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ADAIR COUNTY HEALTH CENTER INC. 401(K) PLAN 401k Plan overview

Plan NameADAIR COUNTY HEALTH CENTER INC. 401(K) PLAN
Plan identification number 001

ADAIR COUNTY HEALTH CENTER INC. 401(K) PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • 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.
  • Partial participant-directed account plan - Participants have the opportunity to direct the investment of a portion of 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.
  • Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
  • Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • 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

ADAIR COUNTY HEALTH CENTER INC. DBA MEMORIAL HOSPITAL has sponsored the creation of one or more 401k plans.

Company Name:ADAIR COUNTY HEALTH CENTER INC. DBA MEMORIAL HOSPITAL
Employer identification number (EIN):730977997
NAIC Classification:813000
NAIC Description: Religious, Grantmaking, Civic, Professional, and Similar Organizations

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ADAIR COUNTY HEALTH CENTER INC. 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01ALAN ADAMS2023-10-09 ALAN ADAMS2023-10-09
0012021-01-01ALAN ADAMS2022-10-12 ALAN ADAMS2022-10-12
0012020-01-01ALAN ADAMS2021-10-12 ALAN ADAMS2021-10-12
0012019-01-01ALAN L. ADAMS2020-10-06 ALAN L. ADAMS2020-10-06
0012018-01-01ALAN L. ADAMS2019-10-13 ALAN L. ADAMS2019-10-13
0012017-01-01
0012016-01-01ALAN L. ADAMS ALAN L. ADAMS2017-10-13
0012015-01-01DARLENE PUTNAM
0012014-01-01DARLENE PUTNAM
0012013-01-01ALAN ADAMS
0012012-01-01ALAN ADAMS
0012011-01-01ALAN ADAMS
0012009-01-01ALAN L. ADAMS ALAN L. ADAMS2011-01-11
0012009-01-01JOE WESTHOFF JOE WESTHOFF2010-10-16
0012009-01-01JOE WESTHOFF JOE WESTHOFF2010-10-15

Plan Statistics for ADAIR COUNTY HEALTH CENTER INC. 401(K) PLAN

401k plan membership statisitcs for ADAIR COUNTY HEALTH CENTER INC. 401(K) PLAN

Measure Date Value
2022: ADAIR COUNTY HEALTH CENTER INC. 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01234
Total number of active participants reported on line 7a of the Form 55002022-01-01194
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-0119
Total of all active and inactive participants2022-01-01213
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01213
Number of participants with account balances2022-01-0186
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010
2021: ADAIR COUNTY HEALTH CENTER INC. 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01267
Total number of active participants reported on line 7a of the Form 55002021-01-01213
Number of retired or separated participants receiving benefits2021-01-0112
Number of other retired or separated participants entitled to future benefits2021-01-0131
Total of all active and inactive participants2021-01-01256
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01256
Number of participants with account balances2021-01-01126
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: ADAIR COUNTY HEALTH CENTER INC. 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01300
Total number of active participants reported on line 7a of the Form 55002020-01-01212
Number of retired or separated participants receiving benefits2020-01-0132
Number of other retired or separated participants entitled to future benefits2020-01-0126
Total of all active and inactive participants2020-01-01270
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01270
Number of participants with account balances2020-01-01152
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: ADAIR COUNTY HEALTH CENTER INC. 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01289
Total number of active participants reported on line 7a of the Form 55002019-01-01226
Number of retired or separated participants receiving benefits2019-01-0136
Number of other retired or separated participants entitled to future benefits2019-01-0134
Total of all active and inactive participants2019-01-01296
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01296
Number of participants with account balances2019-01-01173
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: ADAIR COUNTY HEALTH CENTER INC. 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01292
Total number of active participants reported on line 7a of the Form 55002018-01-01277
Number of retired or separated participants receiving benefits2018-01-0116
Number of other retired or separated participants entitled to future benefits2018-01-0127
Total of all active and inactive participants2018-01-01320
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01320
Number of participants with account balances2018-01-01171
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: ADAIR COUNTY HEALTH CENTER INC. 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01282
Total number of active participants reported on line 7a of the Form 55002017-01-01244
Number of retired or separated participants receiving benefits2017-01-0117
Number of other retired or separated participants entitled to future benefits2017-01-0131
Total of all active and inactive participants2017-01-01292
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-01292
Number of participants with account balances2017-01-01173
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: ADAIR COUNTY HEALTH CENTER INC. 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01252
Total number of active participants reported on line 7a of the Form 55002016-01-01269
Number of retired or separated participants receiving benefits2016-01-013
Number of other retired or separated participants entitled to future benefits2016-01-0130
Total of all active and inactive participants2016-01-01302
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-01302
Number of participants with account balances2016-01-01192
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-0116
2015: ADAIR COUNTY HEALTH CENTER INC. 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01354
Total number of active participants reported on line 7a of the Form 55002015-01-01258
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-0135
Total of all active and inactive participants2015-01-01293
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-01293
Number of participants with account balances2015-01-01177
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: ADAIR COUNTY HEALTH CENTER INC. 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01308
Total number of active participants reported on line 7a of the Form 55002014-01-01257
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-0128
Total of all active and inactive participants2014-01-01285
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-01285
Number of participants with account balances2014-01-01175
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: ADAIR COUNTY HEALTH CENTER INC. 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01267
Total number of active participants reported on line 7a of the Form 55002013-01-01247
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-0133
Total of all active and inactive participants2013-01-01280
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-01280
Number of participants with account balances2013-01-01182
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: ADAIR COUNTY HEALTH CENTER INC. 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01248
Total number of active participants reported on line 7a of the Form 55002012-01-01249
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-0118
Total of all active and inactive participants2012-01-01267
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-01267
Number of participants with account balances2012-01-01181
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: ADAIR COUNTY HEALTH CENTER INC. 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01211
Total number of active participants reported on line 7a of the Form 55002011-01-01246
Number of other retired or separated participants entitled to future benefits2011-01-012
Total of all active and inactive participants2011-01-01248
Total participants2011-01-01248
Number of participants with account balances2011-01-01115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-0120
2009: ADAIR COUNTY HEALTH CENTER INC. 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01189
Total number of active participants reported on line 7a of the Form 55002009-01-01197
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-0112
Total of all active and inactive participants2009-01-01209
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-01209
Number of participants with account balances2009-01-0151
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on ADAIR COUNTY HEALTH CENTER INC. 401(K) PLAN

