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DODGE CITY MEDICAL CENTER, CHARTERED GROUP HEALTH PLAN 401k Plan overview

Plan NameDODGE CITY MEDICAL CENTER, CHARTERED GROUP HEALTH PLAN
Plan identification number 503

DODGE CITY MEDICAL CENTER, CHARTERED GROUP HEALTH PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental

401k Sponsoring company profile

DODGE CITY MEDICAL CENTER CHARTERED has sponsored the creation of one or more 401k plans.

Company Name:DODGE CITY MEDICAL CENTER CHARTERED
Employer identification number (EIN):481092267
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DODGE CITY MEDICAL CENTER, CHARTERED GROUP HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032013-11-01
5032012-11-01MLADEN PERAK, MD
5032011-11-01GENE DOLE
5032009-11-01GENE DOLE

Plan Statistics for DODGE CITY MEDICAL CENTER, CHARTERED GROUP HEALTH PLAN

401k plan membership statisitcs for DODGE CITY MEDICAL CENTER, CHARTERED GROUP HEALTH PLAN

Measure Date Value
2013: DODGE CITY MEDICAL CENTER, CHARTERED GROUP HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year2013-11-01116
Total number of active participants reported on line 7a of the Form 55002013-11-0193
Total of all active and inactive participants2013-11-0193
2012: DODGE CITY MEDICAL CENTER, CHARTERED GROUP HEALTH PLAN 2012 401k membership
Total participants, beginning-of-year2012-11-01117
Total number of active participants reported on line 7a of the Form 55002012-11-01116
Total of all active and inactive participants2012-11-01116
2011: DODGE CITY MEDICAL CENTER, CHARTERED GROUP HEALTH PLAN 2011 401k membership
Total participants, beginning-of-year2011-11-01123
Total number of active participants reported on line 7a of the Form 55002011-11-01117
Total of all active and inactive participants2011-11-01117
2009: DODGE CITY MEDICAL CENTER, CHARTERED GROUP HEALTH PLAN 2009 401k membership
Total participants, beginning-of-year2009-11-01115
Total number of active participants reported on line 7a of the Form 55002009-11-01119
Total of all active and inactive participants2009-11-01119

