401k Plan data: PEACEHEALTH SOUTHWEST MEDICAL CENTER RETIREMENT SAVINGS PLAN plan

PEACEHEALTH SOUTHWEST MEDICAL CENTER RETIREMENT SAVINGS PLAN 401k Plan overview

Plan Name	PEACEHEALTH SOUTHWEST MEDICAL CENTER RETIREMENT SAVINGS PLAN
Plan identification number	002

PEACEHEALTH SOUTHWEST MEDICAL CENTER RETIREMENT SAVINGS PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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 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.
Participant-directed brokerage accounts provided as an investment option under the plan.
Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

PEACEHEALTH, REWARDS has sponsored the creation of one or more 401k plans.

Company Name: PEACEHEALTH, REWARDS

Employer identification number (EIN): 910939479

NAIC Classification: 622000
NAIC Description: Hospitals

Additional information about PEACEHEALTH, REWARDS

Jurisdiction of Incorporation: Washington Secretary of State Corporations Division

Incorporation Date: 1976-06-15

Company Identification Number: 600521489

Legal Registered Office Address: 700 WASHINGTON ST STE 701

VANCOUVER
United States of America (USA)
986603338

More information about PEACEHEALTH, REWARDS

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PEACEHEALTH SOUTHWEST MEDICAL CENTER RETIREMENT SAVINGS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2022-01-01
002 2021-01-01
002 2020-01-01
002 2019-01-01
002 2018-01-01
002 2017-01-01 SALLY HILL
002 2016-01-01 GEORGE HUBEL
002 2016-01-01
002 2015-01-01 GEORGE HUBEL
002 2014-01-01 GEORGE HUBEL
002 2013-01-01 CHRISTINE FULLERTON

Plan Statistics for PEACEHEALTH SOUTHWEST MEDICAL CENTER RETIREMENT SAVINGS PLAN

401k plan membership statisitcs for PEACEHEALTH SOUTHWEST MEDICAL CENTER RETIREMENT SAVINGS PLAN

Measure Date Value
2022: PEACEHEALTH SOUTHWEST MEDICAL CENTER RETIREMENT SAVINGS PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 4,544
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 3,487
Number of retired or separated participants receiving benefits 2022-01-01 48
Number of other retired or separated participants entitled to future benefits 2022-01-01 1,334
Total of all active and inactive participants 2022-01-01 4,869
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 12
Total participants 2022-01-01 4,881
Number of participants with account balances 2022-01-01 3,877
2021: PEACEHEALTH SOUTHWEST MEDICAL CENTER RETIREMENT SAVINGS PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 4,303
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 3,224
Number of retired or separated participants receiving benefits 2021-01-01 48
Number of other retired or separated participants entitled to future benefits 2021-01-01 1,261
Total of all active and inactive participants 2021-01-01 4,533
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 11
Total participants 2021-01-01 4,544
Number of participants with account balances 2021-01-01 3,677
2020: PEACEHEALTH SOUTHWEST MEDICAL CENTER RETIREMENT SAVINGS PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 4,190
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 3,125
Number of retired or separated participants receiving benefits 2020-01-01 38
Number of other retired or separated participants entitled to future benefits 2020-01-01 1,127
Total of all active and inactive participants 2020-01-01 4,290
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 13
Total participants 2020-01-01 4,303
Number of participants with account balances 2020-01-01 3,527
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: PEACEHEALTH SOUTHWEST MEDICAL CENTER RETIREMENT SAVINGS PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 4,074
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 3,023
Number of retired or separated participants receiving benefits 2019-01-01 50
Number of other retired or separated participants entitled to future benefits 2019-01-01 1,108
Total of all active and inactive participants 2019-01-01 4,181
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 9
Total participants 2019-01-01 4,190
Number of participants with account balances 2019-01-01 3,482
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: PEACEHEALTH SOUTHWEST MEDICAL CENTER RETIREMENT SAVINGS PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 3,996
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 2,951
Number of retired or separated participants receiving benefits 2018-01-01 36
Number of other retired or separated participants entitled to future benefits 2018-01-01 1,075
Total of all active and inactive participants 2018-01-01 4,062
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 12
Total participants 2018-01-01 4,074
Number of participants with account balances 2018-01-01 3,419
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: PEACEHEALTH SOUTHWEST MEDICAL CENTER RETIREMENT SAVINGS PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 4,669
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 2,935
Number of retired or separated participants receiving benefits 2017-01-01 32
Number of other retired or separated participants entitled to future benefits 2017-01-01 1,021
Total of all active and inactive participants 2017-01-01 3,988
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 8
Total participants 2017-01-01 3,996
Number of participants with account balances 2017-01-01 3,228
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: PEACEHEALTH SOUTHWEST MEDICAL CENTER RETIREMENT SAVINGS PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 4,197
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 3,380
Number of retired or separated participants receiving benefits 2016-01-01 25
Number of other retired or separated participants entitled to future benefits 2016-01-01 1,255
Total of all active and inactive participants 2016-01-01 4,660
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 9
Total participants 2016-01-01 4,669
Number of participants with account balances 2016-01-01 3,602
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: PEACEHEALTH SOUTHWEST MEDICAL CENTER RETIREMENT SAVINGS PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 3,576
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 2,919
Number of retired or separated participants receiving benefits 2015-01-01 20
Number of other retired or separated participants entitled to future benefits 2015-01-01 1,249
Total of all active and inactive participants 2015-01-01 4,188
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 9
Total participants 2015-01-01 4,197
Number of participants with account balances 2015-01-01 3,452
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: PEACEHEALTH SOUTHWEST MEDICAL CENTER RETIREMENT SAVINGS PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 3,456
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 2,625
Number of retired or separated participants receiving benefits 2014-01-01 35
Number of other retired or separated participants entitled to future benefits 2014-01-01 905
Total of all active and inactive participants 2014-01-01 3,565
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 11
Total participants 2014-01-01 3,576
Number of participants with account balances 2014-01-01 3,576
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: PEACEHEALTH SOUTHWEST MEDICAL CENTER RETIREMENT SAVINGS PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 3,376
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 2,546
Number of retired or separated participants receiving benefits 2013-01-01 28
Number of other retired or separated participants entitled to future benefits 2013-01-01 872
Total of all active and inactive participants 2013-01-01 3,446
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 10
Total participants 2013-01-01 3,456
Number of participants with account balances 2013-01-01 3,456
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0

