401k Plan data: FULTON COUNTY MEDICAL CENTER 403(B) RETIREMENT SAVINGS PLAN plan

FULTON COUNTY MEDICAL CENTER 403(B) RETIREMENT SAVINGS PLAN 401k Plan overview

Plan Name	FULTON COUNTY MEDICAL CENTER 403(B) RETIREMENT SAVINGS PLAN
Plan identification number	002

FULTON COUNTY MEDICAL CENTER 403(B) RETIREMENT SAVINGS PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.
Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Plan covering Self-Employed individuals.

401k Sponsoring company profile

FULTON COUNTY MEDICAL CENTER has sponsored the creation of one or more 401k plans.

Company Name: FULTON COUNTY MEDICAL CENTER

Employer identification number (EIN): 231401561

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FULTON COUNTY MEDICAL CENTER 403(B) RETIREMENT SAVINGS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2023-01-01
002 2022-01-01
002 2022-01-01
002 2021-01-01
002 2020-01-01
002 2019-01-01
002 2018-01-01

Plan Statistics for FULTON COUNTY MEDICAL CENTER 403(B) RETIREMENT SAVINGS PLAN

401k plan membership statisitcs for FULTON COUNTY MEDICAL CENTER 403(B) RETIREMENT SAVINGS PLAN

Measure Date Value
2023: FULTON COUNTY MEDICAL CENTER 403(B) RETIREMENT SAVINGS PLAN 2023 401k membership
Total participants, beginning-of-year 2023-01-01 452
Total number of active participants reported on line 7a of the Form 5500 2023-01-01 372
Number of retired or separated participants receiving benefits 2023-01-01 1
Number of other retired or separated participants entitled to future benefits 2023-01-01 67
Total of all active and inactive participants 2023-01-01 440
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2023-01-01 0
Total participants 2023-01-01 440
Number of participants with account balances 2023-01-01 372
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2023-01-01 7
2022: FULTON COUNTY MEDICAL CENTER 403(B) RETIREMENT SAVINGS PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 463
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 402
Number of retired or separated participants receiving benefits 2022-01-01 24
Number of other retired or separated participants entitled to future benefits 2022-01-01 26
Total of all active and inactive participants 2022-01-01 452
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 452
Number of participants with account balances 2022-01-01 303
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 18
2021: FULTON COUNTY MEDICAL CENTER 403(B) RETIREMENT SAVINGS PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 490
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 435
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 28
Total of all active and inactive participants 2021-01-01 463
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 463
Number of participants with account balances 2021-01-01 253
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 8
2020: FULTON COUNTY MEDICAL CENTER 403(B) RETIREMENT SAVINGS PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 520
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 474
Number of retired or separated participants receiving benefits 2020-01-01 1
Number of other retired or separated participants entitled to future benefits 2020-01-01 15
Total of all active and inactive participants 2020-01-01 490
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 490
Number of participants with account balances 2020-01-01 239
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 6
2019: FULTON COUNTY MEDICAL CENTER 403(B) RETIREMENT SAVINGS PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 495
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 517
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 3
Total of all active and inactive participants 2019-01-01 520
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 520
Number of participants with account balances 2019-01-01 228
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 1
2018: FULTON COUNTY MEDICAL CENTER 403(B) RETIREMENT SAVINGS PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 470
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 495
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 0
Total of all active and inactive participants 2018-01-01 495
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 495
Number of participants with account balances 2018-01-01 184
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0

