401k Plan data: SHAWNEE MEDICAL CENTER CLINIC INC EMPLOYEE RETIREMENT PLAN plan

SHAWNEE MEDICAL CENTER CLINIC INC EMPLOYEE RETIREMENT PLAN 401k Plan overview

Plan Name	SHAWNEE MEDICAL CENTER CLINIC INC EMPLOYEE RETIREMENT PLAN
Plan identification number	001

SHAWNEE MEDICAL CENTER CLINIC INC EMPLOYEE RETIREMENT PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Participant-directed brokerage accounts provided as an investment option under the plan.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Plan covering Self-Employed individuals.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

SHAWNEE MEDCIAL CENTER CLINIC INC. has sponsored the creation of one or more 401k plans.

Company Name: SHAWNEE MEDCIAL CENTER CLINIC INC.

Employer identification number (EIN): 730767098

NAIC Classification: 621111
NAIC Description: Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SHAWNEE MEDICAL CENTER CLINIC INC EMPLOYEE RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01
001 2021-01-01
001 2020-01-01
001 2019-01-01 KAREN ROSE 2020-09-29
001 2018-01-01 PHILIP A HADDAD 2019-09-25
001 2017-01-01
001 2016-01-01 ALAN SIMPSON
001 2015-01-01 ALAN SIMPSON
001 2014-01-01 JEFF GRIFFIN 2015-10-05
001 2013-01-01 JEFF GRIFFIN
001 2011-01-01 SHERRY OLDHAM
001 2009-01-01 SHERRY OLDHAM SHERRY OLDHAM 2010-10-12
001 2009-01-01 SHERRY OLDHAM

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2022-01-01
001	2021-01-01
001	2020-01-01
001	2019-01-01	KAREN ROSE	2020-09-29
001	2018-01-01	PHILIP A HADDAD	2019-09-25
001	2017-01-01
001	2016-01-01	ALAN SIMPSON
001	2015-01-01	ALAN SIMPSON
001	2014-01-01	JEFF GRIFFIN	2015-10-05
001	2013-01-01	JEFF GRIFFIN
001	2011-01-01	SHERRY OLDHAM
001	2009-01-01	SHERRY OLDHAM		SHERRY OLDHAM	2010-10-12
001	2009-01-01	SHERRY OLDHAM

Plan Statistics for SHAWNEE MEDICAL CENTER CLINIC INC EMPLOYEE RETIREMENT PLAN

401k plan membership statisitcs for SHAWNEE MEDICAL CENTER CLINIC INC EMPLOYEE RETIREMENT PLAN

Measure Date Value
2019: SHAWNEE MEDICAL CENTER CLINIC INC EMPLOYEE RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 29
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 30
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 0
Total of all active and inactive participants 2019-01-01 30
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 30
Number of participants with account balances 2019-01-01 28
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: SHAWNEE MEDICAL CENTER CLINIC INC EMPLOYEE RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 33
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 33
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 0
Total of all active and inactive participants 2018-01-01 33
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 33
Number of participants with account balances 2018-01-01 28
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: SHAWNEE MEDICAL CENTER CLINIC INC EMPLOYEE RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 33
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 33
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 0
Total of all active and inactive participants 2017-01-01 33
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 33
Number of participants with account balances 2017-01-01 29
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: SHAWNEE MEDICAL CENTER CLINIC INC EMPLOYEE RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 31
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 33
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 33
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 33
Number of participants with account balances 2016-01-01 29
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: SHAWNEE MEDICAL CENTER CLINIC INC EMPLOYEE RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 29
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 29
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 29
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 29
Number of participants with account balances 2015-01-01 27
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2013: SHAWNEE MEDICAL CENTER CLINIC INC EMPLOYEE RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 24
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 22
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 0
Total of all active and inactive participants 2013-01-01 22
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 22
Number of participants with account balances 2013-01-01 22
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2011: SHAWNEE MEDICAL CENTER CLINIC INC EMPLOYEE RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 297
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 204
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 85
Total of all active and inactive participants 2011-01-01 289
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 1
Total participants 2011-01-01 290
Number of participants with account balances 2011-01-01 282
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 37
2009: SHAWNEE MEDICAL CENTER CLINIC INC EMPLOYEE RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 302
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 193
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 57
Total of all active and inactive participants 2009-01-01 250
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 1
Total participants 2009-01-01 251
Number of participants with account balances 2009-01-01 245
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 39

