401k Plan data: COMMUNITY MEDICAL CENTER 403(B) SUPPLEMENTAL CONTRIBUTORY RETIREMENT PLAN plan

COMMUNITY MEDICAL CENTER 403(B) SUPPLEMENTAL CONTRIBUTORY RETIREMENT PLAN 401k Plan overview

Plan Name	COMMUNITY MEDICAL CENTER 403(B) SUPPLEMENTAL CONTRIBUTORY RETIREMENT PLAN
Plan identification number	003

COMMUNITY MEDICAL CENTER 403(B) SUPPLEMENTAL CONTRIBUTORY RETIREMENT 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.
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.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

COMMUNITY MEDICAL CENTER has sponsored the creation of one or more 401k plans.

Company Name: COMMUNITY MEDICAL CENTER

Employer identification number (EIN): 240862246

NAIC Classification: 622000
NAIC Description: Hospitals

Additional information about COMMUNITY MEDICAL CENTER

Jurisdiction of Incorporation: Iowa Secretary of State Business Entities

Incorporation Date: 1984-04-20

Company Identification Number: 094369

Legal Registered Office Address: 1603 MORGAN ST STE 6

KEOKUK
United States of America (USA)
52632

More information about COMMUNITY MEDICAL CENTER

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COMMUNITY MEDICAL CENTER 403(B) SUPPLEMENTAL CONTRIBUTORY RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
003 2017-01-01 WENDY M. MARSHALL
003 2016-01-01 WENDY M. MARSHALL
003 2015-07-01 WENDY M. MARSHALL
003 2014-07-01 WENDY M. MARSHALL
003 2013-07-01 WENDY MARSHALL
003 2012-07-01 AMY BRAYFORD
003 2011-07-01 AMY BRAYFORD
003 2009-07-01 LOIS WOLFE LOIS WOLFE 2011-04-15

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
003	2017-01-01	WENDY M. MARSHALL
003	2016-01-01	WENDY M. MARSHALL
003	2015-07-01	WENDY M. MARSHALL
003	2014-07-01	WENDY M. MARSHALL
003	2013-07-01	WENDY MARSHALL
003	2012-07-01	AMY BRAYFORD
003	2011-07-01	AMY BRAYFORD
003	2009-07-01	LOIS WOLFE	LOIS WOLFE	2011-04-15

Plan Statistics for COMMUNITY MEDICAL CENTER 403(B) SUPPLEMENTAL CONTRIBUTORY RETIREMENT PLAN

401k plan membership statisitcs for COMMUNITY MEDICAL CENTER 403(B) SUPPLEMENTAL CONTRIBUTORY RETIREMENT PLAN

Measure Date Value
2017: COMMUNITY MEDICAL CENTER 403(B) SUPPLEMENTAL CONTRIBUTORY RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 2,793
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 0
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 0
Total of all active and inactive participants 2017-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: COMMUNITY MEDICAL CENTER 403(B) SUPPLEMENTAL CONTRIBUTORY RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 2,530
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 2,145
Number of retired or separated participants receiving benefits 2016-01-01 34
Number of other retired or separated participants entitled to future benefits 2016-01-01 608
Total of all active and inactive participants 2016-01-01 2,787
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 6
Total participants 2016-01-01 2,793
Number of participants with account balances 2016-01-01 2,233
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: COMMUNITY MEDICAL CENTER 403(B) SUPPLEMENTAL CONTRIBUTORY RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-07-01 2,404
Total number of active participants reported on line 7a of the Form 5500 2015-07-01 1,973
Number of retired or separated participants receiving benefits 2015-07-01 26
Number of other retired or separated participants entitled to future benefits 2015-07-01 527
Total of all active and inactive participants 2015-07-01 2,526
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-07-01 4
Total participants 2015-07-01 2,530
Number of participants with account balances 2015-07-01 1,833
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-07-01 0
2014: COMMUNITY MEDICAL CENTER 403(B) SUPPLEMENTAL CONTRIBUTORY RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-07-01 2,461
Total number of active participants reported on line 7a of the Form 5500 2014-07-01 1,874
Number of retired or separated participants receiving benefits 2014-07-01 26
Number of other retired or separated participants entitled to future benefits 2014-07-01 500
Total of all active and inactive participants 2014-07-01 2,400
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-07-01 4
Total participants 2014-07-01 2,404
Number of participants with account balances 2014-07-01 1,781
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-07-01 0
2013: COMMUNITY MEDICAL CENTER 403(B) SUPPLEMENTAL CONTRIBUTORY RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-07-01 2,419
Total number of active participants reported on line 7a of the Form 5500 2013-07-01 1,951
Number of retired or separated participants receiving benefits 2013-07-01 20
Number of other retired or separated participants entitled to future benefits 2013-07-01 485
Total of all active and inactive participants 2013-07-01 2,456
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-07-01 5
Total participants 2013-07-01 2,461
Number of participants with account balances 2013-07-01 1,583
2012: COMMUNITY MEDICAL CENTER 403(B) SUPPLEMENTAL CONTRIBUTORY RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-07-01 1,198
Total number of active participants reported on line 7a of the Form 5500 2012-07-01 1,937
Number of retired or separated participants receiving benefits 2012-07-01 28
Number of other retired or separated participants entitled to future benefits 2012-07-01 305
Total of all active and inactive participants 2012-07-01 2,270
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-07-01 6
Total participants 2012-07-01 2,276
Number of participants with account balances 2012-07-01 1,432
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-07-01 95
2011: COMMUNITY MEDICAL CENTER 403(B) SUPPLEMENTAL CONTRIBUTORY RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-07-01 1,029
Total number of active participants reported on line 7a of the Form 5500 2011-07-01 1,087
Number of retired or separated participants receiving benefits 2011-07-01 10
Number of other retired or separated participants entitled to future benefits 2011-07-01 101
Total of all active and inactive participants 2011-07-01 1,198
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-07-01 0
Total participants 2011-07-01 1,198
Number of participants with account balances 2011-07-01 1,198
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-07-01 0
2009: COMMUNITY MEDICAL CENTER 403(B) SUPPLEMENTAL CONTRIBUTORY RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-07-01 1,024
Total number of active participants reported on line 7a of the Form 5500 2009-07-01 985
Number of retired or separated participants receiving benefits 2009-07-01 8
Number of other retired or separated participants entitled to future benefits 2009-07-01 26
Total of all active and inactive participants 2009-07-01 1,019
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-07-01 1
Total participants 2009-07-01 1,020
Number of participants with account balances 2009-07-01 1,020
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-07-01 0

