401k Plan data: THE RETIREMENT PLAN FOR THE EMPLOYEES OF COLUMBUS HOSPITAL plan

THE RETIREMENT PLAN FOR THE EMPLOYEES OF COLUMBUS HOSPITAL 401k Plan overview

Plan Name	THE RETIREMENT PLAN FOR THE EMPLOYEES OF COLUMBUS HOSPITAL
Plan identification number	003

THE RETIREMENT PLAN FOR THE EMPLOYEES OF COLUMBUS HOSPITAL Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
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

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

Company Name: COLUMBUS HOSPITAL

Employer identification number (EIN): 221500494

NAIC Classification: 622000
NAIC Description: Hospitals

Additional information about COLUMBUS HOSPITAL

Jurisdiction of Incorporation: New Jersey Division of Revenue and Enterprise Services

Incorporation Date:

Company Identification Number: 0900012436

More information about COLUMBUS HOSPITAL

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE RETIREMENT PLAN FOR THE EMPLOYEES OF COLUMBUS HOSPITAL

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
003 2016-01-01
003 2015-01-01 MIRTA T. WILLIAMS
003 2014-01-01 MIRTA T. WILLIAMS
003 2013-01-01 MIRTA T. WILLIAMS
003 2012-01-01 MIRTA T. WILLIAMS
003 2011-01-01 MIRTA T WILLIAMS
003 2010-01-01 MIRTA T WILLIAMS
003 2009-01-01 YASINAH EL-AMIN

Plan Statistics for THE RETIREMENT PLAN FOR THE EMPLOYEES OF COLUMBUS HOSPITAL

401k plan membership statisitcs for THE RETIREMENT PLAN FOR THE EMPLOYEES OF COLUMBUS HOSPITAL

