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SID PETERSON MEMORIAL HOSPITAL 401(K) SAVINGS AND PROFIT SHARING PLAN 401k Plan overview

Plan NameSID PETERSON MEMORIAL HOSPITAL 401(K) SAVINGS AND PROFIT SHARING PLAN
Plan identification number 003

SID PETERSON MEMORIAL HOSPITAL 401(K) SAVINGS AND PROFIT SHARING 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.
  • 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.
  • Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Plan covering Self-Employed individuals.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

PETERSON REGIONAL MEDICAL CENTER has sponsored the creation of one or more 401k plans.

Company Name:PETERSON REGIONAL MEDICAL CENTER
Employer identification number (EIN):742557820
NAIC Classification:622000
NAIC Description: Hospitals

Additional information about PETERSON REGIONAL MEDICAL CENTER

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 1989-02-13
Company Identification Number: 0110424801
Legal Registered Office Address: 551 HILL COUNTRY DR

KERRVILLE
United States of America (USA)
78028

More information about PETERSON REGIONAL MEDICAL CENTER

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SID PETERSON MEMORIAL HOSPITAL 401(K) SAVINGS AND PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0032022-01-01
0032021-01-01
0032020-01-01
0032019-01-01
0032018-01-01
0032017-01-01JAMES PATRICK MURRAY
0032016-01-01JAMES PATRICK MURRAY SANDRA D. PATTERSON2017-10-06
0032015-01-01JAMES PATRICK MURRAY SANDRA D. PATTERSON2016-10-17
0032014-01-01JAMES PATRICK MURRAY SANDRA D. PATTESON2015-09-21
0032013-01-01JAMES PATRICK MURRAY SANDRA D. PATTERSON2014-07-28
0032012-01-01JAMES PATRICK MURRAY SANDRA D. PATTERSON2013-07-29
0032011-01-01JAMES PATRICK MURRAY SANDRA D. PATTERSON2012-07-26
0032009-01-01SANDRA PATTERSON JAMES PATRICK MURRAY2010-08-11
0032009-01-01SANDRA PATTERSON

Plan Statistics for SID PETERSON MEMORIAL HOSPITAL 401(K) SAVINGS AND PROFIT SHARING PLAN

401k plan membership statisitcs for SID PETERSON MEMORIAL HOSPITAL 401(K) SAVINGS AND PROFIT SHARING PLAN

Measure Date Value
2022: SID PETERSON MEMORIAL HOSPITAL 401(K) SAVINGS AND PROFIT SHARING PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-011,342
Total number of active participants reported on line 7a of the Form 55002022-01-011,227
Number of retired or separated participants receiving benefits2022-01-0128
Number of other retired or separated participants entitled to future benefits2022-01-01248
Total of all active and inactive participants2022-01-011,503
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-011,503
Number of participants with account balances2022-01-011,435
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-0183
2021: SID PETERSON MEMORIAL HOSPITAL 401(K) SAVINGS AND PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-011,351
Total number of active participants reported on line 7a of the Form 55002021-01-011,186
Number of retired or separated participants receiving benefits2021-01-0117
Number of other retired or separated participants entitled to future benefits2021-01-01138
Total of all active and inactive participants2021-01-011,341
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-011
Total participants2021-01-011,342
Number of participants with account balances2021-01-011,211
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-0174
2020: SID PETERSON MEMORIAL HOSPITAL 401(K) SAVINGS AND PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-011,271
Total number of active participants reported on line 7a of the Form 55002020-01-011,209
Number of retired or separated participants receiving benefits2020-01-0118
Number of other retired or separated participants entitled to future benefits2020-01-01123
Total of all active and inactive participants2020-01-011,350
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-011
Total participants2020-01-011,351
Number of participants with account balances2020-01-011,144
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-0152
2019: SID PETERSON MEMORIAL HOSPITAL 401(K) SAVINGS AND PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-011,193
Total number of active participants reported on line 7a of the Form 55002019-01-011,116
Number of retired or separated participants receiving benefits2019-01-0119
Number of other retired or separated participants entitled to future benefits2019-01-01112
Total of all active and inactive participants2019-01-011,247
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-011,247
Number of participants with account balances2019-01-011,001
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-0151
2018: SID PETERSON MEMORIAL HOSPITAL 401(K) SAVINGS AND PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-011,184
Total number of active participants reported on line 7a of the Form 55002018-01-01855
Number of retired or separated participants receiving benefits2018-01-017
Number of other retired or separated participants entitled to future benefits2018-01-01122
Total of all active and inactive participants2018-01-01984
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01984
Number of participants with account balances2018-01-01952
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-0155
2017: SID PETERSON MEMORIAL HOSPITAL 401(K) SAVINGS AND PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-011,429
Total number of active participants reported on line 7a of the Form 55002017-01-011,058
Number of retired or separated participants receiving benefits2017-01-0114
Number of other retired or separated participants entitled to future benefits2017-01-0196
Total of all active and inactive participants2017-01-011,168
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-011,168
Number of participants with account balances2017-01-01940
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-0136
2016: SID PETERSON MEMORIAL HOSPITAL 401(K) SAVINGS AND PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-011,409
Total number of active participants reported on line 7a of the Form 55002016-01-01966
Number of retired or separated participants receiving benefits2016-01-0115
Number of other retired or separated participants entitled to future benefits2016-01-0185
Total of all active and inactive participants2016-01-011,066
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-011,066
Number of participants with account balances2016-01-01868
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-0132
2015: SID PETERSON MEMORIAL HOSPITAL 401(K) SAVINGS AND PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-011,107
Total number of active participants reported on line 7a of the Form 55002015-01-01960
Number of retired or separated participants receiving benefits2015-01-019
Number of other retired or separated participants entitled to future benefits2015-01-0196
Total of all active and inactive participants2015-01-011,065
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-011,065
Number of participants with account balances2015-01-01812
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-011
2014: SID PETERSON MEMORIAL HOSPITAL 401(K) SAVINGS AND PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01716
Total number of active participants reported on line 7a of the Form 55002014-01-011,000
Number of retired or separated participants receiving benefits2014-01-0110
Number of other retired or separated participants entitled to future benefits2014-01-0181
Total of all active and inactive participants2014-01-011,091
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-011,091
Number of participants with account balances2014-01-01737
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-0136
2013: SID PETERSON MEMORIAL HOSPITAL 401(K) SAVINGS AND PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01947
Total number of active participants reported on line 7a of the Form 55002013-01-01627
Number of retired or separated participants receiving benefits2013-01-019
Number of other retired or separated participants entitled to future benefits2013-01-0180
Total of all active and inactive participants2013-01-01716
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-01716
Number of participants with account balances2013-01-01700
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-014
2012: SID PETERSON MEMORIAL HOSPITAL 401(K) SAVINGS AND PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01962
Total number of active participants reported on line 7a of the Form 55002012-01-01864
Number of retired or separated participants receiving benefits2012-01-015
Number of other retired or separated participants entitled to future benefits2012-01-0178
Total of all active and inactive participants2012-01-01947
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-01947
Number of participants with account balances2012-01-01686
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-0193
2011: SID PETERSON MEMORIAL HOSPITAL 401(K) SAVINGS AND PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01948
Total number of active participants reported on line 7a of the Form 55002011-01-01899
Number of retired or separated participants receiving benefits2011-01-016
Number of other retired or separated participants entitled to future benefits2011-01-0157
Total of all active and inactive participants2011-01-01962
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-01962
Number of participants with account balances2011-01-01734
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-0170
2009: SID PETERSON MEMORIAL HOSPITAL 401(K) SAVINGS AND PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01939
Total number of active participants reported on line 7a of the Form 55002009-01-01853
Number of retired or separated participants receiving benefits2009-01-012
Number of other retired or separated participants entitled to future benefits2009-01-0170
Total of all active and inactive participants2009-01-01925
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-01925
Number of participants with account balances2009-01-01682
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-0177