Measure	Date	Value
2023: FULTON COUNTY MEDICAL CENTER 403(B) RETIREMENT SAVINGS PLAN 2023 401k membership
Total participants, beginning-of-year	2023-01-01	452
Total number of active participants reported on line 7a of the Form 5500	2023-01-01	372
Number of retired or separated participants receiving benefits	2023-01-01	1
Number of other retired or separated participants entitled to future benefits	2023-01-01	67
Total of all active and inactive participants	2023-01-01	440
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2023-01-01	0
Total participants	2023-01-01	440
Number of participants with account balances	2023-01-01	372
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2023-01-01	7
2022: FULTON COUNTY MEDICAL CENTER 403(B) RETIREMENT SAVINGS PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	463
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	402
Number of retired or separated participants receiving benefits	2022-01-01	24
Number of other retired or separated participants entitled to future benefits	2022-01-01	26
Total of all active and inactive participants	2022-01-01	452
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	452
Number of participants with account balances	2022-01-01	303
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	18
2021: FULTON COUNTY MEDICAL CENTER 403(B) RETIREMENT SAVINGS PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	490
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	435
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	28
Total of all active and inactive participants	2021-01-01	463
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	463
Number of participants with account balances	2021-01-01	253
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	8
2020: FULTON COUNTY MEDICAL CENTER 403(B) RETIREMENT SAVINGS PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	520
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	474
Number of retired or separated participants receiving benefits	2020-01-01	1
Number of other retired or separated participants entitled to future benefits	2020-01-01	15
Total of all active and inactive participants	2020-01-01	490
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	490
Number of participants with account balances	2020-01-01	239
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	6
2019: FULTON COUNTY MEDICAL CENTER 403(B) RETIREMENT SAVINGS PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	495
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	517
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	3
Total of all active and inactive participants	2019-01-01	520
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	520
Number of participants with account balances	2019-01-01	228
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	1
2018: FULTON COUNTY MEDICAL CENTER 403(B) RETIREMENT SAVINGS PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	470
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	495
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	0
Total of all active and inactive participants	2018-01-01	495
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	495
Number of participants with account balances	2018-01-01	184
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0

