401k Plan data: ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS PLAN plan

ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS PLAN 401k Plan overview

Plan Name	ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS PLAN
Plan identification number	003

ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
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.
Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

ORLEANS COMMUNITY HEALTH has sponsored the creation of one or more 401k plans.

Company Name: ORLEANS COMMUNITY HEALTH

Employer identification number (EIN): 160755799

NAIC Classification: 622000
NAIC Description: Hospitals

Additional information about ORLEANS COMMUNITY HEALTH

Jurisdiction of Incorporation: New York Department of State

Incorporation Date: 1908-04-23

Company Identification Number: 1597773

Legal Registered Office Address: 200 OHIO STREET
Orleans
MEDINA
United States of America (USA)
14103

More information about ORLEANS COMMUNITY HEALTH

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
003 2022-01-01
003 2021-01-01
003 2020-01-01
003 2019-01-01
003 2018-01-01
003 2017-01-01 MARY WILLIAMS
003 2016-01-01 MARY WILLIAMS
003 2015-01-01 MARY WILLIAMS
003 2014-01-01 MARY WILLIAMS
003 2013-01-01 MARY WILLIAMS
003 2012-01-01 MARY WILLIAMS MARY WILLIAMS 2013-10-14
003 2011-01-01 MARY WILLIAMS
003 2009-01-01 MARY WILLIAMS
003 2009-01-01 THOMAS MORIEN
003 2009-01-01 THOMAS MORIEN

Plan Statistics for ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS PLAN

401k plan membership statisitcs for ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS PLAN

