401k Plan data: CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN plan

CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN 401k Plan overview

Plan Name	CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN
Plan identification number	006

CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) 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.
Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

CHILDREN'S HOSPITAL LOS ANGELES has sponsored the creation of one or more 401k plans.

Company Name: CHILDREN'S HOSPITAL LOS ANGELES

Employer identification number (EIN): 951690977

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
006 2022-01-01
006 2021-01-01
006 2020-01-01
006 2020-01-01
006 2019-01-01
006 2019-01-01
006 2018-01-01
006 2018-01-01
006 2017-01-01 REBECCA LEVY REBECCA LEVY 2018-10-15
006 2016-01-01 REBECCA LEVY REBECCA LEVY 2017-10-16
006 2015-01-01 TODD CONNELLY TODD CONNELLY 2016-10-17
006 2014-01-01 TODD CONNELLY TODD CONNELLY 2015-10-13
006 2013-01-01 TODD CONNELLY TODD CONNELLY 2014-10-14
006 2012-01-01 SUSANA VALDRIZ SUSANA VALDRIZ 2013-10-02
006 2011-01-01 PHILIP KOEK PHILIP KOEK 2012-10-09

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
006	2022-01-01
006	2021-01-01
006	2020-01-01
006	2020-01-01
006	2019-01-01
006	2019-01-01
006	2018-01-01
006	2018-01-01
006	2017-01-01	REBECCA LEVY	REBECCA LEVY	2018-10-15
006	2016-01-01	REBECCA LEVY	REBECCA LEVY	2017-10-16
006	2015-01-01	TODD CONNELLY	TODD CONNELLY	2016-10-17
006	2014-01-01	TODD CONNELLY	TODD CONNELLY	2015-10-13
006	2013-01-01	TODD CONNELLY	TODD CONNELLY	2014-10-14
006	2012-01-01	SUSANA VALDRIZ	SUSANA VALDRIZ	2013-10-02
006	2011-01-01	PHILIP KOEK	PHILIP KOEK	2012-10-09

Plan Statistics for CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN

401k plan membership statisitcs for CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN

Measure Date Value
2022: CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 1,423
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 1,134
Number of retired or separated participants receiving benefits 2022-01-01 2
Number of other retired or separated participants entitled to future benefits 2022-01-01 379
Total of all active and inactive participants 2022-01-01 1,515
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 1,515
Number of participants with account balances 2022-01-01 1,515
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 1,315
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 1,097
Number of retired or separated participants receiving benefits 2021-01-01 3
Number of other retired or separated participants entitled to future benefits 2021-01-01 323
Total of all active and inactive participants 2021-01-01 1,423
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 1,423
Number of participants with account balances 2021-01-01 1,423
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 1,241
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 1,023
Number of retired or separated participants receiving benefits 2020-01-01 1
Number of other retired or separated participants entitled to future benefits 2020-01-01 291
Total of all active and inactive participants 2020-01-01 1,315
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 1,315
Number of participants with account balances 2020-01-01 1,315
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 1,057
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 993
Number of retired or separated participants receiving benefits 2019-01-01 1
Number of other retired or separated participants entitled to future benefits 2019-01-01 247
Total of all active and inactive participants 2019-01-01 1,241
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 1,241
Number of participants with account balances 2019-01-01 1,241
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 908
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 862
Number of retired or separated participants receiving benefits 2018-01-01 1
Number of other retired or separated participants entitled to future benefits 2018-01-01 194
Total of all active and inactive participants 2018-01-01 1,057
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 1,057
Number of participants with account balances 2018-01-01 1,057
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 767
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 741
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 167
Total of all active and inactive participants 2017-01-01 908
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 908
Number of participants with account balances 2017-01-01 908
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 679
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 633
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 134
Total of all active and inactive participants 2016-01-01 767
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 767
Number of participants with account balances 2016-01-01 767
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 11
2015: CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 586
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 596
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 83
Total of all active and inactive participants 2015-01-01 679
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 679
Number of participants with account balances 2015-01-01 679
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 504
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 516
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 70
Total of all active and inactive participants 2014-01-01 586
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 586
Number of participants with account balances 2014-01-01 586
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 471
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 444
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 60
Total of all active and inactive participants 2013-01-01 504
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 504
Number of participants with account balances 2013-01-01 504
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 453
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 414
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 57
Total of all active and inactive participants 2012-01-01 471
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 471
Number of participants with account balances 2012-01-01 471
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 429
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 396
Number of retired or separated participants receiving benefits 2011-01-01 1
Number of other retired or separated participants entitled to future benefits 2011-01-01 56
Total of all active and inactive participants 2011-01-01 453
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 453
Number of participants with account balances 2011-01-01 453
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0

