401k Plan data: WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN plan

WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 401k Plan overview

Plan Name	WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN
Plan identification number	005

WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Money purchase (other than target benefit)
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.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

WILLOW VIEW MENTAL HEALTH SYSTEM has sponsored the creation of one or more 401k plans.

Company Name: WILLOW VIEW MENTAL HEALTH SYSTEM

Employer identification number (EIN): 730738716

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
005 2022-01-01 WENDY CHANDLER 2023-10-14
005 2021-01-01 WENDY CHANDLER 2022-10-11
005 2020-01-01 WENDY CHANDLER 2021-10-13
005 2019-01-01 KEITH MINNIS 2020-09-24
005 2018-01-01 VIC BUZACHERO 2019-10-02
005 2017-01-01
005 2016-01-01
005 2015-01-01
005 2014-01-01
005 2013-01-01 JASON ELIOT
005 2012-01-01 JASON ELIOT
005 2011-01-01 ROBERT QUIRING
005 2010-01-01 JASON ELIOT
005 2009-01-01 JASON ELIOT

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
005	2022-01-01	WENDY CHANDLER	2023-10-14
005	2021-01-01	WENDY CHANDLER	2022-10-11
005	2020-01-01	WENDY CHANDLER	2021-10-13
005	2019-01-01	KEITH MINNIS	2020-09-24
005	2018-01-01	VIC BUZACHERO	2019-10-02
005	2017-01-01
005	2016-01-01
005	2015-01-01
005	2014-01-01
005	2013-01-01	JASON ELIOT
005	2012-01-01	JASON ELIOT
005	2011-01-01	ROBERT QUIRING
005	2010-01-01	JASON ELIOT
005	2009-01-01	JASON ELIOT

Plan Statistics for WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN

401k plan membership statisitcs for WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN

Measure Date Value
2022: WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 36
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 4
Number of other retired or separated participants entitled to future benefits 2022-01-01 32
Total of all active and inactive participants 2022-01-01 36
Total participants 2022-01-01 36
Number of participants with account balances 2022-01-01 36
2021: WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 42
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 4
Number of other retired or separated participants entitled to future benefits 2021-01-01 32
Total of all active and inactive participants 2021-01-01 36
Total participants 2021-01-01 36
Number of participants with account balances 2021-01-01 36
2020: WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 42
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 4
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 34
Total of all active and inactive participants 2020-01-01 38
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 1
Total participants 2020-01-01 39
Number of participants with account balances 2020-01-01 39
2019: WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 44
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 6
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 35
Total of all active and inactive participants 2019-01-01 41
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 1
Total participants 2019-01-01 42
Number of participants with account balances 2019-01-01 42
2018: WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 45
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 7
Number of other retired or separated participants entitled to future benefits 2018-01-01 36
Total of all active and inactive participants 2018-01-01 43
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 1
Total participants 2018-01-01 44
Number of participants with account balances 2018-01-01 44
2017: WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 47
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 8
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 37
Total of all active and inactive participants 2017-01-01 45
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 45
Number of participants with account balances 2017-01-01 45
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 49
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 12
Number of other retired or separated participants entitled to future benefits 2016-01-01 35
Total of all active and inactive participants 2016-01-01 47
Total participants 2016-01-01 47
Number of participants with account balances 2016-01-01 47
2015: WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 53
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 16
Number of other retired or separated participants entitled to future benefits 2015-01-01 33
Total of all active and inactive participants 2015-01-01 49
Total participants 2015-01-01 49
Number of participants with account balances 2015-01-01 49
2014: WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 56
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 18
Number of other retired or separated participants entitled to future benefits 2014-01-01 35
Total of all active and inactive participants 2014-01-01 53
Total participants 2014-01-01 53
Number of participants with account balances 2014-01-01 53
2013: WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 58
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 18
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 38
Total of all active and inactive participants 2013-01-01 56
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 56
Number of participants with account balances 2013-01-01 56
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 60
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 14
Number of other retired or separated participants entitled to future benefits 2012-01-01 44
Total of all active and inactive participants 2012-01-01 58
Total participants 2012-01-01 58
Number of participants with account balances 2012-01-01 58
2011: WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 62
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 15
Number of other retired or separated participants entitled to future benefits 2011-01-01 45
Total of all active and inactive participants 2011-01-01 60
Total participants 2011-01-01 60
Number of participants with account balances 2011-01-01 60
2010: WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 62
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 20
Number of other retired or separated participants entitled to future benefits 2010-01-01 42
Total of all active and inactive participants 2010-01-01 62
Total participants 2010-01-01 62
Number of participants with account balances 2010-01-01 62
2009: WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 78
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 20
Number of other retired or separated participants entitled to future benefits 2009-01-01 42
Total of all active and inactive participants 2009-01-01 62
Total participants 2009-01-01 62
Number of participants with account balances 2009-01-01 62