Measure Date Value
2022: ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 505
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 291
Number of retired or separated participants receiving benefits 2022-01-01 8
Number of other retired or separated participants entitled to future benefits 2022-01-01 259
Total of all active and inactive participants 2022-01-01 558
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 2
Total participants 2022-01-01 560
Number of participants with account balances 2022-01-01 529
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 442
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 284
Number of retired or separated participants receiving benefits 2021-01-01 7
Number of other retired or separated participants entitled to future benefits 2021-01-01 213
Total of all active and inactive participants 2021-01-01 504
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 1
Total participants 2021-01-01 505
Number of participants with account balances 2021-01-01 474
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 424
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 269
Number of retired or separated participants receiving benefits 2020-01-01 7
Number of other retired or separated participants entitled to future benefits 2020-01-01 162
Total of all active and inactive participants 2020-01-01 438
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 2
Total participants 2020-01-01 440
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: ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 439
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 288
Number of retired or separated participants receiving benefits 2019-01-01 8
Number of other retired or separated participants entitled to future benefits 2019-01-01 126
Total of all active and inactive participants 2019-01-01 422
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 2
Total participants 2019-01-01 424
Number of participants with account balances 2019-01-01 271
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 471
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 293
Number of retired or separated participants receiving benefits 2018-01-01 7
Number of other retired or separated participants entitled to future benefits 2018-01-01 138
Total of all active and inactive participants 2018-01-01 438
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 1
Total participants 2018-01-01 439
Number of participants with account balances 2018-01-01 278
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 503
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 324
Number of retired or separated participants receiving benefits 2017-01-01 5
Number of other retired or separated participants entitled to future benefits 2017-01-01 141
Total of all active and inactive participants 2017-01-01 470
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 1
Total participants 2017-01-01 471
Number of participants with account balances 2017-01-01 291
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 594
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 357
Number of retired or separated participants receiving benefits 2016-01-01 5
Number of other retired or separated participants entitled to future benefits 2016-01-01 140
Total of all active and inactive participants 2016-01-01 502
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 1
Total participants 2016-01-01 503
Number of participants with account balances 2016-01-01 289
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 632
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 467
Number of retired or separated participants receiving benefits 2015-01-01 5
Number of other retired or separated participants entitled to future benefits 2015-01-01 122
Total of all active and inactive participants 2015-01-01 594
Total participants 2015-01-01 594
Number of participants with account balances 2015-01-01 298
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 632
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 532
Number of retired or separated participants receiving benefits 2014-01-01 4
Number of other retired or separated participants entitled to future benefits 2014-01-01 96
Total of all active and inactive participants 2014-01-01 632
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 632
Number of participants with account balances 2014-01-01 293
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 793
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 545
Number of retired or separated participants receiving benefits 2013-01-01 2
Number of other retired or separated participants entitled to future benefits 2013-01-01 85
Total of all active and inactive participants 2013-01-01 632
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 632
Number of participants with account balances 2013-01-01 294
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 761
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 727
Number of retired or separated participants receiving benefits 2012-01-01 2
Number of other retired or separated participants entitled to future benefits 2012-01-01 64
Total of all active and inactive participants 2012-01-01 793
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 793
Number of participants with account balances 2012-01-01 332
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 771
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 670
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 91
Total of all active and inactive participants 2011-01-01 761
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 761
Number of participants with account balances 2011-01-01 332
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 770
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 682
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 67
Total of all active and inactive participants 2009-01-01 749
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 749
Number of participants with account balances 2009-01-01 310
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2022: ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	505
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	291
Number of retired or separated participants receiving benefits	2022-01-01	8
Number of other retired or separated participants entitled to future benefits	2022-01-01	259
Total of all active and inactive participants	2022-01-01	558
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	2
Total participants	2022-01-01	560
Number of participants with account balances	2022-01-01	529
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	442
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	284
Number of retired or separated participants receiving benefits	2021-01-01	7
Number of other retired or separated participants entitled to future benefits	2021-01-01	213
Total of all active and inactive participants	2021-01-01	504
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	1
Total participants	2021-01-01	505
Number of participants with account balances	2021-01-01	474
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	424
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	269
Number of retired or separated participants receiving benefits	2020-01-01	7
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	438
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	2
Total participants	2020-01-01	440
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: ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	439
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	288
Number of retired or separated participants receiving benefits	2019-01-01	8
Number of other retired or separated participants entitled to future benefits	2019-01-01	126
Total of all active and inactive participants	2019-01-01	422
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	2
Total participants	2019-01-01	424
Number of participants with account balances	2019-01-01	271
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	471
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	293
Number of retired or separated participants receiving benefits	2018-01-01	7
Number of other retired or separated participants entitled to future benefits	2018-01-01	138
Total of all active and inactive participants	2018-01-01	438
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	1
Total participants	2018-01-01	439
Number of participants with account balances	2018-01-01	278
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	503
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	324
Number of retired or separated participants receiving benefits	2017-01-01	5
Number of other retired or separated participants entitled to future benefits	2017-01-01	141
Total of all active and inactive participants	2017-01-01	470
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	1
Total participants	2017-01-01	471
Number of participants with account balances	2017-01-01	291
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	594
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	357
Number of retired or separated participants receiving benefits	2016-01-01	5
Number of other retired or separated participants entitled to future benefits	2016-01-01	140
Total of all active and inactive participants	2016-01-01	502
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	1
Total participants	2016-01-01	503
Number of participants with account balances	2016-01-01	289
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	632
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	467
Number of retired or separated participants receiving benefits	2015-01-01	5
Number of other retired or separated participants entitled to future benefits	2015-01-01	122
Total of all active and inactive participants	2015-01-01	594
Total participants	2015-01-01	594
Number of participants with account balances	2015-01-01	298
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	632
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	532
Number of retired or separated participants receiving benefits	2014-01-01	4
Number of other retired or separated participants entitled to future benefits	2014-01-01	96
Total of all active and inactive participants	2014-01-01	632
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	632
Number of participants with account balances	2014-01-01	293
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	793
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	545
Number of retired or separated participants receiving benefits	2013-01-01	2
Number of other retired or separated participants entitled to future benefits	2013-01-01	85
Total of all active and inactive participants	2013-01-01	632
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	632
Number of participants with account balances	2013-01-01	294
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	761
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	727
Number of retired or separated participants receiving benefits	2012-01-01	2
Number of other retired or separated participants entitled to future benefits	2012-01-01	64
Total of all active and inactive participants	2012-01-01	793
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	793
Number of participants with account balances	2012-01-01	332
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	771
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	670
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	91
Total of all active and inactive participants	2011-01-01	761
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	761
Number of participants with account balances	2011-01-01	332
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	770
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	682
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	67
Total of all active and inactive participants	2009-01-01	749
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	749
Number of participants with account balances	2009-01-01	310
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS PLAN

