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TAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER 401k Plan overview

Plan NameTAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER
Plan identification number 002

TAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • 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.

401k Sponsoring company profile

JEFFERSON HOSPITAL ASSOCIATION, INC has sponsored the creation of one or more 401k plans.

Company Name:JEFFERSON HOSPITAL ASSOCIATION, INC
Employer identification number (EIN):710329353
NAIC Classification:622000
NAIC Description: Hospitals

Additional information about JEFFERSON HOSPITAL ASSOCIATION, INC

Jurisdiction of Incorporation: Arkansas Secretary of State
Incorporation Date:
Company Identification Number: 100027932

More information about JEFFERSON HOSPITAL ASSOCIATION, INC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022023-01-01JEREMY JEFFERY2024-09-04 JEREMY JEFFERY2024-09-04
0022022-01-01JEREMY JEFFERY2023-10-13 JEREMY JEFFERY2023-10-13
0022021-01-01JEREMY JEFFERY2022-10-06 JEREMY JEFFERY2022-10-06
0022020-01-01JEREMY JEFFERY2021-10-15 JEREMY JEFFERY2021-10-15
0022019-01-01JEREMY JEFFERY2020-10-14
0022018-01-01BRYAN JACKSON2019-10-15
0022017-01-01BRYAN JACKSON
0022016-01-01BRYAN JACKSON
0022015-01-01BRYAN JACKSON
0022014-01-01BRYAN JACKSON BRYAN JACKSON2015-10-14
0022013-01-01BRYAN JACKSON BRYAN JACKSON2014-10-15
0022012-01-01BRYAN JACKSON
0022011-01-01BRYAN JACKSON
0022009-01-01BROCK HOLMAN

Plan Statistics for TAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER

401k plan membership statisitcs for TAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER

Measure Date Value
2023: TAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER 2023 401k membership
Total participants, beginning-of-year2023-01-01156
Total number of active participants reported on line 7a of the Form 55002023-01-01120
Number of retired or separated participants receiving benefits2023-01-014
Number of other retired or separated participants entitled to future benefits2023-01-0131
Total of all active and inactive participants2023-01-01155
Total participants2023-01-01155
Number of participants with account balances2023-01-01116
2022: TAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER 2022 401k membership
Total participants, beginning-of-year2022-01-01152
Total number of active participants reported on line 7a of the Form 55002022-01-01119
Number of retired or separated participants receiving benefits2022-01-014
Number of other retired or separated participants entitled to future benefits2022-01-0133
Total of all active and inactive participants2022-01-01156
Total participants2022-01-01156
Number of participants with account balances2022-01-01115
2021: TAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER 2021 401k membership
Total participants, beginning-of-year2021-01-01153
Total number of active participants reported on line 7a of the Form 55002021-01-01115
Number of other retired or separated participants entitled to future benefits2021-01-0137
Total of all active and inactive participants2021-01-01152
Total participants2021-01-01152
Number of participants with account balances2021-01-01117
2020: TAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER 2020 401k membership
Total participants, beginning-of-year2020-01-01155
Total number of active participants reported on line 7a of the Form 55002020-01-01111
Number of other retired or separated participants entitled to future benefits2020-01-0142
Total of all active and inactive participants2020-01-01153
Total participants2020-01-01153
Number of participants with account balances2020-01-01121
2019: TAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER 2019 401k membership
Total participants, beginning-of-year2019-01-01164
Total number of active participants reported on line 7a of the Form 55002019-01-01114
Number of other retired or separated participants entitled to future benefits2019-01-0141
Total of all active and inactive participants2019-01-01155
Total participants2019-01-01155
Number of participants with account balances2019-01-01126
2018: TAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER 2018 401k membership
Total participants, beginning-of-year2018-01-01163
Total number of active participants reported on line 7a of the Form 55002018-01-01121
Number of other retired or separated participants entitled to future benefits2018-01-0143
Total of all active and inactive participants2018-01-01164
Total participants2018-01-01164
Number of participants with account balances2018-01-01138
2017: TAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER 2017 401k membership
Total participants, beginning-of-year2017-01-01164
Total number of active participants reported on line 7a of the Form 55002017-01-01120
Number of other retired or separated participants entitled to future benefits2017-01-0143
Total of all active and inactive participants2017-01-01163
Total participants2017-01-01163
Number of participants with account balances2017-01-01138
2016: TAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER 2016 401k membership
Total participants, beginning-of-year2016-01-01159
Total number of active participants reported on line 7a of the Form 55002016-01-01122
Number of other retired or separated participants entitled to future benefits2016-01-0141
Total of all active and inactive participants2016-01-01163
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-011
Total participants2016-01-01164
Number of participants with account balances2016-01-01139
2015: TAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER 2015 401k membership
Total participants, beginning-of-year2015-01-01159
Total number of active participants reported on line 7a of the Form 55002015-01-01115
Number of retired or separated participants receiving benefits2015-01-0144
Total of all active and inactive participants2015-01-01159
Total participants2015-01-01159
Number of participants with account balances2015-01-01159
2014: TAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER 2014 401k membership
Total participants, beginning-of-year2014-01-01155
Total number of active participants reported on line 7a of the Form 55002014-01-01125
Number of retired or separated participants receiving benefits2014-01-0134
Total of all active and inactive participants2014-01-01159
Total participants2014-01-01159
2013: TAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER 2013 401k membership
Total participants, beginning-of-year2013-01-01159
Total number of active participants reported on line 7a of the Form 55002013-01-01122
Number of other retired or separated participants entitled to future benefits2013-01-0132
Total of all active and inactive participants2013-01-01154
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-011
Total participants2013-01-01155
Number of participants with account balances2013-01-01155
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: TAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER 2012 401k membership
Total participants, beginning-of-year2012-01-01159
Total number of active participants reported on line 7a of the Form 55002012-01-01126
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-0132
Total of all active and inactive participants2012-01-01158
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-011
Total participants2012-01-01159
Number of participants with account balances2012-01-01159
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: TAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER 2011 401k membership
Total participants, beginning-of-year2011-01-01162
Total number of active participants reported on line 7a of the Form 55002011-01-01122
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 participants2011-01-01158
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-011
Total participants2011-01-01159
Number of participants with account balances2011-01-01159
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2009: TAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER 2009 401k membership
Total participants, beginning-of-year2009-01-01182
Total number of active participants reported on line 7a of the Form 55002009-01-01126
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-0137
Total of all active and inactive participants2009-01-01163
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-011
Total participants2009-01-01164
Number of participants with account balances2009-01-01163
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on TAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER

Measure Date Value
2023 : TAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER 2023 401k financial data
Total income from all sources (including contributions)2023-12-31$691,093
Total of all expenses incurred2023-12-31$323,046
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-12-31$322,392
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-12-31$71,861
Value of total assets at end of year2023-12-31$4,733,411
Value of total assets at beginning of year2023-12-31$4,365,364
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-12-31$654
Total interest from all sources2023-12-31$26,640
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2023-12-31No
Was this plan covered by a fidelity bond2023-12-31Yes
Value of fidelity bond cover2023-12-31$500,000
If this is an individual account plan, was there a blackout period2023-12-31No
Were there any nonexempt tranactions with any party-in-interest2023-12-31No
Contributions received from participants2023-12-31$71,861
Administrative expenses (other) incurred2023-12-31$654
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-12-31No
Value of net income/loss2023-12-31$368,047
Value of net assets at end of year (total assets less liabilities)2023-12-31$4,733,411
Value of net assets at beginning of year (total assets less liabilities)2023-12-31$4,365,364
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2023-12-31No
Were any leases to which the plan was party in default or uncollectible2023-12-31No
Value of interest in pooled separate accounts at end of year2023-12-31$3,838,439
Value of interest in pooled separate accounts at beginning of year2023-12-31$3,204,556
Interest earned on other investments2023-12-31$26,640
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2023-12-31$894,972
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2023-12-31$1,160,808
Net investment gain/loss from pooled separate accounts2023-12-31$592,592
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-12-31No
Was there a failure to transmit to the plan any participant contributions2023-12-31No
Has the plan failed to provide any benefit when due under the plan2023-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2023-12-31$322,392
Did the plan have assets held for investment2023-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-12-31No
Opinion of an independent qualified public accountant for this plan2023-12-31Unqualified
Accountancy firm name2023-12-31FORVIS MAZARS, LLP
Accountancy firm EIN2023-12-31440160260
2022 : TAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER 2022 401k financial data
Total income from all sources (including contributions)2022-12-31$-543,006
Total of all expenses incurred2022-12-31$105,171
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$104,404
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$151,984
Value of total assets at end of year2022-12-31$4,365,364
Value of total assets at beginning of year2022-12-31$5,013,541
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$767
Total interest from all sources2022-12-31$29,301
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$500,000
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
Contributions received from participants2022-12-31$151,984
Administrative expenses (other) incurred2022-12-31$767
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-648,177
Value of net assets at end of year (total assets less liabilities)2022-12-31$4,365,364
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$5,013,541
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$3,204,556
Value of interest in pooled separate accounts at beginning of year2022-12-31$3,878,594
Interest earned on other investments2022-12-31$29,301
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$1,160,808
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$1,134,947
Net investment gain/loss from pooled separate accounts2022-12-31$-724,291
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 contributions2022-12-31Yes
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$104,404
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 name2022-12-31FORVIS, LLP
Accountancy firm EIN2022-12-31440160260
2021 : TAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER 2021 401k financial data
Total income from all sources (including contributions)2021-12-31$800,313
Total of all expenses incurred2021-12-31$735,286
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$734,035
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$149,236
Value of total assets at end of year2021-12-31$5,013,541
Value of total assets at beginning of year2021-12-31$4,948,514
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$1,251
Total interest from all sources2021-12-31$28,294
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$500,000
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
Contributions received from participants2021-12-31$149,236
Administrative expenses (other) incurred2021-12-31$1,251
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$65,027
Value of net assets at end of year (total assets less liabilities)2021-12-31$5,013,541
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$4,948,514
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$3,878,594
Value of interest in pooled separate accounts at beginning of year2021-12-31$3,693,912
Interest earned on other investments2021-12-31$28,294
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$1,134,947
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$1,254,602
Net investment gain/loss from pooled separate accounts2021-12-31$622,783
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 contributions2021-12-31Yes
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$734,035
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 name2021-12-31FORVIS, LLP
Accountancy firm EIN2021-12-31440160260
2020 : TAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER 2020 401k financial data
Total income from all sources (including contributions)2020-12-31$691,506
Total of all expenses incurred2020-12-31$731,013
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$729,613
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$160,950
Value of total assets at end of year2020-12-31$4,948,514
Value of total assets at beginning of year2020-12-31$4,988,021
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$1,400
Total interest from all sources2020-12-31$29,317
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$500,000
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
Contributions received from participants2020-12-31$160,950
Administrative expenses (other) incurred2020-12-31$1,400
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$-39,507
Value of net assets at end of year (total assets less liabilities)2020-12-31$4,948,514
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$4,988,021
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$3,693,912
Value of interest in pooled separate accounts at beginning of year2020-12-31$3,908,436
Interest earned on other investments2020-12-31$29,317
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$1,254,602
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$1,079,585