Measure	Date	Value
2022: WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	36
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	4
Number of other retired or separated participants entitled to future benefits	2022-01-01	32
Total of all active and inactive participants	2022-01-01	36
Total participants	2022-01-01	36
Number of participants with account balances	2022-01-01	36
2021: WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	42
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	4
Number of other retired or separated participants entitled to future benefits	2021-01-01	32
Total of all active and inactive participants	2021-01-01	36
Total participants	2021-01-01	36
Number of participants with account balances	2021-01-01	36
2020: WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	42
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	4
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	34
Total of all active and inactive participants	2020-01-01	38
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	1
Total participants	2020-01-01	39
Number of participants with account balances	2020-01-01	39
2019: WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	44
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	6
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	35
Total of all active and inactive participants	2019-01-01	41
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	1
Total participants	2019-01-01	42
Number of participants with account balances	2019-01-01	42
2018: WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	45
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	7
Number of other retired or separated participants entitled to future benefits	2018-01-01	36
Total of all active and inactive participants	2018-01-01	43
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	1
Total participants	2018-01-01	44
Number of participants with account balances	2018-01-01	44
2017: WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	47
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	8
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	37
Total of all active and inactive participants	2017-01-01	45
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	45
Number of participants with account balances	2017-01-01	45
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	49
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	12
Number of other retired or separated participants entitled to future benefits	2016-01-01	35
Total of all active and inactive participants	2016-01-01	47
Total participants	2016-01-01	47
Number of participants with account balances	2016-01-01	47
2015: WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	53
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	16
Number of other retired or separated participants entitled to future benefits	2015-01-01	33
Total of all active and inactive participants	2015-01-01	49
Total participants	2015-01-01	49
Number of participants with account balances	2015-01-01	49
2014: WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	56
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	18
Number of other retired or separated participants entitled to future benefits	2014-01-01	35
Total of all active and inactive participants	2014-01-01	53
Total participants	2014-01-01	53
Number of participants with account balances	2014-01-01	53
2013: WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	58
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	18
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	38
Total of all active and inactive participants	2013-01-01	56
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	56
Number of participants with account balances	2013-01-01	56
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	60
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	14
Number of other retired or separated participants entitled to future benefits	2012-01-01	44
Total of all active and inactive participants	2012-01-01	58
Total participants	2012-01-01	58
Number of participants with account balances	2012-01-01	58
2011: WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	62
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	15
Number of other retired or separated participants entitled to future benefits	2011-01-01	45
Total of all active and inactive participants	2011-01-01	60
Total participants	2011-01-01	60
Number of participants with account balances	2011-01-01	60
2010: WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	62
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	20
Number of other retired or separated participants entitled to future benefits	2010-01-01	42
Total of all active and inactive participants	2010-01-01	62
Total participants	2010-01-01	62
Number of participants with account balances	2010-01-01	62
2009: WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	78
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	20
Number of other retired or separated participants entitled to future benefits	2009-01-01	42
Total of all active and inactive participants	2009-01-01	62
Total participants	2009-01-01	62
Number of participants with account balances	2009-01-01	62