Measure	Date	Value
2022 : ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$24,000
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$24,000
Total income from all sources (including contributions)	2022-12-31	$-1,460,049
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$1,687,020
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$1,646,833
Value of total corrective distributions	2022-12-31	$5,518
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$638,235
Value of total assets at end of year	2022-12-31	$10,340,704
Value of total assets at beginning of year	2022-12-31	$13,487,773
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$34,669
Total interest from all sources	2022-12-31	$85,061
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$297,188
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-12-31	$297,188
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$1,000,000
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	$638,235
Participant contributions at end of year	2022-12-31	$93,835
Participant contributions at beginning of year	2022-12-31	$117,222
Participant contributions at end of year	2022-12-31	$23,204
Participant contributions at beginning of year	2022-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2022-12-31	$24,000
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2022-12-31	$24,000
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	$-3,147,069
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$10,316,704
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$13,463,773
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
Investment advisory and management fees	2022-12-31	$15
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$7,568,303
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$10,696,100
Interest on participant loans	2022-12-31	$5,147
Interest earned on other investments	2022-12-31	$79,914
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$2,655,362
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$2,674,451
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-2,480,533
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	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$1,646,833
Contract administrator fees	2022-12-31	$34,654
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	Unqualified
Accountancy firm name	2022-12-31	LUMSDEN & MCCORMICK, LLP
Accountancy firm EIN	2022-12-31	160765486
2021 : ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$24,000
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$24,000
Total income from all sources (including contributions)	2021-12-31	$1,944,039
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$1,637,202
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$1,595,451
Expenses. Certain deemed distributions of participant loans	2021-12-31	$2,001
Value of total corrective distributions	2021-12-31	$228
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$527,576
Value of total assets at end of year	2021-12-31	$13,487,773
Value of total assets at beginning of year	2021-12-31	$13,180,936
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$39,522
Total interest from all sources	2021-12-31	$82,518
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$760,926
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2021-12-31	$760,926
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
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	$527,576
Participant contributions at end of year	2021-12-31	$117,222
Participant contributions at beginning of year	2021-12-31	$145,993
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2021-12-31	$24,000
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2021-12-31	$24,000
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	$306,837
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$13,463,773
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$13,156,936
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
Investment advisory and management fees	2021-12-31	$15
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$10,696,100
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$10,299,116
Interest on participant loans	2021-12-31	$6,306
Interest earned on other investments	2021-12-31	$76,212
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$2,674,451
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$2,735,827
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$573,019
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	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$1,595,451
Contract administrator fees	2021-12-31	$39,507
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	Unqualified
Accountancy firm name	2021-12-31	LUMSDEN & MCCORMICK, LLP
Accountancy firm EIN	2021-12-31	160765486
2020 : ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$24,000
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$2,460,969
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$1,618,098
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$1,579,878
Expenses. Certain deemed distributions of participant loans	2020-12-31	$12,734
Value of total corrective distributions	2020-12-31	$1,299
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$480,576
Value of total assets at end of year	2020-12-31	$13,180,936
Value of total assets at beginning of year	2020-12-31	$12,314,065
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$24,187
Total interest from all sources	2020-12-31	$91,109
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$532,608
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-31	$532,608
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$1,000,000
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	$466,315
Participant contributions at end of year	2020-12-31	$145,993
Participant contributions at beginning of year	2020-12-31	$122,693
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$14,261
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2020-12-31	$24,000
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2020-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$842,871
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$13,156,936
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$12,314,065
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
Investment advisory and management fees	2020-12-31	$15
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$10,299,116
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$9,371,104
Interest on participant loans	2020-12-31	$6,800
Interest earned on other investments	2020-12-31	$84,309
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$2,735,827
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$2,820,268
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$1,356,676
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	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$1,579,878
Contract administrator fees	2020-12-31	$24,172
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	LUMSDEN & MCCORMICK, LLP
Accountancy firm EIN	2020-12-31	160765486
2019 : ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$2,525,663
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$1,875,987
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$1,844,230
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$466,240
Value of total assets at end of year	2019-12-31	$12,314,065
Value of total assets at beginning of year	2019-12-31	$11,664,389
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$31,757
Total interest from all sources	2019-12-31	$99,044
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$383,293
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$383,293
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$465,833
Participant contributions at end of year	2019-12-31	$122,693
Participant contributions at beginning of year	2019-12-31	$190,923
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$407
Administrative expenses (other) incurred	2019-12-31	$15
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	$649,676
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$12,314,065
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$11,664,389
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 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	$9,371,104
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$8,410,256
Interest on participant loans	2019-12-31	$8,443
Interest earned on other investments	2019-12-31	$90,601
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$2,820,268
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$3,063,210
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$1,577,086
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	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$1,844,230
Contract administrator fees	2019-12-31	$31,742
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
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
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	LUMSDEN & MCCORMICK, LLP
Accountancy firm EIN	2019-12-31	160765486
2018 : ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$40,770
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$1,103,211
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$1,071,362
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$481,067
Value of total assets at end of year	2018-12-31	$11,664,389
Value of total assets at beginning of year	2018-12-31	$12,726,830
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$31,849
Total interest from all sources	2018-12-31	$98,396
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$586,383
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2018-12-31	$586,383
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$1,000,000
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	$479,251
