401k Plan data: COMMUNITY HEALTH NET 403B RETIREMENT PLAN plan

COMMUNITY HEALTH NET 403B RETIREMENT PLAN 401k Plan overview

Plan Name	COMMUNITY HEALTH NET 403B RETIREMENT PLAN
Plan identification number	001

COMMUNITY HEALTH NET 403B RETIREMENT PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.

401k Sponsoring company profile

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

Company Name: COMMUNITY HEALTH NET

Employer identification number (EIN): 251490791

NAIC Classification: 621498
NAIC Description: All Other Outpatient Care Centers

Additional information about COMMUNITY HEALTH NET

Jurisdiction of Incorporation: COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF STATE

Incorporation Date:

Company Identification Number: 854197

More information about COMMUNITY HEALTH NET

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COMMUNITY HEALTH NET 403B RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-07-01
001 2021-07-01
001 2020-07-01
001 2019-07-01
001 2018-07-01
001 2017-07-01
001 2016-07-01 CYNTHIA DEDIONISIO
001 2015-07-01 CYNTHIA DEDIONISIO
001 2014-07-01 R. ANTHONY SNOW, M.D.
001 2013-07-01 R. ANTHONY SNOW, M.D.
001 2012-07-01 R. ANTHONY SNOW, M.D.
001 2011-07-01 R. ANTHONY SNOW, M.D.
001 2009-07-01 JOHN SCHULTZ