Measure Date Value
2022 : ADAIR COUNTY HEALTH CENTER INC. 401(K) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$90
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$914
Total income from all sources (including contributions)2022-12-31$-574,081
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$745,940
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$704,581
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$540,614
Value of total assets at end of year2022-12-31$5,847,638
Value of total assets at beginning of year2022-12-31$7,168,483
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$41,359
Total interest from all sources2022-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$500,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$352,845
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$17,417
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-12-31$40
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-12-31$40
Liabilities. Value of operating payables at beginning of year2022-12-31$825
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-1,320,021
Value of net assets at end of year (total assets less liabilities)2022-12-31$5,847,548
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$7,167,569
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$4,836,551
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$6,598,129
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-12-31$1,009,431
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-12-31$570,354
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-12-31$570,354
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-1,114,695
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$170,352
Employer contributions (assets) at end of year2022-12-31$1,656
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$704,581
Contract administrator fees2022-12-31$41,359
Liabilities. Value of benefit claims payable at end of year2022-12-31$50
Liabilities. Value of benefit claims payable at beginning of year2022-12-31$49
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31WESTHOFF CPA FIRM, PC
Accountancy firm EIN2022-12-31872971220
2021 : ADAIR COUNTY HEALTH CENTER INC. 401(K) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$914
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$4
Total income from all sources (including contributions)2021-12-31$1,349,030
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$293,374
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$250,387
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$535,260
Value of total assets at end of year2021-12-31$7,168,483
Value of total assets at beginning of year2021-12-31$6,111,917
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$42,987
Total interest from all sources2021-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Administrative expenses professional fees incurred2021-12-31$42,987
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$500,000
If this is an individual account plan, was there a blackout period2021-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$354,404
Participant contributions at beginning of year2021-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-12-31$40
Liabilities. Value of operating payables at end of year2021-12-31$825
Liabilities. Value of operating payables at beginning of year2021-12-31$4
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$1,055,656
Value of net assets at end of year (total assets less liabilities)2021-12-31$7,167,569
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$6,111,913
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$6,598,129
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$5,541,566
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-12-31$570,354
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-12-31$570,351
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-12-31$570,351
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$813,770
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$180,856
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$250,387
Liabilities. Value of benefit claims payable at end of year2021-12-31$49
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31WESTHOFF CPA FIRM, PC
Accountancy firm EIN2021-12-31872971220
2020 : ADAIR COUNTY HEALTH CENTER INC. 401(K) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$4
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$951
Total income from all sources (including contributions)2020-12-31$1,325,571
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$706,515
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$666,082
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$581,193
Value of total assets at end of year2020-12-31$6,111,917
Value of total assets at beginning of year2020-12-31$5,493,808
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$40,433
Total interest from all sources2020-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$500,000
If this is an individual account plan, was there a blackout period2020-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$381,165
Participant contributions at end of year2020-12-31$0
Participant contributions at beginning of year2020-12-31$20
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$1,103
Liabilities. Value of operating payables at end of year2020-12-31$4
Liabilities. Value of operating payables at beginning of year2020-12-31$951
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$619,056
Value of net assets at end of year (total assets less liabilities)2020-12-31$6,111,913
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$5,492,857
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$5,541,566
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$5,493,194
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-12-31$570,351
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-12-31$594
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-12-31$594
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$744,378
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$198,925
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$666,082
Contract administrator fees2020-12-31$40,433
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Disclaimer
Accountancy firm name2020-12-31WESTHOFF CPA FIRM, PC
Accountancy firm EIN2020-12-31872971220
2019 : ADAIR COUNTY HEALTH CENTER INC. 401(K) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$951
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$908
Total income from all sources (including contributions)2019-12-31$1,775,044
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$997,212
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$957,425
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$785,918
Value of total assets at end of year2019-12-31$5,493,808
Value of total assets at beginning of year2019-12-31$4,715,933
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$39,787
Total interest from all sources2019-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$143,805
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$143,805
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$500,000
If this is an individual account plan, was there a blackout period2019-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$472,506
Participant contributions at end of year2019-12-31$20
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$56,648
Liabilities. Value of operating payables at end of year2019-12-31$951
Liabilities. Value of operating payables at beginning of year2019-12-31$908