Measure	Date	Value
2017: COMMUNITY MEDICAL CENTER 403(B) SUPPLEMENTAL CONTRIBUTORY RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	2,793
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	0
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	0
Total of all active and inactive participants	2017-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: COMMUNITY MEDICAL CENTER 403(B) SUPPLEMENTAL CONTRIBUTORY RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	2,530
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	2,145
Number of retired or separated participants receiving benefits	2016-01-01	34
Number of other retired or separated participants entitled to future benefits	2016-01-01	608
Total of all active and inactive participants	2016-01-01	2,787
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	6
Total participants	2016-01-01	2,793
Number of participants with account balances	2016-01-01	2,233
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: COMMUNITY MEDICAL CENTER 403(B) SUPPLEMENTAL CONTRIBUTORY RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-07-01	2,404
Total number of active participants reported on line 7a of the Form 5500	2015-07-01	1,973
Number of retired or separated participants receiving benefits	2015-07-01	26
Number of other retired or separated participants entitled to future benefits	2015-07-01	527
Total of all active and inactive participants	2015-07-01	2,526
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-07-01	4
Total participants	2015-07-01	2,530
Number of participants with account balances	2015-07-01	1,833
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-07-01	0
2014: COMMUNITY MEDICAL CENTER 403(B) SUPPLEMENTAL CONTRIBUTORY RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-07-01	2,461
Total number of active participants reported on line 7a of the Form 5500	2014-07-01	1,874
Number of retired or separated participants receiving benefits	2014-07-01	26
Number of other retired or separated participants entitled to future benefits	2014-07-01	500
Total of all active and inactive participants	2014-07-01	2,400
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-07-01	4
Total participants	2014-07-01	2,404
Number of participants with account balances	2014-07-01	1,781
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-07-01	0
2013: COMMUNITY MEDICAL CENTER 403(B) SUPPLEMENTAL CONTRIBUTORY RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-07-01	2,419
Total number of active participants reported on line 7a of the Form 5500	2013-07-01	1,951
Number of retired or separated participants receiving benefits	2013-07-01	20
Number of other retired or separated participants entitled to future benefits	2013-07-01	485
Total of all active and inactive participants	2013-07-01	2,456
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-07-01	5
Total participants	2013-07-01	2,461
Number of participants with account balances	2013-07-01	1,583
2012: COMMUNITY MEDICAL CENTER 403(B) SUPPLEMENTAL CONTRIBUTORY RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-07-01	1,198
Total number of active participants reported on line 7a of the Form 5500	2012-07-01	1,937
Number of retired or separated participants receiving benefits	2012-07-01	28
Number of other retired or separated participants entitled to future benefits	2012-07-01	305
Total of all active and inactive participants	2012-07-01	2,270
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-07-01	6
Total participants	2012-07-01	2,276
Number of participants with account balances	2012-07-01	1,432
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-07-01	95
2011: COMMUNITY MEDICAL CENTER 403(B) SUPPLEMENTAL CONTRIBUTORY RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-07-01	1,029
Total number of active participants reported on line 7a of the Form 5500	2011-07-01	1,087
Number of retired or separated participants receiving benefits	2011-07-01	10
Number of other retired or separated participants entitled to future benefits	2011-07-01	101
Total of all active and inactive participants	2011-07-01	1,198
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-07-01	0
Total participants	2011-07-01	1,198
Number of participants with account balances	2011-07-01	1,198
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-07-01	0
2009: COMMUNITY MEDICAL CENTER 403(B) SUPPLEMENTAL CONTRIBUTORY RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-07-01	1,024
Total number of active participants reported on line 7a of the Form 5500	2009-07-01	985
Number of retired or separated participants receiving benefits	2009-07-01	8
Number of other retired or separated participants entitled to future benefits	2009-07-01	26
Total of all active and inactive participants	2009-07-01	1,019
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-07-01	1
Total participants	2009-07-01	1,020
Number of participants with account balances	2009-07-01	1,020
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-07-01	0