Net investment gain/loss from pooled separate accounts2020-12-31$501,239
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$729,613
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 plan2020-12-31Unqualified
Accountancy firm name2020-12-31BKD, LLP
Accountancy firm EIN2020-12-31440160260
2019 : TAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER 2019 401k financial data
Total income from all sources (including contributions)2019-12-31$996,764
Total income from all sources (including contributions)2019-12-31$996,764
Total of all expenses incurred2019-12-31$376,556
Total of all expenses incurred2019-12-31$376,556
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$375,055
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$192,829
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$192,829
Value of total assets at end of year2019-12-31$4,988,021
Value of total assets at end of year2019-12-31$4,988,021
Value of total assets at beginning of year2019-12-31$4,367,813
Value of total assets at beginning of year2019-12-31$4,367,813
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$1,501
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$1,501
Total interest from all sources2019-12-31$31,832
Total interest from all sources2019-12-31$31,832
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$500,000
Value of fidelity bond cover2019-12-31$500,000
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
Contributions received from participants2019-12-31$192,829
Contributions received from participants2019-12-31$192,829
Administrative expenses (other) incurred2019-12-31$1,501
Administrative expenses (other) incurred2019-12-31$1,501
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$620,208
Value of net assets at end of year (total assets less liabilities)2019-12-31$4,988,021
Value of net assets at end of year (total assets less liabilities)2019-12-31$4,988,021
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$4,367,813
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$4,367,813
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
Value of interest in pooled separate accounts at end of year2019-12-31$3,908,436
Value of interest in pooled separate accounts at end of year2019-12-31$3,908,436
Value of interest in pooled separate accounts at beginning of year2019-12-31$3,027,264
Value of interest in pooled separate accounts at beginning of year2019-12-31$3,027,264
Interest earned on other investments2019-12-31$31,832
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$1,079,585
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$1,079,585
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$1,340,549
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$1,340,549
Net investment gain/loss from pooled separate accounts2019-12-31$772,103
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$375,055
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$375,055
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
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
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31BKD, LLP
Accountancy firm name2019-12-31BKD, LLP
Accountancy firm EIN2019-12-31440160260
Accountancy firm EIN2019-12-31440160260
2018 : TAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER 2018 401k financial data
Total income from all sources (including contributions)2018-12-31$7,589
Total of all expenses incurred2018-12-31$327,925
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$326,386
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$205,051
Value of total assets at end of year2018-12-31$4,367,813
Value of total assets at beginning of year2018-12-31$4,688,149
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$1,539
Total interest from all sources2018-12-31$34,216
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$500,000
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
Contributions received from participants2018-12-31$205,051
Administrative expenses (other) incurred2018-12-31$1,539
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$-320,336
Value of net assets at end of year (total assets less liabilities)2018-12-31$4,367,813
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$4,688,149
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$3,027,264
Value of interest in pooled separate accounts at beginning of year2018-12-31$3,493,270
Interest earned on other investments2018-12-31$34,216
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$1,340,549
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$1,194,879
Net investment gain/loss from pooled separate accounts2018-12-31$-231,678
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$326,386
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 name2018-12-31BKD, LLP
Accountancy firm EIN2018-12-31440160260
2017 : TAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER 2017 401k financial data
Total income from all sources (including contributions)2017-12-31$759,748
Total of all expenses incurred2017-12-31$172,235
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$170,641
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$252,532
Value of total assets at end of year2017-12-31$4,688,149
Value of total assets at beginning of year2017-12-31$4,100,636
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$1,594
Total interest from all sources2017-12-31$32,447
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$500,000
If this is an individual account plan, was there a blackout period2017-12-31No
Aggregate amount of withdrawal liability assessed or estimated to be assessed against such withdrawn employers2017-12-310
Minimum employer required contribution for this plan year2017-12-31$0
Amount contributed by the employer to the plan for this plan year2017-12-31$0
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$225,329
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$27,203
Administrative expenses (other) incurred2017-12-31$1,594
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$587,513
Value of net assets at end of year (total assets less liabilities)2017-12-31$4,688,149
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$4,100,636
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$3,493,270
Value of interest in pooled separate accounts at beginning of year2017-12-31$2,830,350
Interest earned on other investments2017-12-31$32,447
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-12-31$1,194,879
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-12-31$1,270,286
Net investment gain/loss from pooled separate accounts2017-12-31$474,769
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$170,641
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 name2017-12-31BKD, LLP
Accountancy firm EIN2017-12-31440160260
2016 : TAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER 2016 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2016-12-31$31,975
Total unrealized appreciation/depreciation of assets2016-12-31$31,975
Total income from all sources (including contributions)2016-12-31$534,497
Total of all expenses incurred2016-12-31$1,251,777