Financial Data on WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN

Measure	Date	Value
2022 : WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2022 401k financial data
Total income from all sources	2022-12-31	$-26,433
Expenses. Total of all expenses incurred	2022-12-31	$5,500
Total plan assets at end of year	2022-12-31	$585,568
Total plan assets at beginning of year	2022-12-31	$617,501
Value of fidelity bond covering the plan	2022-12-31	$1,000,000
Expenses. Other expenses not covered elsewhere	2022-12-31	$5,500
Other income received	2022-12-31	$-26,433
Net income (gross income less expenses)	2022-12-31	$-31,933
Net plan assets at end of year (total assets less liabilities)	2022-12-31	$585,568
Net plan assets at beginning of year (total assets less liabilities)	2022-12-31	$617,501
2021 : WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2021 401k financial data
Total income from all sources	2021-12-31	$58,704
Expenses. Total of all expenses incurred	2021-12-31	$140,230
Benefits paid (including direct rollovers)	2021-12-31	$140,230
Total plan assets at end of year	2021-12-31	$617,501
Total plan assets at beginning of year	2021-12-31	$699,027
Value of fidelity bond covering the plan	2021-12-31	$1,000,000
Other income received	2021-12-31	$58,704
Net income (gross income less expenses)	2021-12-31	$-81,526
Net plan assets at end of year (total assets less liabilities)	2021-12-31	$617,501
Net plan assets at beginning of year (total assets less liabilities)	2021-12-31	$699,027
Aggregate amount of withdrawal liability assessed or estimated to be assessed against such withdrawn employers	2021-12-31	0
Minimum employer required contribution for this plan year	2021-12-31	$0
Amount contributed by the employer to the plan for this plan year	2021-12-31	$0
2020 : WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2020 401k financial data
Total income from all sources	2020-12-31	$55,289
Expenses. Total of all expenses incurred	2020-12-31	$59,075
Benefits paid (including direct rollovers)	2020-12-31	$49,075
Total plan assets at end of year	2020-12-31	$699,027
Total plan assets at beginning of year	2020-12-31	$702,813
Value of fidelity bond covering the plan	2020-12-31	$1,000,000
Expenses. Other expenses not covered elsewhere	2020-12-31	$10,000
Other income received	2020-12-31	$55,289
Net income (gross income less expenses)	2020-12-31	$-3,786
Net plan assets at end of year (total assets less liabilities)	2020-12-31	$699,027
Net plan assets at beginning of year (total assets less liabilities)	2020-12-31	$702,813
Aggregate amount of withdrawal liability assessed or estimated to be assessed against such withdrawn employers	2020-12-31	0
Minimum employer required contribution for this plan year	2020-12-31	$0
Amount contributed by the employer to the plan for this plan year	2020-12-31	$0
2019 : WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2019 401k financial data
Total income from all sources	2019-12-31	$71,259
Expenses. Total of all expenses incurred	2019-12-31	$108,092
Benefits paid (including direct rollovers)	2019-12-31	$106,592
Total plan assets at end of year	2019-12-31	$702,813
Total plan assets at beginning of year	2019-12-31	$739,646
Value of fidelity bond covering the plan	2019-12-31	$1,000,000
Expenses. Other expenses not covered elsewhere	2019-12-31	$1,500
Other income received	2019-12-31	$71,259
Net income (gross income less expenses)	2019-12-31	$-36,833
Net plan assets at end of year (total assets less liabilities)	2019-12-31	$702,813
Net plan assets at beginning of year (total assets less liabilities)	2019-12-31	$739,646
Aggregate amount of withdrawal liability assessed or estimated to be assessed against such withdrawn employers	2019-12-31	0
Minimum employer required contribution for this plan year	2019-12-31	$0
Amount contributed by the employer to the plan for this plan year	2019-12-31	$0
2018 : WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2018 401k financial data
Total income from all sources	2018-12-31	$8,770
Expenses. Total of all expenses incurred	2018-12-31	$72,376
