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WASHINGTON STATE HOSPITAL ASSOCIATION 401(K) & RETIREMENT PLAN 401k Plan overview

Plan NameWASHINGTON STATE HOSPITAL ASSOCIATION 401(K) & RETIREMENT PLAN
Plan identification number 002

WASHINGTON STATE HOSPITAL ASSOCIATION 401(K) & RETIREMENT PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • 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.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

WASHINGTON STATE HOSPITAL ASSOCIATION has sponsored the creation of one or more 401k plans.

Company Name:WASHINGTON STATE HOSPITAL ASSOCIATION
Employer identification number (EIN):910584257
NAIC Classification:561210
NAIC Description:Facilities Support Services

Additional information about WASHINGTON STATE HOSPITAL ASSOCIATION

Jurisdiction of Incorporation: Washington Secretary of State Corporations Division
Incorporation Date: 1961-06-06
Company Identification Number: 601129611
Legal Registered Office Address: 1001 4TH AVE STE 4500

SEATTLE
United States of America (USA)
981541192

More information about WASHINGTON STATE HOSPITAL ASSOCIATION

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WASHINGTON STATE HOSPITAL ASSOCIATION 401(K) & RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022023-01-01
0022022-01-01
0022021-01-01
0022020-01-01
0022019-01-01
0022018-01-01
0022018-01-01
0022017-01-01LINDA MAGEE2018-06-12 TOM EVERT2018-06-12
0022016-01-01LINDA MAGEE TOM EVERT2017-07-31
0022015-01-01SCOTT BOND2016-10-06 SCOTT BOND2016-10-06
0022014-01-01ANDREA PUGH2015-07-08 KATIE HOLMES2015-07-08
0022013-01-01ANDREA PUGH2014-07-14 ANDREA PUGH2014-07-14
0022012-01-01ANDREA PUGH2013-07-15
0022011-01-01ANDREA PUGH2012-07-23
0022010-01-01CONNIE RAY2011-08-09

Plan Statistics for WASHINGTON STATE HOSPITAL ASSOCIATION 401(K) & RETIREMENT PLAN

401k plan membership statisitcs for WASHINGTON STATE HOSPITAL ASSOCIATION 401(K) & RETIREMENT PLAN

Measure Date Value
2023: WASHINGTON STATE HOSPITAL ASSOCIATION 401(K) & RETIREMENT PLAN 2023 401k membership
Total participants, beginning-of-year2023-01-01155
Total number of active participants reported on line 7a of the Form 55002023-01-0181
Number of retired or separated participants receiving benefits2023-01-012
Number of other retired or separated participants entitled to future benefits2023-01-0157
Total of all active and inactive participants2023-01-01140
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2023-01-010
Total participants2023-01-01140
Number of participants with account balances2023-01-01138
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2023-01-011
2022: WASHINGTON STATE HOSPITAL ASSOCIATION 401(K) & RETIREMENT PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01151
Total number of active participants reported on line 7a of the Form 55002022-01-0180
Number of retired or separated participants receiving benefits2022-01-014
Number of other retired or separated participants entitled to future benefits2022-01-0171
Total of all active and inactive participants2022-01-01155
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01155
Number of participants with account balances2022-01-01154
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-011
2021: WASHINGTON STATE HOSPITAL ASSOCIATION 401(K) & RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01148
Total number of active participants reported on line 7a of the Form 55002021-01-0172
Number of retired or separated participants receiving benefits2021-01-013
Number of other retired or separated participants entitled to future benefits2021-01-0176
Total of all active and inactive participants2021-01-01151
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01151
Number of participants with account balances2021-01-01149
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-017
2020: WASHINGTON STATE HOSPITAL ASSOCIATION 401(K) & RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01146
Total number of active participants reported on line 7a of the Form 55002020-01-0180
Number of retired or separated participants receiving benefits2020-01-013
Number of other retired or separated participants entitled to future benefits2020-01-0162
Total of all active and inactive participants2020-01-01145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-011
Total participants2020-01-01146
Number of participants with account balances2020-01-01145
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-012
2019: WASHINGTON STATE HOSPITAL ASSOCIATION 401(K) & RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01130
Total number of active participants reported on line 7a of the Form 55002019-01-0188
Number of retired or separated participants receiving benefits2019-01-012
Number of other retired or separated participants entitled to future benefits2019-01-0155
Total of all active and inactive participants2019-01-01145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01145
Number of participants with account balances2019-01-01141
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-017
2018: WASHINGTON STATE HOSPITAL ASSOCIATION 401(K) & RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01125
Total number of active participants reported on line 7a of the Form 55002018-01-0198
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-0130
Total of all active and inactive participants2018-01-01128
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01128
Number of participants with account balances2018-01-01126
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-012
2016: WASHINGTON STATE HOSPITAL ASSOCIATION 401(K) & RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0195
Total number of active participants reported on line 7a of the Form 55002016-01-0179
Number of retired or separated participants receiving benefits2016-01-012
Number of other retired or separated participants entitled to future benefits2016-01-0120
Total of all active and inactive participants2016-01-01101
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-01101
Number of participants with account balances2016-01-0199
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-012