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$1,250,144
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$254,964
Value of total assets at end of year2016-12-31$4,100,636
Value of total assets at beginning of year2016-12-31$4,817,916
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$1,633
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$500,000
If this is an individual account plan, was there a blackout period2016-12-31No
Aggregate amount of withdrawal liability assessed or estimated to be assessed against such withdrawn employers2016-12-310
Funding deficiency by the employer to the plan for this plan year2016-12-31$0
Minimum employer required contribution for this plan year2016-12-31$0
Amount contributed by the employer to the plan for this plan year2016-12-31$0
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$254,964
Administrative expenses (other) incurred2016-12-31$1,633
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$-717,280
Value of net assets at end of year (total assets less liabilities)2016-12-31$4,100,636
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$4,817,916
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$2,830,350
Value of interest in pooled separate accounts at beginning of year2016-12-31$3,673,079
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-12-31$1,270,286
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-12-31$1,144,837
Net investment gain/loss from pooled separate accounts2016-12-31$247,558
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$1,250,144
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 name2016-12-31BKD, LLP
Accountancy firm EIN2016-12-31440160260
2015 : TAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER 2015 401k financial data
Total income from all sources (including contributions)2015-12-31$407,076
Total of all expenses incurred2015-12-31$220,912
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$219,129
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$349,047
Value of total assets at end of year2015-12-31$4,817,916
Value of total assets at beginning of year2015-12-31$4,631,752
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$1,783
Total interest from all sources2015-12-31$30,792
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$500,000
If this is an individual account plan, was there a blackout period2015-12-31No
Aggregate amount of withdrawal liability assessed or estimated to be assessed against such withdrawn employers2015-12-310
Minimum employer required contribution for this plan year2015-12-31$0
Amount contributed by the employer to the plan for this plan year2015-12-31$0
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$309,147
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$39,900
Administrative expenses (other) incurred2015-12-31$1,783
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$186,164
Value of net assets at end of year (total assets less liabilities)2015-12-31$4,817,916
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$4,631,752
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 registered invesment companies (eg mutual funds) at end of year2015-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$3,503,147
Value of interest in pooled separate accounts at end of year2015-12-31$3,673,079
Value of interest in pooled separate accounts at beginning of year2015-12-31$0
Interest earned on other investments2015-12-31$30,792
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-12-31$1,144,837
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-12-31$1,128,605
Net investment gain/loss from pooled separate accounts2015-12-31$27,237
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$219,129
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 name2015-12-31BKD, LLP
Accountancy firm EIN2015-12-31440160260
2014 : TAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER 2014 401k financial data
Total income from all sources (including contributions)2014-12-31$599,977
Total of all expenses incurred2014-12-31$199,075
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$197,255
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$296,205
Value of total assets at end of year2014-12-31$4,631,752
Value of total assets at beginning of year2014-12-31$4,230,850
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$1,820
Total interest from all sources2014-12-31$29,422
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$400,000
If this is an individual account plan, was there a blackout period2014-12-31No
Aggregate amount of withdrawal liability assessed or estimated to be assessed against such withdrawn employers2014-12-310
Minimum employer required contribution for this plan year2014-12-31$0
Amount contributed by the employer to the plan for this plan year2014-12-31$0
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$296,205
Administrative expenses (other) incurred2014-12-31$1,820
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$400,902
Value of net assets at end of year (total assets less liabilities)2014-12-31$4,631,752
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$4,230,850
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$3,503,147
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$3,179,597
Interest earned on other investments2014-12-31$29,422
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-12-31$1,128,605
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-12-31$1,051,253
Net investment gain/loss from pooled separate accounts2014-12-31$274,350
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$197,255
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 name2014-12-31BKD, LLP
Accountancy firm EIN2014-12-31440160260
2013 : TAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-12-31$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$941,959
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$262,428
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$260,608
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$269,029
Value of total assets at end of year2013-12-31$4,230,850
Value of total assets at beginning of year2013-12-31$3,551,319
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$1,820
Total interest from all sources2013-12-31$28,747
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$300,000
If this is an individual account plan, was there a blackout period2013-12-31No
Aggregate amount of withdrawal liability assessed or estimated to be assessed against such withdrawn employers2013-12-310
Funding deficiency by the employer to the plan for this plan year2013-12-31$0
Minimum employer required contribution for this plan year2013-12-31$0
Amount contributed by the employer to the plan for this plan year2013-12-31$0
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$269,029
Administrative expenses (other) incurred2013-12-31$1,820
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$679,531
Value of net assets at end of year (total assets less liabilities)2013-12-31$4,230,850
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$3,551,319
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$3,179,597
