401k Plan data: EMPIRE HEALTH SERVICES DEFINED BENEFIT PENSION PLAN plan

EMPIRE HEALTH SERVICES DEFINED BENEFIT PENSION PLAN 401k Plan overview

Plan Name	EMPIRE HEALTH SERVICES DEFINED BENEFIT PENSION PLAN
Plan identification number	001

EMPIRE HEALTH SERVICES DEFINED BENEFIT PENSION PLAN Benefits

401k Plan Type

Defined Benefit Pension

Plan Features/Benefits

Benefits are primarily pay related
Covered by PBGC - Plan is covered under the PBGC insurance program (see ERISA section 4021).
Plan covered by PBGC that was terminated and closed out for PBGC purposes - Before the end of the plan year (or a prior plan year), (1) the plan terminated in a standard (or distress) termination and completed the distribution of plan assets in satisfaction of all benefit liabilities (or all ERISA Title IV benefits for distress termination); or (2) a trustee was appointed for a terminated plan pursuant to ERISA section 4042.
Frozen Plan - As of the last day of the plan year, the plan provides that no participant will get any new benefit accrual (whether because of service or compensation).

401k Sponsoring company profile

EMPIRE HEALTH FOUNDATION has sponsored the creation of one or more 401k plans.

Company Name: EMPIRE HEALTH FOUNDATION

Employer identification number (EIN): 263375286

NAIC Classification: 813000
NAIC Description: Religious, Grantmaking, Civic, Professional, and Similar Organizations

Additional information about EMPIRE HEALTH FOUNDATION

Jurisdiction of Incorporation: Washington Secretary of State Corporations Division

Incorporation Date: 2008-08-22

Company Identification Number: 602858247

Legal Registered Office Address: 1780 BARNES BLVD SW

TUMWATER
United States of America (USA)
985120410

More information about EMPIRE HEALTH FOUNDATION

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPIRE HEALTH SERVICES DEFINED BENEFIT PENSION PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2015-01-01 ANTONY CHIANG
001 2014-01-01 ANTONY CHIANG ANTONY CHIANG 2015-10-14
001 2013-01-01 ANTONY CHIANG ANTONY CHIANG 2014-10-10
001 2012-01-01 ANTONY CHIANG
001 2011-01-01 ANTONY CHIANG
001 2010-01-01 ANTONY CHIANG ANTONY CHIANG 2011-10-13
001 2009-01-01 ANTONY CHIANG ANTONY CHIANG 2010-10-14

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2015-01-01	ANTONY CHIANG
001	2014-01-01	ANTONY CHIANG	ANTONY CHIANG	2015-10-14
001	2013-01-01	ANTONY CHIANG	ANTONY CHIANG	2014-10-10
001	2012-01-01	ANTONY CHIANG
001	2011-01-01	ANTONY CHIANG
001	2010-01-01	ANTONY CHIANG	ANTONY CHIANG	2011-10-13
001	2009-01-01	ANTONY CHIANG	ANTONY CHIANG	2010-10-14

Plan Statistics for EMPIRE HEALTH SERVICES DEFINED BENEFIT PENSION PLAN

401k plan membership statisitcs for EMPIRE HEALTH SERVICES DEFINED BENEFIT PENSION PLAN