Financial Data on COMMUNITY MEDICAL CENTER 403(B) SUPPLEMENTAL CONTRIBUTORY RETIREMENT PLAN

Measure	Date	Value
2017 : COMMUNITY MEDICAL CENTER 403(B) SUPPLEMENTAL CONTRIBUTORY RETIREMENT PLAN 2017 401k financial data
Total transfer of assets from this plan	2017-12-31	$75,568,385
Total income from all sources (including contributions)	2017-12-31	$16,922,693
Total of all expenses incurred	2017-12-31	$5,153,363
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$5,144,233
Expenses. Certain deemed distributions of participant loans	2017-12-31	$-917
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$5,138,887
Value of total assets at beginning of year	2017-12-31	$63,799,055
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$10,047
Total interest from all sources	2017-12-31	$329,000
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$2,329,313
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	$2,329,313
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$5,000,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$4,925,057
Participant contributions at beginning of year	2017-12-31	$623,918
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$213,830
Other income not declared elsewhere	2017-12-31	$16,684
Administrative expenses (other) incurred	2017-12-31	$10,047
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	$11,769,330
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$63,799,055
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 beginning of year	2017-12-31	$51,582,262
Interest on participant loans	2017-12-31	$21,586
Interest earned on other investments	2017-12-31	$307,129
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2017-12-31	$47,807
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2017-12-31	$47,807
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2017-12-31	$285
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$11,545,068
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$9,006,270
Net investment gain/loss from pooled separate accounts	2017-12-31	$102,539
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	$5,144,233
Did the plan have assets held for investment	2017-12-31	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	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	Yes
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	BAKER TILLY VIRCHOW KRAUSE, LLP
Accountancy firm EIN	2017-12-31	390859910
2016 : COMMUNITY MEDICAL CENTER 403(B) SUPPLEMENTAL CONTRIBUTORY RETIREMENT PLAN 2016 401k financial data
Total income from all sources (including contributions)	2016-12-31	$8,286,819
Total of all expenses incurred	2016-12-31	$4,178,762
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$4,171,442
Expenses. Certain deemed distributions of participant loans	2016-12-31	$-1,363
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$4,891,257
Value of total assets at end of year	2016-12-31	$63,799,055
Value of total assets at beginning of year	2016-12-31	$59,690,998
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$8,683
Total interest from all sources	2016-12-31	$362,723
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$1,582,779
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	$1,582,779
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$5,000,000
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
Contributions received from participants	2016-12-31	$4,173,143
Participant contributions at end of year	2016-12-31	$623,918
Participant contributions at beginning of year	2016-12-31	$567,744
Assets. Other investments not covered elsewhere at beginning of year	2016-12-31	$10,638,153
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$718,114
Other income not declared elsewhere	2016-12-31	$19,296
Administrative expenses (other) incurred	2016-12-31	$8,683
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	$4,108,057
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$63,799,055
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$59,690,998
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	$51,582,262
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$47,748,904
Interest on participant loans	2016-12-31	$20,825
Interest earned on other investments	2016-12-31	$341,873
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2016-12-31	$47,807
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2016-12-31	$32,830
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2016-12-31	$32,830
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2016-12-31	$25
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$11,545,068
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$703,367
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$1,374,252
Net investment gain/loss from pooled separate accounts	2016-12-31	$56,512
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	$4,171,442
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	GRANT THORNTON, LLP
Accountancy firm EIN	2016-12-31	366055558
2015 : COMMUNITY MEDICAL CENTER 403(B) SUPPLEMENTAL CONTRIBUTORY RETIREMENT PLAN 2015 401k financial data
Total income from all sources (including contributions)	2015-12-31	$1,204,836
Total of all expenses incurred	2015-12-31	$1,925,635
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$1,918,856
Expenses. Certain deemed distributions of participant loans	2015-12-31	$37
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$2,020,785
Value of total assets at end of year	2015-12-31	$59,690,998
Value of total assets at beginning of year	2015-12-31	$60,411,797
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$6,742
Total interest from all sources	2015-12-31	$10,396
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$1,599,523
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	$1,599,523
Administrative expenses professional fees incurred	2015-12-31	$3,464
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$5,000,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$1,899,663
Participant contributions at end of year	2015-12-31	$567,744
Participant contributions at beginning of year	2015-12-31	$510,035
Assets. Other investments not covered elsewhere at end of year	2015-12-31	$10,638,153
Assets. Other investments not covered elsewhere at beginning of year	2015-12-31	$10,274,751
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$121,122
