401k Plan data: RIVER HOSPITAL, INC. 403(B) PLAN plan

RIVER HOSPITAL, INC. 403(B) PLAN 401k Plan overview

Plan Name	RIVER HOSPITAL, INC. 403(B) PLAN
Plan identification number	001

RIVER HOSPITAL, INC. 403(B) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(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)(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.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

RIVER HOSPITAL, INC. has sponsored the creation of one or more 401k plans.

Company Name: RIVER HOSPITAL, INC.

Employer identification number (EIN): 810600548

NAIC Classification: 622000
NAIC Description: Hospitals

Additional information about RIVER HOSPITAL, INC.

Jurisdiction of Incorporation: New York Department of State

Incorporation Date: 2003-02-20

Company Identification Number: 2872408

Legal Registered Office Address: 4 FULLER STREET
Jefferson
ALEXANDRIA BAY
United States of America (USA)
13607

More information about RIVER HOSPITAL, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan RIVER HOSPITAL, INC. 403(B) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01
001 2021-01-01
001 2020-01-01
001 2019-01-01
001 2018-01-01

Plan Statistics for RIVER HOSPITAL, INC. 403(B) PLAN

401k plan membership statisitcs for RIVER HOSPITAL, INC. 403(B) PLAN

Measure Date Value
2022: RIVER HOSPITAL, INC. 403(B) PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 279
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 245
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 46
Total of all active and inactive participants 2022-01-01 291
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 291
Number of participants with account balances 2022-01-01 153
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 2
2021: RIVER HOSPITAL, INC. 403(B) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 245
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 243
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 34
Total of all active and inactive participants 2021-01-01 277
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 277
Number of participants with account balances 2021-01-01 140
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 2
2020: RIVER HOSPITAL, INC. 403(B) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 232
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 225
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 22
Total of all active and inactive participants 2020-01-01 247
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 247
Number of participants with account balances 2020-01-01 103
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 5
2019: RIVER HOSPITAL, INC. 403(B) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 227
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 218
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 16
Total of all active and inactive participants 2019-01-01 234
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 234
Number of participants with account balances 2019-01-01 93
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 2
2018: RIVER HOSPITAL, INC. 403(B) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 235
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 218
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 9
Total of all active and inactive participants 2018-01-01 227
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 227
Number of participants with account balances 2018-01-01 90
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0

Measure	Date	Value
2022: RIVER HOSPITAL, INC. 403(B) PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	279
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	245
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	46
Total of all active and inactive participants	2022-01-01	291
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	291
Number of participants with account balances	2022-01-01	153
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	2
2021: RIVER HOSPITAL, INC. 403(B) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	245
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	243
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	34
Total of all active and inactive participants	2021-01-01	277
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	277
Number of participants with account balances	2021-01-01	140
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	2
2020: RIVER HOSPITAL, INC. 403(B) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	232
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	225
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	22
Total of all active and inactive participants	2020-01-01	247
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	247
Number of participants with account balances	2020-01-01	103
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	5
2019: RIVER HOSPITAL, INC. 403(B) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	227
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	218
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	16
Total of all active and inactive participants	2019-01-01	234
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	234
Number of participants with account balances	2019-01-01	93
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	2
2018: RIVER HOSPITAL, INC. 403(B) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	235
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	218
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	9
Total of all active and inactive participants	2018-01-01	227
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	227
Number of participants with account balances	2018-01-01	90
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0