Measure Date Value
2015: EMPIRE HEALTH SERVICES DEFINED BENEFIT PENSION PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 1,581
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 0
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: EMPIRE HEALTH SERVICES DEFINED BENEFIT PENSION PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 1,599
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 0
Number of retired or separated participants receiving benefits 2014-01-01 857
Number of other retired or separated participants entitled to future benefits 2014-01-01 687
Total of all active and inactive participants 2014-01-01 1,544
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 37
Total participants 2014-01-01 1,581
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: EMPIRE HEALTH SERVICES DEFINED BENEFIT PENSION PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 1,617
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 0
Number of retired or separated participants receiving benefits 2013-01-01 842
Number of other retired or separated participants entitled to future benefits 2013-01-01 723
Total of all active and inactive participants 2013-01-01 1,565
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 34
Total participants 2013-01-01 1,599
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: EMPIRE HEALTH SERVICES DEFINED BENEFIT PENSION PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 2,657
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 0
Number of retired or separated participants receiving benefits 2012-01-01 840
Number of other retired or separated participants entitled to future benefits 2012-01-01 749
Total of all active and inactive participants 2012-01-01 1,589
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 28
Total participants 2012-01-01 1,617
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: EMPIRE HEALTH SERVICES DEFINED BENEFIT PENSION PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 2,676
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 0
Number of retired or separated participants receiving benefits 2011-01-01 807
Number of other retired or separated participants entitled to future benefits 2011-01-01 1,827
Total of all active and inactive participants 2011-01-01 2,634
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 23
Total participants 2011-01-01 2,657
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: EMPIRE HEALTH SERVICES DEFINED BENEFIT PENSION PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 2,690
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 0
Number of retired or separated participants receiving benefits 2010-01-01 755
Number of other retired or separated participants entitled to future benefits 2010-01-01 1,895
Total of all active and inactive participants 2010-01-01 2,650
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 26
Total participants 2010-01-01 2,676
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: EMPIRE HEALTH SERVICES DEFINED BENEFIT PENSION PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 3,232
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 0
Number of retired or separated participants receiving benefits 2009-01-01 667
Number of other retired or separated participants entitled to future benefits 2009-01-01 2,000
Total of all active and inactive participants 2009-01-01 2,667
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 23
Total participants 2009-01-01 2,690
Number of participants with account balances 2009-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2015: EMPIRE HEALTH SERVICES DEFINED BENEFIT PENSION PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	1,581
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	0
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: EMPIRE HEALTH SERVICES DEFINED BENEFIT PENSION PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	1,599
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	0
Number of retired or separated participants receiving benefits	2014-01-01	857
Number of other retired or separated participants entitled to future benefits	2014-01-01	687
Total of all active and inactive participants	2014-01-01	1,544
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	37
Total participants	2014-01-01	1,581
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: EMPIRE HEALTH SERVICES DEFINED BENEFIT PENSION PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	1,617
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	0
Number of retired or separated participants receiving benefits	2013-01-01	842
Number of other retired or separated participants entitled to future benefits	2013-01-01	723
Total of all active and inactive participants	2013-01-01	1,565
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	34
Total participants	2013-01-01	1,599
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: EMPIRE HEALTH SERVICES DEFINED BENEFIT PENSION PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	2,657
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	0
Number of retired or separated participants receiving benefits	2012-01-01	840
Number of other retired or separated participants entitled to future benefits	2012-01-01	749
Total of all active and inactive participants	2012-01-01	1,589
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	28
Total participants	2012-01-01	1,617
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: EMPIRE HEALTH SERVICES DEFINED BENEFIT PENSION PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	2,676
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	0
Number of retired or separated participants receiving benefits	2011-01-01	807
Number of other retired or separated participants entitled to future benefits	2011-01-01	1,827
Total of all active and inactive participants	2011-01-01	2,634
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	23
Total participants	2011-01-01	2,657
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: EMPIRE HEALTH SERVICES DEFINED BENEFIT PENSION PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	2,690
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	0
Number of retired or separated participants receiving benefits	2010-01-01	755
Number of other retired or separated participants entitled to future benefits	2010-01-01	1,895
Total of all active and inactive participants	2010-01-01	2,650
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	26
Total participants	2010-01-01	2,676
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: EMPIRE HEALTH SERVICES DEFINED BENEFIT PENSION PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	3,232
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	0
Number of retired or separated participants receiving benefits	2009-01-01	667
Number of other retired or separated participants entitled to future benefits	2009-01-01	2,000
Total of all active and inactive participants	2009-01-01	2,667
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	23
Total participants	2009-01-01	2,690
Number of participants with account balances	2009-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on EMPIRE HEALTH SERVICES DEFINED BENEFIT PENSION PLAN

