401k Plan data: LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN plan

LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 401k Plan overview

Plan Name	LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN
Plan identification number	002

LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.
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

LITTLE FALLS HOSPITAL has sponsored the creation of one or more 401k plans.

Company Name: LITTLE FALLS HOSPITAL

Employer identification number (EIN): 150533578

NAIC Classification: 622000
NAIC Description: Hospitals

Additional information about LITTLE FALLS HOSPITAL

Jurisdiction of Incorporation: New York Department of State

Incorporation Date: 1894-03-23

Company Identification Number: 28134

Legal Registered Office Address: 140 BURWELL STREET
Herkimer
LITTLE FALLS
United States of America (USA)
13365

More information about LITTLE FALLS HOSPITAL

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2022-01-01
002 2021-01-01
002 2020-01-01
002 2019-01-01
002 2018-01-01
002 2017-01-01 JIM VIELKIND JIM VIELKIND 2018-10-12
002 2016-01-01 JAMES VIELKIND JAMES VIELKIND 2017-10-16
002 2015-01-01 JAMES VIELKIND JAMES VIELKIND 2016-10-17
002 2014-01-01 JAMES VIELKIND JAMES VIELKIND 2015-10-15
002 2013-01-01 JAMES VIELKIND JAMES VIELKIND 2014-10-14
002 2012-01-01 JAMES VIELKIND JAMES VIELKIND 2013-10-14
002 2009-01-01 JOHN FREDERICKS JOHN FREDERICKS 2010-10-15

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
002	2022-01-01
002	2021-01-01
002	2020-01-01
002	2019-01-01
002	2018-01-01
002	2017-01-01	JIM VIELKIND	JIM VIELKIND	2018-10-12
002	2016-01-01	JAMES VIELKIND	JAMES VIELKIND	2017-10-16
002	2015-01-01	JAMES VIELKIND	JAMES VIELKIND	2016-10-17
002	2014-01-01	JAMES VIELKIND	JAMES VIELKIND	2015-10-15
002	2013-01-01	JAMES VIELKIND	JAMES VIELKIND	2014-10-14
002	2012-01-01	JAMES VIELKIND	JAMES VIELKIND	2013-10-14
002	2009-01-01	JOHN FREDERICKS	JOHN FREDERICKS	2010-10-15

Plan Statistics for LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN

401k plan membership statisitcs for LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN

Measure Date Value
2022: LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 452
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 213
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 228
Total of all active and inactive participants 2022-01-01 441
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 441
Number of participants with account balances 2022-01-01 419
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 448
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 230
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 225
Total of all active and inactive participants 2021-01-01 455
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 455
Number of participants with account balances 2021-01-01 425
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 443
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 290
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 162
Total of all active and inactive participants 2020-01-01 452
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 452
Number of participants with account balances 2020-01-01 412
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 429
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 322
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 124
Total of all active and inactive participants 2019-01-01 446
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 446
Number of participants with account balances 2019-01-01 400
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 390
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 327
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 108
Total of all active and inactive participants 2018-01-01 435
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 435
Number of participants with account balances 2018-01-01 382
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 390
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 313
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 81
Total of all active and inactive participants 2017-01-01 394
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 394
Number of participants with account balances 2017-01-01 350
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 445
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 307
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 85
Total of all active and inactive participants 2016-01-01 392
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 392
Number of participants with account balances 2016-01-01 329
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 13
2015: LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 437
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 300
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 144
Total of all active and inactive participants 2015-01-01 444
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 444
Number of participants with account balances 2015-01-01 397
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 10
2014: LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 378
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 303
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 75
Total of all active and inactive participants 2014-01-01 378
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 378
Number of participants with account balances 2014-01-01 332
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 6
2013: LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 378
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 298
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 74
Total of all active and inactive participants 2013-01-01 372
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 372
Number of participants with account balances 2013-01-01 319
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 9
2012: LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 369
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 302
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 76
Total of all active and inactive participants 2012-01-01 378
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 378
Number of participants with account balances 2012-01-01 328
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 10
2009: LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 348
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 253
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 88
Total of all active and inactive participants 2009-01-01 341
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 341
Number of participants with account balances 2009-01-01 307
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 13

