ST. JOHN'S RIVERSIDE HOSPITAL VOLUNTARY SUPPLEMENTARY TAX DEFERRED RETIREMENT PLAN 401k Plan overview

Plan Name	ST. JOHN'S RIVERSIDE HOSPITAL VOLUNTARY SUPPLEMENTARY TAX DEFERRED RETIREMENT PLAN
Plan identification number	002

ST. JOHN'S RIVERSIDE HOSPITAL VOLUNTARY SUPPLEMENTARY TAX DEFERRED RETIREMENT PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1. Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met. Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations. Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations. Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account. Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers. Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

RIVERSIDE HEALTH CARE SYSTEMS, INC. has sponsored the creation of one or more 401k plans.

Company Name:	RIVERSIDE HEALTH CARE SYSTEMS, INC.
Employer identification number (EIN):	131740126
NAIC Classification:	622000
NAIC Description:	Hospitals

Additional information about RIVERSIDE HEALTH CARE SYSTEMS, INC.

Jurisdiction of Incorporation:	New York Department of State
Incorporation Date:	1870-05-27
Company Identification Number:	10380
Legal Registered Office Address:	967 NORTH BROADWAY Westchester YONKERS United States of America (USA) 10701

More information about RIVERSIDE HEALTH CARE SYSTEMS, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ST. JOHN'S RIVERSIDE HOSPITAL VOLUNTARY SUPPLEMENTARY TAX DEFERRED RETIREMENT PLAN

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2022-01-01
002	2022-01-01
002	2021-01-01
002	2021-01-01
002	2020-01-01
002	2019-01-01
002	2018-01-01
002	2018-01-01
002	2017-01-01	NORA DONOHER
002	2016-01-01	MARC LEFF
002	2016-01-01
002	2015-01-01	MARC LEFF
002	2015-01-01	MARC LEFF
002	2014-01-01	MARC LEFF
002	2013-01-01	MARC LEFF
002	2012-01-01	MARC LEFF
002	2011-01-01	MARC LEFF
002	2009-01-01	PAMELA LAFRANCE		PAMELA LAFRANCE	2010-10-15

Plan Statistics for ST. JOHN'S RIVERSIDE HOSPITAL VOLUNTARY SUPPLEMENTARY TAX DEFERRED RETIREMENT PLAN

401k plan membership statisitcs for ST. JOHN'S RIVERSIDE HOSPITAL VOLUNTARY SUPPLEMENTARY TAX DEFERRED RETIREMENT PLAN

Measure	Date	Value
2022: ST. JOHN'S RIVERSIDE HOSPITAL VOLUNTARY SUPPLEMENTARY TAX DEFERRED RETIREMENT PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	2,646
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	1,345
Number of retired or separated participants receiving benefits	2022-01-01	12
Number of other retired or separated participants entitled to future benefits	2022-01-01	400
Total of all active and inactive participants	2022-01-01	1,757
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	1,757
Number of participants with account balances	2022-01-01	1,757
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	21
2021: ST. JOHN'S RIVERSIDE HOSPITAL VOLUNTARY SUPPLEMENTARY TAX DEFERRED RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	2,464
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	2,267
Number of retired or separated participants receiving benefits	2021-01-01	9
Number of other retired or separated participants entitled to future benefits	2021-01-01	370
Total of all active and inactive participants	2021-01-01	2,646
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	2,646
Number of participants with account balances	2021-01-01	1,716
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	22
2020: ST. JOHN'S RIVERSIDE HOSPITAL VOLUNTARY SUPPLEMENTARY TAX DEFERRED RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	1,624
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	2,114
Number of retired or separated participants receiving benefits	2020-01-01	11
Number of other retired or separated participants entitled to future benefits	2020-01-01	339
Total of all active and inactive participants	2020-01-01	2,464
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	2,464
Number of participants with account balances	2020-01-01	1,657
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	14
2019: ST. JOHN'S RIVERSIDE HOSPITAL VOLUNTARY SUPPLEMENTARY TAX DEFERRED RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	2,341
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	1,301
Number of retired or separated participants receiving benefits	2019-01-01	10
Number of other retired or separated participants entitled to future benefits	2019-01-01	293
Total of all active and inactive participants	2019-01-01	1,604
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	1,604
Number of participants with account balances	2019-01-01	1,604
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	9
2018: ST. JOHN'S RIVERSIDE HOSPITAL VOLUNTARY SUPPLEMENTARY TAX DEFERRED RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	3,292
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	2,045
Number of retired or separated participants receiving benefits	2018-01-01	10
Number of other retired or separated participants entitled to future benefits	2018-01-01	286
Total of all active and inactive participants	2018-01-01	2,341
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	2,341
Number of participants with account balances	2018-01-01	1,563
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	16
2017: ST. JOHN'S RIVERSIDE HOSPITAL VOLUNTARY SUPPLEMENTARY TAX DEFERRED RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	2,130
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	2,536
Number of retired or separated participants receiving benefits	2017-01-01	74
Number of other retired or separated participants entitled to future benefits	2017-01-01	652
Total of all active and inactive participants	2017-01-01	3,262
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	30
Total participants	2017-01-01	3,292
Number of participants with account balances	2017-01-01	1,665
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	14
2016: ST. JOHN'S RIVERSIDE HOSPITAL VOLUNTARY SUPPLEMENTARY TAX DEFERRED RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	2,921
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	1,891
Number of retired or separated participants receiving benefits	2016-01-01	73
Number of other retired or separated participants entitled to future benefits	2016-01-01	837
Total of all active and inactive participants	2016-01-01	2,801
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	15
Total participants	2016-01-01	2,816
Number of participants with account balances	2016-01-01	2,811
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	17
2015: ST. JOHN'S RIVERSIDE HOSPITAL VOLUNTARY SUPPLEMENTARY TAX DEFERRED RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	2,179
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	1,886
Number of retired or separated participants receiving benefits	2015-01-01	85
Number of other retired or separated participants entitled to future benefits	2015-01-01	926
Total of all active and inactive participants	2015-01-01	2,897
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	24
Total participants	2015-01-01	2,921
Number of participants with account balances	2015-01-01	2,921
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	35
2014: ST. JOHN'S RIVERSIDE HOSPITAL VOLUNTARY SUPPLEMENTARY TAX DEFERRED RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	2,018
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	1,624
Number of retired or separated participants receiving benefits	2014-01-01	65
Number of other retired or separated participants entitled to future benefits	2014-01-01	462
Total of all active and inactive participants	2014-01-01	2,151
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	16
Total participants	2014-01-01	2,167
Number of participants with account balances	2014-01-01	2,167
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	25
2013: ST. JOHN'S RIVERSIDE HOSPITAL VOLUNTARY SUPPLEMENTARY TAX DEFERRED RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	1,961
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	1,580
Number of retired or separated participants receiving benefits	2013-01-01	45
Number of other retired or separated participants entitled to future benefits	2013-01-01	377
Total of all active and inactive participants	2013-01-01	2,002
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	16
Total participants	2013-01-01	2,018
Number of participants with account balances	2013-01-01	2,018
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	22
2012: ST. JOHN'S RIVERSIDE HOSPITAL VOLUNTARY SUPPLEMENTARY TAX DEFERRED RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	2,586
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	1,568
Number of retired or separated participants receiving benefits	2012-01-01	36
Number of other retired or separated participants entitled to future benefits	2012-01-01	340
Total of all active and inactive participants	2012-01-01	1,944
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	17
Total participants	2012-01-01	1,961
Number of participants with account balances	2012-01-01	1,961
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	2
2011: ST. JOHN'S RIVERSIDE HOSPITAL VOLUNTARY SUPPLEMENTARY TAX DEFERRED RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	2,502
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	2,220
Number of retired or separated participants receiving benefits	2011-01-01	37
Number of other retired or separated participants entitled to future benefits	2011-01-01	316
Total of all active and inactive participants	2011-01-01	2,573
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	13
Total participants	2011-01-01	2,586
Number of participants with account balances	2011-01-01	1,957
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	10
2009: ST. JOHN'S RIVERSIDE HOSPITAL VOLUNTARY SUPPLEMENTARY TAX DEFERRED RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	1,447
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	2,165
Number of retired or separated participants receiving benefits	2009-01-01	21
Number of other retired or separated participants entitled to future benefits	2009-01-01	563
Total of all active and inactive participants	2009-01-01	2,749
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	8
Total participants	2009-01-01	2,757
Number of participants with account balances	2009-01-01	1,619
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	3