Measure	Date	Value
2022: CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	1,423
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	1,134
Number of retired or separated participants receiving benefits	2022-01-01	2
Number of other retired or separated participants entitled to future benefits	2022-01-01	379
Total of all active and inactive participants	2022-01-01	1,515
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	1,515
Number of participants with account balances	2022-01-01	1,515
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	1,315
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	1,097
Number of retired or separated participants receiving benefits	2021-01-01	3
Number of other retired or separated participants entitled to future benefits	2021-01-01	323
Total of all active and inactive participants	2021-01-01	1,423
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	1,423
Number of participants with account balances	2021-01-01	1,423
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	1,241
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	1,023
Number of retired or separated participants receiving benefits	2020-01-01	1
Number of other retired or separated participants entitled to future benefits	2020-01-01	291
Total of all active and inactive participants	2020-01-01	1,315
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	1,315
Number of participants with account balances	2020-01-01	1,315
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	1,057
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	993
Number of retired or separated participants receiving benefits	2019-01-01	1
Number of other retired or separated participants entitled to future benefits	2019-01-01	247
Total of all active and inactive participants	2019-01-01	1,241
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	1,241
Number of participants with account balances	2019-01-01	1,241
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	908
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	862
Number of retired or separated participants receiving benefits	2018-01-01	1
Number of other retired or separated participants entitled to future benefits	2018-01-01	194
Total of all active and inactive participants	2018-01-01	1,057
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	1,057
Number of participants with account balances	2018-01-01	1,057
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	767
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	741
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	167
Total of all active and inactive participants	2017-01-01	908
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	908
Number of participants with account balances	2017-01-01	908
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	679
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	633
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	134
Total of all active and inactive participants	2016-01-01	767
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	767
Number of participants with account balances	2016-01-01	767
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	11
2015: CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	586
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	596
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	83
Total of all active and inactive participants	2015-01-01	679
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	679
Number of participants with account balances	2015-01-01	679
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	504
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	516
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	70
Total of all active and inactive participants	2014-01-01	586
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	586
Number of participants with account balances	2014-01-01	586
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	471
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	444
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	60
Total of all active and inactive participants	2013-01-01	504
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	504
Number of participants with account balances	2013-01-01	504
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	453
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	414
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	57
Total of all active and inactive participants	2012-01-01	471
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	471
Number of participants with account balances	2012-01-01	471
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	429
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	396
Number of retired or separated participants receiving benefits	2011-01-01	1
Number of other retired or separated participants entitled to future benefits	2011-01-01	56
Total of all active and inactive participants	2011-01-01	453
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	453
Number of participants with account balances	2011-01-01	453
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0