Measure	Date	Value
2022: LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	452
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	213
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	228
Total of all active and inactive participants	2022-01-01	441
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	441
Number of participants with account balances	2022-01-01	419
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	448
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	230
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	225
Total of all active and inactive participants	2021-01-01	455
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	455
Number of participants with account balances	2021-01-01	425
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	443
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	290
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	162
Total of all active and inactive participants	2020-01-01	452
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	452
Number of participants with account balances	2020-01-01	412
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	429
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	322
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	124
Total of all active and inactive participants	2019-01-01	446
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	446
Number of participants with account balances	2019-01-01	400
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	390
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	327
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	108
Total of all active and inactive participants	2018-01-01	435
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	435
Number of participants with account balances	2018-01-01	382
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	390
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	313
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	81
Total of all active and inactive participants	2017-01-01	394
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	394
Number of participants with account balances	2017-01-01	350
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	445
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	307
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	85
Total of all active and inactive participants	2016-01-01	392
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	392
Number of participants with account balances	2016-01-01	329
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	13
2015: LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	437
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	300
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	144
Total of all active and inactive participants	2015-01-01	444
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	444
Number of participants with account balances	2015-01-01	397
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	10
2014: LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	378
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	303
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	75
Total of all active and inactive participants	2014-01-01	378
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	378
Number of participants with account balances	2014-01-01	332
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	6
2013: LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	378
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	298
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	74
Total of all active and inactive participants	2013-01-01	372
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	372
Number of participants with account balances	2013-01-01	319
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	9
2012: LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	369
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	302
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	76
Total of all active and inactive participants	2012-01-01	378
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	378
Number of participants with account balances	2012-01-01	328
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	10
2009: LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	348
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	253
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	88
Total of all active and inactive participants	2009-01-01	341
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	341
Number of participants with account balances	2009-01-01	307
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	13