Measure	Date	Value
2022: PEACEHEALTH SOUTHWEST MEDICAL CENTER RETIREMENT SAVINGS PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	4,544
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	3,487
Number of retired or separated participants receiving benefits	2022-01-01	48
Number of other retired or separated participants entitled to future benefits	2022-01-01	1,334
Total of all active and inactive participants	2022-01-01	4,869
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	12
Total participants	2022-01-01	4,881
Number of participants with account balances	2022-01-01	3,877
2021: PEACEHEALTH SOUTHWEST MEDICAL CENTER RETIREMENT SAVINGS PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	4,303
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	3,224
Number of retired or separated participants receiving benefits	2021-01-01	48
Number of other retired or separated participants entitled to future benefits	2021-01-01	1,261
Total of all active and inactive participants	2021-01-01	4,533
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	11
Total participants	2021-01-01	4,544
Number of participants with account balances	2021-01-01	3,677
2020: PEACEHEALTH SOUTHWEST MEDICAL CENTER RETIREMENT SAVINGS PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	4,190
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	3,125
Number of retired or separated participants receiving benefits	2020-01-01	38
Number of other retired or separated participants entitled to future benefits	2020-01-01	1,127
Total of all active and inactive participants	2020-01-01	4,290
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	13
Total participants	2020-01-01	4,303
Number of participants with account balances	2020-01-01	3,527
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: PEACEHEALTH SOUTHWEST MEDICAL CENTER RETIREMENT SAVINGS PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	4,074
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	3,023
Number of retired or separated participants receiving benefits	2019-01-01	50
Number of other retired or separated participants entitled to future benefits	2019-01-01	1,108
Total of all active and inactive participants	2019-01-01	4,181
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	9
Total participants	2019-01-01	4,190
Number of participants with account balances	2019-01-01	3,482
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: PEACEHEALTH SOUTHWEST MEDICAL CENTER RETIREMENT SAVINGS PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	3,996
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	2,951
Number of retired or separated participants receiving benefits	2018-01-01	36
Number of other retired or separated participants entitled to future benefits	2018-01-01	1,075
Total of all active and inactive participants	2018-01-01	4,062
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	12
Total participants	2018-01-01	4,074
Number of participants with account balances	2018-01-01	3,419
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: PEACEHEALTH SOUTHWEST MEDICAL CENTER RETIREMENT SAVINGS PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	4,669
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	2,935
Number of retired or separated participants receiving benefits	2017-01-01	32
Number of other retired or separated participants entitled to future benefits	2017-01-01	1,021
Total of all active and inactive participants	2017-01-01	3,988
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	8
Total participants	2017-01-01	3,996
Number of participants with account balances	2017-01-01	3,228
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: PEACEHEALTH SOUTHWEST MEDICAL CENTER RETIREMENT SAVINGS PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	4,197
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	3,380
Number of retired or separated participants receiving benefits	2016-01-01	25
Number of other retired or separated participants entitled to future benefits	2016-01-01	1,255
Total of all active and inactive participants	2016-01-01	4,660
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	9
Total participants	2016-01-01	4,669
Number of participants with account balances	2016-01-01	3,602
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: PEACEHEALTH SOUTHWEST MEDICAL CENTER RETIREMENT SAVINGS PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	3,576
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	2,919
Number of retired or separated participants receiving benefits	2015-01-01	20
Number of other retired or separated participants entitled to future benefits	2015-01-01	1,249
Total of all active and inactive participants	2015-01-01	4,188
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	9
Total participants	2015-01-01	4,197
Number of participants with account balances	2015-01-01	3,452
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: PEACEHEALTH SOUTHWEST MEDICAL CENTER RETIREMENT SAVINGS PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	3,456
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	2,625
Number of retired or separated participants receiving benefits	2014-01-01	35
Number of other retired or separated participants entitled to future benefits	2014-01-01	905
Total of all active and inactive participants	2014-01-01	3,565
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	11
Total participants	2014-01-01	3,576
Number of participants with account balances	2014-01-01	3,576
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: PEACEHEALTH SOUTHWEST MEDICAL CENTER RETIREMENT SAVINGS PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	3,376
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	2,546
Number of retired or separated participants receiving benefits	2013-01-01	28
Number of other retired or separated participants entitled to future benefits	2013-01-01	872
Total of all active and inactive participants	2013-01-01	3,446
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	10
Total participants	2013-01-01	3,456
Number of participants with account balances	2013-01-01	3,456
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0