Measure Date Value
2016: THE RETIREMENT PLAN FOR THE EMPLOYEES OF COLUMBUS HOSPITAL 2016 401k membership
Total participants, beginning-of-year 2016-01-01 271
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 0
Number of retired or separated participants receiving benefits 2016-01-01 8
Number of other retired or separated participants entitled to future benefits 2016-01-01 195
Total of all active and inactive participants 2016-01-01 203
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 3
Total participants 2016-01-01 206
Number of participants with account balances 2016-01-01 206
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: THE RETIREMENT PLAN FOR THE EMPLOYEES OF COLUMBUS HOSPITAL 2015 401k membership
Total participants, beginning-of-year 2015-01-01 282
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 0
Number of retired or separated participants receiving benefits 2015-01-01 14
Number of other retired or separated participants entitled to future benefits 2015-01-01 255
Total of all active and inactive participants 2015-01-01 269
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 2
Total participants 2015-01-01 271
Number of participants with account balances 2015-01-01 271
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: THE RETIREMENT PLAN FOR THE EMPLOYEES OF COLUMBUS HOSPITAL 2014 401k membership
Total participants, beginning-of-year 2014-01-01 305
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 162
Number of retired or separated participants receiving benefits 2014-01-01 11
Number of other retired or separated participants entitled to future benefits 2014-01-01 108
Total of all active and inactive participants 2014-01-01 281
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 1
Total participants 2014-01-01 282
Number of participants with account balances 2014-01-01 282
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: THE RETIREMENT PLAN FOR THE EMPLOYEES OF COLUMBUS HOSPITAL 2013 401k membership
Total participants, beginning-of-year 2013-01-01 327
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 180
Number of retired or separated participants receiving benefits 2013-01-01 9
Number of other retired or separated participants entitled to future benefits 2013-01-01 116
Total of all active and inactive participants 2013-01-01 305
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 305
Number of participants with account balances 2013-01-01 305
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: THE RETIREMENT PLAN FOR THE EMPLOYEES OF COLUMBUS HOSPITAL 2012 401k membership
Total participants, beginning-of-year 2012-01-01 348
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 189
Number of retired or separated participants receiving benefits 2012-01-01 9
Number of other retired or separated participants entitled to future benefits 2012-01-01 128
Total of all active and inactive participants 2012-01-01 326
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 1
Total participants 2012-01-01 327
Number of participants with account balances 2012-01-01 327
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: THE RETIREMENT PLAN FOR THE EMPLOYEES OF COLUMBUS HOSPITAL 2011 401k membership
Total participants, beginning-of-year 2011-01-01 376
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 208
Number of retired or separated participants receiving benefits 2011-01-01 7
Number of other retired or separated participants entitled to future benefits 2011-01-01 131
Total of all active and inactive participants 2011-01-01 346
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 2
Total participants 2011-01-01 348
Number of participants with account balances 2011-01-01 348
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: THE RETIREMENT PLAN FOR THE EMPLOYEES OF COLUMBUS HOSPITAL 2010 401k membership
Total participants, beginning-of-year 2010-01-01 433
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 227
Number of retired or separated participants receiving benefits 2010-01-01 2
Number of other retired or separated participants entitled to future benefits 2010-01-01 144
Total of all active and inactive participants 2010-01-01 373
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 3
Total participants 2010-01-01 376
Number of participants with account balances 2010-01-01 376
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: THE RETIREMENT PLAN FOR THE EMPLOYEES OF COLUMBUS HOSPITAL 2009 401k membership
Total participants, beginning-of-year 2009-01-01 183
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 274
Number of retired or separated participants receiving benefits 2009-01-01 3
Number of other retired or separated participants entitled to future benefits 2009-01-01 153
Total of all active and inactive participants 2009-01-01 430
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 3
Total participants 2009-01-01 433
Number of participants with account balances 2009-01-01 433
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2016: THE RETIREMENT PLAN FOR THE EMPLOYEES OF COLUMBUS HOSPITAL 2016 401k membership
Total participants, beginning-of-year	2016-01-01	271
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	0
Number of retired or separated participants receiving benefits	2016-01-01	8
Number of other retired or separated participants entitled to future benefits	2016-01-01	195
Total of all active and inactive participants	2016-01-01	203
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	3
Total participants	2016-01-01	206
Number of participants with account balances	2016-01-01	206
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: THE RETIREMENT PLAN FOR THE EMPLOYEES OF COLUMBUS HOSPITAL 2015 401k membership
Total participants, beginning-of-year	2015-01-01	282
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	0
Number of retired or separated participants receiving benefits	2015-01-01	14
Number of other retired or separated participants entitled to future benefits	2015-01-01	255
Total of all active and inactive participants	2015-01-01	269
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	2
Total participants	2015-01-01	271
Number of participants with account balances	2015-01-01	271
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: THE RETIREMENT PLAN FOR THE EMPLOYEES OF COLUMBUS HOSPITAL 2014 401k membership
Total participants, beginning-of-year	2014-01-01	305
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	162
Number of retired or separated participants receiving benefits	2014-01-01	11
Number of other retired or separated participants entitled to future benefits	2014-01-01	108
Total of all active and inactive participants	2014-01-01	281
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	1
Total participants	2014-01-01	282
Number of participants with account balances	2014-01-01	282
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: THE RETIREMENT PLAN FOR THE EMPLOYEES OF COLUMBUS HOSPITAL 2013 401k membership
Total participants, beginning-of-year	2013-01-01	327
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	180
Number of retired or separated participants receiving benefits	2013-01-01	9
Number of other retired or separated participants entitled to future benefits	2013-01-01	116
Total of all active and inactive participants	2013-01-01	305
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	305
Number of participants with account balances	2013-01-01	305
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: THE RETIREMENT PLAN FOR THE EMPLOYEES OF COLUMBUS HOSPITAL 2012 401k membership
Total participants, beginning-of-year	2012-01-01	348
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	189
Number of retired or separated participants receiving benefits	2012-01-01	9
Number of other retired or separated participants entitled to future benefits	2012-01-01	128
Total of all active and inactive participants	2012-01-01	326
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	1
Total participants	2012-01-01	327
Number of participants with account balances	2012-01-01	327
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: THE RETIREMENT PLAN FOR THE EMPLOYEES OF COLUMBUS HOSPITAL 2011 401k membership
Total participants, beginning-of-year	2011-01-01	376
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	208
Number of retired or separated participants receiving benefits	2011-01-01	7
Number of other retired or separated participants entitled to future benefits	2011-01-01	131
Total of all active and inactive participants	2011-01-01	346
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	2
Total participants	2011-01-01	348
Number of participants with account balances	2011-01-01	348
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: THE RETIREMENT PLAN FOR THE EMPLOYEES OF COLUMBUS HOSPITAL 2010 401k membership
Total participants, beginning-of-year	2010-01-01	433
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	227
Number of retired or separated participants receiving benefits	2010-01-01	2
Number of other retired or separated participants entitled to future benefits	2010-01-01	144
Total of all active and inactive participants	2010-01-01	373
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	3
Total participants	2010-01-01	376
Number of participants with account balances	2010-01-01	376
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: THE RETIREMENT PLAN FOR THE EMPLOYEES OF COLUMBUS HOSPITAL 2009 401k membership
Total participants, beginning-of-year	2009-01-01	183
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	274
Number of retired or separated participants receiving benefits	2009-01-01	3
Number of other retired or separated participants entitled to future benefits	2009-01-01	153
Total of all active and inactive participants	2009-01-01	430
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	3
Total participants	2009-01-01	433
Number of participants with account balances	2009-01-01	433
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on THE RETIREMENT PLAN FOR THE EMPLOYEES OF COLUMBUS HOSPITAL