Other income not declared elsewhere	2015-12-31	$171,767
Administrative expenses (other) incurred	2015-12-31	$3,278
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	$-720,799
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$59,690,998
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$60,411,797
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	$47,748,904
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$48,912,167
Interest on participant loans	2015-12-31	$8,733
Interest earned on other investments	2015-12-31	$1,662
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2015-12-31	$32,830
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2015-12-31	$28,060
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2015-12-31	$28,060
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2015-12-31	$1
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$703,367
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$686,784
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-2,572,989
Net investment gain/loss from pooled separate accounts	2015-12-31	$-24,646
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	$1,918,856
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
Total income from all sources (including contributions)	2015-06-30	$8,370,604
Total of all expenses incurred	2015-06-30	$4,357,570
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-06-30	$4,344,143
Expenses. Certain deemed distributions of participant loans	2015-06-30	$5,711
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-06-30	$5,089,367
Value of total assets at end of year	2015-06-30	$60,411,797
Value of total assets at beginning of year	2015-06-30	$56,398,763
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-06-30	$7,716
Total interest from all sources	2015-06-30	$41,984
Total dividends received (eg from common stock, registered investment company shares)	2015-06-30	$1,722,235
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-06-30	$1,722,235
Was this plan covered by a fidelity bond	2015-06-30	Yes
Value of fidelity bond cover	2015-06-30	$5,000,000
If this is an individual account plan, was there a blackout period	2015-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2015-06-30	No
Contributions received from participants	2015-06-30	$3,561,925
Participant contributions at end of year	2015-06-30	$510,035
Participant contributions at beginning of year	2015-06-30	$542,545
Assets. Other investments not covered elsewhere at end of year	2015-06-30	$10,274,751
Assets. Other investments not covered elsewhere at beginning of year	2015-06-30	$10,750,048
Income. Received or receivable in cash from other sources (including rollovers)	2015-06-30	$1,527,442
Other income not declared elsewhere	2015-06-30	$324,055
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-06-30	No
Value of net income/loss	2015-06-30	$4,013,034
Value of net assets at end of year (total assets less liabilities)	2015-06-30	$60,411,797
Value of net assets at beginning of year (total assets less liabilities)	2015-06-30	$56,398,763
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-06-30	No
Were any leases to which the plan was party in default or uncollectible	2015-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-06-30	$48,912,167
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-06-30	$43,536,301
Value of interest in pooled separate accounts at beginning of year	2015-06-30	$880,718
Interest on participant loans	2015-06-30	$19,127
Interest earned on other investments	2015-06-30	$22,857
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2015-06-30	$28,060
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2015-06-30	$17,135
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2015-06-30	$17,135
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-06-30	$686,784
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-06-30	$672,016
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-06-30	$1,195,228
Net investment gain/loss from pooled separate accounts	2015-06-30	$-2,265
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-06-30	No
Was there a failure to transmit to the plan any participant contributions	2015-06-30	No
Has the plan failed to provide any benefit when due under the plan	2015-06-30	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-06-30	$4,344,143
Contract administrator fees	2015-06-30	$7,716
Did the plan have assets held for investment	2015-06-30	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	2015-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2015-06-30	Disclaimer
Accountancy firm name	2015-06-30	GRANT THORNTON, LLP
Accountancy firm EIN	2015-06-30	366055558
2014 : COMMUNITY MEDICAL CENTER 403(B) SUPPLEMENTAL CONTRIBUTORY RETIREMENT PLAN 2014 401k financial data
Total income from all sources (including contributions)	2014-06-30	$10,964,674
Total of all expenses incurred	2014-06-30	$3,748,249
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-06-30	$3,634,758
Expenses. Certain deemed distributions of participant loans	2014-06-30	$108,275
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-06-30	$3,381,748
Value of total assets at end of year	2014-06-30	$56,398,763
Value of total assets at beginning of year	2014-06-30	$49,182,338
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-06-30	$5,216
Total interest from all sources	2014-06-30	$43,122
Total dividends received (eg from common stock, registered investment company shares)	2014-06-30	$1,467,570
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-06-30	$1,467,570
Was this plan covered by a fidelity bond	2014-06-30	Yes
Value of fidelity bond cover	2014-06-30	$5,000,000
If this is an individual account plan, was there a blackout period	2014-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2014-06-30	No
Contributions received from participants	2014-06-30	$3,290,574
Participant contributions at end of year	2014-06-30	$542,545
Participant contributions at beginning of year	2014-06-30	$621,258
Assets. Other investments not covered elsewhere at end of year	2014-06-30	$10,750,048
Income. Received or receivable in cash from other sources (including rollovers)	2014-06-30	$91,174
Other income not declared elsewhere	2014-06-30	$349,417
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-06-30	No
Value of net income/loss	2014-06-30	$7,216,425