Plan Statistics for COMMUNITY HEALTH NET 403B RETIREMENT PLAN

401k plan membership statisitcs for COMMUNITY HEALTH NET 403B RETIREMENT PLAN

Measure Date Value
2022: COMMUNITY HEALTH NET 403B RETIREMENT PLAN 2022 401k membership
Total participants, beginning-of-year 2022-07-01 151
Total number of active participants reported on line 7a of the Form 5500 2022-07-01 105
Number of retired or separated participants receiving benefits 2022-07-01 0
Number of other retired or separated participants entitled to future benefits 2022-07-01 49
Total of all active and inactive participants 2022-07-01 154
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-07-01 0
Total participants 2022-07-01 154
Number of participants with account balances 2022-07-01 95
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-07-01 7
2021: COMMUNITY HEALTH NET 403B RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year 2021-07-01 144
Total number of active participants reported on line 7a of the Form 5500 2021-07-01 104
Number of retired or separated participants receiving benefits 2021-07-01 0
Number of other retired or separated participants entitled to future benefits 2021-07-01 47
Total of all active and inactive participants 2021-07-01 151
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-07-01 0
Total participants 2021-07-01 151
Number of participants with account balances 2021-07-01 93
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-07-01 0
2020: COMMUNITY HEALTH NET 403B RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year 2020-07-01 139
Total number of active participants reported on line 7a of the Form 5500 2020-07-01 100
Number of retired or separated participants receiving benefits 2020-07-01 0
Number of other retired or separated participants entitled to future benefits 2020-07-01 44
Total of all active and inactive participants 2020-07-01 144
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-07-01 0
Total participants 2020-07-01 144
Number of participants with account balances 2020-07-01 91
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-07-01 3
2019: COMMUNITY HEALTH NET 403B RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year 2019-07-01 138
Total number of active participants reported on line 7a of the Form 5500 2019-07-01 98
Number of retired or separated participants receiving benefits 2019-07-01 0
Number of other retired or separated participants entitled to future benefits 2019-07-01 39
Total of all active and inactive participants 2019-07-01 137
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-07-01 0
Total participants 2019-07-01 137
Number of participants with account balances 2019-07-01 87
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-07-01 1
2018: COMMUNITY HEALTH NET 403B RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year 2018-07-01 137
Total number of active participants reported on line 7a of the Form 5500 2018-07-01 99
Number of retired or separated participants receiving benefits 2018-07-01 0
Number of other retired or separated participants entitled to future benefits 2018-07-01 39
Total of all active and inactive participants 2018-07-01 138
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-07-01 0
Total participants 2018-07-01 138
Number of participants with account balances 2018-07-01 86
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-07-01 2
2017: COMMUNITY HEALTH NET 403B RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-07-01 131
Total number of active participants reported on line 7a of the Form 5500 2017-07-01 94
Number of retired or separated participants receiving benefits 2017-07-01 0
Number of other retired or separated participants entitled to future benefits 2017-07-01 43
Total of all active and inactive participants 2017-07-01 137
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-07-01 0
Total participants 2017-07-01 137
Number of participants with account balances 2017-07-01 82
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-07-01 5
2016: COMMUNITY HEALTH NET 403B RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-07-01 141
Total number of active participants reported on line 7a of the Form 5500 2016-07-01 90
Number of retired or separated participants receiving benefits 2016-07-01 0
Number of other retired or separated participants entitled to future benefits 2016-07-01 40
Total of all active and inactive participants 2016-07-01 130
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-07-01 0
Total participants 2016-07-01 130
Number of participants with account balances 2016-07-01 84
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-07-01 0
2015: COMMUNITY HEALTH NET 403B RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-07-01 145
Total number of active participants reported on line 7a of the Form 5500 2015-07-01 95
Number of retired or separated participants receiving benefits 2015-07-01 0
Number of other retired or separated participants entitled to future benefits 2015-07-01 44
Total of all active and inactive participants 2015-07-01 139
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-07-01 0
Total participants 2015-07-01 139
Number of participants with account balances 2015-07-01 82
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-07-01 0
2014: COMMUNITY HEALTH NET 403B RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-07-01 145
Total number of active participants reported on line 7a of the Form 5500 2014-07-01 93
Number of retired or separated participants receiving benefits 2014-07-01 0
Number of other retired or separated participants entitled to future benefits 2014-07-01 52
Total of all active and inactive participants 2014-07-01 145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-07-01 0
Total participants 2014-07-01 145
Number of participants with account balances 2014-07-01 90
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-07-01 1
2013: COMMUNITY HEALTH NET 403B RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-07-01 149
Total number of active participants reported on line 7a of the Form 5500 2013-07-01 95
Number of retired or separated participants receiving benefits 2013-07-01 0
Number of other retired or separated participants entitled to future benefits 2013-07-01 50
Total of all active and inactive participants 2013-07-01 145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-07-01 0
Total participants 2013-07-01 145
Number of participants with account balances 2013-07-01 95
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-07-01 3
2012: COMMUNITY HEALTH NET 403B RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-07-01 173
Total number of active participants reported on line 7a of the Form 5500 2012-07-01 95
Number of retired or separated participants receiving benefits 2012-07-01 0
Number of other retired or separated participants entitled to future benefits 2012-07-01 54
Total of all active and inactive participants 2012-07-01 149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-07-01 0
Total participants 2012-07-01 149
Number of participants with account balances 2012-07-01 101
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-07-01 6
2011: COMMUNITY HEALTH NET 403B RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-07-01 155
Total number of active participants reported on line 7a of the Form 5500 2011-07-01 125
Number of retired or separated participants receiving benefits 2011-07-01 0
Number of other retired or separated participants entitled to future benefits 2011-07-01 48
Total of all active and inactive participants 2011-07-01 173
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-07-01 0
Total participants 2011-07-01 173
Number of participants with account balances 2011-07-01 108
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-07-01 2
2009: COMMUNITY HEALTH NET 403B RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-07-01 134
Total number of active participants reported on line 7a of the Form 5500 2009-07-01 103
Number of retired or separated participants receiving benefits 2009-07-01 0
Number of other retired or separated participants entitled to future benefits 2009-07-01 37
Total of all active and inactive participants 2009-07-01 140
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-07-01 1
Total participants 2009-07-01 141
Number of participants with account balances 2009-07-01 108
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-07-01 2