Financial Data on CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN

Measure	Date	Value
2022 : CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total income from all sources (including contributions)	2022-12-31	$-7,721,743
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$9,007,568
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$8,856,931
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$12,344,690
Value of total assets at end of year	2022-12-31	$107,145,353
Value of total assets at beginning of year	2022-12-31	$123,874,664
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$150,637
Total interest from all sources	2022-12-31	$329,574
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$1,426,458
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	$1,426,458
Administrative expenses professional fees incurred	2022-12-31	$29,413
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$500,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$11,878,262
Participant contributions at end of year	2022-12-31	$1,212,116
Participant contributions at beginning of year	2022-12-31	$1,099,534
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$466,428
Other income not declared elsewhere	2022-12-31	$13,268
Administrative expenses (other) incurred	2022-12-31	$1,000
Total non interest bearing cash at end of year	2022-12-31	$30
Total non interest bearing cash at beginning of year	2022-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$-16,729,311
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$107,145,353
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$123,874,664
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	$21,228
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$88,749,476
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$106,437,752
Interest on participant loans	2022-12-31	$48,896
Interest earned on other investments	2022-12-31	$280,678
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$17,183,731
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$16,337,378
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-21,835,733
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	Yes
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	$8,856,931
Contract administrator fees	2022-12-31	$98,996
Did the plan have assets held for investment	2022-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	HOLTHOUSE CARLIN & VAN TRIGT LLP
Accountancy firm EIN	2022-12-31	954345526
2021 : CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$25,676,828
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$8,026,466
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$7,827,500
Value of total corrective distributions	2021-12-31	$1,198
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$11,246,054
Value of total assets at end of year	2021-12-31	$123,874,664
Value of total assets at beginning of year	2021-12-31	$106,224,302
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$197,768
Total interest from all sources	2021-12-31	$305,210
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$1,290,460
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	$1,290,460
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$10,778,987
Participant contributions at end of year	2021-12-31	$1,099,534
Participant contributions at beginning of year	2021-12-31	$910,583
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$467,067
Other income not declared elsewhere	2021-12-31	$283,690
Administrative expenses (other) incurred	2021-12-31	$197,768
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	$17,650,362
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$123,874,664
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$106,224,302
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$106,437,752
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$91,021,002
Interest on participant loans	2021-12-31	$45,950
Interest earned on other investments	2021-12-31	$259,260
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$16,337,378
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$14,292,717
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$12,551,414
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	$7,827,500
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	HOLTHOUSE CARLIN & VAN TRIGT LLP
Accountancy firm EIN	2021-12-31	954345526
2020 : CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$27,153,797
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$4,511,194
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$4,401,801
Expenses. Certain deemed distributions of participant loans	2020-12-31	$-7,273
Value of total corrective distributions	2020-12-31	$1,410
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$10,661,408
Value of total assets at end of year	2020-12-31	$106,224,302
Value of total assets at beginning of year	2020-12-31	$83,581,699
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$115,256
Total interest from all sources	2020-12-31	$320,688
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$976,045
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	$976,045
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$10,155,558
Participant contributions at end of year	2020-12-31	$910,583
Participant contributions at beginning of year	2020-12-31	$749,484
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$505,850
Other income not declared elsewhere	2020-12-31	$114,408
Administrative expenses (other) incurred	2020-12-31	$115,256
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	$22,642,603
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$106,224,302
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$83,581,699
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	$91,021,002
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$67,849,077
Interest on participant loans	2020-12-31	$50,754
Interest earned on other investments	2020-12-31	$269,934
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$14,292,717
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$14,983,138
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$15,081,248
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$4,401,801
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	HOLTHOUSE CARLIN & VAN TRIGT LLP
Accountancy firm EIN	2020-12-31	954345526
2019 : CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
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 end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$23,892,893
Total income from all sources (including contributions)	2019-12-31	$23,892,893
Total loss/gain on sale of assets	2019-12-31	$0
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$3,321,462
Total of all expenses incurred	2019-12-31	$3,321,462
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$3,230,000
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$3,230,000
Expenses. Certain deemed distributions of participant loans	2019-12-31	$245
Expenses. Certain deemed distributions of participant loans	2019-12-31	$245
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$9,844,478
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$9,844,478
Value of total assets at end of year	2019-12-31	$83,581,699
Value of total assets at end of year	2019-12-31	$83,581,699
Value of total assets at beginning of year	2019-12-31	$63,010,268
Value of total assets at beginning of year	2019-12-31	$63,010,268
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$91,217
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$91,217
Total interest from all sources	2019-12-31	$352,975
Total interest from all sources	2019-12-31	$352,975
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$958,874
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$958,874
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
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	$958,874
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$958,874
Was this plan covered by a fidelity bond	2019-12-31	Yes
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
Value of fidelity bond cover	2019-12-31	$500,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$9,610,310
Contributions received from participants	2019-12-31	$9,610,310
Participant contributions at end of year	2019-12-31	$749,484
Participant contributions at end of year	2019-12-31	$749,484
Participant contributions at beginning of year	2019-12-31	$730,884
Participant contributions at beginning of year	2019-12-31	$730,884
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$234,168
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$234,168
Other income not declared elsewhere	2019-12-31	$54,444
Other income not declared elsewhere	2019-12-31	$54,444
Administrative expenses (other) incurred	2019-12-31	$91,217
Administrative expenses (other) incurred	2019-12-31	$91,217
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
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	$20,571,431