Financial Data on FULTON COUNTY MEDICAL CENTER 403(B) RETIREMENT SAVINGS PLAN

Measure	Date	Value
2023 : FULTON COUNTY MEDICAL CENTER 403(B) RETIREMENT SAVINGS PLAN 2023 401k financial data
Unrealized appreciation/depreciation of real estate assets	2023-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2023-12-31	$0
Total unrealized appreciation/depreciation of assets	2023-12-31	$0
Total transfer of assets to this plan	2023-12-31	$0
Total transfer of assets from this plan	2023-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2023-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2023-12-31	$0
Expenses. Interest paid	2023-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2023-12-31	$0
Total income from all sources (including contributions)	2023-12-31	$2,966,643
Total loss/gain on sale of assets	2023-12-31	$0
Total of all expenses incurred	2023-12-31	$511,042
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2023-12-31	$475,027
Expenses. Certain deemed distributions of participant loans	2023-12-31	$0
Value of total corrective distributions	2023-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2023-12-31	$1,651,893
Value of total assets at end of year	2023-12-31	$9,926,604
Value of total assets at beginning of year	2023-12-31	$7,471,003
Total of administrative expenses incurred including professional, contract, advisory and management fees	2023-12-31	$36,015
Total income from rents	2023-12-31	$0
Total interest from all sources	2023-12-31	$13,945
Total dividends received (eg from common stock, registered investment company shares)	2023-12-31	$260,063
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2023-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2023-12-31	$260,063
Assets. Real estate other than employer real property at end of year	2023-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2023-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2023-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2023-12-31	$0
Was this plan covered by a fidelity bond	2023-12-31	Yes
Value of fidelity bond cover	2023-12-31	$500,000
If this is an individual account plan, was there a blackout period	2023-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2023-12-31	No
Contributions received from participants	2023-12-31	$1,109,619
Participant contributions at end of year	2023-12-31	$100,261
Participant contributions at beginning of year	2023-12-31	$33,414
Participant contributions at end of year	2023-12-31	$0
Participant contributions at beginning of year	2023-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2023-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2023-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2023-12-31	$42,635
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2023-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2023-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2023-12-31	$0
Assets. Loans (other than to participants) at end of year	2023-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2023-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2023-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2023-12-31	$0
Other income not declared elsewhere	2023-12-31	$0
Administrative expenses (other) incurred	2023-12-31	$0
Liabilities. Value of operating payables at end of year	2023-12-31	$0
Liabilities. Value of operating payables at beginning of year	2023-12-31	$0
Total non interest bearing cash at end of year	2023-12-31	$0
Total non interest bearing cash at beginning of year	2023-12-31	$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	2023-12-31	No
Income. Non cash contributions	2023-12-31	$0
Value of net income/loss	2023-12-31	$2,455,601
Value of net assets at end of year (total assets less liabilities)	2023-12-31	$9,926,604
Value of net assets at beginning of year (total assets less liabilities)	2023-12-31	$7,471,003
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2023-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2023-12-31	No
Were any leases to which the plan was party in default or uncollectible	2023-12-31	No
Assets. partnership/joint venture interests at end of year	2023-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2023-12-31	$0
Investment advisory and management fees	2023-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2023-12-31	$9,336,643
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2023-12-31	$7,022,100
Value of interest in pooled separate accounts at end of year	2023-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2023-12-31	$0
Interest on participant loans	2023-12-31	$4,652
Income. Interest from loans (other than to participants)	2023-12-31	$0
Interest earned on other investments	2023-12-31	$9,293
Income. Interest from US Government securities	2023-12-31	$0
Income. Interest from corporate debt instruments	2023-12-31	$0
Value of interest in master investment trust accounts at end of year	2023-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2023-12-31	$0
Value of interest in common/collective trusts at end of year	2023-12-31	$0
Value of interest in common/collective trusts at beginning of year	2023-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2023-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2023-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2023-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2023-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2023-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2023-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2023-12-31	$489,700
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2023-12-31	$415,489
Expenses. Payments to insurance carriers foe the provision of benefits	2023-12-31	$0
Asset value of US Government securities at end of year	2023-12-31	$0
Asset value of US Government securities at beginning of year	2023-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2023-12-31	$1,040,742
Net investment gain/loss from pooled separate accounts	2023-12-31	$0
Net investment gain or loss from common/collective trusts	2023-12-31	$0
Net gain/loss from 103.12 investment entities	2023-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2023-12-31	No
Was there a failure to transmit to the plan any participant contributions	2023-12-31	No
Has the plan failed to provide any benefit when due under the plan	2023-12-31	No
Assets. Invements in employer securities at end of year	2023-12-31	$0
Assets. Invements in employer securities at beginning of year	2023-12-31	$0
Assets. Value of employer real property at end of year	2023-12-31	$0
Assets. Value of employer real property at beginning of year	2023-12-31	$0
Contributions received in cash from employer	2023-12-31	$499,639
Employer contributions (assets) at end of year	2023-12-31	$0
Employer contributions (assets) at beginning of year	2023-12-31	$0
Income. Dividends from preferred stock	2023-12-31	$0
Income. Dividends from common stock	2023-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2023-12-31	$475,027
Asset. Corporate debt instrument preferred debt at end of year	2023-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2023-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2023-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2023-12-31	$0
Contract administrator fees	2023-12-31	$0
Assets. Corporate common stocks other than exployer securities at end of year	2023-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2023-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2023-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2023-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2023-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2023-12-31	$0
Did the plan have assets held for investment	2023-12-31	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	2023-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2023-12-31	No
Aggregate proceeds on sale of assets	2023-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2023-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2023-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2023-12-31	$0