Financial Data on SID PETERSON MEMORIAL HOSPITAL 401(K) SAVINGS AND PROFIT SHARING PLAN

Measure Date Value
2022 : SID PETERSON MEMORIAL HOSPITAL 401(K) SAVINGS AND PROFIT SHARING 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$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total income from all sources (including contributions)2022-12-31$-3,056,295
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$4,332,679
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$4,149,954
Expenses. Certain deemed distributions of participant loans2022-12-31$3,322
Value of total corrective distributions2022-12-31$13,944
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$5,048,907
Value of total assets at end of year2022-12-31$49,119,750
Value of total assets at beginning of year2022-12-31$56,508,724
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$165,459
Total interest from all sources2022-12-31$461,985
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$525,004
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-12-31$525,004
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$3,945,561
Participant contributions at end of year2022-12-31$709,882
Participant contributions at beginning of year2022-12-31$561,205
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$163,837
Administrative expenses (other) incurred2022-12-31$2,021
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-7,388,974
Value of net assets at end of year (total assets less liabilities)2022-12-31$49,119,750
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$56,508,724
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
Investment advisory and management fees2022-12-31$111,570
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$5,545,551
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$6,183,390
Value of interest in pooled separate accounts at end of year2022-12-31$27,570,157
Value of interest in pooled separate accounts at beginning of year2022-12-31$35,472,679
Interest on participant loans2022-12-31$32,494
Interest earned on other investments2022-12-31$429,491
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$15,294,160
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$14,291,450
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-1,765,648
Net investment gain/loss from pooled separate accounts2022-12-31$-7,326,543
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$939,509
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$4,149,954
Contract administrator fees2022-12-31$51,868
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 name2022-12-31LANE GORMAN TRIBITT, LLC
Accountancy firm EIN2022-12-31751044330
2021 : SID PETERSON MEMORIAL HOSPITAL 401(K) SAVINGS AND PROFIT SHARING 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$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total income from all sources (including contributions)2021-12-31$11,305,451
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$5,939,527
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$5,713,536
Expenses. Certain deemed distributions of participant loans2021-12-31$6,943
Value of total corrective distributions2021-12-31$53,890
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$4,779,209
Value of total assets at end of year2021-12-31$56,508,724
Value of total assets at beginning of year2021-12-31$51,142,800
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$165,158
Total interest from all sources2021-12-31$425,538
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$690,995
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2021-12-31$690,995
Administrative expenses professional fees incurred2021-12-31$0
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$3,483,680
Participant contributions at end of year2021-12-31$561,205
Participant contributions at beginning of year2021-12-31$723,421
Assets. Other investments not covered elsewhere at end of year2021-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2021-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$468,431
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2021-12-31$0
Other income not declared elsewhere2021-12-31$0
Administrative expenses (other) incurred2021-12-31$1,576
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$5,365,924
Value of net assets at end of year (total assets less liabilities)2021-12-31$56,508,724
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$51,142,800
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
Investment advisory and management fees2021-12-31$143,961
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$41,656,069
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$37,896,975
Value of interest in pooled separate accounts at end of year2021-12-31$0
Value of interest in pooled separate accounts at beginning of year2021-12-31$0
Interest on participant loans2021-12-31$36,628
Interest earned on other investments2021-12-31$388,910
Value of interest in common/collective trusts at end of year2021-12-31$0
Value of interest in common/collective trusts at beginning of year2021-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$14,291,450
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$12,522,404
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$776,395
Net investment gain/loss from pooled separate accounts2021-12-31$4,633,314
Net investment gain or loss from common/collective trusts2021-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31Yes
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
Assets. Invements in employer securities at end of year2021-12-31$0
Assets. Invements in employer securities at beginning of year2021-12-31$0
Contributions received in cash from employer2021-12-31$827,098
Income. Dividends from common stock2021-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$5,713,536
Contract administrator fees2021-12-31$19,621
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 name2021-12-31LANE GORMAN TRUBITT, LLC
Accountancy firm EIN2021-12-31751044330
2020 : SID PETERSON MEMORIAL HOSPITAL 401(K) SAVINGS AND PROFIT SHARING 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$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total income from all sources (including contributions)2020-12-31$12,526,750
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$4,299,881
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$4,187,035
Expenses. Certain deemed distributions of participant loans2020-12-31$38,101
Value of total corrective distributions2020-12-31$20,509
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$4,794,715
Value of total assets at end of year2020-12-31$51,142,800
Value of total assets at beginning of year2020-12-31$42,915,931
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$54,236
Total interest from all sources2020-12-31$404,648
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
Total dividends received from registered investment company shares (eg mutual funds)2020-12-31$0
Administrative expenses professional fees incurred2020-12-31$5,155
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$3,081,912
Participant contributions at end of year2020-12-31$723,421
Participant contributions at beginning of year2020-12-31$663,019
Assets. Other investments not covered elsewhere at end of year2020-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2020-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$937,973
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2020-12-31$0
Other income not declared elsewhere2020-12-31$0
Administrative expenses (other) incurred2020-12-31$890
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$8,226,869
Value of net assets at end of year (total assets less liabilities)2020-12-31$51,142,800
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$42,915,931
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
Investment advisory and management fees2020-12-31$30,402
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$37,896,975
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$30,387,319
Value of interest in pooled separate accounts at end of year2020-12-31$0
Value of interest in pooled separate accounts at beginning of year2020-12-31$0
Interest on participant loans2020-12-31$40,951
Interest earned on other investments2020-12-31$363,697
Value of interest in common/collective trusts at end of year2020-12-31$0
Value of interest in common/collective trusts at beginning of year2020-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$12,522,404
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$11,865,593
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$0
Net investment gain/loss from pooled separate accounts2020-12-31$7,327,387
Net investment gain or loss from common/collective trusts2020-12-31$0
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 contributions2020-12-31Yes
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Assets. Invements in employer securities at end of year2020-12-31$0
Assets. Invements in employer securities at beginning of year2020-12-31$0