Value of net income/loss	2019-12-31	$20,571,431
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$83,581,699
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$83,581,699
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$63,010,268
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$63,010,268
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
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 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
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	$67,849,077
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$67,849,077
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$49,717,657
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$49,717,657
Interest on participant loans	2019-12-31	$39,561
Interest on participant loans	2019-12-31	$39,561
Interest earned on other investments	2019-12-31	$313,414
Interest earned on other investments	2019-12-31	$313,414
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$14,983,138
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$14,983,138
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$12,561,727
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$12,561,727
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$12,682,122
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$12,682,122
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
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
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
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	$3,230,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$3,230,000
Did the plan have assets held for investment	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
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
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
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
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	HOLTHOUSE CARLIN & VAN TRIGT LLP
Accountancy firm name	2019-12-31	HOLTHOUSE CARLIN & VAN TRIGT LLP
Accountancy firm EIN	2019-12-31	954345526
Accountancy firm EIN	2019-12-31	954345526
2018 : CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$4,540,745
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$4,214,318
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$4,110,191
Expenses. Certain deemed distributions of participant loans	2018-12-31	$10,205
Value of total corrective distributions	2018-12-31	$3,440
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$8,546,085
Value of total assets at end of year	2018-12-31	$63,010,268
Value of total assets at beginning of year	2018-12-31	$62,683,841
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$90,482
Total interest from all sources	2018-12-31	$273,147
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$787,467
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	$787,467
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$500,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$8,382,943
Participant contributions at end of year	2018-12-31	$730,884
Participant contributions at beginning of year	2018-12-31	$743,906
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$163,142
Other income not declared elsewhere	2018-12-31	$101,969
Administrative expenses (other) incurred	2018-12-31	$90,482
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	$326,427
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$63,010,268
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$62,683,841
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	$49,717,657
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$51,406,833
Interest on participant loans	2018-12-31	$37,666
Interest earned on other investments	2018-12-31	$235,481
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$12,561,727
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$10,533,102
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-5,167,923
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	$4,110,191
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	HOLTHOUSE CARLIN & VAN TRIGT LLP
Accountancy firm EIN	2018-12-31	954345526
2017 : CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) 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	$15,881,070
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$2,842,955
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$2,764,703
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$7,322,042
Value of total assets at end of year	2017-12-31	$62,683,841
Value of total assets at beginning of year	2017-12-31	$49,645,726
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$78,252
Total interest from all sources	2017-12-31	$207,509
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$602,610
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	$602,610
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$500,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$6,894,688
Participant contributions at end of year	2017-12-31	$743,906
Participant contributions at beginning of year	2017-12-31	$436,044
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$427,354
Other income not declared elsewhere	2017-12-31	$76,522
Administrative expenses (other) incurred	2017-12-31	$78,252
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	$13,038,115
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$62,683,841
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$49,645,726
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	$51,406,833
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$39,728,057
Interest on participant loans	2017-12-31	$25,003
Interest earned on other investments	2017-12-31	$182,506
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$10,533,102
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$9,481,625
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$7,672,387
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$2,764,703
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	HOLTHOUSE CARLIN & VAN TRIGT LLP
Accountancy firm EIN	2017-12-31	954345526
2016 : CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) 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	$9,466,282
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$3,518,833
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$3,378,401
Expenses. Certain deemed distributions of participant loans	2016-12-31	$472
Value of total corrective distributions	2016-12-31	$49,439
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$6,158,241
Value of total assets at end of year	2016-12-31	$49,645,726
Value of total assets at beginning of year	2016-12-31	$43,698,277
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$90,521
Total interest from all sources	2016-12-31	$192,115
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$555,931
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	$555,931
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	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$5,785,473
Participant contributions at end of year	2016-12-31	$436,044
Participant contributions at beginning of year	2016-12-31	$371,046
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$372,768
Other income not declared elsewhere	2016-12-31	$21,852
Administrative expenses (other) incurred	2016-12-31	$90,521
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	$5,947,449
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$49,645,726
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$43,698,277
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$39,728,057
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$35,462,224
Interest on participant loans	2016-12-31	$16,887
Interest earned on other investments	2016-12-31	$175,228
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$9,481,625
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$7,865,007
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$2,538,143
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$3,378,401
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	HOLTHOUSE CARLIN & VAN TRIGT LLP
Accountancy firm EIN	2016-12-31	954345526
2015 : CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) 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	$5,721,294
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$3,501,394
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$3,458,510
Value of total corrective distributions	2015-12-31	$4,851
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$5,552,025
Value of total assets at end of year	2015-12-31	$43,698,277
Value of total assets at beginning of year	2015-12-31	$41,478,377
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$38,033
Total interest from all sources	2015-12-31	$158,371
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$505,803
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
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	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$5,285,148