Measure	Date	Value
2019: SHAWNEE MEDICAL CENTER CLINIC INC EMPLOYEE RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	29
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	30
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	0
Total of all active and inactive participants	2019-01-01	30
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	30
Number of participants with account balances	2019-01-01	28
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: SHAWNEE MEDICAL CENTER CLINIC INC EMPLOYEE RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	33
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	33
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	0
Total of all active and inactive participants	2018-01-01	33
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	33
Number of participants with account balances	2018-01-01	28
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: SHAWNEE MEDICAL CENTER CLINIC INC EMPLOYEE RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	33
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	33
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	0
Total of all active and inactive participants	2017-01-01	33
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	33
Number of participants with account balances	2017-01-01	29
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: SHAWNEE MEDICAL CENTER CLINIC INC EMPLOYEE RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	31
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	33
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	33
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	33
Number of participants with account balances	2016-01-01	29
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: SHAWNEE MEDICAL CENTER CLINIC INC EMPLOYEE RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	29
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	29
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	29
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	29
Number of participants with account balances	2015-01-01	27
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2013: SHAWNEE MEDICAL CENTER CLINIC INC EMPLOYEE RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	24
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	22
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	0
Total of all active and inactive participants	2013-01-01	22
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	22
Number of participants with account balances	2013-01-01	22
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2011: SHAWNEE MEDICAL CENTER CLINIC INC EMPLOYEE RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	297
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	204
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	85
Total of all active and inactive participants	2011-01-01	289
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	1
Total participants	2011-01-01	290
Number of participants with account balances	2011-01-01	282
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	37
2009: SHAWNEE MEDICAL CENTER CLINIC INC EMPLOYEE RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	302
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	193
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	57
Total of all active and inactive participants	2009-01-01	250
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	1
Total participants	2009-01-01	251
Number of participants with account balances	2009-01-01	245
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	39