Financial Data on RIVER HOSPITAL, INC. 403(B) PLAN

Measure	Date	Value
2022 : RIVER HOSPITAL, INC. 403(B) 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	$210,165
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$193,763
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$152,875
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$878,961
Value of total assets at end of year	2022-12-31	$4,191,212
Value of total assets at beginning of year	2022-12-31	$4,174,810
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$40,888
Total interest from all sources	2022-12-31	$1,400
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$106,692
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	$106,692
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$1,500,000
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	$608,252
Participant contributions at end of year	2022-12-31	$38,234
Participant contributions at beginning of year	2022-12-31	$41,226
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$155,354
Administrative expenses (other) incurred	2022-12-31	$330
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	$16,402
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$4,191,212
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$4,174,810
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	$31,975
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$3,789,070
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$3,804,754
Value of interest in pooled separate accounts at end of year	2022-12-31	$248,553
Value of interest in pooled separate accounts at beginning of year	2022-12-31	$228,245
Interest on participant loans	2022-12-31	$1,400
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-780,186
Net investment gain/loss from pooled separate accounts	2022-12-31	$3,298
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	$115,355
Employer contributions (assets) at end of year	2022-12-31	$115,355
Employer contributions (assets) at beginning of year	2022-12-31	$100,585
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$152,875
Contract administrator fees	2022-12-31	$8,583
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	LUMSDEN & MCCORMICK LLP
Accountancy firm EIN	2022-12-31	160765486
2021 : RIVER HOSPITAL, INC. 403(B) 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	$1,286,891
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$113,598
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$77,115
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$875,486
Value of total assets at end of year	2021-12-31	$4,174,810
Value of total assets at beginning of year	2021-12-31	$3,001,517
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$36,483
Total interest from all sources	2021-12-31	$4,839
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$161,220
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	$161,220
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$1,500,000
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	$458,278
Participant contributions at end of year	2021-12-31	$41,226
Participant contributions at beginning of year	2021-12-31	$33,533
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$316,623
Administrative expenses (other) incurred	2021-12-31	$220
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	$1,173,293
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$4,174,810
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$3,001,517
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	$29,538
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$3,804,754
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$2,634,145
Value of interest in pooled separate accounts at end of year	2021-12-31	$228,245
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$246,865
Interest on participant loans	2021-12-31	$1,369
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2021-12-31	$3,470
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$244,802
Net investment gain/loss from pooled separate accounts	2021-12-31	$544
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	$100,585
Employer contributions (assets) at end of year	2021-12-31	$100,585
Employer contributions (assets) at beginning of year	2021-12-31	$86,974
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$77,115
Contract administrator fees	2021-12-31	$6,725
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	LUMSDEN & MCCORMICK LLP
Accountancy firm EIN	2021-12-31	160765486
2020 : RIVER HOSPITAL, INC. 403(B) 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	$0
Total income from all sources (including contributions)	2020-12-31	$865,044
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$602,277
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$576,087
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$486,893
Value of total assets at end of year	2020-12-31	$3,001,517
Value of total assets at beginning of year	2020-12-31	$2,738,750
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$26,190
Total interest from all sources	2020-12-31	$1,491
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$60,134
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	$60,134
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$1,500,000
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	$359,934
Participant contributions at end of year	2020-12-31	$33,533
Participant contributions at beginning of year	2020-12-31	$34,440
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$40,997
Administrative expenses (other) incurred	2020-12-31	$1,727
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	$262,767
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$3,001,517
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$2,738,750
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	$18,972
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$2,634,145
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$2,393,033
Value of interest in pooled separate accounts at end of year	2020-12-31	$246,865
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$214,087
Interest on participant loans	2020-12-31	$1,491
Net investment gain/loss from pooled separate accounts	2020-12-31	$3,876
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	$85,962
Employer contributions (assets) at end of year	2020-12-31	$86,974
Employer contributions (assets) at beginning of year	2020-12-31	$97,190
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$576,087
Contract administrator fees	2020-12-31	$5,491
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	LUMSDEN & MCCORMICK LLP
Accountancy firm EIN	2020-12-31	160765486
2019 : RIVER HOSPITAL, INC. 403(B) 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	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$1,026,434
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$229,228
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$203,015
Expenses. Certain deemed distributions of participant loans	2019-12-31	$1,105
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$596,051
Value of total assets at end of year	2019-12-31	$2,738,750
Value of total assets at beginning of year	2019-12-31	$1,941,544
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$25,108
Total interest from all sources	2019-12-31	$1,432
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$77,026
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	$77,026
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$1,500,000
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	$408,722
Participant contributions at end of year	2019-12-31	$34,440
Participant contributions at beginning of year	2019-12-31	$15,824
Participant contributions at end of year	2019-12-31	$0
Participant contributions at beginning of year	2019-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$90,139
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	$797,206
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$2,738,750
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$1,941,544
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	$19,581
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$2,393,033
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$1,638,753
Value of interest in pooled separate accounts at end of year	2019-12-31	$214,087
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$192,150
Interest on participant loans	2019-12-31	$1,432
Net investment gain/loss from pooled separate accounts	2019-12-31	$4,063
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	$97,190
Employer contributions (assets) at end of year	2019-12-31	$97,190
Employer contributions (assets) at beginning of year	2019-12-31	$94,817
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$203,015
Contract administrator fees	2019-12-31	$5,527
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	LUMSDEN & MCCORMICK LLP
Accountancy firm EIN	2019-12-31	160765486
2018 : RIVER HOSPITAL, INC. 403(B) 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	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$408,332
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$31,471
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$11,978
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$524,884
Value of total assets at end of year	2018-12-31	$1,941,544
Value of total assets at beginning of year	2018-12-31	$1,564,683
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$19,493
Total interest from all sources	2018-12-31	$371
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$62,951
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	$62,951
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$250,000
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	$414,680
Participant contributions at end of year	2018-12-31	$15,824
Participant contributions at beginning of year	2018-12-31	$7,047
Participant contributions at end of year	2018-12-31	$0
Participant contributions at beginning of year	2018-12-31	$13,658
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$15,387
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	$376,861
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$1,941,544
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$1,564,683
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	$1,638,753
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$1,384,660
Value of interest in pooled separate accounts at end of year	2018-12-31	$192,150
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$159,318
Interest on participant loans	2018-12-31	$371
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-182,971
Net investment gain/loss from pooled separate accounts	2018-12-31	$3,097
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	$94,817
Employer contributions (assets) at end of year	2018-12-31	$94,817
Employer contributions (assets) at beginning of year	2018-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$11,978
Contract administrator fees	2018-12-31	$19,493
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	LUMSDEN & MCCORMICK LLP
Accountancy firm EIN	2018-12-31	160765486

