401k Plan data: SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN plan

SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 401k Plan overview

Plan Name	SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN
Plan identification number	001

SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

MONTANA CHILDREN'S HOME & HOSPITAL has sponsored the creation of one or more 401k plans.

Company Name: MONTANA CHILDREN'S HOME & HOSPITAL

Employer identification number (EIN): 810231789

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01 CRAIG AASVED 2023-10-11 CRAIG AASVED 2023-10-11
001 2022-01-01 CRAIG AASVED 2023-10-11 CRAIG AASVED 2023-10-11
001 2021-01-01 CRAIG AASVED 2022-07-28 CRAIG AASVED 2022-07-28
001 2020-01-01 CRAIG AASVED 2021-09-27 CRAIG AASVED 2021-09-27
001 2019-01-01 CRAIG AASVED 2020-09-30 CRAIG AASVED 2020-09-30
001 2018-01-01 CRAIG AASVED 2019-09-24 CRAIG AASVED 2019-09-24
001 2017-01-01
001 2016-01-01
001 2015-01-01
001 2014-01-01 JACK CASEY JACK CASEY 2015-08-26
001 2013-01-01 JACK CASEY JACK CASEY 2014-08-13
001 2012-01-01 JACK CASEY JACK CASEY 2013-10-14
001 2011-01-01 JACK CASEY JACK CASEY 2012-10-12
001 2010-01-01 JACK CASEY JACK CASEY 2011-10-12
001 2009-01-01 RONALD WIENS RONALD WIENS 2010-10-15

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2022-01-01	CRAIG AASVED	2023-10-11	CRAIG AASVED	2023-10-11
001	2022-01-01	CRAIG AASVED	2023-10-11	CRAIG AASVED	2023-10-11
001	2021-01-01	CRAIG AASVED	2022-07-28	CRAIG AASVED	2022-07-28
001	2020-01-01	CRAIG AASVED	2021-09-27	CRAIG AASVED	2021-09-27
001	2019-01-01	CRAIG AASVED	2020-09-30	CRAIG AASVED	2020-09-30
001	2018-01-01	CRAIG AASVED	2019-09-24	CRAIG AASVED	2019-09-24
001	2017-01-01
001	2016-01-01
001	2015-01-01
001	2014-01-01	JACK CASEY		JACK CASEY	2015-08-26
001	2013-01-01	JACK CASEY		JACK CASEY	2014-08-13
001	2012-01-01	JACK CASEY		JACK CASEY	2013-10-14
001	2011-01-01	JACK CASEY		JACK CASEY	2012-10-12
001	2010-01-01	JACK CASEY		JACK CASEY	2011-10-12
001	2009-01-01	RONALD WIENS		RONALD WIENS	2010-10-15

Plan Statistics for SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN

401k plan membership statisitcs for SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN

Measure Date Value
2022: SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 561
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 353
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 218
Total of all active and inactive participants 2022-01-01 571
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 1
Total participants 2022-01-01 572
Number of participants with account balances 2022-01-01 450
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 600
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 326
Number of other retired or separated participants entitled to future benefits 2021-01-01 235
Total of all active and inactive participants 2021-01-01 561
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 561
Number of participants with account balances 2021-01-01 453
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 565
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 406
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 194
Total of all active and inactive participants 2020-01-01 600
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 600
Number of participants with account balances 2020-01-01 434
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 516
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 370
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 195
Total of all active and inactive participants 2019-01-01 565
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 565
Number of participants with account balances 2019-01-01 407
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 467
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 313
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 203
Total of all active and inactive participants 2018-01-01 516
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 516
Number of participants with account balances 2018-01-01 408
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 444
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 285
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 182
Total of all active and inactive participants 2017-01-01 467
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 467
Number of participants with account balances 2017-01-01 369
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 443
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 287
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 157
Total of all active and inactive participants 2016-01-01 444
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 444
Number of participants with account balances 2016-01-01 343
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 410
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 314
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 129
Total of all active and inactive participants 2015-01-01 443
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 443
Number of participants with account balances 2015-01-01 320
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 384
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 293
Number of other retired or separated participants entitled to future benefits 2014-01-01 117
Total of all active and inactive participants 2014-01-01 410
Total participants 2014-01-01 410
Number of participants with account balances 2014-01-01 294
2013: SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 380
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 275
Number of other retired or separated participants entitled to future benefits 2013-01-01 109
Total of all active and inactive participants 2013-01-01 384
Total participants 2013-01-01 384
Number of participants with account balances 2013-01-01 289
2012: SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 385
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 280
Number of other retired or separated participants entitled to future benefits 2012-01-01 100
Total of all active and inactive participants 2012-01-01 380
Total participants 2012-01-01 380
Number of participants with account balances 2012-01-01 276
2011: SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 357
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 284
Number of other retired or separated participants entitled to future benefits 2011-01-01 101
Total of all active and inactive participants 2011-01-01 385
Total participants 2011-01-01 385
Number of participants with account balances 2011-01-01 271
2010: SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 279
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 264
Number of other retired or separated participants entitled to future benefits 2010-01-01 93
Total of all active and inactive participants 2010-01-01 357
Total participants 2010-01-01 357
Number of participants with account balances 2010-01-01 237
2009: SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 218
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 195
Number of other retired or separated participants entitled to future benefits 2009-01-01 84
Total of all active and inactive participants 2009-01-01 279
Total participants 2009-01-01 279
Number of participants with account balances 2009-01-01 215