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$777,832
Value of net assets at end of year (total assets less liabilities)2019-12-31$5,492,857
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$4,715,025
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Investment advisory and management fees2019-12-31$39,787
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$5,493,194
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$4,714,466
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$594
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$1,467
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$1,467
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$845,321
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31Yes
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$256,764
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$957,425
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31CAUSON & WESTHOFF, CPA'S PC
Accountancy firm EIN2019-12-31731528438
2018 : ADAIR COUNTY HEALTH CENTER INC. 401(K) PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$908
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$601
Total income from all sources (including contributions)2018-12-31$362,508
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$823,428
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$784,124
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$720,215
Value of total assets at end of year2018-12-31$4,715,933
Value of total assets at beginning of year2018-12-31$5,176,546
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$39,304
Total interest from all sources2018-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$147,908
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2018-12-31$147,908
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$500,000
If this is an individual account plan, was there a blackout period2018-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$473,800
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$502
Other income not declared elsewhere2018-12-31$74
Administrative expenses (other) incurred2018-12-31$181
Liabilities. Value of operating payables at end of year2018-12-31$908
Liabilities. Value of operating payables at beginning of year2018-12-31$601
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$-460,920
Value of net assets at end of year (total assets less liabilities)2018-12-31$4,715,025
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$5,175,945
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$4,714,466
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$5,125,396
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-12-31$1,467
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-12-31$1,195
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-12-31$1,195
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-505,689
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31Yes
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$245,913
Employer contributions (assets) at beginning of year2018-12-31$49,955
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$784,124
Contract administrator fees2018-12-31$39,123
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31CAUSON & WESTHOFF, CPA'S PC
Accountancy firm EIN2018-12-31731528438
2017 : ADAIR COUNTY HEALTH CENTER INC. 401(K) PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$601
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total income from all sources (including contributions)2017-12-31$1,441,933
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$744,432
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$709,577
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$798,587
Value of total assets at end of year2017-12-31$5,176,546
Value of total assets at beginning of year2017-12-31$4,478,444
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$34,855
Total interest from all sources2017-12-31$32
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$137,885
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2017-12-31$137,885
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$500,000
If this is an individual account plan, was there a blackout period2017-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$507,974
Administrative expenses (other) incurred2017-12-31$34,855
Liabilities. Value of operating payables at end of year2017-12-31$601
Total non interest bearing cash at beginning of year2017-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$697,501
Value of net assets at end of year (total assets less liabilities)2017-12-31$5,175,945
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$4,478,444
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$5,125,396
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$4,228,086
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-12-31$1,195
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-12-31$100,534
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-12-31$100,534
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-12-31$32
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-12-31$505,429
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31Yes
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$290,613
Employer contributions (assets) at end of year2017-12-31$49,955
Employer contributions (assets) at beginning of year2017-12-31$149,824
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$709,577
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31CAUSON & WESTHOFF, CPA'S PC
Accountancy firm EIN2017-12-31731528438
2016 : ADAIR COUNTY HEALTH CENTER INC. 401(K) PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total income from all sources (including contributions)2016-12-31$1,122,892
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$271,698
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$255,777
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$907,994
Value of total assets at end of year2016-12-31$4,478,444
Value of total assets at beginning of year2016-12-31$3,627,250
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$15,921
Total interest from all sources2016-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$103,964
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2016-12-31$103,964
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$500,000
If this is an individual account plan, was there a blackout period2016-12-31Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$561,979
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$35,725
Administrative expenses (other) incurred2016-12-31$15,921
Total non interest bearing cash at end of year2016-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$851,194
Value of net assets at end of year (total assets less liabilities)2016-12-31$4,478,444
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$3,627,250
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-31$4,228,086
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$3,037,995
Value of interest in pooled separate accounts at beginning of year2016-12-31$589,255
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$100,534
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-12-31$110,934
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$310,290
Employer contributions (assets) at end of year2016-12-31$149,824
Employer contributions (assets) at beginning of year2016-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$255,777
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-12-31Yes