Financial Data on ST. JOHN'S RIVERSIDE HOSPITAL VOLUNTARY SUPPLEMENTARY TAX DEFERRED RETIREMENT PLAN

Measure	Date	Value
2022 : ST. JOHN'S RIVERSIDE HOSPITAL VOLUNTARY SUPPLEMENTARY TAX DEFERRED RETIREMENT 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	$-15,584,064
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$11,408,522
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$10,742,496
Expenses. Certain deemed distributions of participant loans	2022-12-31	$84,150
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$10,696,785
Value of total assets at end of year	2022-12-31	$180,337,665
Value of total assets at beginning of year	2022-12-31	$207,330,251
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$581,876
Total interest from all sources	2022-12-31	$612,849
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$2,581,768
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	$2,581,768
Administrative expenses professional fees incurred	2022-12-31	$62,100
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$3,000,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$7,425,273
Participant contributions at end of year	2022-12-31	$2,966,733
Participant contributions at beginning of year	2022-12-31	$2,968,479
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$196,600
Other income not declared elsewhere	2022-12-31	$115,343
Administrative expenses (other) incurred	2022-12-31	$2,350
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	$-26,992,586
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$180,337,665
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$207,330,251
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	$106,250
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$121,633,665
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$150,220,026
Value of interest in pooled separate accounts at end of year	2022-12-31	$4,488,637
Value of interest in pooled separate accounts at beginning of year	2022-12-31	$5,782,314
Interest on participant loans	2022-12-31	$139,167
Interest earned on other investments	2022-12-31	$473,682
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$51,248,630
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$48,359,432
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-29,590,809
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
Contributions received in cash from employer	2022-12-31	$3,074,912
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$10,742,496
Contract administrator fees	2022-12-31	$411,176
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	PKF O'CONNOR DAVIES LLP
Accountancy firm EIN	2022-12-31	271728945
2021 : ST. JOHN'S RIVERSIDE HOSPITAL VOLUNTARY SUPPLEMENTARY TAX DEFERRED RETIREMENT 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	$36,118,966
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$12,327,833
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$11,849,373
Expenses. Certain deemed distributions of participant loans	2021-12-31	$11,390
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$11,621,067
Value of total assets at end of year	2021-12-31	$207,330,251
Value of total assets at beginning of year	2021-12-31	$183,539,118
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$467,070
Total interest from all sources	2021-12-31	$597,224
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$2,089,798
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	$2,089,798
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$3,000,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$7,674,588
Participant contributions at end of year	2021-12-31	$2,968,479
Participant contributions at beginning of year	2021-12-31	$2,985,435
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$646,674
Other income not declared elsewhere	2021-12-31	$64,815
Administrative expenses (other) incurred	2021-12-31	$467,070
Total non interest bearing cash at end of year	2021-12-31	$0
Total non interest bearing cash at beginning of year	2021-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$23,791,133
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$207,330,251
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$183,539,118
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	$150,220,026
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$126,802,025
Value of interest in pooled separate accounts at end of year	2021-12-31	$5,782,314
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$4,999,756
Interest on participant loans	2021-12-31	$153,562
Interest earned on other investments	2021-12-31	$443,662
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$48,359,432
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$48,751,902
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$21,746,062
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	Yes
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$3,299,805
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$11,849,373
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Disclaimer
Accountancy firm name	2021-12-31	PKF O'CONNOR DAVIES LLP
Accountancy firm EIN	2021-12-31	271728945
2020 : ST. JOHN'S RIVERSIDE HOSPITAL VOLUNTARY SUPPLEMENTARY TAX DEFERRED RETIREMENT 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	$30,426,432
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$10,930,237
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$10,479,044
Expenses. Certain deemed distributions of participant loans	2020-12-31	$22,301
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$10,579,492
Value of total assets at end of year	2020-12-31	$183,539,118
Value of total assets at beginning of year	2020-12-31	$164,042,923
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$428,892
Total interest from all sources	2020-12-31	$1,427,884
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$1,220,041
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	$1,220,041
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$3,000,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$6,961,917
Participant contributions at end of year	2020-12-31	$2,985,435
Participant contributions at beginning of year	2020-12-31	$3,337,518
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$610,383
Other income not declared elsewhere	2020-12-31	$63,132
Administrative expenses (other) incurred	2020-12-31	$428,892
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	$19,496,195
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$183,539,118
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$164,042,923
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	$126,802,025
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$109,952,091
Value of interest in pooled separate accounts at end of year	2020-12-31	$4,999,756
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$4,402,996
Interest on participant loans	2020-12-31	$173,012
Interest earned on other investments	2020-12-31	$1,254,872
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$48,751,902
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$46,350,318
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$16,304,719
Net investment gain/loss from pooled separate accounts	2020-12-31	$831,164
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	Yes
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$3,007,192
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$10,479,044
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	PKF O'CONNOR DAVIES LLP
Accountancy firm EIN	2020-12-31	271728945
2019 : ST. JOHN'S RIVERSIDE HOSPITAL VOLUNTARY SUPPLEMENTARY TAX DEFERRED RETIREMENT 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	$34,572,805
Total income from all sources (including contributions)	2019-12-31	$34,572,805
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	$11,322,671
Total of all expenses incurred	2019-12-31	$11,322,671
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$10,822,923
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$10,822,923
Expenses. Certain deemed distributions of participant loans	2019-12-31	$93,721
Expenses. Certain deemed distributions of participant loans	2019-12-31	$93,721
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$10,779,678
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$10,779,678
Value of total assets at end of year	2019-12-31	$164,042,923
Value of total assets at end of year	2019-12-31	$164,042,923
Value of total assets at beginning of year	2019-12-31	$140,792,789
Value of total assets at beginning of year	2019-12-31	$140,792,789
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$406,027
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$406,027