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$2,447,773
Interest earned on other investments2013-12-31$28,747
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-12-31$1,051,253
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-12-31$1,103,546
Net investment gain/loss from pooled separate accounts2013-12-31$644,183
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$260,608
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 name2013-12-31BKD, LLP
Accountancy firm EIN2013-12-31440160260
2012 : TAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-12-31$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$602,463
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$414,928
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$412,931
Expenses. Certain deemed distributions of participant loans2012-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$274,820
Value of total assets at end of year2012-12-31$3,551,319
Value of total assets at beginning of year2012-12-31$3,358,611
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$1,997
Total interest from all sources2012-12-31$28,507
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$200,000
If this is an individual account plan, was there a blackout period2012-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$269,736
Participant contributions at end of year2012-12-31$69,095
Participant contributions at beginning of year2012-12-31$30,166
Income. Received or receivable in cash from other sources (including rollovers)2012-12-31$5,084
Other income not declared elsewhere2012-12-31$0
Administrative expenses (other) incurred2012-12-31$1,997
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$187,535
Value of net assets at end of year (total assets less liabilities)2012-12-31$3,551,319
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$3,358,611
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$2,447,773
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$2,309,470
Interest on participant loans2012-12-31$0
Interest earned on other investments2012-12-31$28,507
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-12-31$1,034,451
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-12-31$1,018,975
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$0
Net investment gain/loss from pooled separate accounts2012-12-31$299,136
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
Contributions received in cash from employer2012-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$412,931
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 name2012-12-31CLIFTONLARSONALLEN
Accountancy firm EIN2012-12-31410746749
2011 : TAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
Total income from all sources (including contributions)2011-12-31$219,939
Total loss/gain on sale of assets2011-12-31$0
Total of all expenses incurred2011-12-31$289,181
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$287,195
Expenses. Certain deemed distributions of participant loans2011-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$235,880
Value of total assets at end of year2011-12-31$3,358,611
Value of total assets at beginning of year2011-12-31$3,427,853
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$1,986
Total interest from all sources2011-12-31$24,934
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$200,000
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
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$235,880
Participant contributions at end of year2011-12-31$30,166
Participant contributions at beginning of year2011-12-31$35,462
Income. Received or receivable in cash from other sources (including rollovers)2011-12-31$0
Other income not declared elsewhere2011-12-31$0
Administrative expenses (other) incurred2011-12-31$1,986
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-69,242
Value of net assets at end of year (total assets less liabilities)2011-12-31$3,358,611
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$3,427,853
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$2,309,470
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-12-31$2,765,099
Interest on participant loans2011-12-31$0
Interest earned on other investments2011-12-31$24,934
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-12-31$1,018,975
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-12-31$627,292
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$0
Net investment gain/loss from pooled separate accounts2011-12-31$-40,875
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
Contributions received in cash from employer2011-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$287,195
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 name2011-12-31CLIFTONLARSONALLEN, LLP
Accountancy firm EIN2011-12-31410746749
2010 : TAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER 2010 401k financial data
Total unrealized appreciation/depreciation of assets2010-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total income from all sources (including contributions)2010-12-31$643,153
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$243,216
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$241,131
Expenses. Certain deemed distributions of participant loans2010-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$248,224
Value of total assets at end of year2010-12-31$3,427,853
Value of total assets at beginning of year2010-12-31$3,027,916
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$2,085
Total interest from all sources2010-12-31$17,608
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$200,000
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$248,224
Participant contributions at end of year2010-12-31$35,462
Participant contributions at beginning of year2010-12-31$19,661
Income. Received or receivable in cash from other sources (including rollovers)2010-12-31$0
Other income not declared elsewhere2010-12-31$0
Administrative expenses (other) incurred2010-12-31$2,085
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$399,937
Value of net assets at end of year (total assets less liabilities)2010-12-31$3,427,853
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$3,027,916
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$2,765,099
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$2,513,378
Interest on participant loans2010-12-31$0
Interest earned on other investments2010-12-31$17,608
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$627,292
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$494,877
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$0
Net investment gain/loss from pooled separate accounts2010-12-31$377,321
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
Contributions received in cash from employer2010-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$241,131
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)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31LARSONALLEN LLP
Accountancy firm EIN2010-12-31410746749
2009 : TAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER 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 TAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER

2023: TAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – InsuranceYes
2022: TAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: TAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: TAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: TAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: TAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: TAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: TAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: TAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: TAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: TAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: TAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: TAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2009: TAX DEFERRED ANNUITY PLAN OF JEFFERSON REGIONAL MEDICAL CENTER 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01First time form 5500 has been submittedYes
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number902384
Policy instance 1
Insurance contract or identification number902384
Number of Individuals Covered155
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of fees paid to insurance companyUSD $181
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number008134
Policy instance 1
Insurance contract or identification number008134
Number of Individuals Covered156
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of fees paid to insurance companyUSD $518
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees518
Additional information about fees paid to insurance brokerINCENTIVE COMPENSATION
Insurance broker organization code?3
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number008134-F
Policy instance 1
Insurance contract or identification number008134-F
Number of Individuals Covered152
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of fees paid to insurance companyUSD $200
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees200
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number008134-F
Policy instance 1
Insurance contract or identification number008134-F
Number of Individuals Covered153
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of fees paid to insurance companyUSD $200
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees200
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number008134-F
Policy instance 1
Insurance contract or identification number008134-F
Number of Individuals Covered155
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of fees paid to insurance companyUSD $802
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees802
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number008134-F
Policy instance 1
Insurance contract or identification number008134-F
Number of Individuals Covered164
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of fees paid to insurance companyUSD $263
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees263
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number008134-F
Policy instance 1
Insurance contract or identification number008134-F
Number of Individuals Covered163
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of fees paid to insurance companyUSD $396
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees396
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
Insurance broker nameNASHVILLE REGIONAL OFFICE
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number008134-F
Policy instance 1
Insurance contract or identification number008134-F
Number of Individuals Covered159
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of fees paid to insurance companyUSD $36
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees36
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
Insurance broker nameNASHVILLE REGIONAL OFFICE
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number008134-F
Policy instance 1
Insurance contract or identification number008134-F
Number of Individuals Covered159
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of fees paid to insurance companyUSD $433
Contracts With Unallocated Funds Deposit Administration1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees433
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
Insurance broker nameNASHVILLE REGIONAL OFFICE
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number008134-F
Policy instance 1
Insurance contract or identification number008134-F
Number of Individuals Covered155
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of fees paid to insurance companyUSD $397
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 planNo
Contracts With Unallocated Funds Deposit Administration1
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Amount paid for insurance broker fees397
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
Insurance broker nameNASHVILLE REGIONAL OFFICE
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number008134F
Policy instance 1
Insurance contract or identification number008134F
Number of Individuals Covered159
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $666
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 planNo
Contracts With Unallocated Funds Deposit Administration1
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 BrokerUSD $0
Amount paid for insurance broker fees200
Additional information about fees paid to insurance brokerPORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?3
Insurance broker nameJAY MCFADDEN
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number008134F
Policy instance 1
Insurance contract or identification number008134F
Number of Individuals Covered159
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $648
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 planNo
Contracts With Unallocated Funds Deposit Administration1
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number008134F
Policy instance 1
Insurance contract or identification number008134F
Number of Individuals Covered162
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $667
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 planNo
Contracts With Unallocated Funds Deposit Administration1
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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