Financial Data on SHAWNEE MEDICAL CENTER CLINIC INC EMPLOYEE RETIREMENT PLAN

Measure	Date	Value
2019 : SHAWNEE MEDICAL CENTER CLINIC INC EMPLOYEE RETIREMENT PLAN 2019 401k financial data
Total income from all sources	2019-12-31	$5,292,046
Expenses. Total of all expenses incurred	2019-12-31	$5,437,043
Benefits paid (including direct rollovers)	2019-12-31	$5,387,582
Total plan assets at end of year	2019-12-31	$19,282,054
Total plan assets at beginning of year	2019-12-31	$19,427,051
Value of fidelity bond covering the plan	2019-12-31	$500,000
Total contributions received or receivable from participants	2019-12-31	$633,881
Expenses. Other expenses not covered elsewhere	2019-12-31	$49,461
Other income received	2019-12-31	$3,897,488
Net income (gross income less expenses)	2019-12-31	$-144,997
Net plan assets at end of year (total assets less liabilities)	2019-12-31	$19,282,054
Net plan assets at beginning of year (total assets less liabilities)	2019-12-31	$19,427,051
Assets. Value of participant loans	2019-12-31	$147,108
Total contributions received or receivable from employer(s)	2019-12-31	$760,677
2018 : SHAWNEE MEDICAL CENTER CLINIC INC EMPLOYEE RETIREMENT PLAN 2018 401k financial data
Total income from all sources	2018-12-31	$298,080
Expenses. Total of all expenses incurred	2018-12-31	$434,023
Benefits paid (including direct rollovers)	2018-12-31	$379,339
Total plan assets at end of year	2018-12-31	$19,427,051
Total plan assets at beginning of year	2018-12-31	$19,562,994
Value of fidelity bond covering the plan	2018-12-31	$500,000
Total contributions received or receivable from participants	2018-12-31	$615,167
Other income received	2018-12-31	$-1,042,492
Net income (gross income less expenses)	2018-12-31	$-135,943
Net plan assets at end of year (total assets less liabilities)	2018-12-31	$19,427,051
Net plan assets at beginning of year (total assets less liabilities)	2018-12-31	$19,562,994
Assets. Value of participant loans	2018-12-31	$133,558
Total contributions received or receivable from employer(s)	2018-12-31	$725,405
Expenses. Administrative service providers (salaries,fees and commissions)	2018-12-31	$54,684
2017 : SHAWNEE MEDICAL CENTER CLINIC INC EMPLOYEE RETIREMENT PLAN 2017 401k financial data
Total income from all sources	2017-12-31	$4,046,291
Expenses. Total of all expenses incurred	2017-12-31	$191,077
Benefits paid (including direct rollovers)	2017-12-31	$145,042
Total plan assets at end of year	2017-12-31	$19,562,994
Total plan assets at beginning of year	2017-12-31	$15,707,780
Value of fidelity bond covering the plan	2017-12-31	$500,000
Total contributions received or receivable from participants	2017-12-31	$618,000
Contributions received from other sources (not participants or employers)	2017-12-31	$157,857
Other income received	2017-12-31	$2,558,940
Net income (gross income less expenses)	2017-12-31	$3,855,214
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$19,562,994
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$15,707,780
Assets. Value of participant loans	2017-12-31	$50,000
Total contributions received or receivable from employer(s)	2017-12-31	$711,494
Expenses. Administrative service providers (salaries,fees and commissions)	2017-12-31	$46,035
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
2016 : SHAWNEE MEDICAL CENTER CLINIC INC EMPLOYEE RETIREMENT PLAN 2016 401k financial data
Total income from all sources	2016-12-31	$2,282,764
Expenses. Total of all expenses incurred	2016-12-31	$36,033
Total plan assets at end of year	2016-12-31	$15,707,780
Total plan assets at beginning of year	2016-12-31	$13,461,049
Value of fidelity bond covering the plan	2016-12-31	$500,000
Total contributions received or receivable from participants	2016-12-31	$594,500
Expenses. Other expenses not covered elsewhere	2016-12-31	$36,033
Other income received	2016-12-31	$1,000,990
Net income (gross income less expenses)	2016-12-31	$2,246,731
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$15,707,780
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$13,461,049
Total contributions received or receivable from employer(s)	2016-12-31	$687,274
2015 : SHAWNEE MEDICAL CENTER CLINIC INC EMPLOYEE RETIREMENT PLAN 2015 401k financial data
Total income from all sources	2015-12-31	$1,322,038
Expenses. Total of all expenses incurred	2015-12-31	$30,836
Total plan assets at end of year	2015-12-31	$13,461,049
Total plan assets at beginning of year	2015-12-31	$12,169,847
Value of fidelity bond covering the plan	2015-12-31	$500,000
Total contributions received or receivable from participants	2015-12-31	$582,000
Contributions received from other sources (not participants or employers)	2015-12-31	$329,871
Other income received	2015-12-31	$-296,355
Net income (gross income less expenses)	2015-12-31	$1,291,202
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$13,461,049
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$12,169,847
Total contributions received or receivable from employer(s)	2015-12-31	$706,522
Expenses. Administrative service providers (salaries,fees and commissions)	2015-12-31	$30,836
2013 : SHAWNEE MEDICAL CENTER CLINIC INC EMPLOYEE RETIREMENT PLAN 2013 401k financial data
Total income from all sources	2013-12-31	$2,015,450
Expenses. Total of all expenses incurred	2013-12-31	$1,069,093
Benefits paid (including direct rollovers)	2013-12-31	$1,052,803
Total plan assets at end of year	2013-12-31	$10,133,960
Total plan assets at beginning of year	2013-12-31	$9,187,603
Value of fidelity bond covering the plan	2013-12-31	$1,000,000
Total contributions received or receivable from participants	2013-12-31	$495,918
Expenses. Other expenses not covered elsewhere	2013-12-31	$16,290
Other income received	2013-12-31	$852,626
Net income (gross income less expenses)	2013-12-31	$946,357
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$10,133,960
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$9,187,603
Assets. Value of participant loans	2013-12-31	$50,000
Total contributions received or receivable from employer(s)	2013-12-31	$666,906
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
2012 : SHAWNEE MEDICAL CENTER CLINIC INC EMPLOYEE RETIREMENT PLAN 2012 401k financial data
Total income from all sources (including contributions)	2012-12-31	$4,015,538
Total of all expenses incurred	2012-12-31	$20,643,951
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$20,640,293
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$1,851,281
Value of total assets at end of year	2012-12-31	$9,187,603
Value of total assets at beginning of year	2012-12-31	$25,816,016
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$3,658
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$802,487
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-12-31	$802,487
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$1,000,000
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$1,091,950
Assets. Other investments not covered elsewhere at beginning of year	2012-12-31	$7,199,177
Other income not declared elsewhere	2012-12-31	$1,087
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$-16,628,413
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$9,187,603
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$25,816,016
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Investment advisory and management fees	2012-12-31	$3,658
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$9,187,603
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$14,784,258
Value of interest in common/collective trusts at end of year	2012-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$3,832,581
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$1,360,683
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$759,331
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$20,640,293
Did the plan have assets held for investment	2012-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	KEITH STINGLEY, CPA
Accountancy firm EIN	2012-12-31	731519331
2011 : SHAWNEE MEDICAL CENTER CLINIC INC EMPLOYEE RETIREMENT PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$1,005,842
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$545,301
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$544,463
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$1,535,570
Value of total assets at end of year	2011-12-31	$25,816,016
Value of total assets at beginning of year	2011-12-31	$25,355,475
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$838
Total interest from all sources	2011-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$154,239
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2011-12-31	$154,239
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$544,244
Assets. Other investments not covered elsewhere at end of year	2011-12-31	$7,199,177
Assets. Other investments not covered elsewhere at beginning of year	2011-12-31	$7,159,606
Other income not declared elsewhere	2011-12-31	$144,529
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$460,541
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$25,816,016
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$25,355,475
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Investment advisory and management fees	2011-12-31	$838
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$14,784,258
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$15,723,004
Value of interest in pooled separate accounts at end of year	2011-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$2,472,865
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$3,832,581
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-831,080
Net investment gain/loss from pooled separate accounts	2011-12-31	$2,584
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$991,326
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$544,463
Did the plan have assets held for investment	2011-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	KEITH STINGLEY, CPA
Accountancy firm EIN	2011-12-31	731519331
2010 : SHAWNEE MEDICAL CENTER CLINIC INC EMPLOYEE RETIREMENT PLAN 2010 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2010-12-31	$0
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total transfer of assets to this plan	2010-12-31	$0
Total transfer of assets from this plan	2010-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total income from all sources (including contributions)	2010-12-31	$4,110,681
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$170,217
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$170,217
Expenses. Certain deemed distributions of participant loans	2010-12-31	$0
Value of total corrective distributions	2010-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$1,305,023
Value of total assets at end of year	2010-12-31	$25,355,475
Value of total assets at beginning of year	2010-12-31	$21,415,011
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$0
Total interest from all sources	2010-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$128,543
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2010-12-31	$128,543
Administrative expenses professional fees incurred	2010-12-31	$0
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$518,720
Participant contributions at end of year	2010-12-31	$0
Participant contributions at end of year	2010-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2010-12-31	$7,159,606
Assets. Other investments not covered elsewhere at beginning of year	2010-12-31	$5,168,983
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$0
Other income not declared elsewhere	2010-12-31	$1,990,623
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$3,940,464
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$25,355,475
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$21,415,011
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Investment advisory and management fees	2010-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$15,723,004
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$14,112,387
Value of interest in pooled separate accounts at end of year	2010-12-31	$2,472,865
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$2,133,641
Interest on participant loans	2010-12-31	$0
Value of interest in common/collective trusts at end of year	2010-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2010-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2010-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$636,169
Net investment gain/loss from pooled separate accounts	2010-12-31	$50,323
Net investment gain or loss from common/collective trusts	2010-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Assets. Invements in employer securities at end of year	2010-12-31	$0
Contributions received in cash from employer	2010-12-31	$786,303
Employer contributions (assets) at end of year	2010-12-31	$0
Income. Dividends from common stock	2010-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$170,217
Contract administrator fees	2010-12-31	$0
Did the plan have assets held for investment	2010-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Aggregate proceeds on sale of assets	2010-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2010-12-31	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	KEITH STINGLEY CPA
Accountancy firm EIN	2010-12-31	731519331