Opinion of an independent qualified public accountant for this plan	2023-12-31	Unqualified
Accountancy firm name	2023-12-31	FORVIS MAZARS, LLP
Accountancy firm EIN	2023-12-31	441600260
2022 : FULTON COUNTY MEDICAL CENTER 403(B) RETIREMENT SAVINGS PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total income from all sources (including contributions)	2022-12-31	$344,554
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$686,889
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$595,624
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$1,574,219
Value of total assets at end of year	2022-12-31	$7,471,003
Value of total assets at beginning of year	2022-12-31	$7,813,338
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$91,265
Total interest from all sources	2022-12-31	$1,359
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$403,945
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	$403,945
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$500,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$989,467
Participant contributions at end of year	2022-12-31	$33,414
Participant contributions at beginning of year	2022-12-31	$18,022
Participant contributions at end of year	2022-12-31	$0
Participant contributions at beginning of year	2022-12-31	$31,355
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$126,955
Administrative expenses (other) incurred	2022-12-31	$582
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	$-342,335
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$7,471,003
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$7,813,338
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	$17,968
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$7,022,100
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$7,642,277
Interest on participant loans	2022-12-31	$1,325
Interest earned on other investments	2022-12-31	$34
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$415,489
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$107,842
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-1,634,969
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$457,797
Employer contributions (assets) at end of year	2022-12-31	$0
Employer contributions (assets) at beginning of year	2022-12-31	$13,842
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$595,624
Contract administrator fees	2022-12-31	$72,715
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	FORVIS, LLP
Accountancy firm EIN	2022-12-31	441600260
2021 : FULTON COUNTY MEDICAL CENTER 403(B) RETIREMENT SAVINGS PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$2,466,654
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$711,640
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$622,835
Expenses. Certain deemed distributions of participant loans	2021-12-31	$278
Value of total corrective distributions	2021-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$1,449,987
Value of total assets at end of year	2021-12-31	$7,813,338
Value of total assets at beginning of year	2021-12-31	$6,058,324
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$88,527
Total interest from all sources	2021-12-31	$2,501
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$399,102
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	$399,102
Administrative expenses professional fees incurred	2021-12-31	$0
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$1,002,839
Participant contributions at end of year	2021-12-31	$18,022
Participant contributions at beginning of year	2021-12-31	$4,226
Participant contributions at end of year	2021-12-31	$31,355
Participant contributions at beginning of year	2021-12-31	$33,076
Assets. Other investments not covered elsewhere at end of year	2021-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2021-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$2,972
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2021-12-31	$0
Other income not declared elsewhere	2021-12-31	$0
Administrative expenses (other) incurred	2021-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$1,755,014
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$7,813,338
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$6,058,324
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Investment advisory and management fees	2021-12-31	$86,312
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$7,642,277
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$5,918,595
Value of interest in pooled separate accounts at end of year	2021-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$0
Interest on participant loans	2021-12-31	$815
Interest earned on other investments	2021-12-31	$1,686
Value of interest in common/collective trusts at end of year	2021-12-31	$0
Value of interest in common/collective trusts at beginning of year	2021-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$107,842
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$87,281
Expenses. Payments to insurance carriers foe the provision of benefits	2021-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$615,064
Net investment gain/loss from pooled separate accounts	2021-12-31	$0
Net investment gain or loss from common/collective trusts	2021-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Assets. Invements in employer securities at end of year	2021-12-31	$0
Assets. Invements in employer securities at beginning of year	2021-12-31	$0
Contributions received in cash from employer	2021-12-31	$444,176
Employer contributions (assets) at end of year	2021-12-31	$13,842
Employer contributions (assets) at beginning of year	2021-12-31	$15,146
Income. Dividends from common stock	2021-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$622,835
Contract administrator fees	2021-12-31	$2,215
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	FORVIS, LLP
Accountancy firm EIN	2021-12-31	441600260
2020 : FULTON COUNTY MEDICAL CENTER 403(B) RETIREMENT SAVINGS PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$2,541,552
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$510,061
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$446,820
Expenses. Certain deemed distributions of participant loans	2020-12-31	$2,905
Value of total corrective distributions	2020-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$1,542,565
Value of total assets at end of year	2020-12-31	$6,058,324
Value of total assets at beginning of year	2020-12-31	$4,026,833
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$60,336
Total interest from all sources	2020-12-31	$1,576
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$327,275
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	$327,275
Administrative expenses professional fees incurred	2020-12-31	$0
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$1,008,873
Participant contributions at end of year	2020-12-31	$4,226
Participant contributions at beginning of year	2020-12-31	$4,673
Participant contributions at end of year	2020-12-31	$33,076
Participant contributions at beginning of year	2020-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2020-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2020-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$36,512
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2020-12-31	$0
Other income not declared elsewhere	2020-12-31	$0
Administrative expenses (other) incurred	2020-12-31	$43
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$2,031,491
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$6,058,324
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$4,026,833
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Investment advisory and management fees	2020-12-31	$57,502
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$5,918,595
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$4,001,351
Value of interest in pooled separate accounts at end of year	2020-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$0
Interest on participant loans	2020-12-31	$438