Measure	Date	Value
2022: SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	561
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	353
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	218
Total of all active and inactive participants	2022-01-01	571
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	1
Total participants	2022-01-01	572
Number of participants with account balances	2022-01-01	450
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	600
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	326
Number of other retired or separated participants entitled to future benefits	2021-01-01	235
Total of all active and inactive participants	2021-01-01	561
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	561
Number of participants with account balances	2021-01-01	453
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	565
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	406
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	194
Total of all active and inactive participants	2020-01-01	600
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	600
Number of participants with account balances	2020-01-01	434
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	516
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	370
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	195
Total of all active and inactive participants	2019-01-01	565
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	565
Number of participants with account balances	2019-01-01	407
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	467
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	313
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	203
Total of all active and inactive participants	2018-01-01	516
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	516
Number of participants with account balances	2018-01-01	408
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	444
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	285
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	182
Total of all active and inactive participants	2017-01-01	467
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	467
Number of participants with account balances	2017-01-01	369
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	443
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	287
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	157
Total of all active and inactive participants	2016-01-01	444
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	444
Number of participants with account balances	2016-01-01	343
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	410
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	314
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	129
Total of all active and inactive participants	2015-01-01	443
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	443
Number of participants with account balances	2015-01-01	320
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	384
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	293
Number of other retired or separated participants entitled to future benefits	2014-01-01	117
Total of all active and inactive participants	2014-01-01	410
Total participants	2014-01-01	410
Number of participants with account balances	2014-01-01	294
2013: SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	380
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	275
Number of other retired or separated participants entitled to future benefits	2013-01-01	109
Total of all active and inactive participants	2013-01-01	384
Total participants	2013-01-01	384
Number of participants with account balances	2013-01-01	289
2012: SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	385
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	280
Number of other retired or separated participants entitled to future benefits	2012-01-01	100
Total of all active and inactive participants	2012-01-01	380
Total participants	2012-01-01	380
Number of participants with account balances	2012-01-01	276
2011: SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	357
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	284
Number of other retired or separated participants entitled to future benefits	2011-01-01	101
Total of all active and inactive participants	2011-01-01	385
Total participants	2011-01-01	385
Number of participants with account balances	2011-01-01	271
2010: SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	279
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	264
Number of other retired or separated participants entitled to future benefits	2010-01-01	93
Total of all active and inactive participants	2010-01-01	357
Total participants	2010-01-01	357
Number of participants with account balances	2010-01-01	237
2009: SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	218
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	195
Number of other retired or separated participants entitled to future benefits	2009-01-01	84
Total of all active and inactive participants	2009-01-01	279
Total participants	2009-01-01	279
Number of participants with account balances	2009-01-01	215