Participant contributions at end of year	2018-12-31	$190,923
Participant contributions at beginning of year	2018-12-31	$139,521
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$1,816
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	$-1,062,441
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$11,664,389
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$12,726,830
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	$8,410,256
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$9,378,666
Interest on participant loans	2018-12-31	$6,967
Interest earned on other investments	2018-12-31	$91,429
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$3,063,210
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$3,208,643
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-1,125,076
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	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$1,071,362
Contract administrator fees	2018-12-31	$31,849
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	2018-12-31	No
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	LUMSDEN & MCCORMICK, LLP
Accountancy firm EIN	2018-12-31	160765486
2017 : ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$2,334,631
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$881,853
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$843,795
Expenses. Certain deemed distributions of participant loans	2017-12-31	$8,190
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$668,018
Value of total assets at end of year	2017-12-31	$12,726,830
Value of total assets at beginning of year	2017-12-31	$11,274,052
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$29,868
Total interest from all sources	2017-12-31	$100,016
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$412,210
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$412,210
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	$489,129
Participant contributions at end of year	2017-12-31	$139,521
Participant contributions at beginning of year	2017-12-31	$131,942
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$178,889
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	$1,452,778
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$12,726,830
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$11,274,052
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	$9,378,666
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$7,660,421
Interest on participant loans	2017-12-31	$4,869
Interest earned on other investments	2017-12-31	$95,147
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$3,208,643
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$3,481,689
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$1,154,387
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	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$843,795
Contract administrator fees	2017-12-31	$29,868
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	2017-12-31	No
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	LUMSDEN & MCCORMICK, LLP
Accountancy firm EIN	2017-12-31	160765486
2016 : ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$1,285,676
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$1,106,365
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$1,075,280
Expenses. Certain deemed distributions of participant loans	2016-12-31	$18,029
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$693,020
Value of total assets at end of year	2016-12-31	$11,274,052
Value of total assets at beginning of year	2016-12-31	$11,094,741
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$13,056
Total interest from all sources	2016-12-31	$143,998
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$253,243
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$253,243
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	$563,802
Participant contributions at end of year	2016-12-31	$131,942
Participant contributions at beginning of year	2016-12-31	$182,428
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$129,218
Other income not declared elsewhere	2016-12-31	$799
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	$179,311
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$11,274,052
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$11,094,741
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	$7,660,421
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$7,129,153
Interest on participant loans	2016-12-31	$6,126
Interest earned on other investments	2016-12-31	$137,872
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$3,481,689
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$3,783,160
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$194,616
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	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$1,075,280
Contract administrator fees	2016-12-31	$13,056
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	2016-12-31	No
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	LUMSDEN & MCCORMICK, LLP
Accountancy firm EIN	2016-12-31	160765486
2015 : ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$1,000,962
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$1,550,467
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$1,517,859
Expenses. Certain deemed distributions of participant loans	2015-12-31	$18,864
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$686,359
Value of total assets at end of year	2015-12-31	$11,094,741
Value of total assets at beginning of year	2015-12-31	$11,644,246
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$13,744
Total interest from all sources	2015-12-31	$143,498
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$313,973
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$313,973
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
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$514,360
Participant contributions at end of year	2015-12-31	$182,428
Participant contributions at beginning of year	2015-12-31	$157,703
Participant contributions at end of year	2015-12-31	$0
Participant contributions at beginning of year	2015-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$171,999
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	$-549,505
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$11,094,741
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$11,644,246
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	$7,129,153
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$7,967,851
Interest on participant loans	2015-12-31	$6,401
Interest earned on other investments	2015-12-31	$137,097
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2015-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2015-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2015-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$3,783,160
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$3,518,692
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-142,868
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$1,517,859
Contract administrator fees	2015-12-31	$13,744
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	2015-12-31	No
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	LUMSDEN & MCCORMICK, LLP
Accountancy firm EIN	2015-12-31	160765486
2014 : ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$1,210,017
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$1,358,406
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$1,322,369
Expenses. Certain deemed distributions of participant loans	2014-12-31	$21,776
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$496,187
Value of total assets at end of year	2014-12-31	$11,644,246
Value of total assets at beginning of year	2014-12-31	$11,792,635
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$14,261
Total interest from all sources	2014-12-31	$139,724
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$356,750
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$356,750
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	$496,187
Participant contributions at end of year	2014-12-31	$157,703
Participant contributions at beginning of year	2014-12-31	$142,174
Participant contributions at end of year	2014-12-31	$0
Participant contributions at beginning of year	2014-12-31	$17,921
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	$-148,389
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$11,644,246
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$11,792,635
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	$7,967,851
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$8,038,242
Interest on participant loans	2014-12-31	$6,257
Interest earned on other investments	2014-12-31	$133,467
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2014-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2014-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2014-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$3,518,692
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$3,594,298
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$217,356
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$1,322,369
Contract administrator fees	2014-12-31	$14,261
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	BKD LLPS
Accountancy firm EIN	2014-12-31	440160260
2013 : ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$2,479,448
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$1,458,746
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$1,415,376
Expenses. Certain deemed distributions of participant loans	2013-12-31	$31,575
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$796,215
Value of total assets at end of year	2013-12-31	$11,792,635
Value of total assets at beginning of year	2013-12-31	$10,771,933
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$11,795