Value of net assets at end of year (total assets less liabilities)	2014-06-30	$56,398,763
Value of net assets at beginning of year (total assets less liabilities)	2014-06-30	$49,182,338
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-06-30	No
Were any leases to which the plan was party in default or uncollectible	2014-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-06-30	$43,536,301
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-06-30	$35,935,208
Value of interest in pooled separate accounts at end of year	2014-06-30	$880,718
Value of interest in pooled separate accounts at beginning of year	2014-06-30	$782,017
Interest on participant loans	2014-06-30	$20,257
Interest earned on other investments	2014-06-30	$22,865
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2014-06-30	$17,135
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2014-06-30	$20,507
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2014-06-30	$20,507
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-06-30	$672,016
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-06-30	$11,823,348
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-06-30	$5,722,817
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-06-30	No
Was there a failure to transmit to the plan any participant contributions	2014-06-30	No
Has the plan failed to provide any benefit when due under the plan	2014-06-30	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-06-30	$3,634,758
Contract administrator fees	2014-06-30	$5,216
Did the plan have assets held for investment	2014-06-30	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	2014-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2014-06-30	Disclaimer
Accountancy firm name	2014-06-30	GRANT THORNTON, LLP
Accountancy firm EIN	2014-06-30	366055558
2013 : COMMUNITY MEDICAL CENTER 403(B) SUPPLEMENTAL CONTRIBUTORY RETIREMENT PLAN 2013 401k financial data
Total income from all sources (including contributions)	2013-06-30	$8,721,470
Total of all expenses incurred	2013-06-30	$5,074,985
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-06-30	$5,069,199
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-06-30	$3,390,434
Value of total assets at end of year	2013-06-30	$49,182,338
Value of total assets at beginning of year	2013-06-30	$45,535,853
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-06-30	$5,786
Total interest from all sources	2013-06-30	$222,493
Total dividends received (eg from common stock, registered investment company shares)	2013-06-30	$512,979
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-06-30	$512,979
Was this plan covered by a fidelity bond	2013-06-30	Yes
Value of fidelity bond cover	2013-06-30	$5,000,000
If this is an individual account plan, was there a blackout period	2013-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2013-06-30	No
Contributions received from participants	2013-06-30	$3,217,604
Participant contributions at end of year	2013-06-30	$621,258
Participant contributions at beginning of year	2013-06-30	$561,823
Participant contributions at beginning of year	2013-06-30	$8,613
Income. Received or receivable in cash from other sources (including rollovers)	2013-06-30	$172,830
Administrative expenses (other) incurred	2013-06-30	$5,786
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-06-30	No
Value of net income/loss	2013-06-30	$3,646,485
Value of net assets at end of year (total assets less liabilities)	2013-06-30	$49,182,338
Value of net assets at beginning of year (total assets less liabilities)	2013-06-30	$45,535,853
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-06-30	No
Were any leases to which the plan was party in default or uncollectible	2013-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-06-30	$35,935,208
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-06-30	$32,381,580
Value of interest in pooled separate accounts at end of year	2013-06-30	$782,017
Value of interest in pooled separate accounts at beginning of year	2013-06-30	$727,115
Interest on participant loans	2013-06-30	$19,235
Interest earned on other investments	2013-06-30	$203,258
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2013-06-30	$20,507
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2013-06-30	$77,346
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2013-06-30	$77,346
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-06-30	$11,823,348
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-06-30	$11,779,376
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-06-30	$4,595,564
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-06-30	No
Was there a failure to transmit to the plan any participant contributions	2013-06-30	Yes
Has the plan failed to provide any benefit when due under the plan	2013-06-30	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-06-30	$5,069,199
Did the plan have assets held for investment	2013-06-30	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	2013-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2013-06-30	Disclaimer
Accountancy firm name	2013-06-30	PARENTEBEARD, LLC
Accountancy firm EIN	2013-06-30	232932984
2012 : COMMUNITY MEDICAL CENTER 403(B) SUPPLEMENTAL CONTRIBUTORY RETIREMENT PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-06-30	$0
Total income from all sources (including contributions)	2012-06-30	$3,466,034
Total loss/gain on sale of assets	2012-06-30	$0
Total of all expenses incurred	2012-06-30	$2,230,523
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-06-30	$2,161,192
Expenses. Certain deemed distributions of participant loans	2012-06-30	$60,534
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-06-30	$3,477,382
Value of total assets at end of year	2012-06-30	$45,535,853
Value of total assets at beginning of year	2012-06-30	$44,300,342
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-06-30	$8,797
Total interest from all sources	2012-06-30	$363,906
Total dividends received (eg from common stock, registered investment company shares)	2012-06-30	$367,242
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-06-30	$367,242
Was this plan covered by a fidelity bond	2012-06-30	Yes
Value of fidelity bond cover	2012-06-30	$1,000,000
If this is an individual account plan, was there a blackout period	2012-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2012-06-30	No