Contributions received in cash from employer2020-12-31$774,830
Income. Dividends from common stock2020-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$4,187,035
Contract administrator fees2020-12-31$17,789
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Unqualified
Accountancy firm name2020-12-31LANE GORMAN TRUBITT, LLC
Accountancy firm EIN2020-12-31751044330
2019 : SID PETERSON MEMORIAL HOSPITAL 401(K) SAVINGS AND PROFIT SHARING PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
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$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total income from all sources (including contributions)2019-12-31$10,762,390
Total income from all sources (including contributions)2019-12-31$10,762,390
Total loss/gain on sale of assets2019-12-31$0
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$5,005,610
Total of all expenses incurred2019-12-31$5,005,610
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$4,941,518
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$4,941,518
Expenses. Certain deemed distributions of participant loans2019-12-31$18,035
Expenses. Certain deemed distributions of participant loans2019-12-31$18,035
Value of total corrective distributions2019-12-31$0
Value of total corrective distributions2019-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$3,788,909
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$3,788,909
Value of total assets at end of year2019-12-31$42,915,931
Value of total assets at end of year2019-12-31$42,915,931
Value of total assets at beginning of year2019-12-31$37,159,151
Value of total assets at beginning of year2019-12-31$37,159,151
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$46,057
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$46,057
Total interest from all sources2019-12-31$408,276
Total interest from all sources2019-12-31$408,276
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$0
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$0
Administrative expenses professional fees incurred2019-12-31$2,003
Administrative expenses professional fees incurred2019-12-31$2,003
Was this plan covered by a fidelity bond2019-12-31Yes
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$500,000
Value of fidelity bond cover2019-12-31$500,000
If this is an individual account plan, was there a blackout period2019-12-31No
If this is an individual account plan, was there a blackout period2019-12-31No
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
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$2,795,077
Contributions received from participants2019-12-31$2,795,077
Participant contributions at end of year2019-12-31$663,019
Participant contributions at end of year2019-12-31$663,019
Participant contributions at beginning of year2019-12-31$809,136
Participant contributions at beginning of year2019-12-31$809,136
Assets. Other investments not covered elsewhere at end of year2019-12-31$0
Assets. Other investments not covered elsewhere at end of year2019-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2019-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2019-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$309,063
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$309,063
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2019-12-31$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2019-12-31$0
Other income not declared elsewhere2019-12-31$0
Other income not declared elsewhere2019-12-31$0
Administrative expenses (other) incurred2019-12-31$0
Administrative expenses (other) incurred2019-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$5,756,780
Value of net income/loss2019-12-31$5,756,780
Value of net assets at end of year (total assets less liabilities)2019-12-31$42,915,931
Value of net assets at end of year (total assets less liabilities)2019-12-31$42,915,931
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$37,159,151
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$37,159,151
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Investment advisory and management fees2019-12-31$27,913
Investment advisory and management fees2019-12-31$27,913
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$30,387,319
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$30,387,319
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$23,998,350
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$23,998,350
Value of interest in pooled separate accounts at end of year2019-12-31$0
Value of interest in pooled separate accounts at end of year2019-12-31$0
Value of interest in pooled separate accounts at beginning of year2019-12-31$0
Value of interest in pooled separate accounts at beginning of year2019-12-31$0
Interest on participant loans2019-12-31$46,552
Interest on participant loans2019-12-31$46,552
Interest earned on other investments2019-12-31$361,724
Interest earned on other investments2019-12-31$361,724
Value of interest in common/collective trusts at end of year2019-12-31$0
Value of interest in common/collective trusts at end of year2019-12-31$0
Value of interest in common/collective trusts at beginning of year2019-12-31$0
Value of interest in common/collective trusts at beginning of year2019-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$11,865,593
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$11,865,593
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$12,351,665
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$12,351,665
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$0
Net investment gain/loss from pooled separate accounts2019-12-31$6,565,205
Net investment gain/loss from pooled separate accounts2019-12-31$6,565,205
Net investment gain or loss from common/collective trusts2019-12-31$0
Net investment gain or loss from common/collective trusts2019-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Assets. Invements in employer securities at end of year2019-12-31$0
Assets. Invements in employer securities at end of year2019-12-31$0
Assets. Invements in employer securities at beginning of year2019-12-31$0
Assets. Invements in employer securities at beginning of year2019-12-31$0
Contributions received in cash from employer2019-12-31$684,769
Contributions received in cash from employer2019-12-31$684,769
Income. Dividends from common stock2019-12-31$0
Income. Dividends from common stock2019-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$4,941,518
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$4,941,518
Contract administrator fees2019-12-31$16,141
Contract administrator fees2019-12-31$16,141
Did the plan have assets held for investment2019-12-31Yes
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31LANE GORMAN TRUBITT, LLC
Accountancy firm name2019-12-31LANE GORMAN TRUBITT, LLC
Accountancy firm EIN2019-12-31751044330
Accountancy firm EIN2019-12-31751044330
2018 : SID PETERSON MEMORIAL HOSPITAL 401(K) SAVINGS AND PROFIT SHARING 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$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total income from all sources (including contributions)2018-12-31$2,533,051
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$4,000,488
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$3,871,697
Expenses. Certain deemed distributions of participant loans2018-12-31$45,305
Value of total corrective distributions2018-12-31$37,388
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$3,307,366
Value of total assets at end of year2018-12-31$37,159,151
Value of total assets at beginning of year2018-12-31$38,626,588
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$46,098
Total interest from all sources2018-12-31$409,904
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$6
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$6
Administrative expenses professional fees incurred2018-12-31$0
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$2,428,145
Participant contributions at end of year2018-12-31$809,136
Participant contributions at beginning of year2018-12-31$750,364
Assets. Other investments not covered elsewhere at end of year2018-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2018-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$320,736
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2018-12-31$0
Other income not declared elsewhere2018-12-31$0
Administrative expenses (other) incurred2018-12-31$125
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$-1,467,437
Value of net assets at end of year (total assets less liabilities)2018-12-31$37,159,151
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$38,626,588
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
Investment advisory and management fees2018-12-31$26,781
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$23,998,350
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$25,588,100
Value of interest in pooled separate accounts at end of year2018-12-31$0
Value of interest in pooled separate accounts at beginning of year2018-12-31$0