Measure	Date	Value
2015 : EMPIRE HEALTH SERVICES DEFINED BENEFIT PENSION PLAN 2015 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2015-12-31	$-4,966,759
Total unrealized appreciation/depreciation of assets	2015-12-31	$-4,966,759
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$11,615,777
Total loss/gain on sale of assets	2015-12-31	$2,972,186
Total of all expenses incurred	2015-12-31	$86,112,444
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$86,105,697
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$12,231,642
Value of total assets at end of year	2015-12-31	$0
Value of total assets at beginning of year	2015-12-31	$74,496,667
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$6,747
Total interest from all sources	2015-12-31	$1,378,621
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$87
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2015-12-31	$0
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$1,000,000
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
Value of other receiveables (less allowance for doubtful accounts) at end of year	2015-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2015-12-31	$572,466
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	$-74,496,667
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$74,496,667
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
Investment advisory and management fees	2015-12-31	$6,747
Income. Interest from US Government securities	2015-12-31	$1,374,359
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2015-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2015-12-31	$4,299,524
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2015-12-31	$4,299,524
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2015-12-31	$4,262
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$33,975
Expenses. Payments to insurance carriers foe the provision of benefits	2015-12-31	$72,730,569
Asset value of US Government securities at end of year	2015-12-31	$0
Asset value of US Government securities at beginning of year	2015-12-31	$69,590,702
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	Yes
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	$12,231,642
Income. Dividends from common stock	2015-12-31	$87
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$13,375,128
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	Yes
Aggregate proceeds on sale of assets	2015-12-31	$212,857,712
Aggregate carrying amount (costs) on sale of assets	2015-12-31	$209,885,526
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	CLIFTONLARSONALLEN
Accountancy firm EIN	2015-12-31	410746749
2014 : EMPIRE HEALTH SERVICES DEFINED BENEFIT PENSION PLAN 2014 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2014-12-31	$491,681
Total unrealized appreciation/depreciation of assets	2014-12-31	$491,681
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$8,085,255
Total loss/gain on sale of assets	2014-12-31	$5,933,344
Total of all expenses incurred	2014-12-31	$3,685,360
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$3,680,970
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$0
Value of total assets at end of year	2014-12-31	$74,496,667
Value of total assets at beginning of year	2014-12-31	$70,096,772
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$4,390
Total interest from all sources	2014-12-31	$1,323,078
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$336,444
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2014-12-31	$0
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$180,045
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$1,000,000
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
Value of other receiveables (less allowance for doubtful accounts) at end of year	2014-12-31	$572,466
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2014-12-31	$210,332
Other income not declared elsewhere	2014-12-31	$708
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$4,399,895
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$74,496,667
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$70,096,772
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
Investment advisory and management fees	2014-12-31	$4,390
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$31,849,568
Income. Interest from US Government securities	2014-12-31	$1,205,459
Income. Interest from corporate debt instruments	2014-12-31	$116,009
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2014-12-31	$4,299,524
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2014-12-31	$1,097,009
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2014-12-31	$1,097,009
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2014-12-31	$1,610
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$33,975
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$37,244
Asset value of US Government securities at end of year	2014-12-31	$69,590,702
Asset value of US Government securities at beginning of year	2014-12-31	$15,969,537
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	Yes
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	$0
Employer contributions (assets) at end of year	2014-12-31	$0
Employer contributions (assets) at beginning of year	2014-12-31	$0
Income. Dividends from common stock	2014-12-31	$156,399
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$3,680,970
Asset. Corporate debt instrument debt (other) at end of year	2014-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2014-12-31	$12,471,511
Assets. Corporate common stocks other than exployer securities at end of year	2014-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2014-12-31	$8,461,571
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
Aggregate proceeds on sale of assets	2014-12-31	$189,215,549
Aggregate carrying amount (costs) on sale of assets	2014-12-31	$183,282,205
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	CLIFTONLARSONALLEN
Accountancy firm EIN	2014-12-31	410746749
2013 : EMPIRE HEALTH SERVICES DEFINED BENEFIT PENSION PLAN 2013 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2013-12-31	$3,583,186
Total unrealized appreciation/depreciation of assets	2013-12-31	$3,583,186
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$6,402,731
Total loss/gain on sale of assets	2013-12-31	$1,508,578
Total of all expenses incurred	2013-12-31	$3,745,421
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$3,739,460
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$0
Value of total assets at end of year	2013-12-31	$70,096,772
Value of total assets at beginning of year	2013-12-31	$67,439,462
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$5,961
