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TRI COUNTY HEALTH SYSTEMS INC MONEY PURCHASE PLAN 401k Plan overview

Plan NameTRI COUNTY HEALTH SYSTEMS INC MONEY PURCHASE PLAN
Plan identification number 001

TRI COUNTY HEALTH SYSTEMS INC MONEY PURCHASE PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Money purchase (other than target benefit)
  • Profit-sharing
  • 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.
  • Prototype plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion or notification letter; and under which a seperate funding medium (for example, a seperate trust or custodial account) is established for the use of each adopting employer.

401k Sponsoring company profile

TRI COUNTY HEALTH SYSTEMS INC has sponsored the creation of one or more 401k plans.

Company Name:TRI COUNTY HEALTH SYSTEMS INC
Employer identification number (EIN):581324402
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TRI COUNTY HEALTH SYSTEMS INC MONEY PURCHASE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012014-04-01SHANNON ELZEY
0012013-04-01SHANNON ELZEY
0012012-04-01SHANNON ELZEY
0012011-04-01PHILLIP FARR
0012009-04-01DONNA NEWSOME

Plan Statistics for TRI COUNTY HEALTH SYSTEMS INC MONEY PURCHASE PLAN

401k plan membership statisitcs for TRI COUNTY HEALTH SYSTEMS INC MONEY PURCHASE PLAN

Measure Date Value
2014: TRI COUNTY HEALTH SYSTEMS INC MONEY PURCHASE PLAN 2014 401k membership
Total participants, beginning-of-year2014-04-0122
Total number of active participants reported on line 7a of the Form 55002014-04-010
Number of retired or separated participants receiving benefits2014-04-010
Number of other retired or separated participants entitled to future benefits2014-04-010
Total of all active and inactive participants2014-04-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-04-010
Total participants2014-04-010
Number of participants with account balances2014-04-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-04-010
2013: TRI COUNTY HEALTH SYSTEMS INC MONEY PURCHASE PLAN 2013 401k membership
Total participants, beginning-of-year2013-04-0122
Total number of active participants reported on line 7a of the Form 55002013-04-0112
Number of retired or separated participants receiving benefits2013-04-010
Number of other retired or separated participants entitled to future benefits2013-04-019
Total of all active and inactive participants2013-04-0121
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-04-011
Total participants2013-04-0122
Number of participants with account balances2013-04-0122
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-04-010
2012: TRI COUNTY HEALTH SYSTEMS INC MONEY PURCHASE PLAN 2012 401k membership
Total participants, beginning-of-year2012-04-0128
Total number of active participants reported on line 7a of the Form 55002012-04-0126
Total of all active and inactive participants2012-04-0126
Total participants2012-04-0126
2011: TRI COUNTY HEALTH SYSTEMS INC MONEY PURCHASE PLAN 2011 401k membership
Total participants, beginning-of-year2011-04-0126
Total number of active participants reported on line 7a of the Form 55002011-04-0128
Total of all active and inactive participants2011-04-0128
Total participants2011-04-0128
2009: TRI COUNTY HEALTH SYSTEMS INC MONEY PURCHASE PLAN 2009 401k membership
Total participants, beginning-of-year2009-04-0123
Total number of active participants reported on line 7a of the Form 55002009-04-0129
Total of all active and inactive participants2009-04-0129
Total participants2009-04-0129