Financial Data on WASHINGTON STATE HOSPITAL ASSOCIATION 401(K) & RETIREMENT PLAN

Measure Date Value
2023 : WASHINGTON STATE HOSPITAL ASSOCIATION 401(K) & RETIREMENT PLAN 2023 401k financial data
Total unrealized appreciation/depreciation of assets2023-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-12-31$0
Total income from all sources (including contributions)2023-12-31$4,532,936
Total loss/gain on sale of assets2023-12-31$0
Total of all expenses incurred2023-12-31$1,802,497
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-12-31$1,763,566
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-12-31$1,568,574
Value of total assets at end of year2023-12-31$19,283,425
Value of total assets at beginning of year2023-12-31$16,552,986
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-12-31$38,931
Total interest from all sources2023-12-31$2,507
Total dividends received (eg from common stock, registered investment company shares)2023-12-31$450,564
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2023-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2023-12-31$450,564
Was this plan covered by a fidelity bond2023-12-31Yes
Value of fidelity bond cover2023-12-31$500,000
If this is an individual account plan, was there a blackout period2023-12-31No
Were there any nonexempt tranactions with any party-in-interest2023-12-31No
Contributions received from participants2023-12-31$950,330
Participant contributions at end of year2023-12-31$58,157
Participant contributions at beginning of year2023-12-31$46,789
Other income not declared elsewhere2023-12-31$2,259
Total non interest bearing cash at end of year2023-12-31$3,480
Total non interest bearing cash at beginning of year2023-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-12-31No
Value of net income/loss2023-12-31$2,730,439
Value of net assets at end of year (total assets less liabilities)2023-12-31$19,283,425
Value of net assets at beginning of year (total assets less liabilities)2023-12-31$16,552,986
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2023-12-31No
Were any leases to which the plan was party in default or uncollectible2023-12-31No
Investment advisory and management fees2023-12-31$34,746
Value of interest in registered invesment companies (eg mutual funds) at end of year2023-12-31$18,725,013
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2023-12-31$15,389,927
Interest on participant loans2023-12-31$2,507
Value of interest in common/collective trusts at end of year2023-12-31$175,243
Value of interest in common/collective trusts at beginning of year2023-12-31$852,991
Net investment gain/loss from registered investment companies (e.g. mutual funds)2023-12-31$2,496,126
Net investment gain or loss from common/collective trusts2023-12-31$12,906
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-12-31No
Was there a failure to transmit to the plan any participant contributions2023-12-31No
Has the plan failed to provide any benefit when due under the plan2023-12-31No
Contributions received in cash from employer2023-12-31$618,244
Employer contributions (assets) at end of year2023-12-31$321,532
Employer contributions (assets) at beginning of year2023-12-31$263,279
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2023-12-31$1,763,566
Did the plan have assets held for investment2023-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-12-31No
Opinion of an independent qualified public accountant for this plan2023-12-31Unqualified
Accountancy firm name2023-12-31CLARK NUBER P.S.
Accountancy firm EIN2023-12-31911194016
2022 : WASHINGTON STATE HOSPITAL ASSOCIATION 401(K) & RETIREMENT PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total income from all sources (including contributions)2022-12-31$-2,246,572
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$1,101,958
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$1,044,705
Value of total corrective distributions2022-12-31$2,747
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$1,415,816
Value of total assets at end of year2022-12-31$16,552,986
Value of total assets at beginning of year2022-12-31$19,901,516
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$54,506
Total interest from all sources2022-12-31$2,818
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$430,125
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-12-31$430,125
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$500,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$862,097
Participant contributions at end of year2022-12-31$46,789
Participant contributions at beginning of year2022-12-31$65,549
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$46,330
Other income not declared elsewhere2022-12-31$2,860
Administrative expenses (other) incurred2022-12-31$4,981
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-3,348,530
Value of net assets at end of year (total assets less liabilities)2022-12-31$16,552,986
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$19,901,516
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Investment advisory and management fees2022-12-31$34,738
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$15,389,927
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$18,434,436
Interest on participant loans2022-12-31$2,818
Value of interest in common/collective trusts at end of year2022-12-31$852,991
Value of interest in common/collective trusts at beginning of year2022-12-31$1,152,792
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-4,115,805
Net investment gain or loss from common/collective trusts2022-12-31$17,614
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$507,389
Employer contributions (assets) at end of year2022-12-31$263,279
Employer contributions (assets) at beginning of year2022-12-31$248,739
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$1,044,705
Contract administrator fees2022-12-31$14,787
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31CLARK NUBER P.S.
Accountancy firm EIN2022-12-31911194016
2021 : WASHINGTON STATE HOSPITAL ASSOCIATION 401(K) & RETIREMENT PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total income from all sources (including contributions)2021-12-31$3,747,220
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$1,118,113
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$1,064,424
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$1,427,136
Value of total assets at end of year2021-12-31$19,901,516
Value of total assets at beginning of year2021-12-31$17,272,409
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$53,689
Total interest from all sources2021-12-31$3,620
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$988,875
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2021-12-31$988,875
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$500,000
If this is an individual account plan, was there a blackout period2021-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$860,599
Participant contributions at end of year2021-12-31$65,549
Participant contributions at beginning of year2021-12-31$85,750
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$49,744
Other income not declared elsewhere2021-12-31$1,910
Administrative expenses (other) incurred2021-12-31$1,565
Total non interest bearing cash at end of year2021-12-31$0
Total non interest bearing cash at beginning of year2021-12-31$162
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$2,629,107
Value of net assets at end of year (total assets less liabilities)2021-12-31$19,901,516
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$17,272,409