Financial Data on SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN

Measure	Date	Value
2022 : SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$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	$-1,354,267
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$3,039,261
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$2,971,686
Expenses. Certain deemed distributions of participant loans	2022-12-31	$41,108
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$1,496,164
Value of total assets at end of year	2022-12-31	$14,651,271
Value of total assets at beginning of year	2022-12-31	$19,044,799
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$26,467
Total interest from all sources	2022-12-31	$35,822
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$448,669
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-12-31	$448,669
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$638,044
Participant contributions at end of year	2022-12-31	$152,376
Participant contributions at beginning of year	2022-12-31	$149,900
Participant contributions at end of year	2022-12-31	$0
Participant contributions at beginning of year	2022-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$10,164
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2022-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2022-12-31	$0
Total non interest bearing cash at end of year	2022-12-31	$0
Total non interest bearing cash at beginning of year	2022-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$-4,393,528
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$14,651,271
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$19,044,799
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Investment advisory and management fees	2022-12-31	$26,467
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$10,572,674
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$13,727,930
Value of interest in pooled separate accounts at end of year	2022-12-31	$2,767,620
Value of interest in pooled separate accounts at beginning of year	2022-12-31	$3,740,189
Interest on participant loans	2022-12-31	$4,632
Interest earned on other investments	2022-12-31	$31,190
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$1,158,601
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$1,426,780
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-2,687,522
Net investment gain/loss from pooled separate accounts	2022-12-31	$-647,400
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$847,956
Employer contributions (assets) at end of year	2022-12-31	$0
Employer contributions (assets) at beginning of year	2022-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$2,971,686
Liabilities. Value of benefit claims payable at end of year	2022-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2022-12-31	$0
Did the plan have assets held for investment	2022-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	WIPFLI, LLP
Accountancy firm EIN	2022-12-31	390758449
2021 : SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$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	$4,187,911
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$2,739,750
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$2,715,433
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$1,587,610
Value of total assets at end of year	2021-12-31	$19,044,799
Value of total assets at beginning of year	2021-12-31	$17,596,638
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$24,317
Total interest from all sources	2021-12-31	$35,562
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$728,108
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2021-12-31	$728,108
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$607,838
Participant contributions at end of year	2021-12-31	$149,900
Participant contributions at beginning of year	2021-12-31	$109,302
Participant contributions at end of year	2021-12-31	$0
Participant contributions at beginning of year	2021-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$147,183
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2021-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2021-12-31	$0
Total non interest bearing cash at end of year	2021-12-31	$0
Total non interest bearing cash at beginning of year	2021-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$1,448,161
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$19,044,799
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$17,596,638
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Investment advisory and management fees	2021-12-31	$24,317
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$13,727,930
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$11,521,633
Value of interest in pooled separate accounts at end of year	2021-12-31	$3,740,189
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$4,434,796
Interest on participant loans	2021-12-31	$3,722
Interest earned on other investments	2021-12-31	$31,840
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$1,426,780
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$1,530,907
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$1,217,838
Net investment gain/loss from pooled separate accounts	2021-12-31	$618,793
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$832,589
Employer contributions (assets) at end of year	2021-12-31	$0
Employer contributions (assets) at beginning of year	2021-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$2,715,433
Liabilities. Value of benefit claims payable at end of year	2021-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2021-12-31	$0
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	WIPFLI, LLP
Accountancy firm EIN	2021-12-31	390758449
2020 : SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$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	$791
Total income from all sources (including contributions)	2020-12-31	$3,644,605
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$1,360,197
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$1,338,828
Expenses. Certain deemed distributions of participant loans	2020-12-31	$442
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$1,326,384
Value of total assets at end of year	2020-12-31	$17,596,638
Value of total assets at beginning of year	2020-12-31	$15,313,021
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$20,927
Total interest from all sources	2020-12-31	$42,302
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$491,605
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-31	$491,605
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$572,217
Participant contributions at end of year	2020-12-31	$109,302
Participant contributions at beginning of year	2020-12-31	$52,710
Participant contributions at end of year	2020-12-31	$0