Total interest from all sources	2019-12-31	$1,455,652
Total interest from all sources	2019-12-31	$1,455,652
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$1,592,129
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$1,592,129
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	$1,592,129
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$1,592,129
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$3,000,000
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	$6,983,212
Contributions received from participants	2019-12-31	$6,983,212
Participant contributions at end of year	2019-12-31	$3,337,518
Participant contributions at end of year	2019-12-31	$3,337,518
Participant contributions at beginning of year	2019-12-31	$3,415,801
Participant contributions at beginning of year	2019-12-31	$3,415,801
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$1,101,661
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$1,101,661
Other income not declared elsewhere	2019-12-31	$19,142
Other income not declared elsewhere	2019-12-31	$19,142
Administrative expenses (other) incurred	2019-12-31	$406,027
Administrative expenses (other) incurred	2019-12-31	$406,027
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	$23,250,134
Value of net income/loss	2019-12-31	$23,250,134
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$164,042,923
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$164,042,923
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$140,792,789
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$140,792,789
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	$109,952,091
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$109,952,091
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$87,045,697
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$87,045,697
Value of interest in pooled separate accounts at end of year	2019-12-31	$4,402,996
Value of interest in pooled separate accounts at end of year	2019-12-31	$4,402,996
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$4,447,106
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$4,447,106
Interest on participant loans	2019-12-31	$189,006
Interest on participant loans	2019-12-31	$189,006
Interest earned on other investments	2019-12-31	$1,266,646
Interest earned on other investments	2019-12-31	$1,266,646
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$46,350,318
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$46,350,318
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$45,884,185
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$45,884,185
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$19,703,333
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$19,703,333
Net investment gain/loss from pooled separate accounts	2019-12-31	$1,022,871
Net investment gain/loss from pooled separate accounts	2019-12-31	$1,022,871
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	Yes
Was there a failure to transmit to the plan any participant contributions	2019-12-31	Yes
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
Contributions received in cash from employer	2019-12-31	$2,694,805
Contributions received in cash from employer	2019-12-31	$2,694,805
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$10,822,923
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$10,822,923
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	PKF O'CONNOR DAVIES LLP
Accountancy firm name	2019-12-31	PKF O'CONNOR DAVIES LLP
Accountancy firm EIN	2019-12-31	271728945
Accountancy firm EIN	2019-12-31	271728945
2018 : ST. JOHN'S RIVERSIDE HOSPITAL VOLUNTARY SUPPLEMENTARY TAX DEFERRED RETIREMENT 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	$5,824,285
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$10,548,204
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$10,107,778
Expenses. Certain deemed distributions of participant loans	2018-12-31	$49,003
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$10,696,678
Value of total assets at end of year	2018-12-31	$140,792,789
Value of total assets at beginning of year	2018-12-31	$145,516,708
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$391,423
Total interest from all sources	2018-12-31	$1,391,522
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$1,302,836
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	$1,302,836
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$3,000,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$7,184,914
Participant contributions at end of year	2018-12-31	$3,415,801
Participant contributions at beginning of year	2018-12-31	$3,097,590
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$1,072,699
Other income not declared elsewhere	2018-12-31	$156,821
Administrative expenses (other) incurred	2018-12-31	$391,423
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	$-4,723,919
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$140,792,789
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$145,516,708
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$87,045,697
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$91,373,104
Value of interest in pooled separate accounts at end of year	2018-12-31	$4,447,106
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$5,183,387
Interest on participant loans	2018-12-31	$164,365
Interest earned on other investments	2018-12-31	$1,227,157
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$45,884,185
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$45,862,627
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-6,611,481
Net investment gain/loss from pooled separate accounts	2018-12-31	$-1,112,091
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$2,439,065
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$10,107,778
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	PKF O'CONNOR DAVIES LLP
Accountancy firm EIN	2018-12-31	271728945
2017 : ST. JOHN'S RIVERSIDE HOSPITAL VOLUNTARY SUPPLEMENTARY TAX DEFERRED RETIREMENT 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	$26,665,140
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$8,720,254
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$8,312,423
Expenses. Certain deemed distributions of participant loans	2017-12-31	$76,433
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$10,492,449
Value of total assets at end of year	2017-12-31	$145,516,708
Value of total assets at beginning of year	2017-12-31	$127,571,822
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$331,398
Total interest from all sources	2017-12-31	$1,357,970
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$1,089,442
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	$1,089,442
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$3,000,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$6,643,301
Participant contributions at end of year	2017-12-31	$3,097,590
Participant contributions at beginning of year	2017-12-31	$3,040,556
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$1,267,925
Other income not declared elsewhere	2017-12-31	$94,283
Administrative expenses (other) incurred	2017-12-31	$331,398
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	$17,944,886
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$145,516,708
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$127,571,822
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	$91,373,104
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$74,386,591
Value of interest in pooled separate accounts at end of year	2017-12-31	$5,183,387
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$4,829,343
Interest on participant loans	2017-12-31	$135,919
Interest earned on other investments	2017-12-31	$1,222,051
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$45,862,627
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$45,315,332
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$12,784,835
Net investment gain/loss from pooled separate accounts	2017-12-31	$846,161
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$2,581,223
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$8,312,423
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	PKF O'CONNOR DAVIES LLP
Accountancy firm EIN	2017-12-31	271728945
2016 : ST. JOHN'S RIVERSIDE HOSPITAL VOLUNTARY SUPPLEMENTARY TAX DEFERRED RETIREMENT 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	$18,660,432
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$13,258,501
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$12,851,221
Expenses. Certain deemed distributions of participant loans	2016-12-31	$162,299
Value of total corrective distributions	2016-12-31	$7,353
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$10,976,075