Financial Data on LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN

Measure	Date	Value
2022 : LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 2022 401k financial data
Total income from all sources (including contributions)	2022-12-31	$-1,041,555
Total of all expenses incurred	2022-12-31	$830,838
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$828,556
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$817,002
Value of total assets at end of year	2022-12-31	$9,508,352
Value of total assets at beginning of year	2022-12-31	$11,380,745
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$2,282
Total interest from all sources	2022-12-31	$29,673
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$500,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$566,591
Participant contributions at end of year	2022-12-31	$11,368
Participant contributions at beginning of year	2022-12-31	$120
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$1,468
Administrative expenses (other) incurred	2022-12-31	$2,282
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$-1,872,393
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$9,508,352
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$11,380,745
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$7,900,651
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$9,744,717
Value of interest in pooled separate accounts at end of year	2022-12-31	$25,169
Value of interest in pooled separate accounts at beginning of year	2022-12-31	$34,219
Interest earned on other investments	2022-12-31	$29,673
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$1,322,221
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$1,381,084
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-1,879,188
Net investment gain/loss from pooled separate accounts	2022-12-31	$-9,042
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$248,943
Employer contributions (assets) at end of year	2022-12-31	$248,943
Employer contributions (assets) at beginning of year	2022-12-31	$220,605
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$828,556
Did the plan have assets held for investment	2022-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Qualified
Accountancy firm name	2022-12-31	FUSTCHARLES LLP
Accountancy firm EIN	2022-12-31	161226221
2021 : LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 2021 401k financial data
Total income from all sources (including contributions)	2021-12-31	$2,109,955
Total of all expenses incurred	2021-12-31	$1,919,364
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$1,913,287
Value of total corrective distributions	2021-12-31	$3,021
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$853,512
Value of total assets at end of year	2021-12-31	$11,380,745
Value of total assets at beginning of year	2021-12-31	$11,190,154
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$3,056
Total interest from all sources	2021-12-31	$20,275
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
If this is an individual account plan, was there a blackout period	2021-12-31	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$529,101
Participant contributions at end of year	2021-12-31	$120
Participant contributions at beginning of year	2021-12-31	$19,530
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$103,806
Other income not declared elsewhere	2021-12-31	$35
Administrative expenses (other) incurred	2021-12-31	$3,056
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$190,591
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$11,380,745
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$11,190,154
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$9,744,717
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$9,256,319
Value of interest in pooled separate accounts at end of year	2021-12-31	$34,219
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$27,465
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2021-12-31	$20,275
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$1,381,084
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$1,690,727
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$1,229,379
Net investment gain/loss from pooled separate accounts	2021-12-31	$6,754
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$220,605
Employer contributions (assets) at end of year	2021-12-31	$220,605
Employer contributions (assets) at beginning of year	2021-12-31	$196,113
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$1,913,287
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2021-12-31	Yes
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Qualified
Accountancy firm name	2021-12-31	FUST CHARLES CHAMBERS LLP
Accountancy firm EIN	2021-12-31	161226221
2020 : LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 2020 401k financial data
Total income from all sources (including contributions)	2020-12-31	$1,983,604
Total of all expenses incurred	2020-12-31	$795,149
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$792,755
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$736,237
Value of total assets at end of year	2020-12-31	$11,190,154
Value of total assets at beginning of year	2020-12-31	$10,001,699
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$2,394
Total interest from all sources	2020-12-31	$18,893
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$515,572
Participant contributions at end of year	2020-12-31	$19,530
Participant contributions at beginning of year	2020-12-31	$20,084
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$24,552
Administrative expenses (other) incurred	2020-12-31	$2,394
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$1,188,455
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$11,190,154
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$10,001,699
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$9,256,319
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$8,004,077
Value of interest in pooled separate accounts at end of year	2020-12-31	$27,465
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$52,342
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2020-12-31	$18,893
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$1,690,727
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$1,697,082
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$1,213,351
Net investment gain/loss from pooled separate accounts	2020-12-31	$15,123
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$196,113
Employer contributions (assets) at end of year	2020-12-31	$196,113
Employer contributions (assets) at beginning of year	2020-12-31	$228,114
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$792,755
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	FUST CHARLES CHAMBERS LLP
Accountancy firm EIN	2020-12-31	161226221
2019 : LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 2019 401k financial data
Total income from all sources (including contributions)	2019-12-31	$2,301,184
Total income from all sources (including contributions)	2019-12-31	$2,301,184
Total of all expenses incurred	2019-12-31	$762,391
Total of all expenses incurred	2019-12-31	$762,391
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$760,487
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$760,487
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$777,119
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$777,119
Value of total assets at end of year	2019-12-31	$10,001,699
Value of total assets at end of year	2019-12-31	$10,001,699
Value of total assets at beginning of year	2019-12-31	$8,462,906
Value of total assets at beginning of year	2019-12-31	$8,462,906
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$1,904
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$1,904
Total interest from all sources	2019-12-31	$31,371
Total interest from all sources	2019-12-31	$31,371
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Was this plan covered by a fidelity bond	2019-12-31	Yes
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
Value of fidelity bond cover	2019-12-31	$500,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
If this is an individual account plan, was there a blackout period	2019-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$505,926
Contributions received from participants	2019-12-31	$505,926
Participant contributions at end of year	2019-12-31	$20,084
Participant contributions at end of year	2019-12-31	$20,084
Participant contributions at beginning of year	2019-12-31	$18,696
Participant contributions at beginning of year	2019-12-31	$18,696
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$38,224
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$38,224
Other income not declared elsewhere	2019-12-31	$595
Other income not declared elsewhere	2019-12-31	$595
Administrative expenses (other) incurred	2019-12-31	$1,904
Administrative expenses (other) incurred	2019-12-31	$1,904
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$1,538,793
Value of net income/loss	2019-12-31	$1,538,793
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$10,001,699
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$10,001,699
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$8,462,906
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$8,462,906
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$8,004,077
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$8,004,077
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$6,184,948
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$6,184,948
Value of interest in pooled separate accounts at end of year	2019-12-31	$52,342
Value of interest in pooled separate accounts at end of year	2019-12-31	$52,342
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$40,284
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$40,284