Measure	Date	Value
2022: COMMUNITY HEALTH NET 403B RETIREMENT PLAN 2022 401k membership
Total participants, beginning-of-year	2022-07-01	151
Total number of active participants reported on line 7a of the Form 5500	2022-07-01	105
Number of retired or separated participants receiving benefits	2022-07-01	0
Number of other retired or separated participants entitled to future benefits	2022-07-01	49
Total of all active and inactive participants	2022-07-01	154
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-07-01	0
Total participants	2022-07-01	154
Number of participants with account balances	2022-07-01	95
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-07-01	7
2021: COMMUNITY HEALTH NET 403B RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year	2021-07-01	144
Total number of active participants reported on line 7a of the Form 5500	2021-07-01	104
Number of retired or separated participants receiving benefits	2021-07-01	0
Number of other retired or separated participants entitled to future benefits	2021-07-01	47
Total of all active and inactive participants	2021-07-01	151
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-07-01	0
Total participants	2021-07-01	151
Number of participants with account balances	2021-07-01	93
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-07-01	0
2020: COMMUNITY HEALTH NET 403B RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year	2020-07-01	139
Total number of active participants reported on line 7a of the Form 5500	2020-07-01	100
Number of retired or separated participants receiving benefits	2020-07-01	0
Number of other retired or separated participants entitled to future benefits	2020-07-01	44
Total of all active and inactive participants	2020-07-01	144
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-07-01	0
Total participants	2020-07-01	144
Number of participants with account balances	2020-07-01	91
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-07-01	3
2019: COMMUNITY HEALTH NET 403B RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year	2019-07-01	138
Total number of active participants reported on line 7a of the Form 5500	2019-07-01	98
Number of retired or separated participants receiving benefits	2019-07-01	0
Number of other retired or separated participants entitled to future benefits	2019-07-01	39
Total of all active and inactive participants	2019-07-01	137
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-07-01	0
Total participants	2019-07-01	137
Number of participants with account balances	2019-07-01	87
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-07-01	1
2018: COMMUNITY HEALTH NET 403B RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year	2018-07-01	137
Total number of active participants reported on line 7a of the Form 5500	2018-07-01	99
Number of retired or separated participants receiving benefits	2018-07-01	0
Number of other retired or separated participants entitled to future benefits	2018-07-01	39
Total of all active and inactive participants	2018-07-01	138
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-07-01	0
Total participants	2018-07-01	138
Number of participants with account balances	2018-07-01	86
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-07-01	2
2017: COMMUNITY HEALTH NET 403B RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-07-01	131
Total number of active participants reported on line 7a of the Form 5500	2017-07-01	94
Number of retired or separated participants receiving benefits	2017-07-01	0
Number of other retired or separated participants entitled to future benefits	2017-07-01	43
Total of all active and inactive participants	2017-07-01	137
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-07-01	0
Total participants	2017-07-01	137
Number of participants with account balances	2017-07-01	82
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-07-01	5
2016: COMMUNITY HEALTH NET 403B RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-07-01	141
Total number of active participants reported on line 7a of the Form 5500	2016-07-01	90
Number of retired or separated participants receiving benefits	2016-07-01	0
Number of other retired or separated participants entitled to future benefits	2016-07-01	40
Total of all active and inactive participants	2016-07-01	130
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-07-01	0
Total participants	2016-07-01	130
Number of participants with account balances	2016-07-01	84
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-07-01	0
2015: COMMUNITY HEALTH NET 403B RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-07-01	145
Total number of active participants reported on line 7a of the Form 5500	2015-07-01	95
Number of retired or separated participants receiving benefits	2015-07-01	0
Number of other retired or separated participants entitled to future benefits	2015-07-01	44
Total of all active and inactive participants	2015-07-01	139
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-07-01	0
Total participants	2015-07-01	139
Number of participants with account balances	2015-07-01	82
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-07-01	0
2014: COMMUNITY HEALTH NET 403B RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-07-01	145
Total number of active participants reported on line 7a of the Form 5500	2014-07-01	93
Number of retired or separated participants receiving benefits	2014-07-01	0
Number of other retired or separated participants entitled to future benefits	2014-07-01	52
Total of all active and inactive participants	2014-07-01	145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-07-01	0
Total participants	2014-07-01	145
Number of participants with account balances	2014-07-01	90
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-07-01	1
2013: COMMUNITY HEALTH NET 403B RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-07-01	149
Total number of active participants reported on line 7a of the Form 5500	2013-07-01	95
Number of retired or separated participants receiving benefits	2013-07-01	0
Number of other retired or separated participants entitled to future benefits	2013-07-01	50
Total of all active and inactive participants	2013-07-01	145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-07-01	0
Total participants	2013-07-01	145
Number of participants with account balances	2013-07-01	95
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-07-01	3
2012: COMMUNITY HEALTH NET 403B RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-07-01	173
Total number of active participants reported on line 7a of the Form 5500	2012-07-01	95
Number of retired or separated participants receiving benefits	2012-07-01	0
Number of other retired or separated participants entitled to future benefits	2012-07-01	54
Total of all active and inactive participants	2012-07-01	149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-07-01	0
Total participants	2012-07-01	149
Number of participants with account balances	2012-07-01	101
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-07-01	6
2011: COMMUNITY HEALTH NET 403B RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-07-01	155
Total number of active participants reported on line 7a of the Form 5500	2011-07-01	125
Number of retired or separated participants receiving benefits	2011-07-01	0
Number of other retired or separated participants entitled to future benefits	2011-07-01	48
Total of all active and inactive participants	2011-07-01	173
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-07-01	0
Total participants	2011-07-01	173
Number of participants with account balances	2011-07-01	108
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-07-01	2
2009: COMMUNITY HEALTH NET 403B RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-07-01	134
Total number of active participants reported on line 7a of the Form 5500	2009-07-01	103
Number of retired or separated participants receiving benefits	2009-07-01	0
Number of other retired or separated participants entitled to future benefits	2009-07-01	37
Total of all active and inactive participants	2009-07-01	140
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-07-01	1
Total participants	2009-07-01	141
Number of participants with account balances	2009-07-01	108
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-07-01	2