Interest on participant loans2018-12-31$47,397
Interest earned on other investments2018-12-31$362,507
Value of interest in common/collective trusts at end of year2018-12-31$0
Value of interest in common/collective trusts at beginning of year2018-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$12,351,665
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$12,288,124
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$50,512
Net investment gain/loss from pooled separate accounts2018-12-31$-1,234,737
Net investment gain or loss from common/collective trusts2018-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Assets. Invements in employer securities at end of year2018-12-31$0
Assets. Invements in employer securities at beginning of year2018-12-31$0
Contributions received in cash from employer2018-12-31$558,485
Income. Dividends from common stock2018-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$3,871,697
Contract administrator fees2018-12-31$19,192
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 name2018-12-31PRESSLER, THOMPSON AND COMPANY, LLC
Accountancy firm EIN2018-12-31477236727
2017 : SID PETERSON MEMORIAL HOSPITAL 401(K) SAVINGS AND PROFIT SHARING 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$0
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$8,822,917
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$3,328,884
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$3,256,295
Expenses. Certain deemed distributions of participant loans2017-12-31$4,062
Value of total corrective distributions2017-12-31$29,901
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$3,664,634
Value of total assets at end of year2017-12-31$38,626,588
Value of total assets at beginning of year2017-12-31$33,132,555
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$38,626
Total interest from all sources2017-12-31$394,869
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$5,267
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$5,267
Administrative expenses professional fees incurred2017-12-31$0
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$2,336,653
Participant contributions at end of year2017-12-31$750,364
Participant contributions at beginning of year2017-12-31$741,725
Assets. Other investments not covered elsewhere at end of year2017-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2017-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$814,374
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2017-12-31$0
Other income not declared elsewhere2017-12-31$0
Administrative expenses (other) incurred2017-12-31$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$5,494,033
Value of net assets at end of year (total assets less liabilities)2017-12-31$38,626,588
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$33,132,555
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
Investment advisory and management fees2017-12-31$24,265
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$25,588,100
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$20,516,933
Value of interest in pooled separate accounts at end of year2017-12-31$0
Value of interest in pooled separate accounts at beginning of year2017-12-31$0
Interest on participant loans2017-12-31$40,244
Interest earned on other investments2017-12-31$354,625
Value of interest in common/collective trusts at end of year2017-12-31$0
Value of interest in common/collective trusts at beginning of year2017-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-12-31$12,288,124
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-12-31$11,873,897
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-12-31$110,383
Net investment gain/loss from pooled separate accounts2017-12-31$4,647,764
Net investment gain or loss from common/collective trusts2017-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Assets. Invements in employer securities at end of year2017-12-31$0
Assets. Invements in employer securities at beginning of year2017-12-31$0
Contributions received in cash from employer2017-12-31$513,607
Income. Dividends from common stock2017-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$3,256,295
Contract administrator fees2017-12-31$14,361
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 name2017-12-31PRESSLER THOMPSON & CO., LLC
Accountancy firm EIN2017-12-31472364727
2016 : SID PETERSON MEMORIAL HOSPITAL 401(K) SAVINGS AND PROFIT SHARING 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$4,342,876
Total loss/gain on sale of assets2016-12-31$-41,522
Total of all expenses incurred2016-12-31$3,922,091
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$3,874,358
Expenses. Certain deemed distributions of participant loans2016-12-31$5,109
Value of total corrective distributions2016-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$2,670,713
Value of total assets at end of year2016-12-31$33,132,555
Value of total assets at beginning of year2016-12-31$32,711,770
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$42,624
Total interest from all sources2016-12-31$387,447
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$15,380
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$15,380
Administrative expenses professional fees incurred2016-12-31$0
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$500,000
If this is an individual account plan, was there a blackout period2016-12-31No
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$2,008,575
Participant contributions at end of year2016-12-31$741,725
Participant contributions at beginning of year2016-12-31$650,023
Assets. Other investments not covered elsewhere at end of year2016-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2016-12-31$706,938
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$236,412
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2016-12-31$0
Administrative expenses (other) incurred2016-12-31$125
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$420,785
Value of net assets at end of year (total assets less liabilities)2016-12-31$33,132,555
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$32,711,770
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
Investment advisory and management fees2016-12-31$28,537
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-31$20,516,933
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$19,823,905
Value of interest in pooled separate accounts at end of year2016-12-31$0
Value of interest in pooled separate accounts at beginning of year2016-12-31$0
Interest on participant loans2016-12-31$34,372
Interest earned on other investments2016-12-31$353,075
Value of interest in common/collective trusts at end of year2016-12-31$0
Value of interest in common/collective trusts at beginning of year2016-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-12-31$11,873,897
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-12-31$11,530,904
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-12-31$17,546
Net investment gain/loss from pooled separate accounts2016-12-31$1,293,312
Net investment gain or loss from common/collective trusts2016-12-31$0
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
Assets. Invements in employer securities at end of year2016-12-31$0
Assets. Invements in employer securities at beginning of year2016-12-31$0
Contributions received in cash from employer2016-12-31$425,726
Income. Dividends from common stock2016-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$3,874,358
Contract administrator fees2016-12-31$13,962
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
Aggregate proceeds on sale of assets2016-12-31$1,045,234
Aggregate carrying amount (costs) on sale of assets2016-12-31$1,086,756
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 name2016-12-31PRESSLER THOMPSON & CO. LLC
Accountancy firm EIN2016-12-31472364727
2015 : SID PETERSON MEMORIAL HOSPITAL 401(K) SAVINGS AND PROFIT SHARING 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$2,736,655
Total loss/gain on sale of assets2015-12-31$-1,165
Total of all expenses incurred2015-12-31$2,741,049
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$2,662,026
Expenses. Certain deemed distributions of participant loans2015-12-31$18,185
Value of total corrective distributions2015-12-31$8,322
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$2,159,662
Value of total assets at end of year2015-12-31$32,711,770
Value of total assets at beginning of year2015-12-31$32,716,164
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$52,516
Total interest from all sources2015-12-31$374,091
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$4,712
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$4,712
Administrative expenses professional fees incurred2015-12-31$0
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$1,845,828
Participant contributions at end of year2015-12-31$650,023
Participant contributions at beginning of year2015-12-31$702,077
Assets. Other investments not covered elsewhere at end of year2015-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2015-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$259,508