Total interest from all sources	2013-12-31	$142,749
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$152,736
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-12-31	$152,736
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
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$696,594
Participant contributions at end of year	2013-12-31	$142,174
Participant contributions at beginning of year	2013-12-31	$225,500
Participant contributions at end of year	2013-12-31	$17,921
Participant contributions at beginning of year	2013-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$99,621
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	$1,020,702
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$11,792,635
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$10,771,933
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	$8,038,242
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$6,981,059
Interest on participant loans	2013-12-31	$7,140
Interest earned on other investments	2013-12-31	$135,609
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2013-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2013-12-31	$1,270
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2013-12-31	$1,270
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$3,594,298
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$3,564,104
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$1,387,748
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	Yes
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$1,415,376
Contract administrator fees	2013-12-31	$11,795
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	LUMSDEN & MCCORMICK, LLP
Accountancy firm EIN	2013-12-31	160765486
2012 : ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$33,549
Total income from all sources (including contributions)	2012-12-31	$2,098,810
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$913,390
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$877,813
Expenses. Certain deemed distributions of participant loans	2012-12-31	$19,687
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$1,110,260
Value of total assets at end of year	2012-12-31	$10,384,194
Value of total assets at beginning of year	2012-12-31	$9,232,323
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$15,890
Total interest from all sources	2012-12-31	$135,084
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$171,595
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-12-31	$171,595
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	$756,894
Participant contributions at end of year	2012-12-31	$225,500
Participant contributions at beginning of year	2012-12-31	$140,285
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$353,366
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2012-12-31	$9,150
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2012-12-31	$33,549
Total non interest bearing cash at beginning of year	2012-12-31	$34
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	$1,185,420
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$10,384,194
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$9,198,774
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$6,593,320
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$5,879,196
Interest on participant loans	2012-12-31	$7,858
Interest earned on other investments	2012-12-31	$127,222
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-12-31	$1,270
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-12-31	$27,941
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-12-31	$27,941
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-12-31	$4
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$3,564,104
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$3,175,717
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$681,871
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$877,813
Contract administrator fees	2012-12-31	$15,890
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	LUMSDEN & MCCORMICK, LLP
Accountancy firm EIN	2012-12-31	160765486
2011 : ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS 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	$33,549
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$49,242
Total income from all sources (including contributions)	2011-12-31	$772,376
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$386,898
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$374,824
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$796,794
Value of total assets at end of year	2011-12-31	$9,027,486
Value of total assets at beginning of year	2011-12-31	$8,657,701
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$12,074
Total interest from all sources	2011-12-31	$106,098
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$75,180
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2011-12-31	$75,180
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
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$796,794
Participant contributions at end of year	2011-12-31	$127,989
Participant contributions at beginning of year	2011-12-31	$139,282
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-12-31	$9,150
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-12-31	$21,685
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2011-12-31	$33,549
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2011-12-31	$49,242
Total non interest bearing cash at end of year	2011-12-31	$34
Total non interest bearing cash at beginning of year	2011-12-31	$34
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	$385,478
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$8,993,937
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$8,608,459
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	$5,876,312
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$5,959,614
Interest on participant loans	2011-12-31	$5,898
Interest earned on other investments	2011-12-31	$100,199
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-12-31	$27,941
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-12-31	$32,770
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-12-31	$32,770
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-12-31	$1
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$2,986,060
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$2,504,316
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-205,696
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	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$374,824
Contract administrator fees	2011-12-31	$12,074
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	LUMSDEN & MCCORMICK, LLP
Accountancy firm EIN	2011-12-31	160765486
2010 : ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS 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	$49,242
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$27,892
Expenses. Interest paid	2010-12-31	$731
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2010-12-31	$731
Total income from all sources (including contributions)	2010-12-31	$1,690,120
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$265,439
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$254,297
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$846,020
Value of total assets at end of year	2010-12-31	$8,657,701
Value of total assets at beginning of year	2010-12-31	$7,211,670
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$10,411
Total interest from all sources	2010-12-31	$93,599
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$110,345
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2010-12-31	$110,345
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$500,000
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	$830,360
Participant contributions at end of year	2010-12-31	$139,282
Participant contributions at beginning of year	2010-12-31	$142,037
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$15,660
Value of other receiveables (less allowance for doubtful accounts) at end of year	2010-12-31	$21,685
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2010-12-31	$27,841
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2010-12-31	$49,242
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2010-12-31	$27,892
Total non interest bearing cash at end of year	2010-12-31	$34
Total non interest bearing cash at beginning of year	2010-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$1,424,681
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$8,608,459
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$7,183,778
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	$5,959,614
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$5,016,371
Interest on participant loans	2010-12-31	$7,128
Interest earned on other investments	2010-12-31	$86,469
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2010-12-31	$32,770
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2010-12-31	$26,211
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2010-12-31	$26,211
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2010-12-31	$2
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$2,504,316
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$1,999,210
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$640,156
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$254,297
Contract administrator fees	2010-12-31	$10,411
Did the plan have assets held for investment	2010-12-31	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	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	LUMSDEN & MCCORMICK, LLP
Accountancy firm EIN	2010-12-31	160765486
2009 : ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS 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 ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS PLAN