Financial Data on COMMUNITY HEALTH NET 403B RETIREMENT PLAN

Measure	Date	Value
2023 : COMMUNITY HEALTH NET 403B RETIREMENT PLAN 2023 401k financial data
Total unrealized appreciation/depreciation of assets	2023-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2023-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2023-06-30	$0
Total income from all sources (including contributions)	2023-06-30	$680,278
Total loss/gain on sale of assets	2023-06-30	$0
Total of all expenses incurred	2023-06-30	$398,782
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2023-06-30	$372,227
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2023-06-30	$339,753
Value of total assets at end of year	2023-06-30	$3,202,733
Value of total assets at beginning of year	2023-06-30	$2,921,237
Total of administrative expenses incurred including professional, contract, advisory and management fees	2023-06-30	$26,555
Total interest from all sources	2023-06-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2023-06-30	$77,245
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2023-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2023-06-30	$77,245
Was this plan covered by a fidelity bond	2023-06-30	Yes
Value of fidelity bond cover	2023-06-30	$500,000
If this is an individual account plan, was there a blackout period	2023-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2023-06-30	No
Contributions received from participants	2023-06-30	$284,591
Participant contributions at end of year	2023-06-30	$11,348
Participant contributions at beginning of year	2023-06-30	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2023-06-30	No
Value of net income/loss	2023-06-30	$281,496
Value of net assets at end of year (total assets less liabilities)	2023-06-30	$3,202,733
Value of net assets at beginning of year (total assets less liabilities)	2023-06-30	$2,921,237
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2023-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2023-06-30	No
Were any leases to which the plan was party in default or uncollectible	2023-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2023-06-30	$2,638,779
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2023-06-30	$2,470,583
Value of interest in pooled separate accounts at end of year	2023-06-30	$416,441
Value of interest in pooled separate accounts at beginning of year	2023-06-30	$341,980
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2023-06-30	$73,478
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2023-06-30	$63,313
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2023-06-30	$188,819
Net investment gain/loss from pooled separate accounts	2023-06-30	$74,461
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2023-06-30	No
Was there a failure to transmit to the plan any participant contributions	2023-06-30	No
Has the plan failed to provide any benefit when due under the plan	2023-06-30	No
Contributions received in cash from employer	2023-06-30	$55,162
Employer contributions (assets) at end of year	2023-06-30	$62,687
Employer contributions (assets) at beginning of year	2023-06-30	$45,361
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2023-06-30	$372,227
Contract administrator fees	2023-06-30	$26,555
Did the plan have assets held for investment	2023-06-30	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	2023-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2023-06-30	No
Opinion of an independent qualified public accountant for this plan	2023-06-30	Unqualified
Accountancy firm name	2023-06-30	BAKER TILLY US, LLP
Accountancy firm EIN	2023-06-30	390859910
2022 : COMMUNITY HEALTH NET 403B RETIREMENT PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-06-30	$0
Total income from all sources (including contributions)	2022-06-30	$-197,720
Total loss/gain on sale of assets	2022-06-30	$0
Total of all expenses incurred	2022-06-30	$173,209
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-06-30	$144,685
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-06-30	$278,347
Value of total assets at end of year	2022-06-30	$2,921,237
Value of total assets at beginning of year	2022-06-30	$3,292,166
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-06-30	$28,524
Total interest from all sources	2022-06-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2022-06-30	$346,484
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-06-30	$346,484
Administrative expenses professional fees incurred	2022-06-30	$28,524
Was this plan covered by a fidelity bond	2022-06-30	Yes
Value of fidelity bond cover	2022-06-30	$500,000
If this is an individual account plan, was there a blackout period	2022-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2022-06-30	No
Contributions received from participants	2022-06-30	$230,010
Income. Received or receivable in cash from other sources (including rollovers)	2022-06-30	$2,976
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-06-30	No
Value of net income/loss	2022-06-30	$-370,929
Value of net assets at end of year (total assets less liabilities)	2022-06-30	$2,921,237
Value of net assets at beginning of year (total assets less liabilities)	2022-06-30	$3,292,166
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-06-30	No