Total interest from all sources	2013-12-31	$690,006
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$618,594
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	$414,690
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$1,000,000
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
Value of other receiveables (less allowance for doubtful accounts) at end of year	2013-12-31	$210,332
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2013-12-31	$173,102
Other income not declared elsewhere	2013-12-31	$2,367
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	$2,657,310
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$70,096,772
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$67,439,462
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
Investment advisory and management fees	2013-12-31	$5,961
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$31,849,568
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$27,302,816
Income. Interest from US Government securities	2013-12-31	$394,331
Income. Interest from corporate debt instruments	2013-12-31	$294,961
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2013-12-31	$1,097,009
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2013-12-31	$2,750,871
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2013-12-31	$2,750,871
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2013-12-31	$714
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$37,244
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$40,792
Asset value of US Government securities at end of year	2013-12-31	$15,969,537
Asset value of US Government securities at beginning of year	2013-12-31	$16,206,738
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	Yes
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	$0
Employer contributions (assets) at end of year	2013-12-31	$0
Employer contributions (assets) at beginning of year	2013-12-31	$1,250,000
Income. Dividends from common stock	2013-12-31	$203,904
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$3,739,460
Asset. Corporate debt instrument debt (other) at end of year	2013-12-31	$12,471,511
Asset. Corporate debt instrument debt (other) at beginning of year	2013-12-31	$12,625,685
Assets. Corporate common stocks other than exployer securities at end of year	2013-12-31	$8,461,571
Assets. Corporate common stocks other than exployer securities at beginning of year	2013-12-31	$7,089,458
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
Aggregate proceeds on sale of assets	2013-12-31	$40,532,361
Aggregate carrying amount (costs) on sale of assets	2013-12-31	$39,023,783
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	CLIFTONLARSONALLEN
Accountancy firm EIN	2013-12-31	410746749
2012 : EMPIRE HEALTH SERVICES DEFINED BENEFIT PENSION PLAN 2012 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2012-12-31	$2,077,623
Total unrealized appreciation/depreciation of assets	2012-12-31	$2,077,623
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$5,227,741
Total loss/gain on sale of assets	2012-12-31	$526,826
Total of all expenses incurred	2012-12-31	$31,927,053
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$31,923,159
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$1,250,000
Value of total assets at end of year	2012-12-31	$67,439,462
Value of total assets at beginning of year	2012-12-31	$94,138,774
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$3,894
Total interest from all sources	2012-12-31	$691,193
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$616,901
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	$454,835
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$1,000,000
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
Value of other receiveables (less allowance for doubtful accounts) at end of year	2012-12-31	$173,102
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2012-12-31	$120,532
Other income not declared elsewhere	2012-12-31	$65,198
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	$-26,699,312
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$67,439,462
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$94,138,774
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
Investment advisory and management fees	2012-12-31	$3,894
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$27,302,816
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$6,573,973
Income. Interest from US Government securities	2012-12-31	$353,379
Income. Interest from corporate debt instruments	2012-12-31	$313,257
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-12-31	$2,750,871
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-12-31	$68,899,120
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-12-31	$68,899,120
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-12-31	$24,557
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$40,792
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$62,306
Asset value of US Government securities at end of year	2012-12-31	$16,206,738
Asset value of US Government securities at beginning of year	2012-12-31	$9,794,484
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	Yes
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	$1,250,000
Employer contributions (assets) at end of year	2012-12-31	$1,250,000
Employer contributions (assets) at beginning of year	2012-12-31	$0
Income. Dividends from common stock	2012-12-31	$162,066
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$31,923,159
Asset. Corporate debt instrument debt (other) at end of year	2012-12-31	$12,625,685
Asset. Corporate debt instrument debt (other) at beginning of year	2012-12-31	$7,386,771
Assets. Corporate common stocks other than exployer securities at end of year	2012-12-31	$7,089,458
Assets. Corporate common stocks other than exployer securities at beginning of year	2012-12-31	$1,301,588
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
Aggregate proceeds on sale of assets	2012-12-31	$123,642,242
Aggregate carrying amount (costs) on sale of assets	2012-12-31	$123,115,416
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	CLIFTONLARSONALLEN
Accountancy firm EIN	2012-12-31	410746749
2011 : EMPIRE HEALTH SERVICES DEFINED BENEFIT PENSION PLAN 2011 401k financial data
Unrealized appreciation/depreciation of real estate assets	2011-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2011-12-31	$-15,317,086
Total unrealized appreciation/depreciation of assets	2011-12-31	$-15,317,086
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$15,242,775
Total loss/gain on sale of assets	2011-12-31	$2,474,366
Total of all expenses incurred	2011-12-31	$3,275,544