Participant contributions at beginning of year	2020-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2020-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2020-12-31	$791
Total non interest bearing cash at end of year	2020-12-31	$0
Total non interest bearing cash at beginning of year	2020-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$2,284,408
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$17,596,638
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$15,312,230
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Investment advisory and management fees	2020-12-31	$20,927
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$11,521,633
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$9,448,709
Value of interest in pooled separate accounts at end of year	2020-12-31	$4,434,796
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$4,418,090
Interest on participant loans	2020-12-31	$6,626
Interest earned on other investments	2020-12-31	$35,676
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$1,530,907
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$1,393,512
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$1,117,859
Net investment gain/loss from pooled separate accounts	2020-12-31	$666,455
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$754,167
Employer contributions (assets) at end of year	2020-12-31	$0
Employer contributions (assets) at beginning of year	2020-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$1,338,828
Liabilities. Value of benefit claims payable at end of year	2020-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2020-12-31	$0
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	EIDE BAILLY, LLP
Accountancy firm EIN	2020-12-31	450250958
2019 : SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$791
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$32,649
Total income from all sources (including contributions)	2019-12-31	$4,001,320
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$2,060,121
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$2,017,585
Expenses. Certain deemed distributions of participant loans	2019-12-31	$14,904
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$1,243,261
Value of total assets at end of year	2019-12-31	$15,313,021
Value of total assets at beginning of year	2019-12-31	$13,403,680
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$27,632
Total interest from all sources	2019-12-31	$44,190
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$698,376
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$698,376
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$495,125
Participant contributions at end of year	2019-12-31	$52,710
Participant contributions at beginning of year	2019-12-31	$80,585
Participant contributions at end of year	2019-12-31	$0
Participant contributions at beginning of year	2019-12-31	$8,539
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$25,824
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2019-12-31	$791
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2019-12-31	$1,851
Total non interest bearing cash at end of year	2019-12-31	$0
Total non interest bearing cash at beginning of year	2019-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$1,941,199
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$15,312,230
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$13,371,031
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Investment advisory and management fees	2019-12-31	$27,632
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$9,448,709
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$6,046,995
Value of interest in pooled separate accounts at end of year	2019-12-31	$4,418,090
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$5,499,993
Interest on participant loans	2019-12-31	$3,856
Interest earned on other investments	2019-12-31	$40,334
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$1,393,512
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$1,761,942
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$980,330
Net investment gain/loss from pooled separate accounts	2019-12-31	$1,035,163
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$722,312
Employer contributions (assets) at end of year	2019-12-31	$0
Employer contributions (assets) at beginning of year	2019-12-31	$5,626
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$2,017,585
Liabilities. Value of benefit claims payable at end of year	2019-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2019-12-31	$30,798
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	EIDE BAILLY, LLP
Accountancy firm EIN	2019-12-31	450250958
2018 : SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$32,649
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	$356,994
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$1,239,867
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$1,214,949
Expenses. Certain deemed distributions of participant loans	2018-12-31	$1,307
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$1,173,575
Value of total assets at end of year	2018-12-31	$13,403,680
Value of total assets at beginning of year	2018-12-31	$14,253,904
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$23,611
Total interest from all sources	2018-12-31	$50,906
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$500,285
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2018-12-31	$500,285
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$415,366
Participant contributions at end of year	2018-12-31	$80,585
Participant contributions at beginning of year	2018-12-31	$57,752
Participant contributions at end of year	2018-12-31	$8,539
Participant contributions at beginning of year	2018-12-31	$18,267
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$106,278
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2018-12-31	$1,851
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2018-12-31	$0
Total non interest bearing cash at end of year	2018-12-31	$0
Total non interest bearing cash at beginning of year	2018-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$-882,873
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$13,371,031
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$14,253,904
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$6,046,995
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$5,716,065
Value of interest in pooled separate accounts at end of year	2018-12-31	$5,499,993
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$6,533,454
Interest on participant loans	2018-12-31	$4,218
Interest earned on other investments	2018-12-31	$46,688
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$1,761,942
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$1,906,306
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-933,893
Net investment gain/loss from pooled separate accounts	2018-12-31	$-433,879
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$651,931