Were any leases to which the plan was party in default or uncollectible	2022-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-06-30	$2,470,583
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-06-30	$2,748,229
Value of interest in pooled separate accounts at end of year	2022-06-30	$341,980
Value of interest in pooled separate accounts at beginning of year	2022-06-30	$441,297
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-06-30	$63,313
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-06-30	$54,583
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-06-30	$-725,729
Net investment gain/loss from pooled separate accounts	2022-06-30	$-96,822
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-06-30	No
Was there a failure to transmit to the plan any participant contributions	2022-06-30	No
Has the plan failed to provide any benefit when due under the plan	2022-06-30	No
Contributions received in cash from employer	2022-06-30	$45,361
Employer contributions (assets) at end of year	2022-06-30	$45,361
Employer contributions (assets) at beginning of year	2022-06-30	$48,057
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-06-30	$144,685
Did the plan have assets held for investment	2022-06-30	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	2022-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-06-30	No
Opinion of an independent qualified public accountant for this plan	2022-06-30	Unqualified
Accountancy firm name	2022-06-30	BAKER TILLY US, LLP
Accountancy firm EIN	2022-06-30	390859910
2021 : COMMUNITY HEALTH NET 403B RETIREMENT PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-06-30	$0
Total income from all sources (including contributions)	2021-06-30	$919,637
Total loss/gain on sale of assets	2021-06-30	$0
Total of all expenses incurred	2021-06-30	$89,373
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-06-30	$60,382
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-06-30	$250,082
Value of total assets at end of year	2021-06-30	$3,292,166
Value of total assets at beginning of year	2021-06-30	$2,461,902
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-06-30	$28,991
Total interest from all sources	2021-06-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2021-06-30	$80,028
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2021-06-30	$80,028
Administrative expenses professional fees incurred	2021-06-30	$28,991
Was this plan covered by a fidelity bond	2021-06-30	Yes
Value of fidelity bond cover	2021-06-30	$500,000
If this is an individual account plan, was there a blackout period	2021-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2021-06-30	No
Contributions received from participants	2021-06-30	$195,547
Participant contributions at end of year	2021-06-30	$0
Participant contributions at beginning of year	2021-06-30	$0
Income. Received or receivable in cash from other sources (including rollovers)	2021-06-30	$6,478
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2021-06-30	$887
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-06-30	No
Value of net income/loss	2021-06-30	$830,264
Value of net assets at end of year (total assets less liabilities)	2021-06-30	$3,292,166
Value of net assets at beginning of year (total assets less liabilities)	2021-06-30	$2,461,902
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-06-30	No
Were any leases to which the plan was party in default or uncollectible	2021-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-06-30	$2,748,229
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-06-30	$2,040,356
Value of interest in pooled separate accounts at end of year	2021-06-30	$441,297
Value of interest in pooled separate accounts at beginning of year	2021-06-30	$319,155
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-06-30	$54,583
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-06-30	$52,709
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-06-30	$467,385
Net investment gain/loss from pooled separate accounts	2021-06-30	$122,142
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-06-30	No
Was there a failure to transmit to the plan any participant contributions	2021-06-30	No
Has the plan failed to provide any benefit when due under the plan	2021-06-30	No
Contributions received in cash from employer	2021-06-30	$48,057
Employer contributions (assets) at end of year	2021-06-30	$48,057
Employer contributions (assets) at beginning of year	2021-06-30	$49,682
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-06-30	$59,495
Did the plan have assets held for investment	2021-06-30	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	2021-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-06-30	No
Opinion of an independent qualified public accountant for this plan	2021-06-30	Unqualified
Accountancy firm name	2021-06-30	BAKER TILLY US, LLP
Accountancy firm EIN	2021-06-30	390859910
2020 : COMMUNITY HEALTH NET 403B RETIREMENT PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-06-30	$0
Total income from all sources (including contributions)	2020-06-30	$386,970
Total loss/gain on sale of assets	2020-06-30	$0
Total of all expenses incurred	2020-06-30	$421,808
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-06-30	$402,034
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-06-30	$286,931
