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WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 401k Plan overview

Plan NameWELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN
Plan identification number 002

WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN Benefits

401k Plan TypeDefined 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.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

HAWKINS COUNTY MEMORIAL HOSPITAL has sponsored the creation of one or more 401k plans.

Company Name:HAWKINS COUNTY MEMORIAL HOSPITAL
Employer identification number (EIN):621816368
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022022-01-01TAFT SIMMONS2023-09-25
0022021-01-01TAFT SIMMONS2022-10-13
0022020-01-01TAFT SIMMONS2021-10-14
0022019-01-01TAFT SIMMONS2020-10-14
0022018-01-01TAFT SIMMONS2019-10-14
0022017-01-01HAMLIN WILSON
0022016-01-01HAMLIN WILSON
0022015-01-01HAMLIN WILSON
0022014-01-01HAMLIN WILSON
0022014-01-01HAMLIN WILSON
0022013-01-01HAMLIN WILSON
0022012-01-01HAMLIN J WILSON
0022011-01-01HAMLIN J. WILSON
0022009-01-01HAMLIN J. WILSON
0022008-01-01HAMLIN J. WILSON HAMLIN J. WILSON2010-10-14
0022007-01-01HAMLIN J. WILSON HAMLIN J. WILSON2010-10-14
0022006-01-01HAMLIN J. WILSON HAMLIN J. WILSON2010-10-14

Plan Statistics for WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN

401k plan membership statisitcs for WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN

Measure Date Value
2022: WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01131
Total number of active participants reported on line 7a of the Form 55002022-01-0198
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-0114
Total of all active and inactive participants2022-01-01112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01112
Number of participants with account balances2022-01-0142
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010
2021: WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01166
Total number of active participants reported on line 7a of the Form 55002021-01-01114
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-0117
Total of all active and inactive participants2021-01-01131
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01131
Number of participants with account balances2021-01-0148
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01192
Total number of active participants reported on line 7a of the Form 55002020-01-01133
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-0133
Total of all active and inactive participants2020-01-01166
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01166
Number of participants with account balances2020-01-0172
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01296
Total number of active participants reported on line 7a of the Form 55002019-01-01265
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-0129
Total of all active and inactive participants2019-01-01294
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01294
Number of participants with account balances2019-01-0195
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01307
Total number of active participants reported on line 7a of the Form 55002018-01-01269
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-0128
Total of all active and inactive participants2018-01-01297
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01297
Number of participants with account balances2018-01-0196
2017: WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01321
Total number of active participants reported on line 7a of the Form 55002017-01-01276
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-0132
Total of all active and inactive participants2017-01-01308
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-01308
Number of participants with account balances2017-01-01103
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01288
Total number of active participants reported on line 7a of the Form 55002016-01-01281
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-0139
Total of all active and inactive participants2016-01-01320
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-01320
Number of participants with account balances2016-01-01113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01338
Total number of active participants reported on line 7a of the Form 55002015-01-01288
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01288
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-01288
Number of participants with account balances2015-01-01117
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01340
Total number of active participants reported on line 7a of the Form 55002014-01-01296
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-0141
Total of all active and inactive participants2014-01-01337
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-01337
Number of participants with account balances2014-01-01126
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01342
Total number of active participants reported on line 7a of the Form 55002013-01-01290
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-0136
Total of all active and inactive participants2013-01-01326
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-01326
Number of participants with account balances2013-01-01129
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01331
Total number of active participants reported on line 7a of the Form 55002012-01-01286
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-0137
Total of all active and inactive participants2012-01-01323
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-01323
Number of participants with account balances2012-01-01134
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01326
Total number of active participants reported on line 7a of the Form 55002011-01-01295
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-0136
Total of all active and inactive participants2011-01-01331
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-01331
Number of participants with account balances2011-01-01137
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2009: WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01299
Total number of active participants reported on line 7a of the Form 55002009-01-01262
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-0127
Total of all active and inactive participants2009-01-01289
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-01289
Number of participants with account balances2009-01-01103
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN

Measure Date Value
2022 : WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2022 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2022-12-31$-340,267
Total unrealized appreciation/depreciation of assets2022-12-31$-340,267
Total income from all sources (including contributions)2022-12-31$-320,651
Total of all expenses incurred2022-12-31$166,968
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$166,968
Value of total assets at end of year2022-12-31$1,693,934
Value of total assets at beginning of year2022-12-31$2,181,553
Total interest from all sources2022-12-31$19,616
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$10,000,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-487,619
Value of net assets at end of year (total assets less liabilities)2022-12-31$1,693,934
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$2,181,553
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest in pooled separate accounts at end of year2022-12-31$1,084,048
Value of interest in pooled separate accounts at beginning of year2022-12-31$1,681,973
Interest earned on other investments2022-12-31$19,616
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$609,886
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$499,580
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$166,968
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31PYA, P.C.
Accountancy firm EIN2022-12-31621517792
2021 : WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2021 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2021-12-31$315,328
Total unrealized appreciation/depreciation of assets2021-12-31$315,328
Total income from all sources (including contributions)2021-12-31$336,896
Total of all expenses incurred2021-12-31$453,775
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$453,775
Value of total assets at end of year2021-12-31$2,181,553
Value of total assets at beginning of year2021-12-31$2,298,432
Total interest from all sources2021-12-31$21,568
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$10,000,000
If this is an individual account plan, was there a blackout period2021-12-31No
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$-116,879
Value of net assets at end of year (total assets less liabilities)2021-12-31$2,181,553
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$2,298,432
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest in pooled separate accounts at end of year2021-12-31$1,681,973
Value of interest in pooled separate accounts at beginning of year2021-12-31$1,735,401
Interest earned on other investments2021-12-31$21,568
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$499,580
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$563,031
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$453,775
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31PYA, P.C.
Accountancy firm EIN2021-12-31621517792
2020 : WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2020 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2020-12-31$315,416
Total unrealized appreciation/depreciation of assets2020-12-31$315,416
Total income from all sources (including contributions)2020-12-31$337,789
Total of all expenses incurred2020-12-31$235,429
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$235,429
Value of total assets at end of year2020-12-31$2,298,432
Value of total assets at beginning of year2020-12-31$2,196,072
Total interest from all sources2020-12-31$22,373
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$10,000,000
If this is an individual account plan, was there a blackout period2020-12-31No
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$102,360
Value of net assets at end of year (total assets less liabilities)2020-12-31$2,298,432
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$2,196,072
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest in pooled separate accounts at end of year2020-12-31$1,735,401
Value of interest in pooled separate accounts at beginning of year2020-12-31$1,627,558
Interest earned on other investments2020-12-31$22,373
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$563,031
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$568,514
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$235,429
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Disclaimer
Accountancy firm name2020-12-31PYA, P.C.
Accountancy firm EIN2020-12-31621517792
2019 : WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2019 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2019-12-31$322,832
Unrealized appreciation/depreciation of other (non real estate) assets2019-12-31$322,832
Total unrealized appreciation/depreciation of assets2019-12-31$322,832
Total unrealized appreciation/depreciation of assets2019-12-31$322,832
Total income from all sources (including contributions)2019-12-31$344,628
Total income from all sources (including contributions)2019-12-31$344,628
Total of all expenses incurred2019-12-31$2,355
Total of all expenses incurred2019-12-31$2,355
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$2,355
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$2,355
Value of total assets at end of year2019-12-31$2,196,072
Value of total assets at end of year2019-12-31$2,196,072
Value of total assets at beginning of year2019-12-31$1,853,799
Value of total assets at beginning of year2019-12-31$1,853,799
Total interest from all sources2019-12-31$21,796
Total interest from all sources2019-12-31$21,796
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31Yes
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$10,000,000
Value of fidelity bond cover2019-12-31$10,000,000
If this is an individual account plan, was there a blackout period2019-12-31No
If this is an individual account plan, was there a blackout period2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$342,273
Value of net income/loss2019-12-31$342,273
Value of net assets at end of year (total assets less liabilities)2019-12-31$2,196,072
Value of net assets at end of year (total assets less liabilities)2019-12-31$2,196,072
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$1,853,799
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$1,853,799
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest in pooled separate accounts at end of year2019-12-31$1,627,558
Value of interest in pooled separate accounts at end of year2019-12-31$1,627,558
Value of interest in pooled separate accounts at beginning of year2019-12-31$1,307,081
Value of interest in pooled separate accounts at beginning of year2019-12-31$1,307,081
Interest earned on other investments2019-12-31$21,796
Interest earned on other investments2019-12-31$21,796
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$568,514
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$568,514
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$546,718
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$546,718
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$2,355
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$2,355
Did the plan have assets held for investment2019-12-31Yes