Employer contributions (assets) at end of year	2018-12-31	$5,626
Employer contributions (assets) at beginning of year	2018-12-31	$22,060
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$1,214,949
Contract administrator fees	2018-12-31	$23,611
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2018-12-31	No
Liabilities. Value of benefit claims payable at end of year	2018-12-31	$30,798
Liabilities. Value of benefit claims payable at beginning of year	2018-12-31	$0
Did the plan have assets held for investment	2018-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	EIDE BAILLY, LLP
Accountancy firm EIN	2018-12-31	450250958
2017 : SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$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	$3,071,439
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$1,168,537
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$1,147,914
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$1,341,841
Value of total assets at end of year	2017-12-31	$14,253,904
Value of total assets at beginning of year	2017-12-31	$12,351,002
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$20,623
Total interest from all sources	2017-12-31	$55,258
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$282,674
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$282,674
Administrative expenses professional fees incurred	2017-12-31	$20,623
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$445,315
Participant contributions at end of year	2017-12-31	$57,752
Participant contributions at beginning of year	2017-12-31	$69,506
Participant contributions at end of year	2017-12-31	$18,267
Participant contributions at beginning of year	2017-12-31	$9,259
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$286,607
Total non interest bearing cash at end of year	2017-12-31	$0
Total non interest bearing cash at beginning of year	2017-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$1,902,902
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$14,253,904
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$12,351,002
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$5,716,065
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$4,785,863
Value of interest in pooled separate accounts at end of year	2017-12-31	$6,533,454
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$5,439,052
Interest on participant loans	2017-12-31	$2,738
Interest earned on other investments	2017-12-31	$52,520
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$1,906,306
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$2,037,974
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$556,893
Net investment gain/loss from pooled separate accounts	2017-12-31	$834,773
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$609,919
Employer contributions (assets) at end of year	2017-12-31	$22,060
Employer contributions (assets) at beginning of year	2017-12-31	$9,348
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$1,147,914
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2017-12-31	No
Did the plan have assets held for investment	2017-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	EIDE BAILLY, LLP
Accountancy firm EIN	2017-12-31	450250958
2016 : SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$1,956,585
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$491,276
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$466,872
Expenses. Certain deemed distributions of participant loans	2016-12-31	$1,097
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$1,094,198
Value of total assets at end of year	2016-12-31	$12,351,002
Value of total assets at beginning of year	2016-12-31	$10,885,693
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$23,307
Total interest from all sources	2016-12-31	$55,290
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$145,309
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$145,309
Administrative expenses professional fees incurred	2016-12-31	$23,307
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$470,509
Participant contributions at end of year	2016-12-31	$69,506
Participant contributions at beginning of year	2016-12-31	$76,353
Participant contributions at end of year	2016-12-31	$9,259
Participant contributions at beginning of year	2016-12-31	$10,326
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$5,279
Total non interest bearing cash at end of year	2016-12-31	$0
Total non interest bearing cash at beginning of year	2016-12-31	$142
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$1,465,309
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$12,351,002
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$10,885,693
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$4,785,863
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$4,055,215
Value of interest in pooled separate accounts at end of year	2016-12-31	$5,439,052
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$4,937,489
Interest on participant loans	2016-12-31	$4,290
Interest earned on other investments	2016-12-31	$51,000
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$2,037,974
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$1,796,271
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$306,990
Net investment gain/loss from pooled separate accounts	2016-12-31	$354,798
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$618,410
Employer contributions (assets) at end of year	2016-12-31	$9,348
Employer contributions (assets) at beginning of year	2016-12-31	$9,897
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$466,872
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2016-12-31	No
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	EIDE BAILLY, LLP
Accountancy firm EIN	2016-12-31	450250958
2015 : SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$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	$1,151,835
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$225,570
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$211,468
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$1,273,124
Value of total assets at end of year	2015-12-31	$10,885,693
Value of total assets at beginning of year	2015-12-31	$9,959,428
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$14,102
Total interest from all sources	2015-12-31	$51,693
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$475,371
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$475,371
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$485,680
Participant contributions at end of year	2015-12-31	$76,353
Participant contributions at beginning of year	2015-12-31	$102,146
Participant contributions at end of year	2015-12-31	$10,326
Participant contributions at beginning of year	2015-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$185,708
Total non interest bearing cash at end of year	2015-12-31	$142