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Investment advisory and management fees2021-12-31$36,003
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$18,434,436
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$15,821,773
Interest on participant loans2021-12-31$3,620
Value of interest in common/collective trusts at end of year2021-12-31$1,152,792
Value of interest in common/collective trusts at beginning of year2021-12-31$1,111,486
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$1,309,164
Net investment gain or loss from common/collective trusts2021-12-31$16,515
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$516,793
Employer contributions (assets) at end of year2021-12-31$248,739
Employer contributions (assets) at beginning of year2021-12-31$253,238
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$1,064,424
Contract administrator fees2021-12-31$16,121
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31CLARK NUBER P.S.
Accountancy firm EIN2021-12-31911194016
2020 : WASHINGTON STATE HOSPITAL ASSOCIATION 401(K) & RETIREMENT PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total income from all sources (including contributions)2020-12-31$3,745,367
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$3,638,660
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$3,616,065
Value of total corrective distributions2020-12-31$440
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$1,423,835
Value of total assets at end of year2020-12-31$17,272,409
Value of total assets at beginning of year2020-12-31$17,165,702
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$22,155
Total interest from all sources2020-12-31$42,165
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$542,644
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2020-12-31$542,644
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$500,000
If this is an individual account plan, was there a blackout period2020-12-31Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$872,535
Participant contributions at end of year2020-12-31$85,750
Participant contributions at beginning of year2020-12-31$72,291
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$89,957
Total non interest bearing cash at end of year2020-12-31$162
Total non interest bearing cash at beginning of year2020-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$106,707
Value of net assets at end of year (total assets less liabilities)2020-12-31$17,272,409
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$17,165,702
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$15,821,773
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$15,736,327
Interest on participant loans2020-12-31$4,289
Interest earned on other investments2020-12-31$37,876
Value of interest in common/collective trusts at end of year2020-12-31$1,111,486
Value of interest in common/collective trusts at beginning of year2020-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$1,152,378
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$1,735,219
Net investment gain or loss from common/collective trusts2020-12-31$1,504
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31Yes
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$461,343
Employer contributions (assets) at end of year2020-12-31$253,238
Employer contributions (assets) at beginning of year2020-12-31$204,706
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$3,616,065
Contract administrator fees2020-12-31$22,155
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32020-12-31Yes
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Disclaimer
Accountancy firm name2020-12-31CLARK NUBER P.S.
Accountancy firm EIN2020-12-31911194016
2019 : WASHINGTON STATE HOSPITAL ASSOCIATION 401(K) & RETIREMENT PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total income from all sources (including contributions)2019-12-31$4,705,585
Total income from all sources (including contributions)2019-12-31$4,705,585
Total loss/gain on sale of assets2019-12-31$0
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$691,811
Total of all expenses incurred2019-12-31$691,811
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$688,070
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$688,070
Expenses. Certain deemed distributions of participant loans2019-12-31$0
Expenses. Certain deemed distributions of participant loans2019-12-31$0
Value of total corrective distributions2019-12-31$0
Value of total corrective distributions2019-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$1,942,957
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$1,942,957
Value of total assets at end of year2019-12-31$17,165,702
Value of total assets at end of year2019-12-31$17,165,702
Value of total assets at beginning of year2019-12-31$13,151,928
Value of total assets at beginning of year2019-12-31$13,151,928
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$3,741
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$3,741
Total interest from all sources2019-12-31$40,279
Total interest from all sources2019-12-31$40,279
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$1,210,973
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$1,210,973
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$1,210,973
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$1,210,973
Administrative expenses professional fees incurred2019-12-31$0
Administrative expenses professional fees incurred2019-12-31$0
Was this plan covered by a fidelity bond2019-12-31Yes
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$500,000
Value of fidelity bond cover2019-12-31$500,000
If this is an individual account plan, was there a blackout period2019-12-31No
If this is an individual account plan, was there a blackout period2019-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$777,832
Contributions received from participants2019-12-31$777,832
Participant contributions at end of year2019-12-31$72,291
Participant contributions at end of year2019-12-31$72,291
Participant contributions at beginning of year2019-12-31$46,086
Participant contributions at beginning of year2019-12-31$46,086
Participant contributions at beginning of year2019-12-31$18,925
Assets. Other investments not covered elsewhere at end of year2019-12-31$0
Assets. Other investments not covered elsewhere at end of year2019-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2019-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2019-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$745,269
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$745,269
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2019-12-31$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2019-12-31$0
Other income not declared elsewhere2019-12-31$0
Other income not declared elsewhere2019-12-31$0
Administrative expenses (other) incurred2019-12-31$0
Administrative expenses (other) incurred2019-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$4,013,774
Value of net income/loss2019-12-31$4,013,774
Value of net assets at end of year (total assets less liabilities)2019-12-31$17,165,702
Value of net assets at end of year (total assets less liabilities)2019-12-31$17,165,702
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$13,151,928
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$13,151,928
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Investment advisory and management fees2019-12-31$2,728
Investment advisory and management fees2019-12-31$2,728
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$15,736,327
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$15,736,327
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$11,925,143