Benefits paid (including direct rollovers)	2018-12-31	$66,001
Total plan assets at end of year	2018-12-31	$739,646
Total plan assets at beginning of year	2018-12-31	$803,252
Value of fidelity bond covering the plan	2018-12-31	$1,000,000
Expenses. Other expenses not covered elsewhere	2018-12-31	$6,375
Other income received	2018-12-31	$8,770
Net income (gross income less expenses)	2018-12-31	$-63,606
Net plan assets at end of year (total assets less liabilities)	2018-12-31	$739,646
Net plan assets at beginning of year (total assets less liabilities)	2018-12-31	$803,252
Aggregate amount of withdrawal liability assessed or estimated to be assessed against such withdrawn employers	2018-12-31	0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Minimum employer required contribution for this plan year	2018-12-31	$0
Amount contributed by the employer to the plan for this plan year	2018-12-31	$0
2017 : WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2017 401k financial data
Total income from all sources	2017-12-31	$62,169
Expenses. Total of all expenses incurred	2017-12-31	$57,575
Benefits paid (including direct rollovers)	2017-12-31	$57,575
Total plan assets at end of year	2017-12-31	$803,252
Total plan assets at beginning of year	2017-12-31	$798,658
Value of fidelity bond covering the plan	2017-12-31	$1,000,000
Other income received	2017-12-31	$62,169
Net income (gross income less expenses)	2017-12-31	$4,594
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$803,252
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$798,658
Aggregate amount of withdrawal liability assessed or estimated to be assessed against such withdrawn employers	2017-12-31	0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Minimum employer required contribution for this plan year	2017-12-31	$0
Amount contributed by the employer to the plan for this plan year	2017-12-31	$0
2016 : WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2016 401k financial data
Total income from all sources	2016-12-31	$32,394
Expenses. Total of all expenses incurred	2016-12-31	$37,863
Benefits paid (including direct rollovers)	2016-12-31	$37,863
Total plan assets at end of year	2016-12-31	$798,658
Total plan assets at beginning of year	2016-12-31	$804,127
Value of fidelity bond covering the plan	2016-12-31	$1,000,000
Other income received	2016-12-31	$32,394
Net income (gross income less expenses)	2016-12-31	$-5,469
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$798,658
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$804,127
Aggregate amount of withdrawal liability assessed or estimated to be assessed against such withdrawn employers	2016-12-31	0
Minimum employer required contribution for this plan year	2016-12-31	$0
Amount contributed by the employer to the plan for this plan year	2016-12-31	$0
2015 : WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2015 401k financial data
Total income from all sources	2015-12-31	$19,761
Expenses. Total of all expenses incurred	2015-12-31	$93,273
Benefits paid (including direct rollovers)	2015-12-31	$92,023
Total plan assets at end of year	2015-12-31	$804,127
Total plan assets at beginning of year	2015-12-31	$877,639
Value of fidelity bond covering the plan	2015-12-31	$1,000,000
Other income received	2015-12-31	$19,761
Net income (gross income less expenses)	2015-12-31	$-73,512
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$804,127
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$877,639
Expenses. Administrative service providers (salaries,fees and commissions)	2015-12-31	$1,250
Aggregate amount of withdrawal liability assessed or estimated to be assessed against such withdrawn employers	2015-12-31	0
Minimum employer required contribution for this plan year	2015-12-31	$0
Amount contributed by the employer to the plan for this plan year	2015-12-31	$0
2014 : WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2014 401k financial data
Total income from all sources	2014-12-31	$40,705
Expenses. Total of all expenses incurred	2014-12-31	$72,218