Value of total assets at end of year	2016-12-31	$127,571,822
Value of total assets at beginning of year	2016-12-31	$122,169,891
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$237,628
Total interest from all sources	2016-12-31	$1,106,476
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$949,045
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	$949,045
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$3,000,000
If this is an individual account plan, was there a blackout period	2016-12-31	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$6,105,894
Participant contributions at end of year	2016-12-31	$3,040,556
Participant contributions at beginning of year	2016-12-31	$3,146,223
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$2,459,462
Other income not declared elsewhere	2016-12-31	$227,047
Administrative expenses (other) incurred	2016-12-31	$237,628
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	$5,401,931
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$127,571,822
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$122,169,891
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	$74,386,591
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$68,633,495
Value of interest in pooled separate accounts at end of year	2016-12-31	$4,829,343
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$22,454,992
Interest on participant loans	2016-12-31	$130,298
Interest earned on other investments	2016-12-31	$976,178
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$45,315,332
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$27,935,181
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$4,951,271
Net investment gain/loss from pooled separate accounts	2016-12-31	$450,518
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$2,410,719
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$12,851,221
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2016-12-31	Yes
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	PKF O'CONNOR DAVIES LLP
Accountancy firm EIN	2016-12-31	271728945
2015 : ST. JOHN'S RIVERSIDE HOSPITAL VOLUNTARY SUPPLEMENTARY TAX DEFERRED RETIREMENT PLAN 2015 401k financial data
Total income from all sources (including contributions)	2015-12-31	$10,054,451
Total of all expenses incurred	2015-12-31	$8,989,383
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$8,622,527
Expenses. Certain deemed distributions of participant loans	2015-12-31	$89,998
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$8,910,729
Value of total assets at end of year	2015-12-31	$122,169,891
Value of total assets at beginning of year	2015-12-31	$121,104,823
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$276,858
Total interest from all sources	2015-12-31	$1,046,805
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$796,023
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$796,023
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$3,000,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$6,286,486
Participant contributions at end of year	2015-12-31	$3,146,223
Participant contributions at beginning of year	2015-12-31	$3,276,449
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$217,807
Administrative expenses (other) incurred	2015-12-31	$276,858
Total non interest bearing cash at beginning of year	2015-12-31	$88,936
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	$1,065,068
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$122,169,891
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$121,104,823
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	$68,633,495
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$66,570,664
Value of interest in pooled separate accounts at end of year	2015-12-31	$22,454,992
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$22,574,828
Interest on participant loans	2015-12-31	$138,069
Interest earned on other investments	2015-12-31	$908,736
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$27,935,181
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$28,593,946
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-894,999
Net investment gain/loss from pooled separate accounts	2015-12-31	$195,893
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$2,406,436
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$8,622,527
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2015-12-31	No
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	PKF O'CONNOR DAVIES LLP
Accountancy firm EIN	2015-12-31	271728945
2014 : ST. JOHN'S RIVERSIDE HOSPITAL VOLUNTARY SUPPLEMENTARY TAX DEFERRED RETIREMENT PLAN 2014 401k financial data
Total income from all sources (including contributions)	2014-12-31	$14,856,073
Total of all expenses incurred	2014-12-31	$6,188,863
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$5,907,575
Expenses. Certain deemed distributions of participant loans	2014-12-31	$30,657
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$8,581,542
Value of total assets at end of year	2014-12-31	$121,104,823
Value of total assets at beginning of year	2014-12-31	$112,437,613
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$250,631
Total interest from all sources	2014-12-31	$1,094,250
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$851,556
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	$851,556
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$3,000,000
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	$6,045,772
Participant contributions at end of year	2014-12-31	$3,276,449
Participant contributions at beginning of year	2014-12-31	$3,509,686
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$315,352
Administrative expenses (other) incurred	2014-12-31	$250,631
Total non interest bearing cash at end of year	2014-12-31	$88,936
Total non interest bearing cash at beginning of year	2014-12-31	$58,725
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	$8,667,210
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$121,104,823
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$112,437,613
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	$66,570,664
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$58,803,320
Value of interest in pooled separate accounts at end of year	2014-12-31	$22,574,828
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$20,706,807
Interest on participant loans	2014-12-31	$144,841
Interest earned on other investments	2014-12-31	$949,409
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$28,593,946
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$29,359,075
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$4,139,748
Net investment gain/loss from pooled separate accounts	2014-12-31	$188,977
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$2,220,418
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$5,907,575
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2014-12-31	No
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	O'CONNOR DAVIES LLP
Accountancy firm EIN	2014-12-31	271728945
2013 : ST. JOHN'S RIVERSIDE HOSPITAL VOLUNTARY SUPPLEMENTARY TAX DEFERRED RETIREMENT PLAN 2013 401k financial data
Total income from all sources (including contributions)	2013-12-31	$22,276,437
Total of all expenses incurred	2013-12-31	$6,350,261
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$6,018,906
Expenses. Certain deemed distributions of participant loans	2013-12-31	$99,533
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$8,521,175
Value of total assets at end of year	2013-12-31	$112,437,613
Value of total assets at beginning of year	2013-12-31	$96,511,437
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$231,822
Total interest from all sources	2013-12-31	$1,124,423
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$529,966
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	$529,966
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$3,000,000
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	$6,028,132
Participant contributions at end of year	2013-12-31	$3,509,686
Participant contributions at beginning of year	2013-12-31	$3,437,179
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$438,022
Administrative expenses (other) incurred	2013-12-31	$231,822
Total non interest bearing cash at end of year	2013-12-31	$58,725
Total non interest bearing cash at beginning of year	2013-12-31	$15,722
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	$15,926,176
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$112,437,613
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$96,511,437
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	$58,803,320
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$44,710,402