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$11,925,143
Value of interest in pooled separate accounts at end of year2019-12-31$0
Value of interest in pooled separate accounts at end of year2019-12-31$0
Value of interest in pooled separate accounts at beginning of year2019-12-31$0
Value of interest in pooled separate accounts at beginning of year2019-12-31$0
Interest on participant loans2019-12-31$3,499
Interest on participant loans2019-12-31$3,499
Interest earned on other investments2019-12-31$36,780
Interest earned on other investments2019-12-31$36,780
Value of interest in common/collective trusts at end of year2019-12-31$0
Value of interest in common/collective trusts at end of year2019-12-31$0
Value of interest in common/collective trusts at beginning of year2019-12-31$0
Value of interest in common/collective trusts at beginning of year2019-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$1,152,378
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$1,152,378
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$928,344
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$928,344
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$1,511,376
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$1,511,376
Net investment gain/loss from pooled separate accounts2019-12-31$0
Net investment gain/loss from pooled separate accounts2019-12-31$0
Net investment gain or loss from common/collective trusts2019-12-31$0
Net investment gain or loss from common/collective trusts2019-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31Yes
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31Yes
Was there a failure to transmit to the plan any participant contributions2019-12-31Yes
Was there a failure to transmit to the plan any participant contributions2019-12-31Yes
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Assets. Invements in employer securities at end of year2019-12-31$0
Assets. Invements in employer securities at end of year2019-12-31$0
Assets. Invements in employer securities at beginning of year2019-12-31$0
Assets. Invements in employer securities at beginning of year2019-12-31$0
Contributions received in cash from employer2019-12-31$419,856
Contributions received in cash from employer2019-12-31$419,856
Employer contributions (assets) at end of year2019-12-31$204,706
Employer contributions (assets) at end of year2019-12-31$204,706
Employer contributions (assets) at beginning of year2019-12-31$233,430
Income. Dividends from common stock2019-12-31$0
Income. Dividends from common stock2019-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$688,070
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$688,070
Contract administrator fees2019-12-31$1,013
Contract administrator fees2019-12-31$1,013
Did the plan have assets held for investment2019-12-31Yes
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31CLARK NUBER P.S.
Accountancy firm name2019-12-31CLARK NUBER P.S.
Accountancy firm EIN2019-12-31911194016
Accountancy firm EIN2019-12-31911194016
2018 : WASHINGTON STATE HOSPITAL ASSOCIATION 401(K) & RETIREMENT PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total income from all sources (including contributions)2018-12-31$634,274
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$202,335
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$201,697
Expenses. Certain deemed distributions of participant loans2018-12-31$0
Value of total corrective distributions2018-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$1,372,338
Value of total assets at end of year2018-12-31$13,151,928
Value of total assets at beginning of year2018-12-31$12,719,989
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$638
Total interest from all sources2018-12-31$27,458
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$850,248
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2018-12-31$850,248
Administrative expenses professional fees incurred2018-12-31$0
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$100,000
If this is an individual account plan, was there a blackout period2018-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$641,056
Participant contributions at end of year2018-12-31$46,086
Participant contributions at beginning of year2018-12-31$58,759
Participant contributions at end of year2018-12-31$18,925
Assets. Other investments not covered elsewhere at end of year2018-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2018-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$168,967
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2018-12-31$0
Other income not declared elsewhere2018-12-31$0
Administrative expenses (other) incurred2018-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$431,939
Value of net assets at end of year (total assets less liabilities)2018-12-31$13,151,928
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$12,719,989
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Investment advisory and management fees2018-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$11,925,143
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$12,108,526
Value of interest in pooled separate accounts at end of year2018-12-31$0
Value of interest in pooled separate accounts at beginning of year2018-12-31$0
Interest on participant loans2018-12-31$1,987
Interest earned on other investments2018-12-31$25,471
Value of interest in common/collective trusts at end of year2018-12-31$0
Value of interest in common/collective trusts at beginning of year2018-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$928,344
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$552,704
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-1,615,770
Net investment gain/loss from pooled separate accounts2018-12-31$0
Net investment gain or loss from common/collective trusts2018-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Assets. Invements in employer securities at end of year2018-12-31$0
Assets. Invements in employer securities at beginning of year2018-12-31$0
Contributions received in cash from employer2018-12-31$562,315
Employer contributions (assets) at end of year2018-12-31$233,430
Income. Dividends from common stock2018-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$201,697
Contract administrator fees2018-12-31$638
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31CLARK NUBER P.S.
Accountancy firm EIN2018-12-31911194016
2016 : WASHINGTON STATE HOSPITAL ASSOCIATION 401(K) & RETIREMENT PLAN 2016 401k financial data
Total income from all sources2016-12-31$1,417,894
Expenses. Total of all expenses incurred2016-12-31$2,141,414
Benefits paid (including direct rollovers)2016-12-31$2,113,681
Total plan assets at end of year2016-12-31$10,573,463
Total plan assets at beginning of year2016-12-31$11,296,983
Total contributions received or receivable from participants2016-12-31$430,808
Expenses. Other expenses not covered elsewhere2016-12-31$1,733
Contributions received from other sources (not participants or employers)2016-12-31$44,097
Other income received2016-12-31$637,811
Net income (gross income less expenses)2016-12-31$-723,520
Net plan assets at end of year (total assets less liabilities)2016-12-31$10,573,463
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$11,296,983
Assets. Value of participant loans2016-12-31$22,392
Total contributions received or receivable from employer(s)2016-12-31$305,178
Value of certain deemed distributions of participant loans2016-12-31$0
Value of corrective distributions2016-12-31$2,133
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$23,867
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0

