	144
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $4,107
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
Commission paid to Insurance Broker	USD $4,107
Insurance broker organization code?	3

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

Policy contract number

67160

Policy instance

Insurance contract or identification number	67160
Number of Individuals Covered	26
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $65
Contracts With Unallocated Funds Deposit Administration	1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $33
Insurance broker organization code?	3

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

Policy contract number

67160

Policy instance

Insurance contract or identification number	67160
Number of Individuals Covered	0
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Contracts With Unallocated Funds Deposit Administration	1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

67160

Policy instance

Insurance contract or identification number	67160
Number of Individuals Covered	2957
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Contracts With Unallocated Funds Deposit Administration	1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

67160

Policy instance

Insurance contract or identification number	67160
Number of Individuals Covered	464
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $205
Contracts With Unallocated Funds Deposit Administration	1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $93
Insurance broker organization code?	3

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

Policy contract number

CR30524

Policy instance

Insurance contract or identification number	CR30524
Number of Individuals Covered	167
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $5,201
Contracts With Unallocated Funds Deposit Administration	1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,201
Insurance broker organization code?	3

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

Policy contract number

67160

Policy instance

Insurance contract or identification number	67160
Number of Individuals Covered	579
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $520
Contracts With Unallocated Funds Deposit Administration	1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $274
Insurance broker organization code?	3
Insurance broker name	LIPTON, ZACHARY

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

Policy contract number

67160

Policy instance

Insurance contract or identification number	67160
Number of Individuals Covered	4043
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Contracts With Unallocated Funds Deposit Administration	1
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

CR30524

Policy instance

Insurance contract or identification number	CR30524
Number of Individuals Covered	181
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $3,346
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,346
Insurance broker organization code?	3
Insurance broker name	LINCOLN FINANCIAL ADVISORS

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

Policy contract number

67160

Policy instance

Insurance contract or identification number	67160
Number of Individuals Covered	635
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $580
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $349
Insurance broker organization code?	3
Insurance broker name	BURKE, WILLIAM H

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

Policy contract number

67160

Policy instance

Insurance contract or identification number	67160
Number of Individuals Covered	3809
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	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

CR30524

Policy instance

Insurance contract or identification number	CR30524
Number of Individuals Covered	199
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

CR30524

Policy instance

Insurance contract or identification number	CR30524
Number of Individuals Covered	211
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

67160

Policy instance

Insurance contract or identification number	67160
Number of Individuals Covered	664
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $1,349
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $782
Insurance broker organization code?	3
Insurance broker name	KLEINE-KRACHT,II, JOSEPH M

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

Policy contract number

67160

Policy instance

Insurance contract or identification number	67160
Number of Individuals Covered	3623
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	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

CR30524

Policy instance

Insurance contract or identification number	CR30524
Number of Individuals Covered	225
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $58
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $58
Insurance broker organization code?	4
Insurance broker name	LINCOLN FINANCIAL ADVISORS

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

Policy contract number

67160

Policy instance

Insurance contract or identification number	67160
Number of Individuals Covered	711
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $1,158
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $695
Insurance broker organization code?	3
Insurance broker name	CAMERON, STEPHEN S

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

Policy contract number

67160

Policy instance

Insurance contract or identification number	67160
Number of Individuals Covered	3553
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

67160

Policy instance

Insurance contract or identification number	67160
Number of Individuals Covered	3340
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	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

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

Policy contract number

67160

Policy instance

Insurance contract or identification number	67160
Number of Individuals Covered	754
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $1,037
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $522
Insurance broker organization code?	3
Insurance broker name	JOHNSON, JAY N

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

Policy contract number

CR30524

Policy instance

Insurance contract or identification number	CR30524
Number of Individuals Covered	242
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No

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

Policy contract number

67160

Policy instance

Insurance contract or identification number	67160
Number of Individuals Covered	801
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $1,649

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

Policy contract number

CR30524

Policy instance

Insurance contract or identification number	CR30524
Number of Individuals Covered	262
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $3,704

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

Policy contract number

GP 55372

Policy instance

Insurance contract or identification number	GP 55372
Number of Individuals Covered	0
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31

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

Policy contract number

67160

Policy instance

Insurance contract or identification number	67160
Number of Individuals Covered	3270
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $0

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

Policy contract number

67160

Policy instance

Insurance contract or identification number	67160
Number of Individuals Covered	2159
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $0

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

Policy contract number

GP 55372

Policy instance

Insurance contract or identification number	GP 55372
Number of Individuals Covered	1024
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $15,202

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

Policy contract number

CR30524

Policy instance

Insurance contract or identification number	CR30524
Number of Individuals Covered	286
Insurance policy start date	2010-01-01
Insurance policy end date	2010-01-01
Total amount of commissions paid to insurance broker	USD $3,614

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

Policy contract number

67160

Policy instance

Insurance contract or identification number	67160
Number of Individuals Covered	839
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $880

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Company Name:	DEKALB MEDICAL
Employer identification number (EIN):	581966795
NAIC Classification:	622000
NAIC Description:	Hospitals