Interest earned on other investments	2020-12-31	$1,138
Value of interest in common/collective trusts at end of year	2020-12-31	$0
Value of interest in common/collective trusts at beginning of year	2020-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$87,281
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$20,809
Expenses. Payments to insurance carriers foe the provision of benefits	2020-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$670,136
Net investment gain/loss from pooled separate accounts	2020-12-31	$0
Net investment gain or loss from common/collective trusts	2020-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Assets. Invements in employer securities at end of year	2020-12-31	$0
Assets. Invements in employer securities at beginning of year	2020-12-31	$0
Contributions received in cash from employer	2020-12-31	$497,180
Employer contributions (assets) at end of year	2020-12-31	$15,146
Employer contributions (assets) at beginning of year	2020-12-31	$0
Income. Dividends from common stock	2020-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$446,820
Contract administrator fees	2020-12-31	$2,791
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	BDK CPAS AND ADVISORS
Accountancy firm EIN	2020-12-31	441600260
2019 : FULTON COUNTY MEDICAL CENTER 403(B) RETIREMENT SAVINGS PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$1,238
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$16,488
Total income from all sources (including contributions)	2019-12-31	$3,379,181
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$1,275,036
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$1,227,191
Expenses. Certain deemed distributions of participant loans	2019-12-31	$0
Value of total corrective distributions	2019-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$2,683,987
Value of total assets at end of year	2019-12-31	$4,026,833
Value of total assets at beginning of year	2019-12-31	$1,937,938
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$47,845
Total interest from all sources	2019-12-31	$1,063
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$130,651
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	$130,651
Administrative expenses professional fees incurred	2019-12-31	$0
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$1,005,407
Participant contributions at end of year	2019-12-31	$4,673
Participant contributions at beginning of year	2019-12-31	$6,737
Assets. Other investments not covered elsewhere at end of year	2019-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2019-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$1,225,027
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2019-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2019-12-31	$1,238
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2019-12-31	$16,488
Other income not declared elsewhere	2019-12-31	$0
Administrative expenses (other) incurred	2019-12-31	$2,823
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	$2,104,145
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$4,025,595
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$1,921,450
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Investment advisory and management fees	2019-12-31	$44,322
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$4,001,351
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$1,929,496
Value of interest in pooled separate accounts at end of year	2019-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$0
Interest on participant loans	2019-12-31	$545
Interest earned on other investments	2019-12-31	$518
Value of interest in common/collective trusts at end of year	2019-12-31	$0
Value of interest in common/collective trusts at beginning of year	2019-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$20,809
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$1,705
Expenses. Payments to insurance carriers foe the provision of benefits	2019-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$563,480
Net investment gain/loss from pooled separate accounts	2019-12-31	$0
Net investment gain or loss from common/collective trusts	2019-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Assets. Invements in employer securities at end of year	2019-12-31	$0
Assets. Invements in employer securities at beginning of year	2019-12-31	$0
Contributions received in cash from employer	2019-12-31	$453,553
Income. Dividends from common stock	2019-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$1,227,191
Contract administrator fees	2019-12-31	$700
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	BAKER TILLY US, LLP
Accountancy firm EIN	2019-12-31	390859910
2018 : FULTON COUNTY MEDICAL CENTER 403(B) RETIREMENT SAVINGS PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$16,488
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	$1,974,722
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$53,272
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$40,452
Expenses. Certain deemed distributions of participant loans	2018-12-31	$0
Value of total corrective distributions	2018-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$2,182,712
Value of total assets at end of year	2018-12-31	$1,937,938
Value of total assets at beginning of year	2018-12-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$12,820
Total interest from all sources	2018-12-31	$199
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$9,860
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	$9,860
Administrative expenses professional fees incurred	2018-12-31	$0
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$500,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$756,831
Participant contributions at end of year	2018-12-31	$6,737
Participant contributions at beginning of year	2018-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2018-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2018-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$949,903
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2018-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2018-12-31	$16,488
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2018-12-31	$0
Other income not declared elsewhere	2018-12-31	$0
Administrative expenses (other) incurred	2018-12-31	$0
Total non interest bearing cash at end of year	2018-12-31	$4
Total non interest bearing cash at beginning of year	2018-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$1,921,450
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$1,921,450
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$0
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
Investment advisory and management fees	2018-12-31	$12,455
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$1,929,492
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$0
Value of interest in pooled separate accounts at end of year	2018-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$0
Interest on participant loans	2018-12-31	$192
Interest earned on other investments	2018-12-31	$7
Value of interest in common/collective trusts at end of year	2018-12-31	$0
Value of interest in common/collective trusts at beginning of year	2018-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$1,705
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2018-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-218,049
Net investment gain/loss from pooled separate accounts	2018-12-31	$0
Net investment gain or loss from common/collective trusts	2018-12-31	$0
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
Assets. Invements in employer securities at end of year	2018-12-31	$0
Assets. Invements in employer securities at beginning of year	2018-12-31	$0
Contributions received in cash from employer	2018-12-31	$475,978
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$40,452
Contract administrator fees	2018-12-31	$365
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	BAKER TILLY VIRCHOW KRAUSE,LLP
Accountancy firm EIN	2018-12-31	390859910