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-31	$31,371
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-31	$31,371
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$1,697,082
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$1,697,082
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$1,880,098
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$1,880,098
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$1,479,348
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$1,479,348
Net investment gain/loss from pooled separate accounts	2019-12-31	$12,751
Net investment gain/loss from pooled separate accounts	2019-12-31	$12,751
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2019-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$232,969
Contributions received in cash from employer	2019-12-31	$232,969
Employer contributions (assets) at end of year	2019-12-31	$228,114
Employer contributions (assets) at end of year	2019-12-31	$228,114
Employer contributions (assets) at beginning of year	2019-12-31	$338,880
Employer contributions (assets) at beginning of year	2019-12-31	$338,880
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$760,487
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$760,487
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	FUST CHARLES CHAMBERS LLP
Accountancy firm name	2019-12-31	FUST CHARLES CHAMBERS LLP
Accountancy firm EIN	2019-12-31	161226221
Accountancy firm EIN	2019-12-31	161226221
2018 : LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 2018 401k financial data
Total income from all sources (including contributions)	2018-12-31	$457,961
Total of all expenses incurred	2018-12-31	$1,093,550
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$1,091,330
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$874,599
Value of total assets at end of year	2018-12-31	$8,462,906
Value of total assets at beginning of year	2018-12-31	$9,098,495
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$2,220
Total interest from all sources	2018-12-31	$37,889
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$500,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$529,725
Participant contributions at end of year	2018-12-31	$18,696
Participant contributions at beginning of year	2018-12-31	$20,199
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$5,994
Other income not declared elsewhere	2018-12-31	$4
Administrative expenses (other) incurred	2018-12-31	$2,220
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$-635,589
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$8,462,906
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$9,098,495
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$6,184,948
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$6,956,314
Value of interest in pooled separate accounts at end of year	2018-12-31	$40,284
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$42,420
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2018-12-31	$37,889
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$1,880,098
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$1,738,446
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-452,395
Net investment gain/loss from pooled separate accounts	2018-12-31	$-2,136
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$338,880
Employer contributions (assets) at end of year	2018-12-31	$338,880
Employer contributions (assets) at beginning of year	2018-12-31	$341,116
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$1,091,330
Did the plan have assets held for investment	2018-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	FUST CHARLES CHAMBERS LLP
Accountancy firm EIN	2018-12-31	161226221
2017 : LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 2017 401k financial data
Total income from all sources (including contributions)	2017-12-31	$1,970,985
Total of all expenses incurred	2017-12-31	$561,877
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$559,253
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$985,280
Value of total assets at end of year	2017-12-31	$9,098,495
Value of total assets at beginning of year	2017-12-31	$7,689,387
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$2,624
Total interest from all sources	2017-12-31	$29,326
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$518,729
Participant contributions at end of year	2017-12-31	$20,199
Participant contributions at beginning of year	2017-12-31	$17,195
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$125,435
Other income not declared elsewhere	2017-12-31	$3
Administrative expenses (other) incurred	2017-12-31	$2,624
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$1,409,108
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$9,098,495
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$7,689,387
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$6,956,314
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$5,801,919
Value of interest in pooled separate accounts at end of year	2017-12-31	$42,420
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2017-12-31	$29,326
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$1,738,446
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$1,574,972
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$947,605
Net investment gain/loss from pooled separate accounts	2017-12-31	$8,771
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$341,116
Employer contributions (assets) at end of year	2017-12-31	$341,116
Employer contributions (assets) at beginning of year	2017-12-31	$295,301
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$559,253
Did the plan have assets held for investment	2017-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	FUST CHARLES CHAMBERS LLP
Accountancy firm EIN	2017-12-31	161226221
2016 : LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 2016 401k financial data
Total income from all sources (including contributions)	2016-12-31	$1,224,192
Total of all expenses incurred	2016-12-31	$562,455
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$560,501
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$773,108
Value of total assets at end of year	2016-12-31	$7,689,387
Value of total assets at beginning of year	2016-12-31	$7,027,650
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$1,954
Total interest from all sources	2016-12-31	$27,310
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$477,794
Participant contributions at end of year	2016-12-31	$17,195
Participant contributions at beginning of year	2016-12-31	$17,389
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$7,374
Administrative expenses (other) incurred	2016-12-31	$1,954
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$661,737
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$7,689,387
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$7,027,650
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$5,801,919
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$5,154,587
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2016-12-31	$27,310
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$1,574,972
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$1,559,579
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$423,774
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$287,940
Employer contributions (assets) at end of year	2016-12-31	$295,301
Employer contributions (assets) at beginning of year	2016-12-31	$296,095
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$560,501
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	FUST CHARLES CHAMBERS LLP
Accountancy firm EIN	2016-12-31	161226221
2015 : LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 2015 401k financial data
Total income from all sources (including contributions)	2015-12-31	$716,753
Total of all expenses incurred	2015-12-31	$1,115,547
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$1,113,523
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$798,755
Value of total assets at end of year	2015-12-31	$7,027,650
Value of total assets at beginning of year	2015-12-31	$7,426,444
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$2,024
Total interest from all sources	2015-12-31	$60,219
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$449,607
Participant contributions at end of year	2015-12-31	$17,389
Participant contributions at beginning of year	2015-12-31	$16,130
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$42,919
Other income not declared elsewhere	2015-12-31	$29
Administrative expenses (other) incurred	2015-12-31	$2,024
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$-398,794
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$7,027,650
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$7,426,444
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$5,154,587
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$5,639,225
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2015-12-31	$60,219
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$1,559,579
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$1,460,098
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-142,250
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$306,229
Employer contributions (assets) at end of year	2015-12-31	$296,095
Employer contributions (assets) at beginning of year	2015-12-31	$310,991
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$1,113,523
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	FUST CHARLES CHAMBERS LLP
Accountancy firm EIN	2015-12-31	161226221
2014 : LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 2014 401k financial data
Total income from all sources (including contributions)	2014-12-31	$1,033,423
Total of all expenses incurred	2014-12-31	$356,595
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$354,421