Value of total assets at end of year	2020-06-30	$2,461,902
Value of total assets at beginning of year	2020-06-30	$2,496,740
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-06-30	$19,774
Total interest from all sources	2020-06-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2020-06-30	$50,132
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-06-30	$50,132
Was this plan covered by a fidelity bond	2020-06-30	Yes
Value of fidelity bond cover	2020-06-30	$500,000
If this is an individual account plan, was there a blackout period	2020-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2020-06-30	No
Contributions received from participants	2020-06-30	$192,608
Participant contributions at end of year	2020-06-30	$0
Participant contributions at beginning of year	2020-06-30	$7,024
Income. Received or receivable in cash from other sources (including rollovers)	2020-06-30	$44,641
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2020-06-30	$-702
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-06-30	No
Value of net income/loss	2020-06-30	$-34,838
Value of net assets at end of year (total assets less liabilities)	2020-06-30	$2,461,902
Value of net assets at beginning of year (total assets less liabilities)	2020-06-30	$2,496,740
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-06-30	No
Were any leases to which the plan was party in default or uncollectible	2020-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-06-30	$2,040,356
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-06-30	$2,103,033
Value of interest in pooled separate accounts at end of year	2020-06-30	$319,155
Value of interest in pooled separate accounts at beginning of year	2020-06-30	$302,102
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-06-30	$52,709
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-06-30	$47,333
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-06-30	$32,854
Net investment gain/loss from pooled separate accounts	2020-06-30	$17,053
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-06-30	No
Was there a failure to transmit to the plan any participant contributions	2020-06-30	No
Has the plan failed to provide any benefit when due under the plan	2020-06-30	No
Contributions received in cash from employer	2020-06-30	$49,682
Employer contributions (assets) at end of year	2020-06-30	$49,682
Employer contributions (assets) at beginning of year	2020-06-30	$37,248
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-06-30	$402,736
Contract administrator fees	2020-06-30	$19,774
Did the plan have assets held for investment	2020-06-30	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	2020-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2020-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2020-06-30	Disclaimer
Accountancy firm name	2020-06-30	ARNETT CARBIS TOOTHMAN, LLP
Accountancy firm EIN	2020-06-30	550486667
2019 : COMMUNITY HEALTH NET 403B RETIREMENT PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-06-30	$0
Total income from all sources (including contributions)	2019-06-30	$336,242
Total loss/gain on sale of assets	2019-06-30	$0
Total of all expenses incurred	2019-06-30	$414,003
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-06-30	$391,671
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-06-30	$180,483
Value of total assets at end of year	2019-06-30	$2,496,740
Value of total assets at beginning of year	2019-06-30	$2,574,501
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-06-30	$22,332
Total interest from all sources	2019-06-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2019-06-30	$75,879
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2019-06-30	$75,879
Was this plan covered by a fidelity bond	2019-06-30	Yes
Value of fidelity bond cover	2019-06-30	$500,000
If this is an individual account plan, was there a blackout period	2019-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2019-06-30	No
Contributions received from participants	2019-06-30	$143,461
Participant contributions at end of year	2019-06-30	$7,024
Participant contributions at beginning of year	2019-06-30	$5,631
Income. Received or receivable in cash from other sources (including rollovers)	2019-06-30	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2019-06-30	$-154
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-06-30	No
Income. Non cash contributions	2019-06-30	$0
Value of net income/loss	2019-06-30	$-77,761
Value of net assets at end of year (total assets less liabilities)	2019-06-30	$2,496,740
Value of net assets at beginning of year (total assets less liabilities)	2019-06-30	$2,574,501
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-06-30	No
Were any leases to which the plan was party in default or uncollectible	2019-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-06-30	$2,103,033
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-06-30	$2,191,870
Value of interest in pooled separate accounts at end of year	2019-06-30	$302,102
Value of interest in pooled separate accounts at beginning of year	2019-06-30	$286,240
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-06-30	$47,333
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-06-30	$53,240
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-06-30	$63,801
Net investment gain/loss from pooled separate accounts	2019-06-30	$16,079