Measure	Date	Value
2016 : THE RETIREMENT PLAN FOR THE EMPLOYEES OF COLUMBUS HOSPITAL 2016 401k financial data
Total income from all sources (including contributions)	2016-12-31	$307,683
Total of all expenses incurred	2016-12-31	$3,859,745
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$3,858,819
Value of total assets at end of year	2016-12-31	$3,570,182
Value of total assets at beginning of year	2016-12-31	$7,122,244
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$926
Total interest from all sources	2016-12-31	$48,963
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$70,086
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	$70,086
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$500,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Participant contributions at end of year	2016-12-31	$19
Participant contributions at beginning of year	2016-12-31	$85,699
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2016-12-31	$1,029
Administrative expenses (other) incurred	2016-12-31	$926
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	$-3,552,062
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$3,570,182
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$7,122,244
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	$2,553,963
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$5,124,429
Interest on participant loans	2016-12-31	$1,567
Interest earned on other investments	2016-12-31	$47,396
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$1,016,200
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$1,911,087
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$188,634
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	$3,858,819
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	WITHUM, SMITH & BROWN, PC
Accountancy firm EIN	2016-12-31	222027092
2015 : THE RETIREMENT PLAN FOR THE EMPLOYEES OF COLUMBUS HOSPITAL 2015 401k financial data
Total income from all sources (including contributions)	2015-12-31	$89,714
Total of all expenses incurred	2015-12-31	$739,353
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$738,559
Value of total assets at end of year	2015-12-31	$7,122,244
Value of total assets at beginning of year	2015-12-31	$7,771,883
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$794
Total interest from all sources	2015-12-31	$58,938
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$84,199
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	$84,199
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$500,000
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
Participant contributions at end of year	2015-12-31	$85,699
Participant contributions at beginning of year	2015-12-31	$92,366
Value of other receiveables (less allowance for doubtful accounts) at end of year	2015-12-31	$1,029
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2015-12-31	$742
Administrative expenses (other) incurred	2015-12-31	$794
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	$-649,639
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$7,122,244
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$7,771,883
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$5,124,429
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$5,752,705
Interest on participant loans	2015-12-31	$4,696
Interest earned on other investments	2015-12-31	$54,242
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$1,911,087
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$1,926,070
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-53,423
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	$738,559
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	WITHUM, SMITH & BROWN, PC
Accountancy firm EIN	2015-12-31	222027092
2014 : THE RETIREMENT PLAN FOR THE EMPLOYEES OF COLUMBUS HOSPITAL 2014 401k financial data
Total income from all sources (including contributions)	2014-12-31	$378,831
Total of all expenses incurred	2014-12-31	$529,600
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$512,511
Expenses. Certain deemed distributions of participant loans	2014-12-31	$16,389
Value of total assets at end of year	2014-12-31	$7,771,883
Value of total assets at beginning of year	2014-12-31	$7,922,652
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$700
Total interest from all sources	2014-12-31	$59,163
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$112,538
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	$112,538
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$500,000
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
Participant contributions at end of year	2014-12-31	$92,366
Participant contributions at beginning of year	2014-12-31	$94,707
Value of other receiveables (less allowance for doubtful accounts) at end of year	2014-12-31	$742
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2014-12-31	$785
Administrative expenses (other) incurred	2014-12-31	$700
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	$-150,769
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$7,771,883
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$7,922,652
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$5,752,705
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$5,863,188
Interest on participant loans	2014-12-31	$4,663
Interest earned on other investments	2014-12-31	$54,500
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$1,926,070
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$1,963,972
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$207,130
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	$512,511
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	2014-12-31	No
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	WITHUM, SMITH & BROWN, PC
Accountancy firm EIN	2014-12-31	222027092
2013 : THE RETIREMENT PLAN FOR THE EMPLOYEES OF COLUMBUS HOSPITAL 2013 401k financial data
Total income from all sources (including contributions)	2013-12-31	$976,100
Total of all expenses incurred	2013-12-31	$662,550
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$654,377
Expenses. Certain deemed distributions of participant loans	2013-12-31	$7,573
Value of total assets at end of year	2013-12-31	$7,922,652
Value of total assets at beginning of year	2013-12-31	$7,609,102
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$600
Total interest from all sources	2013-12-31	$65,891
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$99,976
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	$99,976
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$500,000
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
Participant contributions at end of year	2013-12-31	$94,707
Participant contributions at beginning of year	2013-12-31	$114,220
Value of other receiveables (less allowance for doubtful accounts) at end of year	2013-12-31	$785
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2013-12-31	$1,525
Administrative expenses (other) incurred	2013-12-31	$600
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	$313,550
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$7,922,652