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31PYA, P.C.
Accountancy firm name2019-12-31PYA, P.C.
Accountancy firm EIN2019-12-31621517792
Accountancy firm EIN2019-12-31621517792
2018 : WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2018 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2018-12-31$-53,720
Total unrealized appreciation/depreciation of assets2018-12-31$-53,720
Total income from all sources (including contributions)2018-12-31$-31,811
Total of all expenses incurred2018-12-31$129,881
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$129,881
Value of total assets at end of year2018-12-31$1,853,799
Value of total assets at beginning of year2018-12-31$2,015,491
Total interest from all sources2018-12-31$21,909
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$10,000,000
If this is an individual account plan, was there a blackout period2018-12-31No
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$-161,692
Value of net assets at end of year (total assets less liabilities)2018-12-31$1,853,799
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$2,015,491
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Value of interest in pooled separate accounts at end of year2018-12-31$1,307,081
Value of interest in pooled separate accounts at beginning of year2018-12-31$1,464,613
Interest earned on other investments2018-12-31$21,909
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$546,718
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$550,878
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$129,881
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31PERSHING YOAKLEY & ASSOCIATES
Accountancy firm EIN2018-12-31621517792
2017 : WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2017 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2017-12-31$245,665
Total unrealized appreciation/depreciation of assets2017-12-31$245,665
Total income from all sources (including contributions)2017-12-31$267,499
Total of all expenses incurred2017-12-31$62,971
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$62,971
Value of total assets at end of year2017-12-31$2,015,491
Value of total assets at beginning of year2017-12-31$1,810,963
Total interest from all sources2017-12-31$21,834
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$10,000,000
If this is an individual account plan, was there a blackout period2017-12-31No
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$204,528
Value of net assets at end of year (total assets less liabilities)2017-12-31$2,015,491
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$1,810,963
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest in pooled separate accounts at end of year2017-12-31$1,464,613
Value of interest in pooled separate accounts at beginning of year2017-12-31$1,259,759
Interest earned on other investments2017-12-31$21,834
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-12-31$550,878
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-12-31$551,204
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$62,971
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31RODEFER MOSS & CO PLLC
Accountancy firm EIN2017-12-31621690032
2016 : WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2016 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2016-12-31$45,817
Total unrealized appreciation/depreciation of assets2016-12-31$45,817
Total income from all sources (including contributions)2016-12-31$68,330
Total of all expenses incurred2016-12-31$139,434
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$139,434
Value of total assets at end of year2016-12-31$1,810,963
Value of total assets at beginning of year2016-12-31$1,882,067
Total interest from all sources2016-12-31$22,513
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$10,000,000
If this is an individual account plan, was there a blackout period2016-12-31No
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$-71,104
Value of net assets at end of year (total assets less liabilities)2016-12-31$1,810,963
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$1,882,067
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest in pooled separate accounts at end of year2016-12-31$1,259,759
Value of interest in pooled separate accounts at beginning of year2016-12-31$1,289,458
Interest earned on other investments2016-12-31$22,513
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-12-31$551,204
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-12-31$592,609
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$139,434
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31RODEFER MOSS & CO PLLC
Accountancy firm EIN2016-12-31621690032
2015 : WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2015 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2015-12-31$-9,847
Total unrealized appreciation/depreciation of assets2015-12-31$-9,847
Total income from all sources (including contributions)2015-12-31$12,967
Total of all expenses incurred2015-12-31$46,532
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$46,532
Value of total assets at end of year2015-12-31$1,882,067
Value of total assets at beginning of year2015-12-31$1,915,632
Total interest from all sources2015-12-31$22,814
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$1,000,000
If this is an individual account plan, was there a blackout period2015-12-31No
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$-33,565
Value of net assets at end of year (total assets less liabilities)2015-12-31$1,882,067
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$1,915,632
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest in pooled separate accounts at end of year2015-12-31$1,289,458
Value of interest in pooled separate accounts at beginning of year2015-12-31$1,369,051
Interest earned on other investments2015-12-31$22,814
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-12-31$592,609
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-12-31$546,581
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$46,532
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31RODEFER MOSS & CO PLLC
Accountancy firm EIN2015-12-31621690032
2014 : WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2014 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2014-12-31$96,736
Total unrealized appreciation/depreciation of assets2014-12-31$96,736
Total income from all sources (including contributions)2014-12-31$116,745
Total of all expenses incurred2014-12-31$11,403
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$11,403
Value of total assets at end of year2014-12-31$1,915,632
Value of total assets at beginning of year2014-12-31$1,810,290
Total interest from all sources2014-12-31$20,009
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$10,000,000
If this is an individual account plan, was there a blackout period2014-12-31No
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$105,342
Value of net assets at end of year (total assets less liabilities)2014-12-31$1,915,632
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$1,810,290