Form 5500 Responses for SHAWNEE MEDICAL CENTER CLINIC INC EMPLOYEE RETIREMENT PLAN

2019: SHAWNEE MEDICAL CENTER CLINIC INC EMPLOYEE RETIREMENT PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: SHAWNEE MEDICAL CENTER CLINIC INC EMPLOYEE RETIREMENT PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: SHAWNEE MEDICAL CENTER CLINIC INC EMPLOYEE RETIREMENT PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: SHAWNEE MEDICAL CENTER CLINIC INC EMPLOYEE RETIREMENT PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: SHAWNEE MEDICAL CENTER CLINIC INC EMPLOYEE RETIREMENT PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2013: SHAWNEE MEDICAL CENTER CLINIC INC EMPLOYEE RETIREMENT PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2011: SHAWNEE MEDICAL CENTER CLINIC INC EMPLOYEE RETIREMENT PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: SHAWNEE MEDICAL CENTER CLINIC INC EMPLOYEE RETIREMENT PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

NEW YORK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66915 )

Policy contract number

GA28083

Policy instance

Insurance contract or identification number	GA28083
Insurance policy start date	2012-01-01
Insurance policy end date	2012-06-30
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

NEW YORK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66915 )

Policy contract number

31501

Policy instance

Insurance contract or identification number	31501
Number of Individuals Covered	0
Insurance policy start date	2011-01-01
Insurance policy end date	2011-01-20
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No

NEW YORK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66915 )

Policy contract number

GA28083

Policy instance

Insurance contract or identification number	GA28083
Number of Individuals Covered	282
Insurance policy start date	2011-01-20
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

NEW YORK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66915 )

Policy contract number

31501

Policy instance

Insurance contract or identification number	31501
Number of Individuals Covered	262
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 $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No

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Company Name:	SHAWNEE MEDCIAL CENTER CLINIC INC.
Employer identification number (EIN):	730767098
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)