Financial Data on PEACEHEALTH SOUTHWEST MEDICAL CENTER RETIREMENT SAVINGS PLAN

Measure	Date	Value
2022 : PEACEHEALTH SOUTHWEST MEDICAL CENTER RETIREMENT SAVINGS 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	$-27,055,014
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$22,183,859
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$22,042,752
Expenses. Certain deemed distributions of participant loans	2022-12-31	$72,660
Value of total corrective distributions	2022-12-31	$2,512
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$23,822,769
Value of total assets at end of year	2022-12-31	$259,899,280
Value of total assets at beginning of year	2022-12-31	$309,138,153
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$65,935
Total interest from all sources	2022-12-31	$772,865
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$5,664,336
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	$5,664,336
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$10,000,000
If this is an individual account plan, was there a blackout period	2022-12-31	Yes
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$21,516,994
Participant contributions at end of year	2022-12-31	$2,676,877
Participant contributions at beginning of year	2022-12-31	$2,971,936
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$2,305,775
Administrative expenses (other) incurred	2022-12-31	$49,723
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	$-49,238,873
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$259,899,280
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$309,138,153
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	$16,130
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$234,137,482
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$282,157,324
Value of interest in pooled separate accounts at end of year	2022-12-31	$4,268,264
Value of interest in pooled separate accounts at beginning of year	2022-12-31	$5,415,674
Interest on participant loans	2022-12-31	$137,541
Interest earned on other investments	2022-12-31	$507,164
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2022-12-31	$128,160
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$18,816,657
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$18,593,219
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-57,314,984
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$22,042,752
Contract administrator fees	2022-12-31	$82
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	2022-12-31	Yes
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	Disclaimer
Accountancy firm name	2022-12-31	MOSS ADAMS
Accountancy firm EIN	2022-12-31	910189318
2021 : PEACEHEALTH SOUTHWEST MEDICAL CENTER RETIREMENT SAVINGS 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	$60,307,392
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$23,452,698
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$23,337,255
Expenses. Certain deemed distributions of participant loans	2021-12-31	$68,144
Value of total corrective distributions	2021-12-31	$1,437
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$21,371,537
Value of total assets at end of year	2021-12-31	$309,138,153
Value of total assets at beginning of year	2021-12-31	$272,283,459
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$45,862
Total interest from all sources	2021-12-31	$625,576
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$7,587,655
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	$7,587,655
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$10,000,000
If this is an individual account plan, was there a blackout period	2021-12-31	Yes
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	$20,021,249
Participant contributions at end of year	2021-12-31	$2,971,936
Participant contributions at beginning of year	2021-12-31	$3,050,014
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$1,350,288
Other income not declared elsewhere	2021-12-31	$117,613
Administrative expenses (other) incurred	2021-12-31	$44,016
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	$36,854,694
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$309,138,153
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$272,283,459
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	$1,773
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$282,157,324
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$243,449,814
Value of interest in pooled separate accounts at end of year	2021-12-31	$5,415,674
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$4,837,945
Interest on participant loans	2021-12-31	$155,433
Interest earned on other investments	2021-12-31	$469,102
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2021-12-31	$1,041
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$18,593,219
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$20,945,686
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$30,605,011
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$23,337,255
Contract administrator fees	2021-12-31	$73
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	2021-12-31	Yes
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	Disclaimer
Accountancy firm name	2021-12-31	KPMG
Accountancy firm EIN	2021-12-31	135565207
2020 : PEACEHEALTH SOUTHWEST MEDICAL CENTER RETIREMENT SAVINGS 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	$53,808,482
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$20,308,694
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$20,226,751
Expenses. Certain deemed distributions of participant loans	2020-12-31	$43,100
Value of total corrective distributions	2020-12-31	$1,947
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$18,668,766
Value of total assets at end of year	2020-12-31	$272,283,459
Value of total assets at beginning of year	2020-12-31	$238,783,671
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$36,896
Total interest from all sources	2020-12-31	$501,306
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$5,324,064
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	$5,324,064
Administrative expenses professional fees incurred	2020-12-31	$7,585
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$10,000,000
If this is an individual account plan, was there a blackout period	2020-12-31	Yes
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	$17,619,383
Participant contributions at end of year	2020-12-31	$3,050,014
Participant contributions at beginning of year	2020-12-31	$3,241,840
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$1,048,623