Total non interest bearing cash at beginning of year	2015-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$926,265
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$10,885,693
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$9,959,428
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Investment advisory and management fees	2015-12-31	$14,102
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$4,055,215
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$8,229,560
Value of interest in pooled separate accounts at end of year	2015-12-31	$4,937,489
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$0
Interest on participant loans	2015-12-31	$6,077
Interest earned on other investments	2015-12-31	$45,616
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$1,796,271
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$1,627,722
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-648,353
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$601,736
Employer contributions (assets) at end of year	2015-12-31	$9,897
Employer contributions (assets) at beginning of year	2015-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$211,468
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2015-12-31	No
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	EIDE BAILLY, LLP
Accountancy firm EIN	2015-12-31	450250958
2014 : SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2014 401k financial data
Total income from all sources (including contributions)	2014-12-31	$1,572,795
Total of all expenses incurred	2014-12-31	$1,261,375
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$1,230,660
Expenses. Certain deemed distributions of participant loans	2014-12-31	$3,110
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$1,043,716
Value of total assets at end of year	2014-12-31	$9,959,428
Value of total assets at beginning of year	2014-12-31	$9,648,008
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$27,605
Total interest from all sources	2014-12-31	$48,032
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$34,786
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$34,786
Administrative expenses professional fees incurred	2014-12-31	$11,826
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$448,247
Participant contributions at end of year	2014-12-31	$102,146
Participant contributions at beginning of year	2014-12-31	$80,615
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$16,533
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$311,420
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$9,959,428
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$9,648,008
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Investment advisory and management fees	2014-12-31	$15,779
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$8,229,560
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$7,645,573
Interest on participant loans	2014-12-31	$4,480
Interest earned on other investments	2014-12-31	$43,552
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$1,627,722
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$1,921,700
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$446,261
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$578,936
Employer contributions (assets) at beginning of year	2014-12-31	$120
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$1,230,660
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2014-12-31	No
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	EIDE BAILLY, LLP
Accountancy firm EIN	2014-12-31	450250958
2013 : SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2013 401k financial data
Total income from all sources (including contributions)	2013-12-31	$2,447,760
Total of all expenses incurred	2013-12-31	$590,521
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$564,992
Expenses. Certain deemed distributions of participant loans	2013-12-31	$2,446
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$1,033,142
Value of total assets at end of year	2013-12-31	$9,648,008
Value of total assets at beginning of year	2013-12-31	$7,790,769
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$23,083
Total interest from all sources	2013-12-31	$55,204
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$34,365
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-12-31	$34,365
Administrative expenses professional fees incurred	2013-12-31	$10,671
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$750,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$452,854
Participant contributions at end of year	2013-12-31	$80,615
Participant contributions at beginning of year	2013-12-31	$67,175
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$15,073
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$1,857,239
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$9,648,008
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$7,790,769
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Investment advisory and management fees	2013-12-31	$12,412
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$7,645,573
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$5,844,112
Interest on participant loans	2013-12-31	$3,286
Interest earned on other investments	2013-12-31	$51,918
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$1,921,700
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$1,879,482
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$1,325,049
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$565,215
Employer contributions (assets) at end of year	2013-12-31	$120
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$564,992
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2013-12-31	No
Did the plan have assets held for investment	2013-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	EIDE BAILLY, LLP
Accountancy firm EIN	2013-12-31	450250958
2012 : SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2012 401k financial data
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$1,524
Total income from all sources (including contributions)	2012-12-31	$1,599,932
Total of all expenses incurred	2012-12-31	$607,032
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$583,067
Expenses. Certain deemed distributions of participant loans	2012-12-31	$2,045
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$942,889
Value of total assets at end of year	2012-12-31	$7,790,769
Value of total assets at beginning of year	2012-12-31	$6,799,393
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$21,920
Total interest from all sources	2012-12-31	$56,504
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$38,989
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-12-31	$38,989
Administrative expenses professional fees incurred	2012-12-31	$10,709
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$750,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$382,676