Benefits paid (including direct rollovers)	2014-12-31	$68,718
Total plan assets at end of year	2014-12-31	$877,639
Total plan assets at beginning of year	2014-12-31	$909,152
Value of fidelity bond covering the plan	2014-12-31	$1,000,000
Other income received	2014-12-31	$40,705
Net income (gross income less expenses)	2014-12-31	$-31,513
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$877,639
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$909,152
Expenses. Administrative service providers (salaries,fees and commissions)	2014-12-31	$3,500
Aggregate amount of withdrawal liability assessed or estimated to be assessed against such withdrawn employers	2014-12-31	0
Minimum employer required contribution for this plan year	2014-12-31	$0
Amount contributed by the employer to the plan for this plan year	2014-12-31	$0
2013 : WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2013 401k financial data
Total income from all sources	2013-12-31	$74,223
Expenses. Total of all expenses incurred	2013-12-31	$22,258
Benefits paid (including direct rollovers)	2013-12-31	$22,258
Total plan assets at end of year	2013-12-31	$909,152
Total plan assets at beginning of year	2013-12-31	$857,187
Value of fidelity bond covering the plan	2013-12-31	$1,000,000
Other income received	2013-12-31	$74,223
Net income (gross income less expenses)	2013-12-31	$51,965
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$909,152
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$857,187
Aggregate amount of withdrawal liability assessed or estimated to be assessed against such withdrawn employers	2013-12-31	0
Minimum employer required contribution for this plan year	2013-12-31	$0
Amount contributed by the employer to the plan for this plan year	2013-12-31	$0
2012 : WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$48,077
Expenses. Total of all expenses incurred	2012-12-31	$53,977
Benefits paid (including direct rollovers)	2012-12-31	$53,977
Total plan assets at end of year	2012-12-31	$857,187
Total plan assets at beginning of year	2012-12-31	$863,087
Value of fidelity bond covering the plan	2012-12-31	$1,000,000
Other income received	2012-12-31	$48,077
Net income (gross income less expenses)	2012-12-31	$-5,900
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$857,187
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$863,087
Aggregate amount of withdrawal liability assessed or estimated to be assessed against such withdrawn employers	2012-12-31	0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
Minimum employer required contribution for this plan year	2012-12-31	$0
Amount contributed by the employer to the plan for this plan year	2012-12-31	$0
2011 : WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$16,076
Expenses. Total of all expenses incurred	2011-12-31	$16,120
Benefits paid (including direct rollovers)	2011-12-31	$16,120
Total plan assets at end of year	2011-12-31	$863,087
Total plan assets at beginning of year	2011-12-31	$863,131
Value of fidelity bond covering the plan	2011-12-31	$1,000,000
Other income received	2011-12-31	$16,076
Net income (gross income less expenses)	2011-12-31	$-44
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$863,087
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$863,131
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Minimum employer required contribution for this plan year	2011-12-31	$0
Amount contributed by the employer to the plan for this plan year	2011-12-31	$0
2010 : WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$47,563
Expenses. Total of all expenses incurred	2010-12-31	$1,649
Total plan assets at end of year	2010-12-31	$863,131
Total plan assets at beginning of year	2010-12-31	$817,217
Value of fidelity bond covering the plan	2010-12-31	$1,000,000
Expenses. Other expenses not covered elsewhere	2010-12-31	$1,649
Other income received	2010-12-31	$47,563
Net income (gross income less expenses)	2010-12-31	$45,914
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$863,131
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$817,217