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$1,369,051
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$1,328,420
Interest earned on other investments2014-12-31$20,009
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-12-31$546,581
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-12-31$481,870
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$11,403
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31RODEFER MOSS & CO PLLC
Accountancy firm EIN2014-12-31621690032
2013 : WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2013 401k financial data
Total income from all sources (including contributions)2013-12-31$279,703
Total of all expenses incurred2013-12-31$10,439
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$10,439
Value of total assets at end of year2013-12-31$1,810,290
Value of total assets at beginning of year2013-12-31$1,541,026
Total interest from all sources2013-12-31$18,496
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$10,000,000
If this is an individual account plan, was there a blackout period2013-12-31No
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$269,264
Value of net assets at end of year (total assets less liabilities)2013-12-31$1,810,290
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$1,541,026
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-12-31$1,328,420
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$1,074,488
Interest earned on other investments2013-12-31$18,496
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-12-31$481,870
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-12-31$466,538
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-12-31$261,207
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$10,439
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31Yes
Opinion of an independent qualified public accountant for this plan2013-12-31Disclaimer
Accountancy firm name2013-12-31RODEFER MOSS & CO PLLC
Accountancy firm EIN2013-12-31621690032
2012 : WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2012 401k financial data
Total income from all sources (including contributions)2012-12-31$128,201
Total of all expenses incurred2012-12-31$138,007
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$138,007
Value of total assets at end of year2012-12-31$1,541,026
Value of total assets at beginning of year2012-12-31$1,550,832
Total interest from all sources2012-12-31$18,104
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$1,000,000
If this is an individual account plan, was there a blackout period2012-12-31No
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$-9,806
Value of net assets at end of year (total assets less liabilities)2012-12-31$1,541,026
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$1,550,832
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-12-31$1,074,488
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$1,069,198
Interest earned on other investments2012-12-31$18,104
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-12-31$466,538
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-12-31$481,301
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-12-31$110,097
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Employer contributions (assets) at beginning of year2012-12-31$333
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$138,007
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31Yes
Opinion of an independent qualified public accountant for this plan2012-12-31Disclaimer
Accountancy firm name2012-12-31RODEFER MOSS & CO PLLC
Accountancy firm EIN2012-12-31621690032
2011 : WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2011 401k financial data
Total income from all sources (including contributions)2011-12-31$166,887
Total of all expenses incurred2011-12-31$179,983
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$179,983
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$174,538
Value of total assets at end of year2011-12-31$1,550,832
Value of total assets at beginning of year2011-12-31$1,563,928
Total interest from all sources2011-12-31$17,284
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$1,000,000
If this is an individual account plan, was there a blackout period2011-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
Minimum employer required contribution for this plan year2011-12-31$0
Amount contributed by the employer to the plan for this plan year2011-12-31$0
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$174,538
Participant contributions at end of year2011-12-31$333
Participant contributions at beginning of year2011-12-31$4,949
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-13,096
Value of net assets at end of year (total assets less liabilities)2011-12-31$1,550,832
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$1,563,928
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-12-31$1,069,198
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-12-31$1,059,293
Interest earned on other investments2011-12-31$17,284
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-12-31$481,301
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-12-31$499,686
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-12-31$-24,935
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$179,983
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31KPMG LLP
Accountancy firm EIN2011-12-31135565207
2010 : WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2010 401k financial data
Total income from all sources (including contributions)2010-12-31$294,041
Total of all expenses incurred2010-12-31$155,728
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$155,728
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$160,361
Value of total assets at end of year2010-12-31$1,563,928
Value of total assets at beginning of year2010-12-31$1,425,615
Total interest from all sources2010-12-31$21,246
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$1,000,000
If this is an individual account plan, was there a blackout period2010-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$160,361
Participant contributions at end of year2010-12-31$4,949
Participant contributions at beginning of year2010-12-31$11,471
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$138,313
Value of net assets at end of year (total assets less liabilities)2010-12-31$1,563,928
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$1,425,615
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2010-12-31$1,059,293
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$876,075
Interest earned on other investments2010-12-31$21,246
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$499,686
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$538,069
Net investment gain/loss from registered investment companies (e.g. mutual funds)2010-12-31$112,434
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$155,728
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31No
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31KPMG LLP
Accountancy firm EIN2010-12-31135565207
2009 : WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2009-12-31$0