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2015-12-31$0
Other income not declared elsewhere2015-12-31$0
Administrative expenses (other) incurred2015-12-31$125
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$-4,394
Value of net assets at end of year (total assets less liabilities)2015-12-31$32,711,770
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$32,716,164
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
Investment advisory and management fees2015-12-31$38,892
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$706,938
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$20,794,567
Value of interest in pooled separate accounts at end of year2015-12-31$19,823,905
Value of interest in pooled separate accounts at beginning of year2015-12-31$0
Interest on participant loans2015-12-31$31,145
Interest earned on other investments2015-12-31$342,946
Value of interest in common/collective trusts at end of year2015-12-31$0
Value of interest in common/collective trusts at beginning of year2015-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-12-31$11,530,904
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-12-31$11,219,520
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$-8,951
Net investment gain/loss from pooled separate accounts2015-12-31$208,306
Net investment gain or loss from common/collective trusts2015-12-31$0
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
Assets. Invements in employer securities at end of year2015-12-31$0
Assets. Invements in employer securities at beginning of year2015-12-31$0
Contributions received in cash from employer2015-12-31$54,326
Income. Dividends from common stock2015-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$2,662,026
Contract administrator fees2015-12-31$13,499
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
Aggregate proceeds on sale of assets2015-12-31$156,336
Aggregate carrying amount (costs) on sale of assets2015-12-31$157,501
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 name2015-12-31PRESSLER THMPSON & CO. LLC
Accountancy firm EIN2015-12-31472364727
2014 : SID PETERSON MEMORIAL HOSPITAL 401(K) SAVINGS AND PROFIT SHARING 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$3,999,103
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$2,247,351
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$2,012,135
Expenses. Certain deemed distributions of participant loans2014-12-31$153,216
Value of total corrective distributions2014-12-31$22,083
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$2,260,874
Value of total assets at end of year2014-12-31$32,716,164
Value of total assets at beginning of year2014-12-31$30,964,412
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$59,917
Total interest from all sources2014-12-31$370,346
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$0
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$0
Administrative expenses professional fees incurred2014-12-31$0
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$1,702,324
Participant contributions at end of year2014-12-31$702,077
Participant contributions at beginning of year2014-12-31$1,134,215
Assets. Other investments not covered elsewhere at end of year2014-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2014-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2014-12-31$129,590
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2014-12-31$0
Other income not declared elsewhere2014-12-31$0
Administrative expenses (other) incurred2014-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$1,751,752
Value of net assets at end of year (total assets less liabilities)2014-12-31$32,716,164
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$30,964,412
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
Investment advisory and management fees2014-12-31$45,763
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$0
Value of interest in pooled separate accounts at end of year2014-12-31$20,794,567
Value of interest in pooled separate accounts at beginning of year2014-12-31$19,043,719
Interest on participant loans2014-12-31$49,323
Interest earned on other investments2014-12-31$321,023
Value of interest in common/collective trusts at end of year2014-12-31$0
Value of interest in common/collective trusts at beginning of year2014-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-12-31$11,219,520
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-12-31$10,786,478
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-12-31$0
Net investment gain/loss from pooled separate accounts2014-12-31$1,367,883
Net investment gain or loss from common/collective trusts2014-12-31$0
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
Assets. Invements in employer securities at end of year2014-12-31$0
Assets. Invements in employer securities at beginning of year2014-12-31$0
Contributions received in cash from employer2014-12-31$428,960
Income. Dividends from common stock2014-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$2,012,135
Contract administrator fees2014-12-31$14,154
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 name2014-12-31PRESSLER THOMPSON & CO. LLC
Accountancy firm EIN2014-12-31472364727
2013 : SID PETERSON MEMORIAL HOSPITAL 401(K) SAVINGS AND PROFIT SHARING 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$6,732,641
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$2,655,712
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$2,582,263
Expenses. Certain deemed distributions of participant loans2013-12-31$12,563
Value of total corrective distributions2013-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$1,628,637
Value of total assets at end of year2013-12-31$30,964,412
Value of total assets at beginning of year2013-12-31$26,887,483
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$60,886
Total interest from all sources2013-12-31$365,412
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2013-12-31$0
Administrative expenses professional fees incurred2013-12-31$0
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$500,000
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$1,481,377
Participant contributions at end of year2013-12-31$1,134,215
Participant contributions at beginning of year2013-12-31$1,213,957
Assets. Other investments not covered elsewhere at end of year2013-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2013-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2013-12-31$147,120
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2013-12-31$0
Other income not declared elsewhere2013-12-31$0
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$4,076,929
Value of net assets at end of year (total assets less liabilities)2013-12-31$30,964,412
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$26,887,483
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
Investment advisory and management fees2013-12-31$41,251
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$0
Value of interest in pooled separate accounts at end of year2013-12-31$19,043,719
Value of interest in pooled separate accounts at beginning of year2013-12-31$15,603,671
Interest on participant loans2013-12-31$56,237
Interest earned on other investments2013-12-31$309,175
Value of interest in common/collective trusts at end of year2013-12-31$0
Value of interest in common/collective trusts at beginning of year2013-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-12-31$10,786,478
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-12-31$10,069,855
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-12-31$0
Net investment gain/loss from pooled separate accounts2013-12-31$4,738,592
Net investment gain or loss from common/collective trusts2013-12-31$0
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
Assets. Invements in employer securities at end of year2013-12-31$0
Assets. Invements in employer securities at beginning of year2013-12-31$0
Contributions received in cash from employer2013-12-31$140
Income. Dividends from common stock2013-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$2,582,263
Contract administrator fees2013-12-31$19,635
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 name2013-12-31PRESSLER THOMPSON & CO. PC
Accountancy firm EIN2013-12-31741845723
2012 : SID PETERSON MEMORIAL HOSPITAL 401(K) SAVINGS AND PROFIT SHARING 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$4,920,878
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$3,733,150
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$3,622,392
Expenses. Certain deemed distributions of participant loans2012-12-31$40,960
Value of total corrective distributions2012-12-31$8,303
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$2,342,831
Value of total assets at end of year2012-12-31$26,887,483
Value of total assets at beginning of year2012-12-31$25,699,755
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$61,495
Total interest from all sources2012-12-31$376,179