Contributions received from participants	2012-06-30	$3,076,532
Participant contributions at end of year	2012-06-30	$561,823
Participant contributions at beginning of year	2012-06-30	$562,689
Participant contributions at end of year	2012-06-30	$8,613
Participant contributions at beginning of year	2012-06-30	$8,751
Income. Received or receivable in cash from other sources (including rollovers)	2012-06-30	$400,850
Other income not declared elsewhere	2012-06-30	$-2,757
Administrative expenses (other) incurred	2012-06-30	$8,797
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-06-30	No
Value of net income/loss	2012-06-30	$1,235,511
Value of net assets at end of year (total assets less liabilities)	2012-06-30	$45,535,853
Value of net assets at beginning of year (total assets less liabilities)	2012-06-30	$44,300,342
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-06-30	No
Were any leases to which the plan was party in default or uncollectible	2012-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-06-30	$32,381,580
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-06-30	$32,025,661
Value of interest in pooled separate accounts at end of year	2012-06-30	$727,115
Value of interest in pooled separate accounts at beginning of year	2012-06-30	$839,491
Interest on participant loans	2012-06-30	$25,101
Interest earned on other investments	2012-06-30	$338,793
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-06-30	$77,346
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-06-30	$72,416
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-06-30	$72,416
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-06-30	$12
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-06-30	$11,779,376
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-06-30	$10,791,334
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-06-30	$-737,308
Net investment gain/loss from pooled separate accounts	2012-06-30	$-2,431
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-06-30	No
Was there a failure to transmit to the plan any participant contributions	2012-06-30	No
Has the plan failed to provide any benefit when due under the plan	2012-06-30	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-06-30	$2,161,192
Did the plan have assets held for investment	2012-06-30	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	2012-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2012-06-30	Disclaimer
Accountancy firm name	2012-06-30	PARENTEBEARD, LLC
Accountancy firm EIN	2012-06-30	232932984
2011 : COMMUNITY MEDICAL CENTER 403(B) SUPPLEMENTAL CONTRIBUTORY RETIREMENT PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-06-30	$0
Total income from all sources (including contributions)	2011-06-30	$10,577,050
Total loss/gain on sale of assets	2011-06-30	$0
Total of all expenses incurred	2011-06-30	$2,948,932
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-06-30	$2,883,967
Expenses. Certain deemed distributions of participant loans	2011-06-30	$57,017
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-06-30	$3,074,842
Value of total assets at end of year	2011-06-30	$44,300,342
Value of total assets at beginning of year	2011-06-30	$36,672,224
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-06-30	$7,948
Total interest from all sources	2011-06-30	$349,889
Total dividends received (eg from common stock, registered investment company shares)	2011-06-30	$317,864
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2011-06-30	$317,864
Was this plan covered by a fidelity bond	2011-06-30	Yes
Value of fidelity bond cover	2011-06-30	$1,000,000
If this is an individual account plan, was there a blackout period	2011-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2011-06-30	No
Contributions received from participants	2011-06-30	$2,885,161
Participant contributions at end of year	2011-06-30	$562,689
Participant contributions at beginning of year	2011-06-30	$465,208
Income. Received or receivable in cash from other sources (including rollovers)	2011-06-30	$189,681
Other income not declared elsewhere	2011-06-30	$5,881
Administrative expenses (other) incurred	2011-06-30	$7,948
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-06-30	No
Value of net income/loss	2011-06-30	$7,628,118
Value of net assets at end of year (total assets less liabilities)	2011-06-30	$44,300,342
Value of net assets at beginning of year (total assets less liabilities)	2011-06-30	$36,672,224
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-06-30	No
Were any leases to which the plan was party in default or uncollectible	2011-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-06-30	$32,025,661
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-06-30	$24,846,300
Value of interest in pooled separate accounts at end of year	2011-06-30	$839,491
Value of interest in pooled separate accounts at beginning of year	2011-06-30	$766,931
Interest on participant loans	2011-06-30	$24,871
Interest earned on other investments	2011-06-30	$324,981
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-06-30	$72,416
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-06-30	$211,412
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-06-30	$211,412
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-06-30	$37
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-06-30	$10,791,334
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-06-30	$10,382,373
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-06-30	$6,657,115
Net investment gain/loss from pooled separate accounts	2011-06-30	$171,459
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-06-30	No
Was there a failure to transmit to the plan any participant contributions	2011-06-30	No
Has the plan failed to provide any benefit when due under the plan	2011-06-30	No
Employer contributions (assets) at end of year	2011-06-30	$8,751
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-06-30	$2,883,967
Did the plan have assets held for investment	2011-06-30	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	2011-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2011-06-30	Disclaimer
Accountancy firm name	2011-06-30	PARENTEBEARD, LLC
Accountancy firm EIN	2011-06-30	232932984
2010 : COMMUNITY MEDICAL CENTER 403(B) SUPPLEMENTAL CONTRIBUTORY RETIREMENT PLAN 2010 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-06-30	$0