Administrative expenses (other) incurred	2020-12-31	$29,208
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	$33,499,788
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$272,283,459
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$238,783,671
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$243,449,814
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$209,979,439
Value of interest in pooled separate accounts at end of year	2020-12-31	$4,837,945
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$4,908,186
Interest on participant loans	2020-12-31	$167,714
Interest earned on other investments	2020-12-31	$305,086
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2020-12-31	$28,506
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$20,945,686
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$20,654,206
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$29,314,346
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	$760
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$20,226,751
Contract administrator fees	2020-12-31	$103
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	2020-12-31	Yes
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	KPMG
Accountancy firm EIN	2020-12-31	135565207
2019 : PEACEHEALTH SOUTHWEST MEDICAL CENTER RETIREMENT SAVINGS 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	$59,612,704
Total loss/gain on sale of assets	2019-12-31	$-874
Total of all expenses incurred	2019-12-31	$19,250,425
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$19,244,188
Expenses. Certain deemed distributions of participant loans	2019-12-31	$21,141
Value of total corrective distributions	2019-12-31	$2,100
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$18,140,341
Value of total assets at end of year	2019-12-31	$238,783,671
Value of total assets at beginning of year	2019-12-31	$198,421,392
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$-17,004
Total interest from all sources	2019-12-31	$797,354
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$19,298,719
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	$19,298,719
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$20,000,000
If this is an individual account plan, was there a blackout period	2019-12-31	Yes
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	$16,913,240
Participant contributions at end of year	2019-12-31	$3,241,840
Participant contributions at beginning of year	2019-12-31	$2,793,174
Assets. Other investments not covered elsewhere at end of year	2019-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2019-12-31	$29,444
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$1,227,101
Administrative expenses (other) incurred	2019-12-31	$-17,118
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	$40,362,279
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$238,783,671
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$198,421,392
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$209,979,439
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$169,739,758
Value of interest in pooled separate accounts at end of year	2019-12-31	$4,908,186
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$4,668,679
Interest on participant loans	2019-12-31	$156,851
Interest earned on other investments	2019-12-31	$501,990
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-31	$138,513
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$20,654,206
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$21,190,337
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$21,377,164
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$19,244,188
Contract administrator fees	2019-12-31	$114
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	2019-12-31	Yes
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
Aggregate proceeds on sale of assets	2019-12-31	$7,075
Aggregate carrying amount (costs) on sale of assets	2019-12-31	$7,949
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	KPMG
Accountancy firm EIN	2019-12-31	135565207
2018 : PEACEHEALTH SOUTHWEST MEDICAL CENTER RETIREMENT SAVINGS 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	$7,682,230
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$18,175,546
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$18,151,657
Expenses. Certain deemed distributions of participant loans	2018-12-31	$-7,904
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$17,209,870
Value of total assets at end of year	2018-12-31	$198,421,392
Value of total assets at beginning of year	2018-12-31	$208,914,708
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$31,793
Total interest from all sources	2018-12-31	$420,009
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$5,427,908
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	$5,427,908
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$20,000,000
If this is an individual account plan, was there a blackout period	2018-12-31	Yes
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	$15,676,659
Participant contributions at end of year	2018-12-31	$2,793,174
Participant contributions at beginning of year	2018-12-31	$2,531,074
Participant contributions at end of year	2018-12-31	$0
Participant contributions at beginning of year	2018-12-31	$470,754
Assets. Other investments not covered elsewhere at end of year	2018-12-31	$29,444
Assets. Other investments not covered elsewhere at beginning of year	2018-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$1,533,211
Administrative expenses (other) incurred	2018-12-31	$31,629
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	$-10,493,316
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$198,421,392
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$208,914,708
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	$169,739,758
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$178,527,080
Value of interest in pooled separate accounts at end of year	2018-12-31	$4,668,679
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$5,259,160
Interest on participant loans	2018-12-31	$126,291
Interest earned on other investments	2018-12-31	$176,109
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2018-12-31	$117,609
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$21,190,337
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$22,126,640
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-15,375,557
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$18,151,657
Contract administrator fees	2018-12-31	$164
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	Yes
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	KPMG