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31CAUSON & WESTHOFF, CPA'S PC
Accountancy firm EIN2016-12-31731528438
2015 : ADAIR COUNTY HEALTH CENTER INC. 401(K) PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total income from all sources (including contributions)2015-12-31$876,792
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$650,403
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$650,381
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$704,733
Value of total assets at end of year2015-12-31$3,627,250
Value of total assets at beginning of year2015-12-31$3,400,861
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$22
Total interest from all sources2015-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$453,905
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2015-12-31$453,905
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$500,000
If this is an individual account plan, was there a blackout period2015-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$454,954
Administrative expenses (other) incurred2015-12-31$22
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$226,389
Value of net assets at end of year (total assets less liabilities)2015-12-31$3,627,250
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$3,400,861
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$3,037,995
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$2,966,287
Value of interest in pooled separate accounts at end of year2015-12-31$589,255
Value of interest in pooled separate accounts at beginning of year2015-12-31$434,574
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$-287,648
Net investment gain/loss from pooled separate accounts2015-12-31$5,802
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$249,779
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$650,381
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31CAUSON & WESTHOFF, CPA'S, PC
Accountancy firm EIN2015-12-31731528438
2014 : ADAIR COUNTY HEALTH CENTER INC. 401(K) PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total income from all sources (including contributions)2014-12-31$745,071
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$912,672
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$912,624
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$647,172
Value of total assets at end of year2014-12-31$3,400,861
Value of total assets at beginning of year2014-12-31$3,568,462
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$48
Total interest from all sources2014-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$242,979
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2014-12-31$242,979
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$500,000
If this is an individual account plan, was there a blackout period2014-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$413,274
Administrative expenses (other) incurred2014-12-31$48
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$-167,601
Value of net assets at end of year (total assets less liabilities)2014-12-31$3,400,861
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$3,568,462
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$2,966,287
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$3,057,651
Value of interest in pooled separate accounts at end of year2014-12-31$434,574
Value of interest in pooled separate accounts at beginning of year2014-12-31$510,811
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-12-31$-150,611
Net investment gain/loss from pooled separate accounts2014-12-31$5,531
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$233,898
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$912,624
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31CAUSON & WESTHOFF, CPA'S, PC
Accountancy firm EIN2014-12-31731528438
2013 : ADAIR COUNTY HEALTH CENTER INC. 401(K) PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total income from all sources (including contributions)2013-12-31$1,006,223
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$255,390
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$255,390
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$721,780
Value of total assets at end of year2013-12-31$3,568,462
Value of total assets at beginning of year2013-12-31$2,817,629
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$0
Total interest from all sources2013-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$136,585
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2013-12-31$136,585
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$350,000
If this is an individual account plan, was there a blackout period2013-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$470,449
Income. Received or receivable in cash from other sources (including rollovers)2013-12-31$1,961
Administrative expenses (other) incurred2013-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$750,833
Value of net assets at end of year (total assets less liabilities)2013-12-31$3,568,462
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$2,817,629
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-12-31$3,057,651
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$2,476,787
Value of interest in pooled separate accounts at end of year2013-12-31$510,811
Value of interest in pooled separate accounts at beginning of year2013-12-31$340,842
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-12-31$141,108
Net investment gain/loss from pooled separate accounts2013-12-31$6,750
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$249,370
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$255,390
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31Yes
Opinion of an independent qualified public accountant for this plan2013-12-31Disclaimer
Accountancy firm name2013-12-31CAUSON & WESTHOFF, CPA'S, PC
Accountancy firm EIN2013-12-31731528438
2012 : ADAIR COUNTY HEALTH CENTER INC. 401(K) PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total income from all sources (including contributions)2012-12-31$904,388
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$131,277
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$128,933
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$672,533
Value of total assets at end of year2012-12-31$2,817,629
Value of total assets at beginning of year2012-12-31$2,044,518
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$2,344
Total interest from all sources2012-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$32,764
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2012-12-31$32,764
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$300,000
If this is an individual account plan, was there a blackout period2012-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$432,559
Participant contributions at end of year2012-12-31$0
Participant contributions at beginning of year2012-12-31$7
Administrative expenses (other) incurred2012-12-31$2,344
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$773,111
Value of net assets at end of year (total assets less liabilities)2012-12-31$2,817,629
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$2,044,518
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-12-31$2,476,787
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$324,930
Value of interest in pooled separate accounts at end of year2012-12-31$340,842
Value of interest in pooled separate accounts at beginning of year2012-12-31$1,485,853
Value of interest in common/collective trusts at end of year2012-12-31$0
Value of interest in common/collective trusts at beginning of year2012-12-31$233,727