Participant contributions at end of year	2015-12-31	$371,046
Participant contributions at beginning of year	2015-12-31	$352,513
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$266,877
Other income not declared elsewhere	2015-12-31	$61,090
Administrative expenses (other) incurred	2015-12-31	$38,033
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	$2,219,900
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$43,698,277
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$41,478,377
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	$35,462,224
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$34,387,605
Interest on participant loans	2015-12-31	$16,576
Interest earned on other investments	2015-12-31	$141,795
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$7,865,007
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$6,738,259
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-555,995
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
Income. Dividends from common stock	2015-12-31	$505,803
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$3,458,510
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	HOLTHOUSE CARLIN & VAN TRIGT LLP
Accountancy firm EIN	2015-12-31	954345526
2014 : CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$6,971,782
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$2,548,905
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$2,497,817
Value of total corrective distributions	2014-12-31	$5,937
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$4,956,001
Value of total assets at end of year	2014-12-31	$41,478,377
Value of total assets at beginning of year	2014-12-31	$37,055,500
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$45,151
Total interest from all sources	2014-12-31	$147,981
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$375,564
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	$375,564
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	No
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	$4,559,403
Participant contributions at end of year	2014-12-31	$352,513
Participant contributions at beginning of year	2014-12-31	$469,331
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$396,598
Other income not declared elsewhere	2014-12-31	$56,540
Administrative expenses (other) incurred	2014-12-31	$45,151
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	$4,422,877
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$41,478,377
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$37,055,500
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	$34,387,605
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$30,650,586
Interest on participant loans	2014-12-31	$16,776
Interest earned on other investments	2014-12-31	$131,205
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$6,738,259
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$5,935,583
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$1,435,696
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	$2,497,817
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	HOLTHOUSE CARLIN & VAN TRIGT LLP
Accountancy firm EIN	2014-12-31	954345526
2013 : CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$10,041,544
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$1,159,084
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$1,133,175
Value of total corrective distributions	2013-12-31	$1,595
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$4,275,869
Value of total assets at end of year	2013-12-31	$37,055,500
Value of total assets at beginning of year	2013-12-31	$28,173,040
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$24,314
Total interest from all sources	2013-12-31	$141,728
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$280,597
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	$280,597
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	$4,138,682
Participant contributions at end of year	2013-12-31	$469,331
Participant contributions at beginning of year	2013-12-31	$550,355
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$137,187
Other income not declared elsewhere	2013-12-31	$57,766
Administrative expenses (other) incurred	2013-12-31	$24,314
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	$8,882,460
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$37,055,500
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$28,173,040
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	$30,650,586
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$22,495,259
Interest on participant loans	2013-12-31	$21,336
Interest earned on other investments	2013-12-31	$120,392
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$5,935,583
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$5,127,426
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$5,285,584
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	$1,133,175
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	HOLTHOUSE CARLIN & VAN TRIGT LLP
Accountancy firm EIN	2013-12-31	954345526
2012 : CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$6,838,538
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$2,234,220
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$2,202,505
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$3,613,880
Value of total assets at end of year	2012-12-31	$28,173,040
Value of total assets at beginning of year	2012-12-31	$23,568,722
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$31,715
Total interest from all sources	2012-12-31	$135,272
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$312,798
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-12-31	$312,798
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$500,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$3,577,524
Participant contributions at end of year	2012-12-31	$550,355
Participant contributions at beginning of year	2012-12-31	$536,890
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$36,356
Other income not declared elsewhere	2012-12-31	$34,388
Administrative expenses (other) incurred	2012-12-31	$31,715
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$4,604,318
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$28,173,040
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$23,568,722
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$22,495,259
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$18,508,202
Interest on participant loans	2012-12-31	$24,470
Interest earned on other investments	2012-12-31	$110,802
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$5,127,426
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$4,523,630
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$2,742,200
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$2,202,505
Did the plan have assets held for investment	2012-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	HOLTHOUSE CARLIN & VAN TRIGT LLP
Accountancy firm EIN	2012-12-31	954345526
2011 : CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$3,051,534
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$1,075,034
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$1,047,582
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$3,564,852
Value of total assets at end of year	2011-12-31	$23,568,722
Value of total assets at beginning of year	2011-12-31	$21,592,222
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$27,452
Total interest from all sources	2011-12-31	$133,241
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$248,908
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2011-12-31	$248,908
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$500,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$3,196,787
Participant contributions at end of year	2011-12-31	$536,890
Participant contributions at beginning of year	2011-12-31	$479,260
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$368,065
Other income not declared elsewhere	2011-12-31	$30,819
Administrative expenses (other) incurred	2011-12-31	$27,452
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$1,976,500
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$23,568,722
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$21,592,222
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$18,508,202
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$17,206,582
Interest on participant loans	2011-12-31	$24,910
Interest earned on other investments	2011-12-31	$108,331
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$4,523,630
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$3,906,380
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-926,286
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$1,047,582
Did the plan have assets held for investment	2011-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	HOLTHOUSE CARLIN & VAN TRIGT LLP
Accountancy firm EIN	2011-12-31	954345526