Form 5500 Responses for WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN

2022: WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2021: WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2020: WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2019: WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2018: WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2017: WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2016: WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2015: WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2010: WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2009: WILLOW VIEW MENTAL HEALTH SYSTEM EMPLOYEES' PENSION PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G93099

Policy instance

Insurance contract or identification number	G93099
Number of Individuals Covered	12
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
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 number

G93099

Policy instance

Insurance contract or identification number	G93099
Number of Individuals Covered	33
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
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 number

G93099

Policy instance

Insurance contract or identification number	G93099
Number of Individuals Covered	12
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
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 number

G93099

Policy instance

Insurance contract or identification number	G93099
Number of Individuals Covered	33
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
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 number

G93099

Policy instance

Insurance contract or identification number	G93099
Number of Individuals Covered	13
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
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 number

G93099

Policy instance

Insurance contract or identification number	G93099
Number of Individuals Covered	36
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
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 number

G93099

Policy instance

Insurance contract or identification number	G93099
Number of Individuals Covered	39
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
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 number

G93099

Policy instance

Insurance contract or identification number	G93099
Number of Individuals Covered	14
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
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 number

G93099

Policy instance

Insurance contract or identification number	G93099
Number of Individuals Covered	41
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
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 number

G93099

Policy instance

Insurance contract or identification number	G93099
Number of Individuals Covered	16
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
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 number

G93099

Policy instance

Insurance contract or identification number	G93099
Number of Individuals Covered	17
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $150
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	150
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3
Insurance broker name	GALLAGHER BEN SERVICES INC.

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G93099

Policy instance

Insurance contract or identification number	G93099
Number of Individuals Covered	42
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $459
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	459
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3
Insurance broker name	GALLAGHER BEN SERVICES INC.

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G93099

Policy instance

Insurance contract or identification number	G93099
Number of Individuals Covered	19
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of fees paid to insurance company	USD $239
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 fees	239
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3
Insurance broker name	GARDNER & WHITE

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G93099

Policy instance

Insurance contract or identification number	G93099
Number of Individuals Covered	46
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of fees paid to insurance company	USD $861
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 fees	861
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3
Insurance broker name	GARDNER & WHITE

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G93099

Policy instance

Insurance contract or identification number	G93099
Number of Individuals Covered	20
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of fees paid to insurance company	USD $238
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 fees	238
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3
Insurance broker name	GARDNER & WHITE

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G93099

Policy instance

Insurance contract or identification number	G93099
Number of Individuals Covered	50
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of fees paid to insurance company	USD $644
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 fees	644
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3
Insurance broker name	GARDNER & WHITE

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G93099

Policy instance

Insurance contract or identification number	G93099
Number of Individuals Covered	53
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of fees paid to insurance company	USD $644
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 fees	644
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3
Insurance broker name	GARDNER & WHITE

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G93099

Policy instance

Insurance contract or identification number	G93099
Number of Individuals Covered	22
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of fees paid to insurance company	USD $221
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 fees	221
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3
Insurance broker name	GARDNER & WHITE

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G93099

Policy instance

Insurance contract or identification number	G93099
Number of Individuals Covered	22
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of fees paid to insurance company	USD $211
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 fees	211
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3
Insurance broker name	GARDNER & WHITE

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G93099

Policy instance

Insurance contract or identification number	G93099
Number of Individuals Covered	55
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of fees paid to insurance company	USD $663
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 fees	663
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3
Insurance broker name	GARDNER & WHITE

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G93099

Policy instance

Insurance contract or identification number	G93099
Number of Individuals Covered	57
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of fees paid to insurance company	USD $644
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 number

G93099

Policy instance

Insurance contract or identification number	G93099
Number of Individuals Covered	25
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of fees paid to insurance company	USD $217
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 number

G93099

Policy instance

Insurance contract or identification number	G93099
Number of Individuals Covered	59
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $621
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	621
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3
Insurance broker name	GARDNER & WHITE

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G93099

Policy instance

Insurance contract or identification number	G93099
Number of Individuals Covered	25
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $205
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	205
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3
Insurance broker name	GARDNER & WHITE

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Company Name:	WILLOW VIEW MENTAL HEALTH SYSTEM
Employer identification number (EIN):	730738716
NAIC Classification:	622000
NAIC Description:	Hospitals