2022: ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS 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	Yes
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: ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS 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	Yes
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: ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS 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	Yes
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: ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS 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	Yes
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: ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS 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	Yes
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: ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS 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	Yes
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: ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS 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	Yes
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: ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS 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	Yes
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: ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS 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	Yes
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: ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS 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	Yes
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: ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	Yes
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	Yes
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: ORLEANS COMMUNITY HEALTH RETIREMENT SAVINGS PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	Yes
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

LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 60139 )

Policy contract number

192760+030

Policy instance

Insurance contract or identification number	192760+030
Number of Individuals Covered	29
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $5,846
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,846
Insurance broker organization code?	4

LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 60139 )

Policy contract number

894695+007

Policy instance

Insurance contract or identification number	894695+007
Number of Individuals Covered	111
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $2,024
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,024
Insurance broker organization code?	4

LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 60139 )

Policy contract number

192760+030

Policy instance

Insurance contract or identification number	192760+030
Number of Individuals Covered	29
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $4,971
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,971
Insurance broker organization code?	4

LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 60139 )

Policy contract number

894695+007

Policy instance

Insurance contract or identification number	894695+007
Number of Individuals Covered	117
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $1,990
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,990
Insurance broker organization code?	4

LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 60139 )

Policy contract number

192760+030

Policy instance

Insurance contract or identification number	192760+030
Number of Individuals Covered	31
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $5,382
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,382
Insurance broker organization code?	4

LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 60139 )

Policy contract number

894695+007

Policy instance

Insurance contract or identification number	894695+007
Number of Individuals Covered	123
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $2,329
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,329
Insurance broker organization code?	4

LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 60139 )

Policy contract number

894695+007

Policy instance

Insurance contract or identification number	894695+007
Number of Individuals Covered	108
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $2,652
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,652
Insurance broker organization code?	4

LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 60139 )

Policy contract number

192760+030

Policy instance

Insurance contract or identification number	192760+030
Number of Individuals Covered	31
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $5,094
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,094
Insurance broker organization code?	4

LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 60139 )

Policy contract number

894695+007

Policy instance

Insurance contract or identification number	894695+007
Number of Individuals Covered	120
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $2,587
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,587
Insurance broker organization code?	4

LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 60139 )

Policy contract number

192760+030

Policy instance

Insurance contract or identification number	192760+030
Number of Individuals Covered	33
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $5,229
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,229
Insurance broker organization code?	4

LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 60139 )

Policy contract number

192760+030

Policy instance

Insurance contract or identification number	192760+030
Number of Individuals Covered	36
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $5,598
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,598
Insurance broker organization code?	4
Insurance broker name	HEALTHCARE COMMUNITY SECURITIE

LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 60139 )

Policy contract number

894695+007

Policy instance

Insurance contract or identification number	894695+007
Number of Individuals Covered	134
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $2,960
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,960
Insurance broker organization code?	4
Insurance broker name	HEALTHCARE COMMUNITY

LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 60139 )

Policy contract number

192760+030

Policy instance

Insurance contract or identification number	192760+030
Number of Individuals Covered	42
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $5,659
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,659
Insurance broker organization code?	4
Insurance broker name	HEALTHCARE COMMUNITY SECURITIE

LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 60139 )

Policy contract number

891846-007

Policy instance

Insurance contract or identification number	891846-007
Number of Individuals Covered	159
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $3,324
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,324
Insurance broker organization code?	4
Insurance broker name	HEALTHCARE COMMUNITY SECURITIES COR

LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 60139 )

Policy contract number

192760+030

Policy instance

Insurance contract or identification number	192760+030
Number of Individuals Covered	44
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $5,515
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,515
Insurance broker organization code?	4
Insurance broker name	HEALTHCARE COMMUNITY SECURITIE

LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 60139 )

Policy contract number

891846-007

Policy instance

Insurance contract or identification number	891846-007
Number of Individuals Covered	174
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $3,308
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,308
Insurance broker organization code?	4
Insurance broker name	HEALTHCARE COMMUNITY SECURITIES COR

LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 60139 )

Policy contract number

891846-007

Policy instance

Insurance contract or identification number	891846-007
Number of Individuals Covered	204
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $3,381
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,381
Insurance broker organization code?	4
Insurance broker name	HEALTHCARE COMMUNITY SECURITIES COR

LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 60139 )

Policy contract number

192760+030

Policy instance

Insurance contract or identification number	192760+030
Number of Individuals Covered	48
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $5,438
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,438
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

192760+030

Policy instance

Insurance contract or identification number	192760+030
Number of Individuals Covered	52
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $4,688
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,688
Insurance broker organization code?	4
Insurance broker name	HEALTHCARE COMMUNITY SECURITIES COR

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

Policy contract number

891846-007

Policy instance

Insurance contract or identification number	891846-007
Number of Individuals Covered	233
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $3,376
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,376
Insurance broker organization code?	4
Insurance broker name	HEALTHCARE COMMUNITY SECURITIES COR

LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 60139 )

Policy contract number

891846-007

Policy instance

Insurance contract or identification number	891846-007
Number of Individuals Covered	236
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $445
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

192760+030

Policy instance

Insurance contract or identification number	192760+030
Number of Individuals Covered	43
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $3,740
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

192760-030

Policy instance

Insurance contract or identification number	192760-030
Number of Individuals Covered	45
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $996
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 60139 )

Policy contract number

891846-007

Policy instance

Insurance contract or identification number	891846-007
Number of Individuals Covered	226
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $1,803
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	ORLEANS COMMUNITY HEALTH
Employer identification number (EIN):	160755799
NAIC Classification:	622000
NAIC Description:	Hospitals

Jurisdiction of Incorporation:	New York Department of State
Incorporation Date:	1908-04-23
Company Identification Number:	1597773
Legal Registered Office Address:	200 OHIO STREET Orleans MEDINA United States of America (USA) 14103