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2012-12-31$0
Administrative expenses professional fees incurred2012-12-31$0
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$500,000
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$1,654,763
Participant contributions at end of year2012-12-31$1,213,957
Participant contributions at beginning of year2012-12-31$1,328,454
Assets. Other investments not covered elsewhere at end of year2012-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2012-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2012-12-31$100,855
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2012-12-31$0
Other income not declared elsewhere2012-12-31$0
Administrative expenses (other) incurred2012-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$1,187,728
Value of net assets at end of year (total assets less liabilities)2012-12-31$26,887,483
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$25,699,755
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
Investment advisory and management fees2012-12-31$37,771
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$0
Value of interest in pooled separate accounts at end of year2012-12-31$15,603,671
Value of interest in pooled separate accounts at beginning of year2012-12-31$14,445,034
Interest on participant loans2012-12-31$75,316
Interest earned on other investments2012-12-31$300,863
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$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-12-31$10,069,855
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-12-31$9,926,267
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-12-31$0
Net investment gain/loss from pooled separate accounts2012-12-31$2,201,868
Net investment gain or loss from common/collective trusts2012-12-31$0
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
Assets. Invements in employer securities at end of year2012-12-31$0
Assets. Invements in employer securities at beginning of year2012-12-31$0
Contributions received in cash from employer2012-12-31$587,213
Income. Dividends from common stock2012-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$3,622,392
Contract administrator fees2012-12-31$23,724
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 name2012-12-31PRESSLER THOMPSON & CO. PC
Accountancy firm EIN2012-12-31741845723
2011 : SID PETERSON MEMORIAL HOSPITAL 401(K) SAVINGS AND PROFIT SHARING PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
Total income from all sources (including contributions)2011-12-31$3,078,819
Total loss/gain on sale of assets2011-12-31$0
Total of all expenses incurred2011-12-31$2,190,673
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$2,116,099
Expenses. Certain deemed distributions of participant loans2011-12-31$8,034
Value of total corrective distributions2011-12-31$3,792
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$2,762,242
Value of total assets at end of year2011-12-31$25,699,755
Value of total assets at beginning of year2011-12-31$24,811,609
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$62,748
Total interest from all sources2011-12-31$341,743
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2011-12-31$0
Administrative expenses professional fees incurred2011-12-31$0
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$500,000
If this is an individual account plan, was there a blackout period2011-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$1,638,383
Participant contributions at end of year2011-12-31$1,328,454
Participant contributions at beginning of year2011-12-31$1,182,609
Assets. Other investments not covered elsewhere at end of year2011-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2011-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2011-12-31$62,018
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2011-12-31$0
Other income not declared elsewhere2011-12-31$0
Administrative expenses (other) incurred2011-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$888,146
Value of net assets at end of year (total assets less liabilities)2011-12-31$25,699,755
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$24,811,609
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
Investment advisory and management fees2011-12-31$36,617
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$0
Value of interest in pooled separate accounts at end of year2011-12-31$14,445,034
Value of interest in pooled separate accounts at beginning of year2011-12-31$15,040,800
Interest on participant loans2011-12-31$70,179
Interest earned on other investments2011-12-31$271,564
Value of interest in common/collective trusts at end of year2011-12-31$0
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$9,926,267
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-12-31$8,588,200
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-12-31$0
Net investment gain/loss from pooled separate accounts2011-12-31$-25,166
Net investment gain or loss from common/collective trusts2011-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31Yes
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
Assets. Invements in employer securities at end of year2011-12-31$0
Assets. Invements in employer securities at beginning of year2011-12-31$0
Contributions received in cash from employer2011-12-31$1,061,841
Income. Dividends from common stock2011-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$2,116,099
Contract administrator fees2011-12-31$26,131
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31PRESSLER THOMPSON & CO. PC
Accountancy firm EIN2011-12-31741845723
2010 : SID PETERSON MEMORIAL HOSPITAL 401(K) SAVINGS AND PROFIT SHARING PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets2010-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total income from all sources (including contributions)2010-12-31$4,978,083
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$1,698,829
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$1,609,840
Expenses. Certain deemed distributions of participant loans2010-12-31$23,322
Value of total corrective distributions2010-12-31$4,754
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$2,558,606
Value of total assets at end of year2010-12-31$24,811,609
Value of total assets at beginning of year2010-12-31$21,532,355
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$60,913
Total interest from all sources2010-12-31$307,584
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2010-12-31$0
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$500,000
If this is an individual account plan, was there a blackout period2010-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$1,549,248
Participant contributions at end of year2010-12-31$1,182,609
Participant contributions at beginning of year2010-12-31$1,096,264
Assets. Other investments not covered elsewhere at end of year2010-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2010-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2010-12-31$28,267
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2010-12-31$0
Other income not declared elsewhere2010-12-31$0
Administrative expenses (other) incurred2010-12-31$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$3,279,254
Value of net assets at end of year (total assets less liabilities)2010-12-31$24,811,609
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$21,532,355
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Investment advisory and management fees2010-12-31$31,819
Value of interest in registered invesment companies (eg mutual funds) at end of year2010-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$0
Value of interest in pooled separate accounts at end of year2010-12-31$15,040,800
Value of interest in pooled separate accounts at beginning of year2010-12-31$13,387,682
Interest on participant loans2010-12-31$69,222
Interest earned on other investments2010-12-31$238,362
Value of interest in common/collective trusts at end of year2010-12-31$0
Value of interest in common/collective trusts at beginning of year2010-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$8,588,200
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$7,048,409
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$0
Net investment gain/loss from pooled separate accounts2010-12-31$2,111,893
Net investment gain or loss from common/collective trusts2010-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Assets. Invements in employer securities at end of year2010-12-31$0
Assets. Invements in employer securities at beginning of year2010-12-31$0
Contributions received in cash from employer2010-12-31$981,091
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$1,609,840
Contract administrator fees2010-12-31$29,094
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31PRESSLER THOMPSON & CO. PC
Accountancy firm EIN2010-12-31741845723
2009 : SID PETERSON MEMORIAL HOSPITAL 401(K) SAVINGS AND PROFIT SHARING 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 SID PETERSON MEMORIAL HOSPITAL 401(K) SAVINGS AND PROFIT SHARING PLAN