Accountancy firm EIN	2018-12-31	135565207
2017 : PEACEHEALTH SOUTHWEST MEDICAL CENTER RETIREMENT SAVINGS 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	$43,152,742
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$16,777,040
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$16,679,191
Expenses. Certain deemed distributions of participant loans	2017-12-31	$67,679
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$14,918,811
Value of total assets at end of year	2017-12-31	$208,914,708
Value of total assets at beginning of year	2017-12-31	$182,539,006
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$30,170
Total interest from all sources	2017-12-31	$317,309
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$4,801,149
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	$4,801,149
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$20,000,000
If this is an individual account plan, was there a blackout period	2017-12-31	Yes
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	$13,888,658
Participant contributions at end of year	2017-12-31	$2,531,074
Participant contributions at beginning of year	2017-12-31	$2,335,256
Participant contributions at end of year	2017-12-31	$470,754
Participant contributions at beginning of year	2017-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$1,030,153
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2017-12-31	$1,611
Value of other receiveables (less allowance for doubtful accounts) at end of year	2017-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2017-12-31	$36,907
Administrative expenses (other) incurred	2017-12-31	$30,002
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	$26,375,702
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$208,914,708
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$182,539,006
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	$178,527,080
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$152,942,647
Value of interest in pooled separate accounts at end of year	2017-12-31	$5,259,160
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$4,642,009
Interest on participant loans	2017-12-31	$107,583
Interest earned on other investments	2017-12-31	$209,726
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$22,126,640
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$22,582,187
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$23,115,473
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	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$16,677,580
Contract administrator fees	2017-12-31	$168
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	Yes
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	KPMG
Accountancy firm EIN	2017-12-31	135565207
2016 : PEACEHEALTH SOUTHWEST MEDICAL CENTER RETIREMENT SAVINGS 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	$25,823,927
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$18,017,237
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$17,955,348
Expenses. Certain deemed distributions of participant loans	2016-12-31	$5,941
Value of total corrective distributions	2016-12-31	$8,193
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$14,249,010
Value of total assets at end of year	2016-12-31	$182,539,006
Value of total assets at beginning of year	2016-12-31	$174,732,316
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$47,755
Total interest from all sources	2016-12-31	$383,433
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$3,691,596
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	$3,691,596
Administrative expenses professional fees incurred	2016-12-31	$20,000
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$500,000
If this is an individual account plan, was there a blackout period	2016-12-31	Yes
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	$13,085,833
Participant contributions at end of year	2016-12-31	$2,335,256
Participant contributions at beginning of year	2016-12-31	$2,359,837
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$1,163,177
Value of other receiveables (less allowance for doubtful accounts) at end of year	2016-12-31	$36,907
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2016-12-31	$1,633
Administrative expenses (other) incurred	2016-12-31	$27,589
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	$7,806,690
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$182,539,006
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$174,732,316
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
Investment advisory and management fees	2016-12-31	$141
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$152,942,647
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$144,891,414
Value of interest in pooled separate accounts at end of year	2016-12-31	$4,642,009
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$4,888,922
Interest on participant loans	2016-12-31	$99,173
Interest earned on other investments	2016-12-31	$284,260
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$22,582,187
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$22,590,510
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$7,499,888
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	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$17,955,348
Contract administrator fees	2016-12-31	$25
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	Yes
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	KPMG
Accountancy firm EIN	2016-12-31	135565207
2015 : PEACEHEALTH SOUTHWEST MEDICAL CENTER RETIREMENT SAVINGS 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	$13,421,199
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$18,755,475
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$18,735,460
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$14,085,268
Value of total assets at end of year	2015-12-31	$174,732,316
Value of total assets at beginning of year	2015-12-31	$180,066,592
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$20,015
Total interest from all sources	2015-12-31	$405,496
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$4,362,614
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	$4,362,614
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$500,000
If this is an individual account plan, was there a blackout period	2015-12-31	Yes
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	$13,022,717
Participant contributions at end of year	2015-12-31	$2,359,837
Participant contributions at beginning of year	2015-12-31	$2,732,234