Financial Data on TRI COUNTY HEALTH SYSTEMS INC MONEY PURCHASE PLAN

Measure Date Value
2015 : TRI COUNTY HEALTH SYSTEMS INC MONEY PURCHASE PLAN 2015 401k financial data
Total income from all sources2015-03-31$158,029
Expenses. Total of all expenses incurred2015-03-31$767,983
Benefits paid (including direct rollovers)2015-03-31$752,073
Total plan assets at end of year2015-03-31$0
Total plan assets at beginning of year2015-03-31$609,954
Value of fidelity bond covering the plan2015-03-31$25,000
Other income received2015-03-31$34,664
Net income (gross income less expenses)2015-03-31$-609,954
Net plan assets at end of year (total assets less liabilities)2015-03-31$0
Net plan assets at beginning of year (total assets less liabilities)2015-03-31$609,954
Total contributions received or receivable from employer(s)2015-03-31$123,365
Expenses. Administrative service providers (salaries,fees and commissions)2015-03-31$15,910
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-03-31$0
Funding deficiency by the employer to the plan for this plan year2015-03-31$0
Minimum employer required contribution for this plan year2015-03-31$123,365
Amount contributed by the employer to the plan for this plan year2015-03-31$123,365
2014 : TRI COUNTY HEALTH SYSTEMS INC MONEY PURCHASE PLAN 2014 401k financial data
Total income from all sources2014-03-31$97,557
Expenses. Total of all expenses incurred2014-03-31$19,372
Benefits paid (including direct rollovers)2014-03-31$13,235
Total plan assets at end of year2014-03-31$609,954
Total plan assets at beginning of year2014-03-31$531,769
Value of fidelity bond covering the plan2014-03-31$25,000
Other income received2014-03-31$60,167
Net income (gross income less expenses)2014-03-31$78,185
Net plan assets at end of year (total assets less liabilities)2014-03-31$609,954
Net plan assets at beginning of year (total assets less liabilities)2014-03-31$531,769
Total contributions received or receivable from employer(s)2014-03-31$37,390
Expenses. Administrative service providers (salaries,fees and commissions)2014-03-31$6,137
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-03-31$0
Funding deficiency by the employer to the plan for this plan year2014-03-31$0
Minimum employer required contribution for this plan year2014-03-31$37,390
Amount contributed by the employer to the plan for this plan year2014-03-31$37,390
2013 : TRI COUNTY HEALTH SYSTEMS INC MONEY PURCHASE PLAN 2013 401k financial data
Total income from all sources2013-03-31$66,765
Expenses. Total of all expenses incurred2013-03-31$91,509
Benefits paid (including direct rollovers)2013-03-31$85,425
Total plan assets at end of year2013-03-31$531,769
Total plan assets at beginning of year2013-03-31$556,513
Value of fidelity bond covering the plan2013-03-31$25,000
Other income received2013-03-31$38,434
Net income (gross income less expenses)2013-03-31$-24,744
Net plan assets at end of year (total assets less liabilities)2013-03-31$531,769
Net plan assets at beginning of year (total assets less liabilities)2013-03-31$556,513
Total contributions received or receivable from employer(s)2013-03-31$28,331
Expenses. Administrative service providers (salaries,fees and commissions)2013-03-31$6,084
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-03-31$0
Funding deficiency by the employer to the plan for this plan year2013-03-31$0
Minimum employer required contribution for this plan year2013-03-31$28,331
Amount contributed by the employer to the plan for this plan year2013-03-31$28,331
2012 : TRI COUNTY HEALTH SYSTEMS INC MONEY PURCHASE PLAN 2012 401k financial data
Total income from all sources2012-03-31$59,064
Expenses. Total of all expenses incurred2012-03-31$5,625
Total plan assets at end of year2012-03-31$556,513
Total plan assets at beginning of year2012-03-31$503,074
Value of fidelity bond covering the plan2012-03-31$25,000
Other income received2012-03-31$26,151
Net income (gross income less expenses)2012-03-31$53,439
Net plan assets at end of year (total assets less liabilities)2012-03-31$556,513
Net plan assets at beginning of year (total assets less liabilities)2012-03-31$503,074
Total contributions received or receivable from employer(s)2012-03-31$32,913
Expenses. Administrative service providers (salaries,fees and commissions)2012-03-31$5,625
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-03-31$0
Funding deficiency by the employer to the plan for this plan year2012-03-31$0
Minimum employer required contribution for this plan year2012-03-31$10,487
Amount contributed by the employer to the plan for this plan year2012-03-31$10,487
2011 : TRI COUNTY HEALTH SYSTEMS INC MONEY PURCHASE PLAN 2011 401k financial data
Total income from all sources2011-03-31$14,981
Expenses. Total of all expenses incurred2011-03-31$1,394
Benefits paid (including direct rollovers)2011-03-31$38
Total plan assets at end of year2011-03-31$503,074
Total plan assets at beginning of year2011-03-31$517,166
Value of fidelity bond covering the plan2011-03-31$25,000
Other income received2011-03-31$4,975
Net income (gross income less expenses)2011-03-31$13,587
Net plan assets at end of year (total assets less liabilities)2011-03-31$503,074
Net plan assets at beginning of year (total assets less liabilities)2011-03-31$517,166
Total contributions received or receivable from employer(s)2011-03-31$10,006
Expenses. Administrative service providers (salaries,fees and commissions)2011-03-31$1,356
Funding deficiency by the employer to the plan for this plan year2011-03-31$0
Minimum employer required contribution for this plan year2011-03-31$10,006
Amount contributed by the employer to the plan for this plan year2011-03-31$10,006
2010 : TRI COUNTY HEALTH SYSTEMS INC MONEY PURCHASE PLAN 2010 401k financial data
Funding deficiency by the employer to the plan for this plan year2010-03-31$0
Minimum employer required contribution for this plan year2010-03-31$52,574
Amount contributed by the employer to the plan for this plan year2010-03-31$52,574