Value of interest in pooled separate accounts at end of year	2013-12-31	$20,706,807
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$18,568,579
Interest on participant loans	2013-12-31	$144,758
Interest earned on other investments	2013-12-31	$979,665
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$29,359,075
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$29,779,555
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$10,935,236
Net investment gain/loss from pooled separate accounts	2013-12-31	$1,165,637
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$2,055,021
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$6,018,906
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2013-12-31	No
Did the plan have assets held for investment	2013-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	O'CONNOR DAVIES LLP
Accountancy firm EIN	2013-12-31	271728945
2012 : ST. JOHN'S RIVERSIDE HOSPITAL VOLUNTARY SUPPLEMENTARY TAX DEFERRED RETIREMENT PLAN 2012 401k financial data
Total income from all sources (including contributions)	2012-12-31	$16,669,135
Total of all expenses incurred	2012-12-31	$4,787,587
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$4,722,262
Expenses. Certain deemed distributions of participant loans	2012-12-31	$31,038
Value of total corrective distributions	2012-12-31	$482
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$9,420,898
Value of total assets at end of year	2012-12-31	$96,511,437
Value of total assets at beginning of year	2012-12-31	$84,629,889
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$33,805
Total interest from all sources	2012-12-31	$1,144,722
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$538,011
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	$538,011
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$3,000,000
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	$5,677,776
Participant contributions at end of year	2012-12-31	$3,437,179
Participant contributions at beginning of year	2012-12-31	$3,115,596
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$1,786,997
Administrative expenses (other) incurred	2012-12-31	$33,805
Total non interest bearing cash at end of year	2012-12-31	$15,722
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	$11,881,548
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$96,511,437
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$84,629,889
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	$44,710,402
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$35,840,256
Value of interest in pooled separate accounts at end of year	2012-12-31	$18,568,579
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$15,224,124
Interest on participant loans	2012-12-31	$138,991
Interest earned on other investments	2012-12-31	$1,005,731
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$29,779,555
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$30,449,913
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$4,903,608
Net investment gain/loss from pooled separate accounts	2012-12-31	$661,896
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$1,956,125
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$4,722,262
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2012-12-31	No
Did the plan have assets held for investment	2012-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	O'CONNOR DAVIES LLP
Accountancy firm EIN	2012-12-31	271728945
2011 : ST. JOHN'S RIVERSIDE HOSPITAL VOLUNTARY SUPPLEMENTARY TAX DEFERRED RETIREMENT PLAN 2011 401k financial data
Total income from all sources (including contributions)	2011-12-31	$8,268,923
Total of all expenses incurred	2011-12-31	$4,776,220
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$4,743,272
Expenses. Certain deemed distributions of participant loans	2011-12-31	$727
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$7,488,297
Value of total assets at end of year	2011-12-31	$84,629,889
Value of total assets at beginning of year	2011-12-31	$81,137,186
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$32,221
Total interest from all sources	2011-12-31	$1,167,577
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$363,721
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	$363,721
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$3,000,000
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	$5,432,349
Participant contributions at end of year	2011-12-31	$3,115,596
Participant contributions at beginning of year	2011-12-31	$2,486,993
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$265,936
Other income not declared elsewhere	2011-12-31	$722
Administrative expenses (other) incurred	2011-12-31	$32,176
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	$3,492,703
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$84,629,889
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$81,137,186
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	$35,840,256
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$33,611,724
Value of interest in pooled separate accounts at end of year	2011-12-31	$15,224,124
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$13,482,451
Interest on participant loans	2011-12-31	$125,559
Interest earned on other investments	2011-12-31	$1,042,018
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$30,449,913
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$31,556,018
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-942,508
Net investment gain/loss from pooled separate accounts	2011-12-31	$191,114
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
Contributions received in cash from employer	2011-12-31	$1,790,012
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$4,743,272
Contract administrator fees	2011-12-31	$45
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2011-12-31	No
Did the plan have assets held for investment	2011-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	O'CONNOR DAVIES, LLP
Accountancy firm EIN	2011-12-31	271728945
2010 : ST. JOHN'S RIVERSIDE HOSPITAL VOLUNTARY SUPPLEMENTARY TAX DEFERRED RETIREMENT PLAN 2010 401k financial data
Total income from all sources (including contributions)	2010-12-31	$13,751,186
Total of all expenses incurred	2010-12-31	$3,830,242
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$3,795,317
Expenses. Certain deemed distributions of participant loans	2010-12-31	$11,981
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$7,721,169
Value of total assets at end of year	2010-12-31	$81,137,186
Value of total assets at beginning of year	2010-12-31	$71,216,242
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$22,944
Total interest from all sources	2010-12-31	$1,235,015
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$261,835
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2010-12-31	$261,835
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$3,000,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$6,342,362
Participant contributions at end of year	2010-12-31	$2,486,993
Participant contributions at beginning of year	2010-12-31	$2,124,628
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$659,093
Administrative expenses (other) incurred	2010-12-31	$22,944
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$9,920,944
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$81,137,186
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$71,216,242
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$33,611,724
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$27,862,293
Value of interest in pooled separate accounts at end of year	2010-12-31	$13,482,451
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$4,817,758
Interest on participant loans	2010-12-31	$116,406
Interest earned on other investments	2010-12-31	$1,118,609
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$31,556,018
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$36,411,563
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$3,763,048
Net investment gain/loss from pooled separate accounts	2010-12-31	$770,119
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$719,714
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$3,795,317
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2010-12-31	No
Did the plan have assets held for investment	2010-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	O'CONNOR DAVIES MUNNS AND DOBBINS
Accountancy firm EIN	2010-12-31	133385019
2009 : ST. JOHN'S RIVERSIDE HOSPITAL VOLUNTARY SUPPLEMENTARY TAX DEFERRED RETIREMENT PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for ST. JOHN'S RIVERSIDE HOSPITAL VOLUNTARY SUPPLEMENTARY TAX DEFERRED RETIREMENT PLAN