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$7,609,102
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$5,863,188
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$5,196,779
Interest on participant loans	2013-12-31	$4,818
Interest earned on other investments	2013-12-31	$61,073
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$1,963,972
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$2,296,578
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$810,233
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$654,377
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	2013-12-31	No
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	WITHUM SMITH & BROWN, PC
Accountancy firm EIN	2013-12-31	222027092
2012 : THE RETIREMENT PLAN FOR THE EMPLOYEES OF COLUMBUS HOSPITAL 2012 401k financial data
Total income from all sources (including contributions)	2012-12-31	$691,515
Total of all expenses incurred	2012-12-31	$968,717
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$967,973
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$32,722
Value of total assets at end of year	2012-12-31	$7,609,102
Value of total assets at beginning of year	2012-12-31	$7,886,304
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$744
Total interest from all sources	2012-12-31	$75,268
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$131,999
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	$131,999
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$500,000
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
Participant contributions at end of year	2012-12-31	$114,220
Participant contributions at beginning of year	2012-12-31	$126,923
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$32,722
Value of other receiveables (less allowance for doubtful accounts) at end of year	2012-12-31	$1,525
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2012-12-31	$1,151
Administrative expenses (other) incurred	2012-12-31	$744
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	$-277,202
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$7,609,102
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$7,886,304
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	$5,196,779
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$5,327,692
Interest on participant loans	2012-12-31	$7,093
Interest earned on other investments	2012-12-31	$68,175
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$2,296,578
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$2,430,538
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$451,526
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	$967,973
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	2012-12-31	No
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	WITHUM SMITH & BROWN, PC
Accountancy firm EIN	2012-12-31	222027092
2011 : THE RETIREMENT PLAN FOR THE EMPLOYEES OF COLUMBUS HOSPITAL 2011 401k financial data
Total income from all sources (including contributions)	2011-12-31	$80,370
Total of all expenses incurred	2011-12-31	$969,729
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$963,835
Expenses. Certain deemed distributions of participant loans	2011-12-31	$5,194
Value of total assets at end of year	2011-12-31	$7,886,304
Value of total assets at beginning of year	2011-12-31	$8,775,663
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$700
Total interest from all sources	2011-12-31	$83,476
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$90,135
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	$90,135
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$500,000
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
Participant contributions at end of year	2011-12-31	$126,923
Participant contributions at beginning of year	2011-12-31	$127,369
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-12-31	$1,151
Administrative expenses (other) incurred	2011-12-31	$700
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	$-889,359
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$7,886,304
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$8,775,663
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	$5,327,692
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$5,889,562
Interest on participant loans	2011-12-31	$7,798
Interest earned on other investments	2011-12-31	$75,678
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$2,430,538
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$2,758,732
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-93,241
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	$963,835
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	2011-12-31	No
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	WITHUM SMITH & BROWN, PC
Accountancy firm EIN	2011-12-31	222027092
2010 : THE RETIREMENT PLAN FOR THE EMPLOYEES OF COLUMBUS HOSPITAL 2010 401k financial data
Total income from all sources (including contributions)	2010-12-31	$767,310
Total of all expenses incurred	2010-12-31	$1,798,745
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$1,776,599
Expenses. Certain deemed distributions of participant loans	2010-12-31	$12,346
Value of total assets at end of year	2010-12-31	$8,775,663
Value of total assets at beginning of year	2010-12-31	$9,807,098
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$9,800
Total interest from all sources	2010-12-31	$105,845
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$94,965
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	$94,965
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
Participant contributions at end of year	2010-12-31	$126,013
Participant contributions at beginning of year	2010-12-31	$151,922
Value of other receiveables (less allowance for doubtful accounts) at end of year	2010-12-31	$1,356
Administrative expenses (other) incurred	2010-12-31	$9,800
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	$-1,031,435
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$8,775,663
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$9,807,098
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	$5,889,562
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$6,128,777
Interest on participant loans	2010-12-31	$11,518
Income. Interest from loans (other than to participants)	2010-12-31	$1,356
Interest earned on other investments	2010-12-31	$94,327
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$2,758,732
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$3,526,399
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$566,500
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	$1,776,599
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	2010-12-31	No
Did the plan have assets held for investment	2010-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	WITHUMSMITH & BROWN, PC
Accountancy firm EIN	2010-12-31	222027092
2009 : THE RETIREMENT PLAN FOR THE EMPLOYEES OF COLUMBUS HOSPITAL 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 THE RETIREMENT PLAN FOR THE EMPLOYEES OF COLUMBUS HOSPITAL