Assets. Other investments not covered elsewhere at end of year	2015-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2015-12-31	$6,002,614
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$1,062,551
Value of other receiveables (less allowance for doubtful accounts) at end of year	2015-12-31	$1,633
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2015-12-31	$0
Other income not declared elsewhere	2015-12-31	$44,545
Administrative expenses (other) incurred	2015-12-31	$19,848
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	$-5,334,276
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$174,732,316
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$180,066,592
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$144,891,414
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$140,080,599
Value of interest in pooled separate accounts at end of year	2015-12-31	$4,888,922
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$5,262,143
Interest on participant loans	2015-12-31	$95,794
Interest earned on other investments	2015-12-31	$309,702
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$22,590,510
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$25,989,002
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-5,474,747
Net investment gain/loss from pooled separate accounts	2015-12-31	$-1,977
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$18,735,460
Contract administrator fees	2015-12-31	$167
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	Yes
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	KPMG
Accountancy firm EIN	2015-12-31	135565207
2014 : PEACEHEALTH SOUTHWEST MEDICAL CENTER RETIREMENT SAVINGS PLAN 2014 401k financial data
Total income from all sources (including contributions)	2014-12-31	$22,940,830
Total of all expenses incurred	2014-12-31	$21,381,409
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$21,318,311
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$12,309,985
Value of total assets at end of year	2014-12-31	$180,066,592
Value of total assets at beginning of year	2014-12-31	$178,507,171
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$63,098
Total interest from all sources	2014-12-31	$664,474
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$2,667,608
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	$2,667,608
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$500,000
If this is an individual account plan, was there a blackout period	2014-12-31	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$12,210,769
Participant contributions at end of year	2014-12-31	$2,732,234
Participant contributions at beginning of year	2014-12-31	$2,712,239
Assets. Other investments not covered elsewhere at end of year	2014-12-31	$6,002,614
Assets. Other investments not covered elsewhere at beginning of year	2014-12-31	$6,646,715
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$99,216
Other income not declared elsewhere	2014-12-31	$319,589
Administrative expenses (other) incurred	2014-12-31	$63,098
Total non interest bearing cash at beginning of year	2014-12-31	$13,901
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	$1,559,421
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$180,066,592
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$178,507,171
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$140,080,599
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$135,453,077
Value of interest in pooled separate accounts at end of year	2014-12-31	$5,262,143
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$26,469,998
Interest on participant loans	2014-12-31	$102,603
Interest earned on other investments	2014-12-31	$561,871
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$25,989,002
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$7,211,241
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$6,650,799
Net investment gain/loss from pooled separate accounts	2014-12-31	$328,375
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$21,318,311
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	Yes
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	KPMG
Accountancy firm EIN	2014-12-31	135565207
2013 : PEACEHEALTH SOUTHWEST MEDICAL CENTER RETIREMENT SAVINGS PLAN 2013 401k financial data
Total income from all sources (including contributions)	2013-12-31	$40,499,110
Total of all expenses incurred	2013-12-31	$18,659,947
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$18,620,058
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$13,088,068
Value of total assets at end of year	2013-12-31	$178,507,171
Value of total assets at beginning of year	2013-12-31	$156,668,008
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$39,889
Total interest from all sources	2013-12-31	$85,002
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$2,925,446
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	$2,925,446
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$500,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$12,861,694
Participant contributions at end of year	2013-12-31	$2,712,239
Participant contributions at beginning of year	2013-12-31	$2,426,785
Assets. Other investments not covered elsewhere at end of year	2013-12-31	$6,646,715
Assets. Other investments not covered elsewhere at beginning of year	2013-12-31	$5,136,014
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$226,374
Other income not declared elsewhere	2013-12-31	$983,414
Administrative expenses (other) incurred	2013-12-31	$39,889
Total non interest bearing cash at end of year	2013-12-31	$13,901
Total non interest bearing cash at beginning of year	2013-12-31	$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	2013-12-31	No
Value of net income/loss	2013-12-31	$21,839,163
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$178,507,171
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$156,668,008
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$135,453,077
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$113,610,020
Value of interest in pooled separate accounts at end of year	2013-12-31	$26,469,998
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$27,361,537
Interest on participant loans	2013-12-31	$85,002
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$7,211,241
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$8,133,652
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$22,886,663
Net investment gain/loss from pooled separate accounts	2013-12-31	$530,517
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$18,620,058
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	KPMG
Accountancy firm EIN	2013-12-31	135565207