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$778,721
Value of total assets at end of year	2014-12-31	$7,426,444
Value of total assets at beginning of year	2014-12-31	$6,749,616
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$2,174
Total interest from all sources	2014-12-31	$19,528
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$446,665
Participant contributions at end of year	2014-12-31	$16,130
Participant contributions at beginning of year	2014-12-31	$670
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$30,016
Administrative expenses (other) incurred	2014-12-31	$2,174
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$676,828
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$7,426,444
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$6,749,616
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$5,639,225
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$5,170,484
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2014-12-31	$19,528
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$1,460,098
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$1,303,444
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$235,174
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$302,040
Employer contributions (assets) at end of year	2014-12-31	$310,991
Employer contributions (assets) at beginning of year	2014-12-31	$275,018
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$354,421
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	FUST CHARLES CHAMBERS LLP
Accountancy firm EIN	2014-12-31	161226221
2013 : LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 2013 401k financial data
Total income from all sources (including contributions)	2013-12-31	$1,463,677
Total of all expenses incurred	2013-12-31	$526,700
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$524,276
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$725,715
Value of total assets at end of year	2013-12-31	$6,749,616
Value of total assets at beginning of year	2013-12-31	$5,812,639
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$2,424
Total interest from all sources	2013-12-31	$14,897
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$418,210
Participant contributions at end of year	2013-12-31	$670
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$31,426
Administrative expenses (other) incurred	2013-12-31	$2,424
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$936,977
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$6,749,616
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$5,812,639
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$5,170,484
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$4,143,204
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2013-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2013-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2013-12-31	$14,897
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$1,303,444
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$1,396,496
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$723,065
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$276,079
Employer contributions (assets) at end of year	2013-12-31	$275,018
Employer contributions (assets) at beginning of year	2013-12-31	$272,939
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$524,276
Did the plan have assets held for investment	2013-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	FUST CHARLES CHAMBERS LLP
Accountancy firm EIN	2013-12-31	161226221
2012 : LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 2012 401k financial data
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$50
Total income from all sources (including contributions)	2012-12-31	$1,323,104
Total of all expenses incurred	2012-12-31	$432,195
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$431,621
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$886,622
Value of total assets at end of year	2012-12-31	$5,812,639
Value of total assets at beginning of year	2012-12-31	$4,921,780
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$574
Total interest from all sources	2012-12-31	$12,021
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$430,834
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$185,161
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2012-12-31	$50
Administrative expenses (other) incurred	2012-12-31	$574
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$890,909
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$5,812,639
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$4,921,730
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$4,011,390
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$3,010,169
Value of interest in pooled separate accounts at end of year	2012-12-31	$131,814
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-12-31	$391,220
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-12-31	$391,220
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-12-31	$12,021
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$1,396,496
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$1,249,410
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$415,780
Net investment gain/loss from pooled separate accounts	2012-12-31	$8,681
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$270,627
Employer contributions (assets) at end of year	2012-12-31	$272,939
Employer contributions (assets) at beginning of year	2012-12-31	$270,981
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$431,621
Did the plan have assets held for investment	2012-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	FUST CHARLES CHAMBERS LLP
Accountancy firm EIN	2012-12-31	161226221
2011 : LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$50
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$688,860
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$258,465
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$258,291
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$741,653
Value of total assets at end of year	2011-12-31	$4,921,780
Value of total assets at beginning of year	2011-12-31	$4,491,335
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$174
Total interest from all sources	2011-12-31	$18,979
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$420,846
Participant contributions at beginning of year	2011-12-31	$400
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$54,050
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2011-12-31	$50
Administrative expenses (other) incurred	2011-12-31	$174
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$430,395
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$4,921,730
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$4,491,335
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$3,010,169
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$2,862,998
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-12-31	$391,220
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-12-31	$292,175
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-12-31	$292,175
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-12-31	$18,979
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$1,249,410
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$1,089,687
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-71,772
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$266,757
Employer contributions (assets) at end of year	2011-12-31	$270,981
Employer contributions (assets) at beginning of year	2011-12-31	$246,075
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$258,291
Did the plan have assets held for investment	2011-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	FUST CHARLES CHAMBERS LLP
Accountancy firm EIN	2011-12-31	161226221
2010 : LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total income from all sources (including contributions)	2010-12-31	$915,341
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$236,229
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$236,055
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$582,875
Value of total assets at end of year	2010-12-31	$4,491,335
Value of total assets at beginning of year	2010-12-31	$3,812,223
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$174
Total interest from all sources	2010-12-31	$22,296
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$343,455
Participant contributions at end of year	2010-12-31	$400
Administrative expenses (other) incurred	2010-12-31	$174
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$679,112
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$4,491,335
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$3,812,223
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$2,862,998
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$2,244,316
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2010-12-31	$292,175
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2010-12-31	$331,300
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2010-12-31	$331,300
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2010-12-31	$22,296
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$1,089,687
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$990,252
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$310,170
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$239,420
Employer contributions (assets) at end of year	2010-12-31	$246,075
Employer contributions (assets) at beginning of year	2010-12-31	$246,355
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$236,055
Did the plan have assets held for investment	2010-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	FUST CHARLES CHAMBERS LLP
Accountancy firm EIN	2010-12-31	161226221
2009 : LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN

2022: LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	Yes
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2009: LITTLE FALLS HOSPITAL 403(B) RETIREMENT PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

901475E

Policy instance

Insurance contract or identification number	901475E
Number of Individuals Covered	4
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $8
Contracts With Unallocated Funds Deposit Administration	1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	8
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

GAP-D1-MF7F

Policy instance

Insurance contract or identification number	GAP-D1-MF7F
Number of Individuals Covered	419
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $745
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $745
Insurance broker organization code?	3

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

GAP-D1-UQ64

Policy instance

Insurance contract or identification number	GAP-D1-UQ64
Number of Individuals Covered	0
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $446
Total amount of fees paid to insurance company	USD $223
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $446
Amount paid for insurance broker fees	223
Additional information about fees paid to insurance broker	OTHER COMMISSIONS
Insurance broker organization code?	3

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

006133-E

Policy instance

Insurance contract or identification number	006133-E
Number of Individuals Covered	5
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $10
Contracts With Unallocated Funds Deposit Administration	1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	10
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

GAP-D1-MF7F

Policy instance

Insurance contract or identification number	GAP-D1-MF7F
Number of Individuals Covered	425
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $765
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $765
Insurance broker organization code?	3

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

006133-E

Policy instance

Insurance contract or identification number	006133-E
Number of Individuals Covered	7
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $10
Contracts With Unallocated Funds Deposit Administration	1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	10
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