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-12-31$195,425
Net investment gain/loss from pooled separate accounts2012-12-31$3,666
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$239,974
Employer contributions (assets) at end of year2012-12-31$0
Employer contributions (assets) at beginning of year2012-12-31$1
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$128,933
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31Yes
Opinion of an independent qualified public accountant for this plan2012-12-31Disclaimer
Accountancy firm name2012-12-31CAUSON & WESTHOFF, CPA'S, PC
Accountancy firm EIN2012-12-31731528438
2011 : ADAIR COUNTY HEALTH CENTER INC. 401(K) PLAN 2011 401k financial data
Total income from all sources (including contributions)2011-12-31$27,463
Total of all expenses incurred2011-12-31$1,704,577
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$1,702,822
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$2,150,452
Value of total assets at end of year2011-12-31$0
Value of total assets at beginning of year2011-12-31$1,677,114
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$1,755
Total interest from all sources2011-12-31$1,283
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$7,926
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan2011-12-31$0
Total dividends received from registered investment company shares (eg mutual funds)2011-12-31$7,926
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$100,000
If this is an individual account plan, was there a blackout period2011-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
Minimum employer required contribution for this plan year2011-12-31$0
Amount contributed by the employer to the plan for this plan year2011-12-31$0
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$352,564
Participant contributions at end of year2011-12-31$7
Participant contributions at beginning of year2011-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2011-12-31$1,611,907
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-1,677,114
Value of net assets at end of year (total assets less liabilities)2011-12-31$0
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$1,677,114
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-12-31$1,315,794
Value of interest in pooled separate accounts at end of year2011-12-31$1,485,853
Value of interest in pooled separate accounts at beginning of year2011-12-31$0
Interest earned on other investments2011-12-31$1,283
Value of interest in common/collective trusts at end of year2011-12-31$233,727
Value of interest in common/collective trusts at beginning of year2011-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-12-31$361,320
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-12-31$26,180
Net investment gain/loss from pooled separate accounts2011-12-31$-65,788
Net investment gain or loss from common/collective trusts2011-12-31$6,716
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$185,981
Employer contributions (assets) at end of year2011-12-31$1
Employer contributions (assets) at beginning of year2011-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$1,702,822
Contract administrator fees2011-12-31$1,755
Did the plan have assets held for investment2011-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31CAUSON & WESTHOFF CPA'S PC
Accountancy firm EIN2011-12-31731528438
2010 : ADAIR COUNTY HEALTH CENTER INC. 401(K) PLAN 2010 401k financial data
Unrealized appreciation/depreciation of real estate assets2010-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2010-12-31$0
Total unrealized appreciation/depreciation of assets2010-12-31$0
Total transfer of assets to this plan2010-12-31$0
Total transfer of assets from this plan2010-12-31$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$504,207
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$26,510
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$15,768
Value of total corrective distributions2010-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$362,131
Value of total assets at end of year2010-12-31$1,677,114
Value of total assets at beginning of year2010-12-31$1,199,417
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$10,742
Total income from rents2010-12-31$0
Total interest from all sources2010-12-31$10,061
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$38,635
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2010-12-31$38,635
Administrative expenses professional fees incurred2010-12-31$0
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$50,000
If this is an individual account plan, was there a blackout period2010-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Amount of non-exempt transactions with any party-in-interest2010-12-31$0
Contributions received from participants2010-12-31$233,758
Participant contributions at end of year2010-12-31$0
Participant contributions at beginning of year2010-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2010-12-31$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2010-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2010-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2010-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2010-12-31$0
Other income not declared elsewhere2010-12-31$0
Administrative expenses (other) incurred2010-12-31$0
Liabilities. Value of operating payables at beginning of year2010-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$477,697
Value of net assets at end of year (total assets less liabilities)2010-12-31$1,677,114
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$1,199,417
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year2010-12-31$0
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year2010-12-31$0
Investment advisory and management fees2010-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2010-12-31$1,315,794
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$844,141
Income. Interest from loans (other than to participants)2010-12-31$0
Interest earned on other investments2010-12-31$10,061
Income. Interest from US Government securities2010-12-31$0
Income. Interest from corporate debt instruments2010-12-31$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 year2010-12-31$361,320
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$355,276
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2010-12-31$93,380
Net investment gain/loss from pooled separate accounts2010-12-31$0
Net investment gain or loss from common/collective trusts2010-12-31$0
Net gain/loss from 103.12 investment entities2010-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31Yes
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$128,373
Employer contributions (assets) at end of year2010-12-31$0
Employer contributions (assets) at beginning of year2010-12-31$0
Income. Dividends from preferred stock2010-12-31$0
Income. Dividends from common stock2010-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$15,768
Contract administrator fees2010-12-31$10,742
Liabilities. Value of benefit claims payable at beginning of year2010-12-31$0
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Aggregate proceeds on sale of assets2010-12-31$0
Aggregate carrying amount (costs) on sale of assets2010-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2010-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31CAUSON & WESTHOFF, CPA'S P.C.
Accountancy firm EIN2010-12-31731528438
2009 : ADAIR COUNTY HEALTH CENTER INC. 401(K) PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2009-12-31$0