Form 5500 Responses for PEACEHEALTH SOUTHWEST MEDICAL CENTER RETIREMENT SAVINGS PLAN

2022: PEACEHEALTH SOUTHWEST MEDICAL CENTER RETIREMENT SAVINGS 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	Yes
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: PEACEHEALTH SOUTHWEST MEDICAL CENTER RETIREMENT SAVINGS 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	Yes
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: PEACEHEALTH SOUTHWEST MEDICAL CENTER RETIREMENT SAVINGS 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	Yes
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: PEACEHEALTH SOUTHWEST MEDICAL CENTER RETIREMENT SAVINGS 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	Yes
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: PEACEHEALTH SOUTHWEST MEDICAL CENTER RETIREMENT SAVINGS 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	Yes
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: PEACEHEALTH SOUTHWEST MEDICAL CENTER RETIREMENT SAVINGS 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	Yes
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: PEACEHEALTH SOUTHWEST MEDICAL CENTER RETIREMENT SAVINGS PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	Yes
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	Yes
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: PEACEHEALTH SOUTHWEST MEDICAL CENTER RETIREMENT SAVINGS 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	Yes
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: PEACEHEALTH SOUTHWEST MEDICAL CENTER RETIREMENT SAVINGS 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: PEACEHEALTH SOUTHWEST MEDICAL CENTER RETIREMENT SAVINGS 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

Insurance Providers Used on plan

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

Policy contract number

GA80243

Policy instance

Insurance contract or identification number	GA80243
Number of Individuals Covered	1
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?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

715857-001

Policy instance

Insurance contract or identification number	715857-001
Number of Individuals Covered	6
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?	Yes
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

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

CR14219

Policy instance

Insurance contract or identification number	CR14219
Number of Individuals Covered	83
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $13,114
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	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?	Yes
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 $13,114
Insurance broker organization code?	4

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

Policy contract number

86041-01

Policy instance

Insurance contract or identification number	86041-01
Number of Individuals Covered	183
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?	Yes
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

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

Policy contract number

86041-01

Policy instance

Insurance contract or identification number	86041-01
Number of Individuals Covered	189
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?	Yes
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

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

CR14219

Policy instance

Insurance contract or identification number	CR14219
Number of Individuals Covered	85
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $12,605
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	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?	Yes
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 $12,605
Insurance broker organization code?	4

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

715857-001

Policy instance

Insurance contract or identification number	715857-001
Number of Individuals Covered	7
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?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

GA80243

Policy instance

Insurance contract or identification number	GA80243
Number of Individuals Covered	1
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?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

621518/806600

Policy instance

Insurance contract or identification number	621518/806600
Number of Individuals Covered	0
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $7,250
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?	Yes
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
Amount paid for insurance broker fees	7250
Additional information about fees paid to insurance broker	REFERRAL/SERVICE FEE
Insurance broker organization code?	3

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

Policy contract number

86041-01

Policy instance

Insurance contract or identification number	86041-01
Number of Individuals Covered	202
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?	Yes
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

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

CR14219

Policy instance

Insurance contract or identification number	CR14219
Number of Individuals Covered	88
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $16,640
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	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?	Yes
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 $16,640
Insurance broker organization code?	4

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

715857-001

Policy instance

Insurance contract or identification number	715857-001
Number of Individuals Covered	7
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?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

GA80243

Policy instance

Insurance contract or identification number	GA80243
Number of Individuals Covered	1
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?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

621518/806600

Policy instance

Insurance contract or identification number	621518/806600
Number of Individuals Covered	0
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $32,001
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?	Yes
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
Amount paid for insurance broker fees	32001
Additional information about fees paid to insurance broker	REFERRAL/SERVICE FEE
Insurance broker organization code?	3

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

Policy contract number

86041-01

Policy instance

Insurance contract or identification number	86041-01
Number of Individuals Covered	220
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?	Yes
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

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

CR14219

Policy instance

Insurance contract or identification number	CR14219
Number of Individuals Covered	94
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $16,239
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	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?	Yes
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 $16,239
Insurance broker organization code?	4