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$3,275,544
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$166,631
Value of total assets at end of year	2011-12-31	$94,138,774
Value of total assets at beginning of year	2011-12-31	$82,171,543
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$0
Total interest from all sources	2011-12-31	$25,101,608
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$139,908
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2011-12-31	$123,563
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$1,000,000
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
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-12-31	$120,532
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-12-31	$486,604
Other income not declared elsewhere	2011-12-31	$2,677,348
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
Income. Non cash contributions	2011-12-31	$166,631
Value of net income/loss	2011-12-31	$11,967,231
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$94,138,774
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$82,171,543
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	$6,573,973
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$0
Income. Interest from US Government securities	2011-12-31	$21,778,461
Income. Interest from corporate debt instruments	2011-12-31	$3,314,023
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-12-31	$68,899,120
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-12-31	$3,184,618
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-12-31	$3,184,618
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-12-31	$9,124
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$62,306
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$63,561
Asset value of US Government securities at end of year	2011-12-31	$9,794,484
Asset value of US Government securities at beginning of year	2011-12-31	$63,026,756
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	Yes
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
Employer contributions (assets) at end of year	2011-12-31	$0
Employer contributions (assets) at beginning of year	2011-12-31	$8,400,000
Income. Dividends from common stock	2011-12-31	$16,345
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$3,275,544
Asset. Corporate debt instrument debt (other) at end of year	2011-12-31	$7,386,771
Asset. Corporate debt instrument debt (other) at beginning of year	2011-12-31	$7,010,004
Assets. Corporate common stocks other than exployer securities at end of year	2011-12-31	$1,301,588
Assets. Corporate common stocks other than exployer securities at beginning of year	2011-12-31	$0
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
Aggregate proceeds on sale of assets	2011-12-31	$114,111,419
Aggregate carrying amount (costs) on sale of assets	2011-12-31	$111,637,053
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	CLIFTONLARSONALLEN
Accountancy firm EIN	2011-12-31	410746749
2010 : EMPIRE HEALTH SERVICES DEFINED BENEFIT PENSION PLAN 2010 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2010-12-31	$-5,538,320
Total unrealized appreciation/depreciation of assets	2010-12-31	$-5,538,320
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total income from all sources (including contributions)	2010-12-31	$8,050,227
Total loss/gain on sale of assets	2010-12-31	$1,148,629
Total of all expenses incurred	2010-12-31	$3,115,164
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$3,115,082
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$9,282,019
Value of total assets at end of year	2010-12-31	$82,171,543
Value of total assets at beginning of year	2010-12-31	$77,236,480
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$82
Total interest from all sources	2010-12-31	$1,365,587
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$145,233
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$1,000,000
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
Value of other receiveables (less allowance for doubtful accounts) at end of year	2010-12-31	$486,604
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2010-12-31	$187,649
Other income not declared elsewhere	2010-12-31	$14,493
Administrative expenses (other) incurred	2010-12-31	$82
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
Income. Non cash contributions	2010-12-31	$7,978,804
Value of net income/loss	2010-12-31	$4,935,063
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$82,171,543
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$77,236,480
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	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$16,925,952
Interest earned on other investments	2010-12-31	$388
Income. Interest from US Government securities	2010-12-31	$968,307
Income. Interest from corporate debt instruments	2010-12-31	$377,761
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2010-12-31	$3,184,618
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2010-12-31	$1,562,279
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2010-12-31	$1,562,279
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2010-12-31	$19,131
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$63,561
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$105,205
Asset value of US Government securities at end of year	2010-12-31	$63,026,756
Asset value of US Government securities at beginning of year	2010-12-31	$10,260,743
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$1,632,586
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	Yes
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	$1,303,215
Employer contributions (assets) at end of year	2010-12-31	$8,400,000
Employer contributions (assets) at beginning of year	2010-12-31	$14,715,970
Income. Dividends from common stock	2010-12-31	$145,233
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$3,115,082
Asset. Corporate debt instrument debt (other) at end of year	2010-12-31	$7,010,004
Asset. Corporate debt instrument debt (other) at beginning of year	2010-12-31	$8,851,404
Assets. Corporate common stocks other than exployer securities at end of year	2010-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2010-12-31	$24,627,278
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
Aggregate proceeds on sale of assets	2010-12-31	$138,994,712
Aggregate carrying amount (costs) on sale of assets	2010-12-31	$137,846,083
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	LARSONALLEN
Accountancy firm EIN	2010-12-31	410746749
2009 : EMPIRE HEALTH SERVICES DEFINED BENEFIT PENSION 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 EMPIRE HEALTH SERVICES DEFINED BENEFIT PENSION PLAN