Form 5500 Responses for WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN

2022: WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedYes
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedYes
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2009: WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes
2008: WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2008 form 5500 responses
2008-01-01Type of plan entitySingle employer plan
2008-01-01Submission has been amendedNo
2008-01-01This submission is the final filingNo
2008-01-01This return/report is a short plan year return/report (less than 12 months)No
2008-01-01Plan is a collectively bargained planNo
2007: WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2007 form 5500 responses
2007-01-01Type of plan entitySingle employer plan
2007-01-01Submission has been amendedNo
2007-01-01This submission is the final filingNo
2007-01-01This return/report is a short plan year return/report (less than 12 months)No
2007-01-01Plan is a collectively bargained planNo
2006: WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL TAX DEFERRED ANNUITY PLAN 2006 form 5500 responses
2006-01-01Type of plan entitySingle employer plan
2006-01-01Submission has been amendedNo
2006-01-01This submission is the final filingNo
2006-01-01This return/report is a short plan year return/report (less than 12 months)No
2006-01-01Plan is a collectively bargained planNo

Insurance Providers Used on plan

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG90898
Policy instance 1
Insurance contract or identification numberG90898
Number of Individuals Covered42
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG90898
Policy instance 1
Insurance contract or identification numberG90898
Number of Individuals Covered48
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG90898
Policy instance 1
Insurance contract or identification numberG90898
Number of Individuals Covered72
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG90898
Policy instance 1
Insurance contract or identification numberG90898
Number of Individuals Covered95
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG90898
Policy instance 1
Insurance contract or identification numberG90898
Number of Individuals Covered96
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG90898
Policy instance 1
Insurance contract or identification numberG90898
Number of Individuals Covered103
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of fees paid to insurance companyUSD $1,495
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees1495
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameGALLAGHER BEN SERVICES INC.
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG90898
Policy instance 1
Insurance contract or identification numberG90898
Number of Individuals Covered117
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of fees paid to insurance companyUSD $1,905
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees1905
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameGARDNER & WHITE
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG90898
Policy instance 1
Insurance contract or identification numberG90898
Number of Individuals Covered126
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of fees paid to insurance companyUSD $1,862
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees1862
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameGARDNER & WHITE
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG90898
Policy instance 1
Insurance contract or identification numberG90898
Number of Individuals Covered129
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of fees paid to insurance companyUSD $1,651
Are there contracts with allocated funds for group deferred annuity?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees1651
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameGARDNER & WHITE
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG90898
Policy instance 1
Insurance contract or identification numberG90898
Number of Individuals Covered134
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $8
Total amount of fees paid to insurance companyUSD $1,522
Are there contracts with allocated funds for group deferred annuity?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8
Amount paid for insurance broker fees1522
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
Insurance broker nameGARDNER & WHITE
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG90898
Policy instance 1
Insurance contract or identification numberG90898
Number of Individuals Covered137
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $3,330
Total amount of fees paid to insurance companyUSD $1,491
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG90898
Policy instance 1
Insurance contract or identification numberG90898
Number of Individuals Covered103
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $3,490
Total amount of fees paid to insurance companyUSD $2,673
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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