2022: ST. JOHN'S RIVERSIDE HOSPITAL VOLUNTARY SUPPLEMENTARY TAX DEFERRED RETIREMENT 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: ST. JOHN'S RIVERSIDE HOSPITAL VOLUNTARY SUPPLEMENTARY TAX DEFERRED RETIREMENT 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: ST. JOHN'S RIVERSIDE HOSPITAL VOLUNTARY SUPPLEMENTARY TAX DEFERRED RETIREMENT 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: ST. JOHN'S RIVERSIDE HOSPITAL VOLUNTARY SUPPLEMENTARY TAX DEFERRED RETIREMENT 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: ST. JOHN'S RIVERSIDE HOSPITAL VOLUNTARY SUPPLEMENTARY TAX DEFERRED RETIREMENT 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: ST. JOHN'S RIVERSIDE HOSPITAL VOLUNTARY SUPPLEMENTARY TAX DEFERRED RETIREMENT 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: ST. JOHN'S RIVERSIDE HOSPITAL VOLUNTARY SUPPLEMENTARY TAX DEFERRED RETIREMENT PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	Yes
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	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: ST. JOHN'S RIVERSIDE HOSPITAL VOLUNTARY SUPPLEMENTARY TAX DEFERRED RETIREMENT PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	Yes
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: ST. JOHN'S RIVERSIDE HOSPITAL VOLUNTARY SUPPLEMENTARY TAX DEFERRED RETIREMENT PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: ST. JOHN'S RIVERSIDE HOSPITAL VOLUNTARY SUPPLEMENTARY TAX DEFERRED RETIREMENT PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: ST. JOHN'S RIVERSIDE HOSPITAL VOLUNTARY SUPPLEMENTARY TAX DEFERRED RETIREMENT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: ST. JOHN'S RIVERSIDE HOSPITAL VOLUNTARY SUPPLEMENTARY TAX DEFERRED RETIREMENT PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: ST. JOHN'S RIVERSIDE HOSPITAL VOLUNTARY SUPPLEMENTARY TAX DEFERRED RETIREMENT PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number	L7550278
Policy instance	6
Insurance contract or identification number L7550278 Number of Individuals Covered 621 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? Yes Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Additional information about fees paid to insurance broker N/A Insurance broker organization code? 3
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number	L7550018 00018
Policy instance	5
Insurance contract or identification number L7550018 00018 Number of Individuals Covered 44 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? Yes Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Additional information about fees paid to insurance broker N/A Insurance broker organization code? 3
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract number	074924
Policy instance	4
Insurance contract or identification number 074924 Number of Individuals Covered 1757 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? No Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number	016511-F
Policy instance	3
Insurance contract or identification number 016511-F Number of Individuals Covered 7 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? Yes Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	1009501-02
Policy instance	2
Insurance contract or identification number 1009501-02 Number of Individuals Covered 209 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
LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )
Policy contract number	891445 006
Policy instance	1
Insurance contract or identification number 891445 006 Number of Individuals Covered 13 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
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number	016511-F
Policy instance	3
Insurance contract or identification number 016511-F Number of Individuals Covered 7 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 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? Yes Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract number	074924
Policy instance	4
Insurance contract or identification number 074924 Number of Individuals Covered 1716 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 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
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number	L7550018 00018
Policy instance	5
Insurance contract or identification number L7550018 00018 Number of Individuals Covered 47 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 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? Yes Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Additional information about fees paid to insurance broker N/A Insurance broker organization code? 3
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number	L7550278
Policy instance	6
Insurance contract or identification number L7550278 Number of Individuals Covered 645 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 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? Yes Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Additional information about fees paid to insurance broker N/A Insurance broker organization code? 3
LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )
Policy contract number	891445 006
Policy instance	1
Insurance contract or identification number 891445 006 Number of Individuals Covered 15 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 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
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	1009501-02
Policy instance	2
Insurance contract or identification number 1009501-02 Number of Individuals Covered 216 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 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
LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )
Policy contract number	891445 006
Policy instance	1
Insurance contract or identification number 891445 006 Number of Individuals Covered 16 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
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	1009501-02
Policy instance	2
Insurance contract or identification number 1009501-02 Number of Individuals Covered 224 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
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number	016511-F
Policy instance	3
Insurance contract or identification number 016511-F Number of Individuals Covered 7 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? Yes Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract number	074924
Policy instance	4
Insurance contract or identification number 074924 Number of Individuals Covered 1657 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
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number	L7550018 00018
Policy instance	5
Insurance contract or identification number L7550018 00018 Number of Individuals Covered 48 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? Yes Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Additional information about fees paid to insurance broker N/A Insurance broker organization code? 3
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number	L7550278
Policy instance	6
Insurance contract or identification number L7550278 Number of Individuals Covered 684 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? Yes Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Additional information about fees paid to insurance broker N/A Insurance broker organization code? 3
LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )
Policy contract number	891445 006
Policy instance	1
Insurance contract or identification number 891445 006 Number of Individuals Covered 18 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
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	1009501-02
Policy instance	2
Insurance contract or identification number 1009501-02 Number of Individuals Covered 235 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 RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract number	074924
Policy instance	4
Insurance contract or identification number 074924 Number of Individuals Covered 1604 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? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number	016511-F
Policy instance	3
Insurance contract or identification number 016511-F Number of Individuals Covered 12 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? Yes Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number	L7550018 00018
Policy instance	5
Insurance contract or identification number L7550018 00018 Number of Individuals Covered 51 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 $1,140 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? Yes Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Amount paid for insurance broker fees 1140 Additional information about fees paid to insurance broker N/A Insurance broker organization code? 3