2016: THE RETIREMENT PLAN FOR THE EMPLOYEES OF COLUMBUS HOSPITAL 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
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: THE RETIREMENT PLAN FOR THE EMPLOYEES OF COLUMBUS HOSPITAL 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
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: THE RETIREMENT PLAN FOR THE EMPLOYEES OF COLUMBUS HOSPITAL 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
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: THE RETIREMENT PLAN FOR THE EMPLOYEES OF COLUMBUS HOSPITAL 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
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: THE RETIREMENT PLAN FOR THE EMPLOYEES OF COLUMBUS HOSPITAL 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
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: THE RETIREMENT PLAN FOR THE EMPLOYEES OF COLUMBUS HOSPITAL 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	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
2010: THE RETIREMENT PLAN FOR THE EMPLOYEES OF COLUMBUS HOSPITAL 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	Yes
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: THE RETIREMENT PLAN FOR THE EMPLOYEES OF COLUMBUS HOSPITAL 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )

Policy contract number

TA080173

Policy instance

Insurance contract or identification number	TA080173
Number of Individuals Covered	271
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $1,434
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,434
Insurance broker organization code?	3
Insurance broker name	CAMMACK LARHETTE BROKERAGE, INC.

TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )

Policy contract number

TA080173

Policy instance

Insurance contract or identification number	TA080173
Number of Individuals Covered	282
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $1,447
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,447
Insurance broker organization code?	3
Insurance broker name	CAMMACK LARHETTE BROKERAGE, INC.

TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )

Policy contract number

TA080173

Policy instance

Insurance contract or identification number	TA080173
Number of Individuals Covered	305
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $1,608
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,608
Insurance broker organization code?	3
Insurance broker name	CAMMACK LARHETTE BROKERAGE, INC.

TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )

Policy contract number

TA080173

Policy instance

Insurance contract or identification number	TA080173
Number of Individuals Covered	327
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $1,764
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,764
Insurance broker organization code?	3
Insurance broker name	CAMMACK LARHETTE BROKERAGE, INC.

TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )

Policy contract number

TA080173

Policy instance

Insurance contract or identification number	TA080173
Number of Individuals Covered	348
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $1,907
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )

Policy contract number

TA080173

Policy instance

Insurance contract or identification number	TA080173
Number of Individuals Covered	376
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $2,363
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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The information published is supplied by third parties so we make no warranty on the accuracy, completeness etc. This information is provided "as-is". The information is subject to change as we obtain updates and corrections from the primary information sources.
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Company Name:	COLUMBUS HOSPITAL
Employer identification number (EIN):	221500494
NAIC Classification:	622000
NAIC Description:	Hospitals

Jurisdiction of Incorporation:	New Jersey Division of Revenue and Enterprise Services
Incorporation Date:
Company Identification Number:	0900012436

Plan id#	Filing Submission Date	Name of Administrator
003	2016-01-01
003	2015-01-01	MIRTA T. WILLIAMS
003	2014-01-01	MIRTA T. WILLIAMS
003	2013-01-01	MIRTA T. WILLIAMS
003	2012-01-01	MIRTA T. WILLIAMS
003	2011-01-01	MIRTA T WILLIAMS
003	2010-01-01	MIRTA T WILLIAMS
003	2009-01-01	YASINAH EL-AMIN