Form 5500 Responses for ADAIR COUNTY HEALTH CENTER INC. 401(K) PLAN

2022: ADAIR COUNTY HEALTH CENTER INC. 401(K) PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement - TrustYes
2021: ADAIR COUNTY HEALTH CENTER INC. 401(K) PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement - TrustYes
2020: ADAIR COUNTY HEALTH CENTER INC. 401(K) PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement - TrustYes
2019: ADAIR COUNTY HEALTH CENTER INC. 401(K) PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement - TrustYes
2018: ADAIR COUNTY HEALTH CENTER INC. 401(K) PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement - TrustYes
2017: ADAIR COUNTY HEALTH CENTER INC. 401(K) PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement - TrustYes
2016: ADAIR COUNTY HEALTH CENTER INC. 401(K) PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: ADAIR COUNTY HEALTH CENTER INC. 401(K) PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: ADAIR COUNTY HEALTH CENTER INC. 401(K) PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: ADAIR COUNTY HEALTH CENTER INC. 401(K) PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: ADAIR COUNTY HEALTH CENTER INC. 401(K) PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: ADAIR COUNTY HEALTH CENTER INC. 401(K) PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01First time form 5500 has been submittedYes
2011-01-01Submission has been amendedYes
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2009: ADAIR COUNTY HEALTH CENTER INC. 401(K) PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedYes
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

NEW YORK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66915 )
Policy contract numberGA32001
Policy instance 1
Insurance contract or identification numberGA32001
Number of Individuals Covered177
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NEW YORK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66915 )
Policy contract numberGA32001
Policy instance 1
Insurance contract or identification numberGA32001
Number of Individuals Covered46
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NEW YORK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66915 )
Policy contract numberGA32001
Policy instance 1
Insurance contract or identification numberGA32001
Number of Individuals Covered47
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number522212
Policy instance 1
Insurance contract or identification number522212
Number of Individuals Covered0
Insurance policy start date2012-01-01
Insurance policy end date2012-04-12
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NEW YORK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66915 )
Policy contract numberGA32001
Policy instance 2
Insurance contract or identification numberGA32001
Number of Individuals Covered36
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number522212
Policy instance 1
Insurance contract or identification number522212
Number of Individuals Covered248
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $3,877
Total amount of fees paid to insurance companyUSD $238
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number441463
Policy instance 1
Insurance contract or identification number441463
Number of Individuals Covered232
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $844
Total amount of fees paid to insurance companyUSD $2,674
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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