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number	L7550278
Policy instance	6
Insurance contract or identification number L7550278 Number of Individuals Covered 721 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 $14,682 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? No Are there contracts with allocated funds for types other than group deferred annuity or individual? No Contract purchased, in whole or in part, to distribute benefits from a terminating plan No Contracts With Unallocated Funds Deposit Administration 0 Are there contracts with unallocated funds for contracts of type immediate participation guarantee? No Are there contracts with unallocated funds for contracts of type guaranteed investment? Yes Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $0 Amount paid for insurance broker fees 14682 Additional information about fees paid to insurance broker N/A Insurance broker organization code? 3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	1009501-02
Policy instance	2
Insurance contract or identification number 1009501-02 Number of Individuals Covered 256 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
LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )
Policy contract number	891445 006
Policy instance	1
Insurance contract or identification number 891445 006 Number of Individuals Covered 19 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
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number	016511-F
Policy instance	3
Insurance contract or identification number 016511-F Number of Individuals Covered 9 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? Yes Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract number	074924
Policy instance	4
Insurance contract or identification number 074924 Number of Individuals Covered 2341 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? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number	L7550018
Policy instance	5
Insurance contract or identification number L7550018 Number of Individuals Covered 53 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $1,196 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? Yes Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $1,196 Amount paid for insurance broker fees 0 Insurance broker organization code? 3
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number	L7550278
Policy instance	6
Insurance contract or identification number L7550278 Number of Individuals Covered 773 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $15,279 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? Yes Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $15,279 Amount paid for insurance broker fees 0 Insurance broker organization code? 3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	1009501-02
Policy instance	2
Insurance contract or identification number 1009501-02 Number of Individuals Covered 269 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
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number	016511-F
Policy instance	3
Insurance contract or identification number 016511-F Number of Individuals Covered 12 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? Yes Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number	L7550018
Policy instance	4
Insurance contract or identification number L7550018 Number of Individuals Covered 58 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $1,228 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? Yes Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $1,228 Amount paid for insurance broker fees 0 Insurance broker organization code? 3 Insurance broker name HEALTHCARE COMMUNITY SECURITIES COR
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number	L7550278
Policy instance	5
Insurance contract or identification number L7550278 Number of Individuals Covered 819 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $15,288 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? Yes Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $15,288 Amount paid for insurance broker fees 0 Insurance broker organization code? 3 Insurance broker name HEALTHCARE COMMUNITY SECURITIES COR
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number	TT069364
Policy instance	6
Insurance contract or identification number TT069364 Insurance policy start date 2017-01-01 Insurance policy end date 2017-10-15 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? Yes Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? No Health Insurance Welfare Benefit No Dental Insurance Welfare Benefit No Vision Insurance Welfare Benefit No Life Insurance Welfare Benefit No Temporary Disability Insurance Welfare Benefit No Long Term Disability Insurance Welfare Benefit No Unemployment Insurance Welfare Benefit No Were dividends or retroactive rate refunds paid in cash? No Were dividends or retroactive rate refunds paid as a credit? No Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Insurance broker organization code? 3 Insurance broker name CAMMACK LARHETTE BROKERAGE, INC.
LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )
Policy contract number	891445 006
Policy instance	1
Insurance contract or identification number 891445 006 Number of Individuals Covered 19 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
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	1009501-02
Policy instance	1
Insurance contract or identification number 1009501-02 Number of Individuals Covered 290 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )
Policy contract number	891445 006
Policy instance	5
Insurance contract or identification number 891445 006 Number of Individuals Covered 22 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number	L7550278
Policy instance	4
Insurance contract or identification number L7550278 Number of Individuals Covered 962 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $16,941 Are there contracts with unallocated funds for contracts of type guaranteed investment? Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $16,941 Insurance broker organization code? 3 Insurance broker name HEALTHCARE COMMUNITY SECURITIES COR
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number	L7550018
Policy instance	3
Insurance contract or identification number L7550018 Number of Individuals Covered 73 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $1,393 Are there contracts with unallocated funds for contracts of type guaranteed investment? Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $1,393 Insurance broker organization code? 3 Insurance broker name HEALTHCARE COMMUNITY SECURITIES COR
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number	016511-F
Policy instance	2
Insurance contract or identification number 016511-F Number of Individuals Covered 12 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Are there contracts with unallocated funds for contracts of type guaranteed investment? Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number	TT069364
Policy instance	6
Insurance contract or identification number TT069364 Number of Individuals Covered 1569 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Are there contracts with unallocated funds for contracts of type guaranteed investment? Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )
Policy contract number	891445 006
Policy instance	5
Insurance contract or identification number 891445 006 Number of Individuals Covered 24 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number	L7550278
Policy instance	4
Insurance contract or identification number L7550278 Number of Individuals Covered 1023 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $17,518 Are there contracts with unallocated funds for contracts of type guaranteed investment? Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $17,518 Insurance broker organization code? 3 Insurance broker name HEALTHCARE COMMUNITY SECURITIES COR
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number	L7550018
Policy instance	3
Insurance contract or identification number L7550018 Number of Individuals Covered 78 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $1,453 Are there contracts with unallocated funds for contracts of type guaranteed investment? Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $1,453 Insurance broker organization code? 3 Insurance broker name HEALTHCARE COMMUNITY SECURITIES COR
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number	016511-F