2022: SID PETERSON MEMORIAL HOSPITAL 401(K) SAVINGS AND PROFIT SHARING 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 – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: SID PETERSON MEMORIAL HOSPITAL 401(K) SAVINGS AND PROFIT SHARING 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 – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: SID PETERSON MEMORIAL HOSPITAL 401(K) SAVINGS AND PROFIT SHARING 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 – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: SID PETERSON MEMORIAL HOSPITAL 401(K) SAVINGS AND PROFIT SHARING 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 – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: SID PETERSON MEMORIAL HOSPITAL 401(K) SAVINGS AND PROFIT SHARING 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 – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: SID PETERSON MEMORIAL HOSPITAL 401(K) SAVINGS AND PROFIT SHARING 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 – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: SID PETERSON MEMORIAL HOSPITAL 401(K) SAVINGS AND PROFIT SHARING 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: SID PETERSON MEMORIAL HOSPITAL 401(K) SAVINGS AND PROFIT SHARING 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: SID PETERSON MEMORIAL HOSPITAL 401(K) SAVINGS AND PROFIT SHARING 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: SID PETERSON MEMORIAL HOSPITAL 401(K) SAVINGS AND PROFIT SHARING 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: SID PETERSON MEMORIAL HOSPITAL 401(K) SAVINGS AND PROFIT SHARING 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: SID PETERSON MEMORIAL HOSPITAL 401(K) SAVINGS AND PROFIT SHARING PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2009: SID PETERSON MEMORIAL HOSPITAL 401(K) SAVINGS AND PROFIT SHARING 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