Form 5500 Responses for COMMUNITY MEDICAL CENTER 403(B) SUPPLEMENTAL CONTRIBUTORY RETIREMENT PLAN

2017: COMMUNITY MEDICAL CENTER 403(B) SUPPLEMENTAL CONTRIBUTORY RETIREMENT PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	This submission is the final filing	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: COMMUNITY MEDICAL CENTER 403(B) SUPPLEMENTAL CONTRIBUTORY RETIREMENT PLAN 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: COMMUNITY MEDICAL CENTER 403(B) SUPPLEMENTAL CONTRIBUTORY RETIREMENT PLAN 2015 form 5500 responses
2015-07-01	Type of plan entity	Single employer plan
2015-07-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2015-07-01	Plan funding arrangement – Insurance	Yes
2015-07-01	Plan funding arrangement – Trust	Yes
2015-07-01	Plan benefit arrangement – Insurance	Yes
2015-07-01	Plan benefit arrangement - Trust	Yes
2014: COMMUNITY MEDICAL CENTER 403(B) SUPPLEMENTAL CONTRIBUTORY RETIREMENT PLAN 2014 form 5500 responses
2014-07-01	Type of plan entity	Single employer plan
2014-07-01	Plan funding arrangement – Insurance	Yes
2014-07-01	Plan funding arrangement – Trust	Yes
2014-07-01	Plan benefit arrangement – Insurance	Yes
2014-07-01	Plan benefit arrangement - Trust	Yes
2013: COMMUNITY MEDICAL CENTER 403(B) SUPPLEMENTAL CONTRIBUTORY RETIREMENT PLAN 2013 form 5500 responses
2013-07-01	Type of plan entity	Single employer plan
2013-07-01	Plan funding arrangement – Insurance	Yes
2013-07-01	Plan funding arrangement – Trust	Yes
2013-07-01	Plan benefit arrangement – Insurance	Yes
2013-07-01	Plan benefit arrangement - Trust	Yes
2012: COMMUNITY MEDICAL CENTER 403(B) SUPPLEMENTAL CONTRIBUTORY RETIREMENT PLAN 2012 form 5500 responses
2012-07-01	Type of plan entity	Single employer plan
2012-07-01	Plan funding arrangement – Insurance	Yes
2012-07-01	Plan funding arrangement – Trust	Yes
2012-07-01	Plan benefit arrangement – Insurance	Yes
2012-07-01	Plan benefit arrangement - Trust	Yes
2011: COMMUNITY MEDICAL CENTER 403(B) SUPPLEMENTAL CONTRIBUTORY RETIREMENT PLAN 2011 form 5500 responses
2011-07-01	Type of plan entity	Single employer plan
2011-07-01	Submission has been amended	No
2011-07-01	This submission is the final filing	No
2011-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-07-01	Plan is a collectively bargained plan	No
2011-07-01	Plan funding arrangement – Insurance	Yes
2011-07-01	Plan funding arrangement – Trust	Yes
2011-07-01	Plan benefit arrangement – Insurance	Yes
2011-07-01	Plan benefit arrangement - Trust	Yes
2009: COMMUNITY MEDICAL CENTER 403(B) SUPPLEMENTAL CONTRIBUTORY RETIREMENT PLAN 2009 form 5500 responses
2009-07-01	Type of plan entity	Single employer plan
2009-07-01	Submission has been amended	No
2009-07-01	This submission is the final filing	No
2009-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-07-01	Plan is a collectively bargained plan	No
2009-07-01	Plan funding arrangement – Insurance	Yes
2009-07-01	Plan funding arrangement – Trust	Yes
2009-07-01	Plan benefit arrangement – Insurance	Yes
2009-07-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )

Policy contract number

GA 300283

Policy instance

Insurance contract or identification number	GA 300283
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
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

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G05057

Policy instance

Insurance contract or identification number	G05057
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )

Policy contract number

923600

Policy instance

Insurance contract or identification number	923600
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $6
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6
Additional information about fees paid to insurance broker	ASSET ALLOC. & REBALANCING ADVICE
Insurance broker organization code?	3
Insurance broker name	BRIGHTHOUSE SECURITIES, LLC

METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )

Policy contract number

917765

Policy instance

Insurance contract or identification number	917765
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $3,794
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,794
Additional information about fees paid to insurance broker	ASSET ALLOC AND REBALANCING
Insurance broker organization code?	3
Insurance broker name	BRIGHTHOUSE SECURITIES LLC

PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )

Policy contract number

GA 300283

Policy instance

Insurance contract or identification number	GA 300283
Number of Individuals Covered	784
Insurance policy start date	2015-07-01
Insurance policy end date	2015-12-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G05057

Policy instance

Insurance contract or identification number	G05057
Number of Individuals Covered	16
Insurance policy start date	2015-07-01
Insurance policy end date	2015-12-31
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

COPE0101CC12

Policy instance

Insurance contract or identification number	COPE0101CC12
Number of Individuals Covered	5
Insurance policy start date	2015-07-01
Insurance policy end date	2015-12-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

METLIFE INVESTORS (National Association of Insurance Commissioners NAIC id number: 80950 )

Policy contract number

923600

Policy instance

Insurance contract or identification number	923600
Number of Individuals Covered	5
Insurance policy start date	2015-07-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $4
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4
Additional information about fees paid to insurance broker	ASSET ALLOC. & REBALANCING ADVICE
Insurance broker organization code?	3
Insurance broker name	METLIFE SECURITIES, INC.