GAP-D1-UQ64

Policy instance

Insurance contract or identification number	GAP-D1-UQ64
Number of Individuals Covered	412
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $1,616
Total amount of fees paid to insurance company	USD $808
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,616
Amount paid for insurance broker fees	808
Additional information about fees paid to insurance broker	OTHER COMMISSIONS
Insurance broker organization code?	3

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

006133-E

Policy instance

Insurance contract or identification number	006133-E
Number of Individuals Covered	7
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $53
Contracts With Unallocated Funds Deposit Administration	1
Amount paid for insurance broker fees	53
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

GAP-D1-UQ64

Policy instance

Insurance contract or identification number	GAP-D1-UQ64
Number of Individuals Covered	400
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $1,960
Total amount of fees paid to insurance company	USD $980
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $1,960
Amount paid for insurance broker fees	980
Additional information about fees paid to insurance broker	OTHER COMMISSIONS
Insurance broker organization code?	3

LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )

Policy contract number

890527+006

Policy instance

Insurance contract or identification number	890527+006
Number of Individuals Covered	0
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $260
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $260
Insurance broker organization code?	4

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

006133-E

Policy instance

Insurance contract or identification number	006133-E
Number of Individuals Covered	7
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $38
Contracts With Unallocated Funds Deposit Administration	1
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	38
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

GAP-D1-UQ64

Policy instance

Insurance contract or identification number	GAP-D1-UQ64
Number of Individuals Covered	382
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $1,869
Total amount of fees paid to insurance company	USD $934
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $1,869
Amount paid for insurance broker fees	934
Additional information about fees paid to insurance broker	OTHER COMMISSIONS
Insurance broker organization code?	3

LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )

Policy contract number

890527+006

Policy instance

Insurance contract or identification number	890527+006
Number of Individuals Covered	1
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $396
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $396
Insurance broker organization code?	4

LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )

Policy contract number

890527+006

Policy instance

Insurance contract or identification number	890527+006
Number of Individuals Covered	1
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $412
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $412
Insurance broker organization code?	4
Insurance broker name	HEALTHCARE COMMUNITY SECURITIE

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

GAP-D1-UQ64

Policy instance

Insurance contract or identification number	GAP-D1-UQ64
Number of Individuals Covered	350
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $1,631
Total amount of fees paid to insurance company	USD $816
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $1,631
Amount paid for insurance broker fees	816
Additional information about fees paid to insurance broker	OTHER COMMISSIONS
Insurance broker organization code?	3
Insurance broker name	MORGAN STANLEY SMITH BARNEY LL

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

006133-E

Policy instance

Insurance contract or identification number	006133-E
Number of Individuals Covered	7
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $63
Contracts With Unallocated Funds Deposit Administration	1
Amount paid for insurance broker fees	63
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMPENSATION PROGRAM
Insurance broker organization code?	3
Insurance broker name	ROCHESTER REGIONAL OFFICE

LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )

Policy contract number

890527+006

Policy instance

Insurance contract or identification number	890527+006
Number of Individuals Covered	1
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $345
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $345
Insurance broker organization code?	4
Insurance broker name	HEALTHCARE COMMUNITY SECURITIE

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

384-80038

Policy instance

Insurance contract or identification number	384-80038
Number of Individuals Covered	397
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $1,481
Total amount of fees paid to insurance company	USD $741
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $1,481
Amount paid for insurance broker fees	741
Additional information about fees paid to insurance broker	OTHER COMMISSIONS
Insurance broker organization code?	3
Insurance broker name	MORGAN STANLEY CO. LLC

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

006133-E

Policy instance

Insurance contract or identification number	006133-E
Number of Individuals Covered	8
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $39
Are there contracts with allocated funds for types other than group deferred annuity or individual?	Yes
Other information about contract	GROUP VARIABLE ANNUITY WITH GUARANTEED FUND
Amount paid for insurance broker fees	39
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP PROGRAM
Insurance broker organization code?	3
Insurance broker name	ROCHESTER REGIONAL OFFICE