Participant contributions at end of year	2012-12-31	$67,175
Participant contributions at beginning of year	2012-12-31	$55,483
Participant contributions at end of year	2012-12-31	$0
Participant contributions at beginning of year	2012-12-31	$5,797
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$34,801
Administrative expenses (other) incurred	2012-12-31	$1,870
Liabilities. Value of operating payables at beginning of year	2012-12-31	$1,524
Total non interest bearing cash at end of year	2012-12-31	$0
Total non interest bearing cash at beginning of year	2012-12-31	$124
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$992,900
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$7,790,769
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$6,797,869
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Investment advisory and management fees	2012-12-31	$9,341
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$5,844,112
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$5,007,793
Interest on participant loans	2012-12-31	$3,457
Interest earned on other investments	2012-12-31	$53,047
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$1,879,482
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$1,719,193
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$561,550
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$525,412
Employer contributions (assets) at end of year	2012-12-31	$0
Employer contributions (assets) at beginning of year	2012-12-31	$11,003
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$583,067
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2012-12-31	No
Did the plan have assets held for investment	2012-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	EIDE BAILLY, LLP
Accountancy firm EIN	2012-12-31	450250958
2011 : SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2011 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$1,524
Total income from all sources (including contributions)	2011-12-31	$839,428
Total of all expenses incurred	2011-12-31	$396,492
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$361,295
Expenses. Certain deemed distributions of participant loans	2011-12-31	$4,202
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$859,594
Value of total assets at end of year	2011-12-31	$6,799,393
Value of total assets at beginning of year	2011-12-31	$6,354,933
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$30,995
Total interest from all sources	2011-12-31	$48,742
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$35,877
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2011-12-31	$35,877
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$750,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$354,512
Participant contributions at end of year	2011-12-31	$55,483
Participant contributions at beginning of year	2011-12-31	$34,270
Participant contributions at end of year	2011-12-31	$5,797
Participant contributions at beginning of year	2011-12-31	$7,344
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$15,465
Administrative expenses (other) incurred	2011-12-31	$30,995
Liabilities. Value of operating payables at end of year	2011-12-31	$1,524
Total non interest bearing cash at end of year	2011-12-31	$124
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$442,936
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$6,797,869
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$6,354,933
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$5,007,793
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$4,794,037
Interest on participant loans	2011-12-31	$1,812
Interest earned on other investments	2011-12-31	$46,930
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$1,719,193
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$1,470,667
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-104,785
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$489,617
Employer contributions (assets) at end of year	2011-12-31	$11,003
Employer contributions (assets) at beginning of year	2011-12-31	$48,615
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$361,295
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2011-12-31	No
Did the plan have assets held for investment	2011-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	EIDE BAILLY, LLP
Accountancy firm EIN	2011-12-31	450250958
2010 : SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2010 401k financial data
Total income from all sources (including contributions)	2010-12-31	$1,400,048
Total of all expenses incurred	2010-12-31	$474,367
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$425,957
Expenses. Certain deemed distributions of participant loans	2010-12-31	$30,695
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$840,139
Value of total assets at end of year	2010-12-31	$6,354,933
Value of total assets at beginning of year	2010-12-31	$5,429,252
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$17,715
Total interest from all sources	2010-12-31	$49,175
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$41,633
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2010-12-31	$41,633
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$750,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$340,891
Participant contributions at end of year	2010-12-31	$34,270
Participant contributions at beginning of year	2010-12-31	$52,906
Participant contributions at end of year	2010-12-31	$7,344
Participant contributions at beginning of year	2010-12-31	$22,621
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$6,087
Administrative expenses (other) incurred	2010-12-31	$17,715
Total non interest bearing cash at end of year	2010-12-31	$0
Total non interest bearing cash at beginning of year	2010-12-31	$10,652
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$925,681
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$6,354,933
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$5,429,252
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$4,794,037
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$3,874,252
Interest on participant loans	2010-12-31	$2,904
Interest earned on other investments	2010-12-31	$46,271
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$1,470,667
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$1,438,976
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$469,101
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$493,161
Employer contributions (assets) at end of year	2010-12-31	$48,615
Employer contributions (assets) at beginning of year	2010-12-31	$29,845
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$425,957
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2010-12-31	No
Did the plan have assets held for investment	2010-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	EIDE BAILLY, LLP
Accountancy firm EIN	2010-12-31	450250958