2015: EMPIRE HEALTH SERVICES DEFINED BENEFIT PENSION PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	Yes
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: EMPIRE HEALTH SERVICES DEFINED BENEFIT PENSION PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: EMPIRE HEALTH SERVICES DEFINED BENEFIT PENSION PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: EMPIRE HEALTH SERVICES DEFINED BENEFIT PENSION PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: EMPIRE HEALTH SERVICES DEFINED BENEFIT PENSION PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: EMPIRE HEALTH SERVICES DEFINED BENEFIT PENSION PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: EMPIRE HEALTH SERVICES DEFINED BENEFIT PENSION 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

JOHN HANCOCK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65099 )

Policy contract number

GAC-1179

Policy instance

Insurance contract or identification number	GAC-1179
Number of Individuals Covered	0
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	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

JOHN HANCOCK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65099 )

Policy contract number

GAC-1179

Policy instance

Insurance contract or identification number	GAC-1179
Number of Individuals Covered	17
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	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

JOHN HANCOCK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65099 )

Policy contract number

GAC-1179

Policy instance

Insurance contract or identification number	GAC-1179
Number of Individuals Covered	18
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	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

JOHN HANCOCK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65099 )

Policy contract number

GAC-1179

Policy instance

Insurance contract or identification number	GAC-1179
Number of Individuals Covered	20
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	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

JOHN HANCOCK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65099 )

Policy contract number

GAC-1179

Policy instance

Insurance contract or identification number	GAC-1179
Number of Individuals Covered	29
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	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

JOHN HANCOCK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65099 )

Policy contract number

GAC-1179

Policy instance

Insurance contract or identification number	GAC-1179
Number of Individuals Covered	33
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	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

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Company Name:	EMPIRE HEALTH FOUNDATION
Employer identification number (EIN):	263375286
NAIC Classification:	813000
NAIC Description:	Religious, Grantmaking, Civic, Professional, and Similar Organizations

Jurisdiction of Incorporation:	Washington Secretary of State Corporations Division
Incorporation Date:	2008-08-22
Company Identification Number:	602858247
Legal Registered Office Address:	1780 BARNES BLVD SW TUMWATER United States of America (USA) 985120410