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

006133-E

Policy instance

Insurance contract or identification number	006133-E
Number of Individuals Covered	8
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $32
Are there contracts with allocated funds for types other than group deferred annuity or individual?	Yes
Other information about contract	GROUP VARIABLE ANNUITY WITH GUARANTEED FUND
Amount paid for insurance broker fees	32
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3
Insurance broker name	ROCHESTER REGIONAL OFFICE

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

384-80038

Policy instance

Insurance contract or identification number	384-80038
Number of Individuals Covered	303
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $1,446
Total amount of fees paid to insurance company	USD $723
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $1,446
Amount paid for insurance broker fees	723
Additional information about fees paid to insurance broker	OTHER COMMISSIONS
Insurance broker organization code?	3
Insurance broker name	MORGAN STANLEY CO. LLC

LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )

Policy contract number

890527+006

Policy instance

Insurance contract or identification number	890527+006
Number of Individuals Covered	1
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $373
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $373
Insurance broker organization code?	4
Insurance broker name	HEALTHCARE COMMUNITY SECURITIE

LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )

Policy contract number

890527+006

Policy instance

Insurance contract or identification number	890527+006
Number of Individuals Covered	1
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $360
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $360
Insurance broker organization code?	4
Insurance broker name	HEALTHCARE COMMUNITY SECURITIE

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

384-80038

Policy instance

Insurance contract or identification number	384-80038
Number of Individuals Covered	319
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $2,973
Total amount of fees paid to insurance company	USD $743
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $2,973
Amount paid for insurance broker fees	743
Additional information about fees paid to insurance broker	OTHER COMMISSIONS
Insurance broker organization code?	3
Insurance broker name	MORGAN STANLEY SMITH BARNEY LL

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

006133-E

Policy instance

Insurance contract or identification number	006133-E
Number of Individuals Covered	8
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $57
Are there contracts with allocated funds for types other than group deferred annuity or individual?	Yes
Other information about contract	GROUP VARIABLE ANNUITY WITH GUARANTEED FUND
Amount paid for insurance broker fees	57
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3
Insurance broker name	ROCHESTER REGIONAL OFFICE

LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )

Policy contract number

890527+006

Policy instance

Insurance contract or identification number	890527+006
Number of Individuals Covered	1
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $343
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $343
Insurance broker organization code?	4
Insurance broker name	HEALTHCARE COMMUNITY SECURITIE

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

384-80038

Policy instance

Insurance contract or identification number	384-80038
Number of Individuals Covered	328
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $3,278
Total amount of fees paid to insurance company	USD $820
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $3,278
Amount paid for insurance broker fees	820
Additional information about fees paid to insurance broker	OTHER COMMISSIONS
Insurance broker organization code?	3
Insurance broker name	MORGAN STANLEY SMITH BARNEY LL

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

006133-E

Policy instance

Insurance contract or identification number	006133-E
Number of Individuals Covered	7
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $27
Are there contracts with allocated funds for types other than group deferred annuity or individual?	Yes
Other information about contract	GROUP VARIABLE ANNUITY WITH GUARANTEED FUND
Amount paid for insurance broker fees	12
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3
Insurance broker name	KERRI MCNEES

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

384-80038

Policy instance

Insurance contract or identification number	384-80038
Number of Individuals Covered	308
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $3,697
Total amount of fees paid to insurance company	USD $924
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $3,697
Amount paid for insurance broker fees	924
Additional information about fees paid to insurance broker	OTHER COMMISSIONS
Insurance broker organization code?	3
Insurance broker name	MORGAN STANLEY SMITH BARNEY LL

LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )

Policy contract number

890527+006

Policy instance

Insurance contract or identification number	890527+006
Number of Individuals Covered	1
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $92
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $92
Insurance broker organization code?	3
Insurance broker name	HEALTHCARE COMMUNITY SECURITIE

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Company Name:	LITTLE FALLS HOSPITAL
Employer identification number (EIN):	150533578
NAIC Classification:	622000
NAIC Description:	Hospitals

Jurisdiction of Incorporation:	New York Department of State
Incorporation Date:	1894-03-23
Company Identification Number:	28134
Legal Registered Office Address:	140 BURWELL STREET Herkimer LITTLE FALLS United States of America (USA) 13365