Form 5500 Responses for FULTON COUNTY MEDICAL CENTER 403(B) RETIREMENT SAVINGS PLAN

2023: FULTON COUNTY MEDICAL CENTER 403(B) RETIREMENT SAVINGS PLAN 2023 form 5500 responses
2023-01-01	Type of plan entity	Single employer plan
2023-01-01	Submission has been amended	No
2023-01-01	This submission is the final filing	No
2023-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2023-01-01	Plan is a collectively bargained plan	No
2023-01-01	Plan funding arrangement – Insurance	Yes
2023-01-01	Plan funding arrangement – Trust	Yes
2023-01-01	Plan benefit arrangement – Insurance	Yes
2023-01-01	Plan benefit arrangement - Trust	Yes
2022: FULTON COUNTY MEDICAL CENTER 403(B) RETIREMENT SAVINGS PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	Yes
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: FULTON COUNTY MEDICAL CENTER 403(B) RETIREMENT SAVINGS PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	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: FULTON COUNTY MEDICAL CENTER 403(B) RETIREMENT SAVINGS PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	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: FULTON COUNTY MEDICAL CENTER 403(B) RETIREMENT SAVINGS PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	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: FULTON COUNTY MEDICAL CENTER 403(B) RETIREMENT SAVINGS PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	First time form 5500 has been submitted	Yes
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

748711

Policy instance

Insurance contract or identification number	748711
Number of Individuals Covered	372
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
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

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

748711-01

Policy instance

Insurance contract or identification number	748711-01
Number of Individuals Covered	452
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

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

MR 62661

Policy instance

Insurance contract or identification number	MR 62661
Number of Individuals Covered	463
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

MR 62661

Policy instance

Insurance contract or identification number	MR 62661
Number of Individuals Covered	490
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

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

MR 62661

Policy instance

Insurance contract or identification number	MR 62661
Number of Individuals Covered	520
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

MR 62661

Policy instance

Insurance contract or identification number	MR 62661
Number of Individuals Covered	495
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

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Company Name:	FULTON COUNTY MEDICAL CENTER
Employer identification number (EIN):	231401561
NAIC Classification:	622000
NAIC Description:	Hospitals