METLIFE INVESTORS (National Association of Insurance Commissioners NAIC id number: 80950 )

Policy contract number

917765

Policy instance

Insurance contract or identification number	917765
Number of Individuals Covered	78
Insurance policy start date	2015-07-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $2,048
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,048
Additional information about fees paid to insurance broker	ASSET ALLOC AND REBALANCING
Insurance broker organization code?	3
Insurance broker name	METLIFE SECURITIES INC.

METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )

Policy contract number

917765

Policy instance

Insurance contract or identification number	917765
Number of Individuals Covered	80
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Total amount of fees paid to insurance company	USD $4,233
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	4233
Additional information about fees paid to insurance broker	ASSET ALLOC AND REBALANCING
Insurance broker organization code?	3
Insurance broker name	METLIFE SECURITIES INC.

METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )

Policy contract number

923600

Policy instance

Insurance contract or identification number	923600
Number of Individuals Covered	5
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Total amount of fees paid to insurance company	USD $8
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	8
Additional information about fees paid to insurance broker	ASSET ALLOC. & REBALANCING ADVICE
Insurance broker organization code?	3
Insurance broker name	METLIFE SECURITIES, INC.

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

Policy contract number

COPE0101CC12

Policy instance

Insurance contract or identification number	COPE0101CC12
Number of Individuals Covered	5
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G05057

Policy instance

Insurance contract or identification number	G05057
Number of Individuals Covered	16
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )

Policy contract number

GA 300283

Policy instance

Insurance contract or identification number	GA 300283
Number of Individuals Covered	801
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
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

METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )

Policy contract number

917765

Policy instance

Insurance contract or identification number	917765
Number of Individuals Covered	84
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
Total amount of commissions paid to insurance broker	USD $4,095
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,095
Additional information about fees paid to insurance broker	ASSET ALLOC. & REBALANCING ADVICE
Insurance broker organization code?	3
Insurance broker name	METLIFE SECURITIES INC.

METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )

Policy contract number

923600

Policy instance

Insurance contract or identification number	923600
Number of Individuals Covered	5
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
Total amount of commissions paid to insurance broker	USD $8
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $8
Additional information about fees paid to insurance broker	ASSET ALLOC. & REBALANCING ADVICE
Insurance broker organization code?	3
Insurance broker name	METLIFE SECURITIES, INC.

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

Policy contract number

COPE0101CC12

Policy instance

Insurance contract or identification number	COPE0101CC12
Number of Individuals Covered	5
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G05057

Policy instance

Insurance contract or identification number	G05057
Number of Individuals Covered	20
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )

Policy contract number

GA 300283

Policy instance

Insurance contract or identification number	GA 300283
Number of Individuals Covered	887
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
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

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

Policy contract number

COMMOOPAOOPI

Policy instance

Insurance contract or identification number	COMMOOPAOOPI
Number of Individuals Covered	5
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

300283

Policy instance

Insurance contract or identification number	300283
Number of Individuals Covered	963
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
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

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G05057

Policy instance

Insurance contract or identification number	G05057
Number of Individuals Covered	20
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )

Policy contract number

917765

Policy instance

Insurance contract or identification number	917765
Number of Individuals Covered	84
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
Total amount of fees paid to insurance company	USD $3,761
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	3761
Insurance broker organization code?	6
Insurance broker name	METLIFE SECURITIES INC

METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )

Policy contract number

917759

Policy instance

Insurance contract or identification number	917759
Number of Individuals Covered	87
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $0
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

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

Policy contract number

COMMOOPAOOPI

Policy instance

Insurance contract or identification number	COMMOOPAOOPI
Number of Individuals Covered	5
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $0
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?	No
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

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

300283

Policy instance

Insurance contract or identification number	300283
Number of Individuals Covered	1198
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $21,878
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?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
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

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GO5057

Policy instance

Insurance contract or identification number	GO5057
Number of Individuals Covered	20
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $0
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

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GO5057

Policy instance

Insurance contract or identification number	GO5057
Insurance policy start date	2010-07-01
Insurance policy end date	2011-06-30
Total amount of commissions paid to insurance broker	USD $0
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

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

300283

Policy instance

Insurance contract or identification number	300283
Number of Individuals Covered	1029
Insurance policy start date	2010-07-01
Insurance policy end date	2011-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $19,549
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?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
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

METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )

Policy contract number

917759

Policy instance

Insurance contract or identification number	917759
Insurance policy start date	2010-07-01
Insurance policy end date	2011-06-30
Total amount of commissions paid to insurance broker	USD $0
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

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

Policy contract number

COMMOOPAOOPI

Policy instance

Insurance contract or identification number	COMMOOPAOOPI
Insurance policy start date	2010-07-01
Insurance policy end date	2011-06-30
Total amount of commissions paid to insurance broker	USD $0
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?	No
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:	COMMUNITY MEDICAL CENTER
Employer identification number (EIN):	240862246
NAIC Classification:	622000
NAIC Description:	Hospitals

Jurisdiction of Incorporation:	Iowa Secretary of State Business Entities
Incorporation Date:	1984-04-20
Company Identification Number:	094369
Legal Registered Office Address:	1603 MORGAN ST STE 6 KEOKUK United States of America (USA) 52632