Form 5500 Responses for RIVER HOSPITAL, INC. 403(B) PLAN

2022: RIVER HOSPITAL, INC. 403(B) 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: RIVER HOSPITAL, INC. 403(B) 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: RIVER HOSPITAL, INC. 403(B) 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: RIVER HOSPITAL, INC. 403(B) 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: RIVER HOSPITAL, INC. 403(B) PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	First time form 5500 has been submitted	Yes
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

Insurance Providers Used on plan

PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )

Policy contract number

63808

Policy instance

Insurance contract or identification number	63808
Number of Individuals Covered	153
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?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )

Policy contract number

63808

Policy instance

Insurance contract or identification number	63808
Number of Individuals Covered	140
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?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )

Policy contract number

63808

Policy instance

Insurance contract or identification number	63808
Number of Individuals Covered	103
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?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )

Policy contract number

63808

Policy instance

Insurance contract or identification number	63808
Number of Individuals Covered	93
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?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )

Policy contract number

63808

Policy instance

Insurance contract or identification number	63808
Number of Individuals Covered	90
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?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	RIVER HOSPITAL, INC.
Employer identification number (EIN):	810600548
NAIC Classification:	622000
NAIC Description:	Hospitals

Jurisdiction of Incorporation:	New York Department of State
Incorporation Date:	2003-02-20
Company Identification Number:	2872408
Legal Registered Office Address:	4 FULLER STREET Jefferson ALEXANDRIA BAY United States of America (USA) 13607