Form 5500 Responses for WASHINGTON STATE HOSPITAL ASSOCIATION 401(K) & RETIREMENT PLAN

2023: WASHINGTON STATE HOSPITAL ASSOCIATION 401(K) & RETIREMENT PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Submission has been amendedNo
2023-01-01This submission is the final filingNo
2023-01-01This return/report is a short plan year return/report (less than 12 months)No
2023-01-01Plan is a collectively bargained planNo
2023-01-01Plan funding arrangement – TrustYes
2023-01-01Plan benefit arrangement - TrustYes
2022: WASHINGTON STATE HOSPITAL ASSOCIATION 401(K) & RETIREMENT PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement - TrustYes
2021: WASHINGTON STATE HOSPITAL ASSOCIATION 401(K) & RETIREMENT PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement - TrustYes
2020: WASHINGTON STATE HOSPITAL ASSOCIATION 401(K) & RETIREMENT PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: WASHINGTON STATE HOSPITAL ASSOCIATION 401(K) & RETIREMENT PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: WASHINGTON STATE HOSPITAL ASSOCIATION 401(K) & RETIREMENT PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedYes
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2016: WASHINGTON STATE HOSPITAL ASSOCIATION 401(K) & RETIREMENT PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberMR 61192-1
Policy instance 1
Insurance contract or identification numberMR 61192-1
Number of Individuals Covered0
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberMR 61192
Policy instance 1
Insurance contract or identification numberMR 61192
Number of Individuals Covered145
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberMR 61192
Policy instance 1
Insurance contract or identification numberMR 61192
Number of Individuals Covered128
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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

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