Policy instance	2
Insurance contract or identification number 016511-F Number of Individuals Covered 12 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Are there contracts with unallocated funds for contracts of type guaranteed investment? Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	1009501-02
Policy instance	1
Insurance contract or identification number 1009501-02 Number of Individuals Covered 303 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number	TT069364
Policy instance	6
Insurance contract or identification number TT069364 Number of Individuals Covered 1483 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Are there contracts with unallocated funds for contracts of type guaranteed investment? Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number	TT069364
Policy instance	6
Insurance contract or identification number TT069364 Number of Individuals Covered 1402 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Are there contracts with unallocated funds for contracts of type guaranteed investment? Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number	L7550278
Policy instance	4
Insurance contract or identification number L7550278 Number of Individuals Covered 1075 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $11,327 Are there contracts with unallocated funds for contracts of type guaranteed investment? Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $11,327 Insurance broker organization code? 3 Insurance broker name HEALTHCARE COMMUNITY SECURITIES COR
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number	L7550018
Policy instance	3
Insurance contract or identification number L7550018 Number of Individuals Covered 85 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $855 Are there contracts with unallocated funds for contracts of type guaranteed investment? Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $855 Insurance broker organization code? 3 Insurance broker name HEALTHCARE COMMUNITY SECURITIES COR
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number	016511-F
Policy instance	2
Insurance contract or identification number 016511-F Number of Individuals Covered 16 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Are there contracts with unallocated funds for contracts of type guaranteed investment? Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	1009501-02
Policy instance	1
Insurance contract or identification number 1009501-02 Number of Individuals Covered 320 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )
Policy contract number	891445 006
Policy instance	5
Insurance contract or identification number 891445 006 Number of Individuals Covered 24 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	1009501-02
Policy instance	1
Insurance contract or identification number 1009501-02 Number of Individuals Covered 337 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )
Policy contract number	891445 006
Policy instance	5
Insurance contract or identification number 891445 006 Number of Individuals Covered 24 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number	L7550278
Policy instance	4
Insurance contract or identification number L7550278 Number of Individuals Covered 1118 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $19,253 Are there contracts with unallocated funds for contracts of type guaranteed investment? Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $19,253 Insurance broker organization code? 3 Insurance broker name HEALTHCARE COMMUNITY SECURITIES COR
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number	L7550018
Policy instance	3
Insurance contract or identification number L7550018 Number of Individuals Covered 89 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $1,532 Are there contracts with unallocated funds for contracts of type guaranteed investment? Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No Commission paid to Insurance Broker USD $1,532 Insurance broker organization code? 3 Insurance broker name HEALTHCARE COMMUNITY SECURITIES COR
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number	016511-F
Policy instance	2
Insurance contract or identification number 016511-F Number of Individuals Covered 1 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Are there contracts with unallocated funds for contracts of type guaranteed investment? Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number	TT069364
Policy instance	6
Insurance contract or identification number TT069364 Number of Individuals Covered 1331 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Are there contracts with unallocated funds for contracts of type guaranteed investment? Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number	TT069364
Policy instance	6
Insurance contract or identification number TT069364 Number of Individuals Covered 1248 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Are there contracts with unallocated funds for contracts of type guaranteed investment? Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )
Policy contract number	891445 006
Policy instance	5
Insurance contract or identification number 891445 006 Number of Individuals Covered 24 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number	L7550278
Policy instance	4
Insurance contract or identification number L7550278 Number of Individuals Covered 1180 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Total amount of commissions paid to insurance broker USD $28,619 Are there contracts with unallocated funds for contracts of type guaranteed investment? Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number	L7550018
Policy instance	3
Insurance contract or identification number L7550018 Number of Individuals Covered 91 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Total amount of commissions paid to insurance broker USD $2,809 Are there contracts with unallocated funds for contracts of type guaranteed investment? Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number	016511-F
Policy instance	2
Insurance contract or identification number 016511-F Number of Individuals Covered 9 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Are there contracts with unallocated funds for contracts of type guaranteed investment? Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	1009501-02
Policy instance	1
Insurance contract or identification number 1009501-02 Number of Individuals Covered 377 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )
Policy contract number	016511-F
Policy instance	2
Insurance contract or identification number 016511-F Number of Individuals Covered 17 Insurance policy start date 2010-01-01 Insurance policy end date 2010-12-31 Are there contracts with unallocated funds for contracts of type guaranteed investment? Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number	L7550278
Policy instance	4
Insurance contract or identification number L7550278 Number of Individuals Covered 1254 Insurance policy start date 2010-01-01 Insurance policy end date 2010-12-31 Total amount of commissions paid to insurance broker USD $166,194 Are there contracts with unallocated funds for contracts of type guaranteed investment? Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number	L7550018
Policy instance	3
Insurance contract or identification number L7550018 Number of Individuals Covered 101 Insurance policy start date 2010-01-01 Insurance policy end date 2010-12-31 Total amount of commissions paid to insurance broker USD $4,492 Are there contracts with unallocated funds for contracts of type guaranteed investment? Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )
Policy contract number	891445 006
Policy instance	5
Insurance contract or identification number 891445 006 Number of Individuals Covered 25 Insurance policy start date 2010-01-01 Insurance policy end date 2010-12-31 Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number	TT069364
Policy instance	6
Insurance contract or identification number TT069364 Number of Individuals Covered 1183 Insurance policy start date 2010-01-25 Insurance policy end date 2010-12-31 Are there contracts with unallocated funds for contracts of type guaranteed investment? Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	1009501-02
Policy instance	1
Insurance contract or identification number 1009501-02 Number of Individuals Covered 441 Insurance policy start date 2010-01-01 Insurance policy end date 2010-12-31 Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? Yes Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? No

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