Form 5500 Responses for CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN

2022: CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
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: CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: CHILDRENS HOSPITAL LOS ANGELES EMPLOYEES 403 (B) PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

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

Policy contract number

039733

Policy instance

Insurance contract or identification number	039733
Number of Individuals Covered	1515
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $0
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

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

Policy contract number

006024

Policy instance

Insurance contract or identification number	006024
Number of Individuals Covered	1423
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

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

Policy contract number

006024

Policy instance

Insurance contract or identification number	006024
Number of Individuals Covered	1315
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 $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

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

Policy contract number

006024

Policy instance

Insurance contract or identification number	006024
Number of Individuals Covered	1241
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 $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

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

006024

Policy instance

Insurance contract or identification number	006024
Number of Individuals Covered	1057
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 $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

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

006024

Policy instance

Insurance contract or identification number	006024
Number of Individuals Covered	908
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 $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

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

Policy contract number

006024

Policy instance

Insurance contract or identification number	006024
Number of Individuals Covered	679
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 $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

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

Policy contract number

006024

Policy instance

Insurance contract or identification number	006024
Number of Individuals Covered	586
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $0
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

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

Policy contract number

006024

Policy instance

Insurance contract or identification number	006024
Number of Individuals Covered	504
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $0
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

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

Policy contract number

006024

Policy instance

Insurance contract or identification number	006024
Number of Individuals Covered	471
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $0
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

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

Policy contract number

006024

Policy instance

Insurance contract or identification number	006024
Number of Individuals Covered	453
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $0
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

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Company Name:	CHILDREN'S HOSPITAL LOS ANGELES
Employer identification number (EIN):	951690977
NAIC Classification:	622000
NAIC Description:	Hospitals