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

715857-001

Policy instance

Insurance contract or identification number	715857-001
Number of Individuals Covered	9
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?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

GA80243

Policy instance

Insurance contract or identification number	GA80243
Number of Individuals Covered	0
Insurance policy start date	2019-03-02
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?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

GA80243

Policy instance

Insurance contract or identification number	GA80243
Number of Individuals Covered	0
Insurance policy start date	2018-03-02
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?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

715857-001

Policy instance

Insurance contract or identification number	715857-001
Number of Individuals Covered	10
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?	Yes
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

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

CR14219

Policy instance

Insurance contract or identification number	CR14219
Number of Individuals Covered	106
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $14,136
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	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?	Yes
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 $14,136
Insurance broker organization code?	4

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

Policy contract number

86041-01

Policy instance

Insurance contract or identification number	86041-01
Number of Individuals Covered	241
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?	Yes
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

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

621518/806600

Policy instance

Insurance contract or identification number	621518/806600
Number of Individuals Covered	0
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $38,963
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?	Yes
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
Amount paid for insurance broker fees	38963
Additional information about fees paid to insurance broker	REFERRAL/SERVICE FEE
Insurance broker organization code?	3

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

715857-001

Policy instance

Insurance contract or identification number	715857-001
Number of Individuals Covered	10
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
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?	Yes
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

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

CR14219

Policy instance

Insurance contract or identification number	CR14219
Number of Individuals Covered	121
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $17,166
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	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?	Yes
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 $17,166
Insurance broker organization code?	4
Insurance broker name	LINCOLN FINANCIAL ADVISORS

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

Policy contract number

86041-01

Policy instance

Insurance contract or identification number	86041-01
Number of Individuals Covered	251
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
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?	Yes
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

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

806600/621518

Policy instance

Insurance contract or identification number	806600/621518
Number of Individuals Covered	0
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $41,570
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?	Yes
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
Amount paid for insurance broker fees	41570
Additional information about fees paid to insurance broker	REFERRAL/SERVICE FEE
Insurance broker organization code?	3
Insurance broker name	FIDELITY INVESTMENTS TAX-EXEMPT SER

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

439694/617012

Policy instance

Insurance contract or identification number	439694/617012
Number of Individuals Covered	0
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $211,403
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
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 $0
Amount paid for insurance broker fees	211403
Additional information about fees paid to insurance broker	REFERRAL/SERVICE FEE
Insurance broker organization code?	3
Insurance broker name	FIDELITY INVESTMENTS TAX-EXEMPT SVC

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

Policy contract number

86041-01

Policy instance

Insurance contract or identification number	86041-01
Number of Individuals Covered	292
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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?	Yes
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

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

CR14219

Policy instance

Insurance contract or identification number	CR14219
Number of Individuals Covered	142
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $19,543
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
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 $19,543
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	SALES AND BASE COMMISSIONS
Insurance broker organization code?	4
Insurance broker name	LINCOLN FINANCIAL ADVISORS

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

715857-001

Policy instance

Insurance contract or identification number	715857-001
Number of Individuals Covered	11
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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

TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )

Policy contract number

TT069019

Policy instance

Insurance contract or identification number	TT069019
Number of Individuals Covered	0
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

715857-001

Policy instance

Insurance contract or identification number	715857-001
Number of Individuals Covered	14
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Are there contracts with allocated funds for types other than group deferred annuity or individual?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Other information about contract	GUARANTEED INTEREST OPTION

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

CR14219

Policy instance

Insurance contract or identification number	CR14219
Number of Individuals Covered	170
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $15,943
Are there contracts with allocated funds for types other than group deferred annuity or individual?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Other information about contract	GROUP ANNUITY
Commission paid to Insurance Broker	USD $15,928
Insurance broker organization code?	4
Insurance broker name	LINCOLN INVESTMENT PLANNING

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

Policy contract number

86041-01

Policy instance

Insurance contract or identification number	86041-01
Number of Individuals Covered	329
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )

Policy contract number

TT069019

Policy instance

Insurance contract or identification number	TT069019
Number of Individuals Covered	3456
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	PEACEHEALTH, REWARDS
Employer identification number (EIN):	910939479
NAIC Classification:	622000
NAIC Description:	Hospitals

Jurisdiction of Incorporation:	Washington Secretary of State Corporations Division
Incorporation Date:	1976-06-15
Company Identification Number:	600521489
Legal Registered Office Address:	700 WASHINGTON ST STE 701 VANCOUVER United States of America (USA) 986603338