Form 5500 Responses for TRI COUNTY HEALTH SYSTEMS INC MONEY PURCHASE PLAN

2014: TRI COUNTY HEALTH SYSTEMS INC MONEY PURCHASE PLAN 2014 form 5500 responses
2014-04-01Type of plan entitySingle employer plan
2014-04-01Submission has been amendedNo
2014-04-01This submission is the final filingYes
2014-04-01This return/report is a short plan year return/report (less than 12 months)No
2014-04-01Plan is a collectively bargained planNo
2014-04-01Plan funding arrangement – InsuranceYes
2014-04-01Plan benefit arrangement – InsuranceYes
2013: TRI COUNTY HEALTH SYSTEMS INC MONEY PURCHASE PLAN 2013 form 5500 responses
2013-04-01Type of plan entitySingle employer plan
2013-04-01Submission has been amendedNo
2013-04-01This submission is the final filingNo
2013-04-01This return/report is a short plan year return/report (less than 12 months)No
2013-04-01Plan is a collectively bargained planNo
2013-04-01Plan funding arrangement – InsuranceYes
2013-04-01Plan benefit arrangement – InsuranceYes
2012: TRI COUNTY HEALTH SYSTEMS INC MONEY PURCHASE PLAN 2012 form 5500 responses
2012-04-01Type of plan entitySingle employer plan
2012-04-01Submission has been amendedNo
2012-04-01This submission is the final filingNo
2012-04-01This return/report is a short plan year return/report (less than 12 months)No
2012-04-01Plan is a collectively bargained planNo
2012-04-01Plan funding arrangement – InsuranceYes
2012-04-01Plan benefit arrangement – InsuranceYes
2011: TRI COUNTY HEALTH SYSTEMS INC MONEY PURCHASE PLAN 2011 form 5500 responses
2011-04-01Type of plan entitySingle employer plan
2011-04-01Submission has been amendedNo
2011-04-01This submission is the final filingNo
2011-04-01This return/report is a short plan year return/report (less than 12 months)No
2011-04-01Plan is a collectively bargained planNo
2011-04-01Plan funding arrangement – InsuranceYes
2011-04-01Plan benefit arrangement – InsuranceYes
2009: TRI COUNTY HEALTH SYSTEMS INC MONEY PURCHASE PLAN 2009 form 5500 responses
2009-04-01Type of plan entitySingle employer plan
2009-04-01Submission has been amendedNo
2009-04-01This submission is the final filingNo
2009-04-01This return/report is a short plan year return/report (less than 12 months)No
2009-04-01Plan is a collectively bargained planNo
2009-04-01Plan funding arrangement – InsuranceYes
2009-04-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )
Policy contract numberGP 85187
Policy instance 1
Insurance contract or identification numberGP 85187
Number of Individuals Covered0
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $806
Total amount of fees paid to insurance companyUSD $786
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?Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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
Other information about contractGROUP VAR ANNUITY WITH GUARANTEED FUND
Commission paid to Insurance BrokerUSD $806
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerSALES AND BASE COMMISSIONS
Insurance broker organization code?4
Insurance broker nameLPL FINANCIAL CORP
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )
Policy contract numberGP 85187
Policy instance 1
Insurance contract or identification numberGP 85187
Number of Individuals Covered22
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $2,076
Total amount of fees paid to insurance companyUSD $775
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?Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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
Other information about contractGROUP VAR ANNUITY WITH GUARANTEED FUND
Commission paid to Insurance BrokerUSD $2,076
Insurance broker organization code?4
Amount paid for insurance broker fees750
Additional information about fees paid to insurance brokerTPA SUBSIDY
Insurance broker nameLINCOLN FINANCIAL ADVISORS
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )
Policy contract numberGP 85187
Policy instance 1
Insurance contract or identification numberGP 85187
Number of Individuals Covered26
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $2,067
Total amount of fees paid to insurance companyUSD $1,026
Are there contracts with allocated funds for types other than group deferred annuity or individual?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Other information about contractGROUP VAR ANNUITY WITH GUARANTEED FUND
Commission paid to Insurance BrokerUSD $2,067
Additional information about fees paid to insurance brokerSALES AND BASE COMMISSIONS
Insurance broker organization code?4
Amount paid for insurance broker fees1000
Insurance broker nameLINCOLN FINANCIAL ADVISORS
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )
Policy contract numberGP 85187
Policy instance 1
Insurance contract or identification numberGP 85187
Number of Individuals Covered28
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $1,890
Total amount of fees paid to insurance companyUSD $794
Are there contracts with allocated funds for types other than group deferred annuity or individual?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Other information about contractGROUP VAR ANNUITY WITH GUARANTEED FUND
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )
Policy contract numberGP 85187
Policy instance 1
Insurance contract or identification numberGP 85187
Number of Individuals Covered26
Insurance policy start date2010-04-01
Insurance policy end date2011-03-31
Total amount of commissions paid to insurance brokerUSD $1,754
Total amount of fees paid to insurance companyUSD $1,020
Are there contracts with allocated funds for types other than group deferred annuity or individual?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Other information about contractGROUP VAR ANNUITY WITH GUARANTEED FUND

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