Financial Data on DODGE CITY MEDICAL CENTER, CHARTERED GROUP HEALTH PLAN

Measure Date Value
2014 : DODGE CITY MEDICAL CENTER, CHARTERED GROUP HEALTH PLAN 2014 401k financial data
Total income from all sources (including contributions)2014-10-31$1,041,641
Total of all expenses incurred2014-10-31$1,128,393
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-10-31$1,069,210
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-10-31$1,041,636
Value of total assets at end of year2014-10-31$12,311
Value of total assets at beginning of year2014-10-31$99,063
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-10-31$59,183
Total interest from all sources2014-10-31$5
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-10-31Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan2014-10-31$0
Administrative expenses professional fees incurred2014-10-31$1,295
Was this plan covered by a fidelity bond2014-10-31Yes
Value of fidelity bond cover2014-10-31$100,000
If this is an individual account plan, was there a blackout period2014-10-31No
Were there any nonexempt tranactions with any party-in-interest2014-10-31No
Contributions received from participants2014-10-31$184,202
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-10-31No
Value of net income/loss2014-10-31$-86,752
Value of net assets at end of year (total assets less liabilities)2014-10-31$12,311
Value of net assets at beginning of year (total assets less liabilities)2014-10-31$99,063
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-10-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-10-31No
Were any leases to which the plan was party in default or uncollectible2014-10-31No
Investment advisory and management fees2014-10-31$1,000
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-10-31$12,311
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-10-31$99,063
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-10-31$99,063
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-10-31$5
Expenses. Payments to insurance carriers foe the provision of benefits2014-10-31$198,149
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-10-31No
Was there a failure to transmit to the plan any participant contributions2014-10-31No
Has the plan failed to provide any benefit when due under the plan2014-10-31No
Contributions received in cash from employer2014-10-31$857,434
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-10-31$871,061
Contract administrator fees2014-10-31$56,888
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32014-10-31No
Did the plan have assets held for investment2014-10-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-10-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-10-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-10-31No
Opinion of an independent qualified public accountant for this plan2014-10-31Unqualified
Accountancy firm name2014-10-31VARNEY & ASSOCIATES, CPAS, LLC
Accountancy firm EIN2014-10-31300038643
2013 : DODGE CITY MEDICAL CENTER, CHARTERED GROUP HEALTH PLAN 2013 401k financial data
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-10-31$81
Total income from all sources (including contributions)2013-10-31$884,417
Total of all expenses incurred2013-10-31$1,004,562
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-10-31$938,703
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-10-31$884,405
Value of total assets at end of year2013-10-31$99,063
Value of total assets at beginning of year2013-10-31$219,289
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-10-31$65,859
Total interest from all sources2013-10-31$12
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-10-31No
Administrative expenses professional fees incurred2013-10-31$1,277
Was this plan covered by a fidelity bond2013-10-31Yes
Value of fidelity bond cover2013-10-31$100,000
If this is an individual account plan, was there a blackout period2013-10-31No
Were there any nonexempt tranactions with any party-in-interest2013-10-31No
Contributions received from participants2013-10-31$225,969
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-10-31No
Value of net income/loss2013-10-31$-120,145
Value of net assets at end of year (total assets less liabilities)2013-10-31$99,063
Value of net assets at beginning of year (total assets less liabilities)2013-10-31$219,208
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-10-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-10-31No
Were any leases to which the plan was party in default or uncollectible2013-10-31No
Investment advisory and management fees2013-10-31$1,077
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-10-31$99,063
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-10-31$216,319
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-10-31$216,319
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-10-31$12
Expenses. Payments to insurance carriers foe the provision of benefits2013-10-31$180,837
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-10-31No
Was there a failure to transmit to the plan any participant contributions2013-10-31No
Has the plan failed to provide any benefit when due under the plan2013-10-31No
Contributions received in cash from employer2013-10-31$658,436
Employer contributions (assets) at beginning of year2013-10-31$2,970
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-10-31$757,866
Contract administrator fees2013-10-31$63,505
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32013-10-31No
Liabilities. Value of benefit claims payable at beginning of year2013-10-31$81
Did the plan have assets held for investment2013-10-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-10-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-10-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-10-31No
Opinion of an independent qualified public accountant for this plan2013-10-31Unqualified
Accountancy firm name2013-10-31VARNEY & ASSOCIATES, CPAS, LLC
Accountancy firm EIN2013-10-31300038643
2012 : DODGE CITY MEDICAL CENTER, CHARTERED GROUP HEALTH PLAN 2012 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-10-31$81
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-10-31$49,168
Total income from all sources (including contributions)2012-10-31$773,638
Total of all expenses incurred2012-10-31$993,320
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-10-31$928,691
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-10-31$773,605
Value of total assets at end of year2012-10-31$219,289
Value of total assets at beginning of year2012-10-31$488,058
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-10-31$64,629
Total interest from all sources2012-10-31$33
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-10-31No
Administrative expenses professional fees incurred2012-10-31$1,250
Was this plan covered by a fidelity bond2012-10-31Yes
Value of fidelity bond cover2012-10-31$100,000
If this is an individual account plan, was there a blackout period2012-10-31No
Were there any nonexempt tranactions with any party-in-interest2012-10-31No
Contributions received from participants2012-10-31$202,491
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-10-31No
Value of net income/loss2012-10-31$-219,682
Value of net assets at end of year (total assets less liabilities)2012-10-31$219,208
Value of net assets at beginning of year (total assets less liabilities)2012-10-31$438,890
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-10-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-10-31No
Were any leases to which the plan was party in default or uncollectible2012-10-31No
Investment advisory and management fees2012-10-31$2,375
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-10-31$216,319
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-10-31$484,955
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-10-31$484,955
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-10-31$33
Expenses. Payments to insurance carriers foe the provision of benefits2012-10-31$155,628
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-10-31No
Was there a failure to transmit to the plan any participant contributions2012-10-31No
Has the plan failed to provide any benefit when due under the plan2012-10-31No
Contributions received in cash from employer2012-10-31$571,114
Employer contributions (assets) at end of year2012-10-31$2,970
Employer contributions (assets) at beginning of year2012-10-31$3,103
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-10-31$773,063
Contract administrator fees2012-10-31$61,004
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32012-10-31No
Liabilities. Value of benefit claims payable at end of year2012-10-31$81
Liabilities. Value of benefit claims payable at beginning of year2012-10-31$49,168
Did the plan have assets held for investment2012-10-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-10-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-10-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-10-31No
Opinion of an independent qualified public accountant for this plan2012-10-31Unqualified
Accountancy firm name2012-10-31VARNEY & ASSOCIATES, CPAS, LLC
Accountancy firm EIN2012-10-31300038643
2011 : DODGE CITY MEDICAL CENTER, CHARTERED GROUP HEALTH PLAN 2011 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-10-31$49,168
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-10-31$8,367
Total income from all sources (including contributions)2011-10-31$833,526
Total of all expenses incurred2011-10-31$967,355
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-10-31$911,108
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-10-31$833,462
Value of total assets at end of year2011-10-31$488,058
Value of total assets at beginning of year2011-10-31$581,086
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-10-31$56,247
Total interest from all sources2011-10-31$64
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-10-31No
Administrative expenses professional fees incurred2011-10-31$1,174
Was this plan covered by a fidelity bond2011-10-31Yes
Value of fidelity bond cover2011-10-31$100,000
If this is an individual account plan, was there a blackout period2011-10-31No
Were there any nonexempt tranactions with any party-in-interest2011-10-31No
Contributions received from participants2011-10-31$211,528
Liabilities. Value of operating payables at beginning of year2011-10-31$349
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-10-31No
Value of net income/loss2011-10-31$-133,829
Value of net assets at end of year (total assets less liabilities)2011-10-31$438,890
Value of net assets at beginning of year (total assets less liabilities)2011-10-31$572,719
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-10-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-10-31No
Were any leases to which the plan was party in default or uncollectible2011-10-31No
Investment advisory and management fees2011-10-31$4,020
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-10-31$484,955
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-10-31$581,086
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-10-31$581,086
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-10-31$64
Expenses. Payments to insurance carriers foe the provision of benefits2011-10-31$144,196
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-10-31No
Was there a failure to transmit to the plan any participant contributions2011-10-31No
Has the plan failed to provide any benefit when due under the plan2011-10-31No
Contributions received in cash from employer2011-10-31$621,934
Employer contributions (assets) at end of year2011-10-31$3,103
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-10-31$766,912
Contract administrator fees2011-10-31$51,053
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32011-10-31No
Liabilities. Value of benefit claims payable at end of year2011-10-31$49,168
Liabilities. Value of benefit claims payable at beginning of year2011-10-31$8,018
Did the plan have assets held for investment2011-10-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-10-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-10-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-10-31No
Opinion of an independent qualified public accountant for this plan2011-10-31Unqualified
Accountancy firm name2011-10-31VARNEY & ASSOCIATES, CPAS, LLC
Accountancy firm EIN2011-10-31300038643