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number765672-01
Policy instance 1
Insurance contract or identification number765672-01
Number of Individuals Covered1503
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $59,906
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
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?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $59,906
Insurance broker organization code?3
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberSF 2510
Policy instance 1
Insurance contract or identification numberSF 2510
Number of Individuals Covered1342
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $70,963
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
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?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $70,963
Insurance broker organization code?4
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberSF 2510
Policy instance 1
Insurance contract or identification numberSF 2510
Number of Individuals Covered1351
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $65,842
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
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?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $65,842
Insurance broker organization code?4
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberSF 2510
Policy instance 1
Insurance contract or identification numberSF 2510
Number of Individuals Covered1247
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $59,822
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
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?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $59,822
Insurance broker organization code?4
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberSF 2510
Policy instance 1
Insurance contract or identification numberSF 2510
Number of Individuals Covered1168
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $51,302
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
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?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $51,302
Insurance broker organization code?4
Insurance broker nameTBS AGENCY INC
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberSF 2510
Policy instance 1
Insurance contract or identification numberSF 2510
Number of Individuals Covered1065
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $48,137
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?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $48,137
Insurance broker organization code?4
Insurance broker nameINTERSECURITIES INS AGENCY INC
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberSF 2510
Policy instance 1
Insurance contract or identification numberSF 2510
Number of Individuals Covered1091
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $46,086
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?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $46,086
Insurance broker organization code?4
Insurance broker nameINTERSECURITIES INS AGENCY INC
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberSF 2510
Policy instance 1
Insurance contract or identification numberSF 2510
Number of Individuals Covered716
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $41,831
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?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $41,831
Insurance broker organization code?4
Insurance broker nameINTERSECURITIES INS AGENCY INC
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberSF 2510
Policy instance 1
Insurance contract or identification numberSF 2510
Number of Individuals Covered947
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $41,091
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?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $41,091
Insurance broker organization code?4
Insurance broker nameINTERSECURITIES INS AGENCY INC
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberSF 2510
Policy instance 1
Insurance contract or identification numberSF 2510
Number of Individuals Covered962
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $36,651
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?Yes
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
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberSF 2510
Policy instance 1
Insurance contract or identification numberSF 2510
Number of Individuals Covered948
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $31,846
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?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $31,846
Insurance broker organization code?4
Insurance broker nameINTERSECURITIES INS AGENCY INC

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