Form 5500 Responses for SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN

2022: SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: SHODAIR HOSPITAL EMPLOYEES TAX DEFERRED ANNUITY PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	This submission is the final filing	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

372726-01

Policy instance

Insurance contract or identification number	372726-01
Number of Individuals Covered	12
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
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?	Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Other information about contract	GROUP ANNUITY CONTRACT

RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )

Policy contract number

67105

Policy instance

Insurance contract or identification number	67105
Number of Individuals Covered	61
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $3,505
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,327
Insurance broker organization code?	3

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

372726-01

Policy instance

Insurance contract or identification number	372726-01
Number of Individuals Covered	19
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
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?	Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Other information about contract	GROUP ANNUITY CONTRACT

RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )

Policy contract number

67105

Policy instance

Insurance contract or identification number	67105
Number of Individuals Covered	68
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $7,584
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $7,297
Insurance broker organization code?	3

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

372726-01

Policy instance

Insurance contract or identification number	372726-01
Number of Individuals Covered	9
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
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?	Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Other information about contract	GROUP ANNUITY CONTRACT

RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )

Policy contract number

67105

Policy instance

Insurance contract or identification number	67105
Number of Individuals Covered	168
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $7,870
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $7,443
Insurance broker organization code?	3

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

372726-01

Policy instance

Insurance contract or identification number	372726-01
Number of Individuals Covered	5
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
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?	Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Other information about contract	GROUP ANNUITY CONTRACT

RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )

Policy contract number

67105

Policy instance

Insurance contract or identification number	67105
Number of Individuals Covered	92
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $9,784
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $9,316
Insurance broker organization code?	3

RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )

Policy contract number

67105

Policy instance

Insurance contract or identification number	67105
Number of Individuals Covered	115
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $28,952
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $26,802
Insurance broker organization code?	3

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

372726-01

Policy instance

Insurance contract or identification number	372726-01
Number of Individuals Covered	3
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
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?	Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Other information about contract	GROUP ANNUITY CONTRACT

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

372726-01

Policy instance

Insurance contract or identification number	372726-01
Number of Individuals Covered	3
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $206
Total amount of fees paid to insurance company	USD $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?	Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Other information about contract	GROUP ANNUITY CONTRACT
Commission paid to Insurance Broker	USD $70
Insurance broker organization code?	3
Insurance broker name	PAUL MALOY

RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )

Policy contract number

67105

Policy instance

Insurance contract or identification number	67105
Number of Individuals Covered	251
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $32,110
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $29,078
Insurance broker organization code?	3
Insurance broker name	CETERA ADVISOR NETWORKS, LLC

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

372726-01

Policy instance

Insurance contract or identification number	372726-01
Number of Individuals Covered	3
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $163
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Other information about contract	GROUP ANNUITY CONTRACT
Commission paid to Insurance Broker	USD $55
Insurance broker organization code?	3
Insurance broker name	PAUL MALOY

RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )

Policy contract number

67105

Policy instance

Insurance contract or identification number	67105
Number of Individuals Covered	136
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $50,237
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $46,407
Insurance broker organization code?	3
Insurance broker name	CETERA ADVISOR NETWORKS, LLC

RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )

Policy contract number

67105

Policy instance

Insurance contract or identification number	67105
Number of Individuals Covered	135
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $83,377
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $78,782
Insurance broker organization code?	3
Insurance broker name	CETERA ADVISOR NETWORKS, LLC

RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )

Policy contract number

67105

Policy instance

Insurance contract or identification number	67105
Number of Individuals Covered	288
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $51,449
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $29,977
Insurance broker organization code?	3
Insurance broker name	CETERA ADVISOR NETWORKS, LLC

RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )

Policy contract number

67105

Policy instance

Insurance contract or identification number	67105
Number of Individuals Covered	286
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $42,911
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $36,218
Insurance broker organization code?	3
Insurance broker name	CETERA ADVISOR NETWORKS, LLC

RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )

Policy contract number

67105

Policy instance

Insurance contract or identification number	67105
Number of Individuals Covered	255
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $5,424
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )

Policy contract number

67105

Policy instance

Insurance contract or identification number	67105
Number of Individuals Covered	123
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $4,645
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,072
Insurance broker organization code?	3
Insurance broker name	FINANCIAL NETWORK INVESTMENTS CORP

Was this data useful?

If you found the data here useful, PLEASE HELP US. We are a start-up and believe in making information freely available. By linking to us, posting on twitter, facebook and linkedin about us and generally spreading the word, you'll help us to grow. Our vision is to provide high quality data about the activities of all the companies in the world and where possible make it free to use and view. Finding and integrating data from thousands of data sources is time consuming and needs lots of effort. By simply spreading the word about us, you will help us. Please use the share buttons. It will only take a few seconds of your time. Thanks for helping

Information Disclaimer

The information provided on this website is not advice, endorsement or recommendation
The information published is supplied by third parties so we make no warranty on the accuracy, completeness etc. This information is provided "as-is". The information is subject to change as we obtain updates and corrections from the primary information sources.
You are free to use the information for your own personal research on the understanding to do so is at your own risk.

See full terms and conditions

Company Name:	MONTANA CHILDREN'S HOME & HOSPITAL
Employer identification number (EIN):	810231789
NAIC Classification:	622000
NAIC Description:	Hospitals