Form 5500 Responses for DODGE CITY MEDICAL CENTER, CHARTERED GROUP HEALTH PLAN

2013: DODGE CITY MEDICAL CENTER, CHARTERED GROUP HEALTH PLAN 2013 form 5500 responses
2013-11-01Type of plan entitySingle employer plan
2013-11-01Submission has been amendedYes
2013-11-01This submission is the final filingYes
2013-11-01Plan funding arrangement – InsuranceYes
2013-11-01Plan funding arrangement – TrustYes
2013-11-01Plan benefit arrangement – InsuranceYes
2013-11-01Plan benefit arrangement - TrustYes
2012: DODGE CITY MEDICAL CENTER, CHARTERED GROUP HEALTH PLAN 2012 form 5500 responses
2012-11-01Type of plan entitySingle employer plan
2012-11-01Plan funding arrangement – InsuranceYes
2012-11-01Plan funding arrangement – TrustYes
2012-11-01Plan benefit arrangement – InsuranceYes
2012-11-01Plan benefit arrangement - TrustYes
2011: DODGE CITY MEDICAL CENTER, CHARTERED GROUP HEALTH PLAN 2011 form 5500 responses
2011-11-01Type of plan entitySingle employer plan
2011-11-01Plan funding arrangement – InsuranceYes
2011-11-01Plan funding arrangement – TrustYes
2011-11-01Plan benefit arrangement – InsuranceYes
2011-11-01Plan benefit arrangement - TrustYes
2009: DODGE CITY MEDICAL CENTER, CHARTERED GROUP HEALTH PLAN 2009 form 5500 responses
2009-11-01Type of plan entitySingle employer plan
2009-11-01This submission is the final filingNo
2009-11-01Plan funding arrangement – InsuranceYes
2009-11-01Plan funding arrangement – TrustYes
2009-11-01Plan benefit arrangement – InsuranceYes
2009-11-01Plan benefit arrangement - TrustYes

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