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-06-30	No
Was there a failure to transmit to the plan any participant contributions	2019-06-30	No
Has the plan failed to provide any benefit when due under the plan	2019-06-30	No
Contributions received in cash from employer	2019-06-30	$37,022
Employer contributions (assets) at end of year	2019-06-30	$37,248
Employer contributions (assets) at beginning of year	2019-06-30	$37,520
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-06-30	$391,825
Contract administrator fees	2019-06-30	$22,332
Did the plan have assets held for investment	2019-06-30	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	2019-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2019-06-30	Disclaimer
Accountancy firm name	2019-06-30	ARNETT CARBIS TOOTHMAN, LLP
Accountancy firm EIN	2019-06-30	550486667
2018 : COMMUNITY HEALTH NET 403B RETIREMENT PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-06-30	$0
Total income from all sources (including contributions)	2018-06-30	$386,856
Total loss/gain on sale of assets	2018-06-30	$0
Total of all expenses incurred	2018-06-30	$459,455
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-06-30	$437,157
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-06-30	$199,791
Value of total assets at end of year	2018-06-30	$2,574,501
Value of total assets at beginning of year	2018-06-30	$2,647,100
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-06-30	$22,298
Total interest from all sources	2018-06-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2018-06-30	$58,469
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2018-06-30	$58,469
Was this plan covered by a fidelity bond	2018-06-30	Yes
Value of fidelity bond cover	2018-06-30	$500,000
If this is an individual account plan, was there a blackout period	2018-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2018-06-30	No
Contributions received from participants	2018-06-30	$162,497
Participant contributions at end of year	2018-06-30	$5,631
Participant contributions at beginning of year	2018-06-30	$1,692
Income. Received or receivable in cash from other sources (including rollovers)	2018-06-30	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2018-06-30	$1,692
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-06-30	No
Income. Non cash contributions	2018-06-30	$0
Value of net income/loss	2018-06-30	$-72,599
Value of net assets at end of year (total assets less liabilities)	2018-06-30	$2,574,501
Value of net assets at beginning of year (total assets less liabilities)	2018-06-30	$2,647,100
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-06-30	No
Were any leases to which the plan was party in default or uncollectible	2018-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-06-30	$2,191,870
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-06-30	$2,276,121
Value of interest in pooled separate accounts at end of year	2018-06-30	$286,240
Value of interest in pooled separate accounts at beginning of year	2018-06-30	$259,637
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-06-30	$53,240
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-06-30	$74,684
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-06-30	$93,527
Net investment gain/loss from pooled separate accounts	2018-06-30	$35,069
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-06-30	No
Was there a failure to transmit to the plan any participant contributions	2018-06-30	No
Has the plan failed to provide any benefit when due under the plan	2018-06-30	No
Contributions received in cash from employer	2018-06-30	$37,294
Employer contributions (assets) at end of year	2018-06-30	$37,520
Employer contributions (assets) at beginning of year	2018-06-30	$34,966
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-06-30	$435,465
Contract administrator fees	2018-06-30	$22,298
Did the plan have assets held for investment	2018-06-30	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	2018-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2018-06-30	Disclaimer
Accountancy firm name	2018-06-30	ARNETT CARBIS TOOTHMAN, LLP
Accountancy firm EIN	2018-06-30	550486667
2017 : COMMUNITY HEALTH NET 403B RETIREMENT PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-06-30	$0
Total income from all sources (including contributions)	2017-06-30	$529,978
Total loss/gain on sale of assets	2017-06-30	$0
Total of all expenses incurred	2017-06-30	$190,176
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-06-30	$168,745
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-06-30	$268,159
Value of total assets at end of year	2017-06-30	$2,647,100
Value of total assets at beginning of year	2017-06-30	$2,307,298
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-06-30	$21,431
Total interest from all sources	2017-06-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2017-06-30	$56,721
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-06-30	$56,721
Was this plan covered by a fidelity bond	2017-06-30	Yes
Value of fidelity bond cover	2017-06-30	$500,000
If this is an individual account plan, was there a blackout period	2017-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2017-06-30	No
Contributions received from participants	2017-06-30	$216,763
Participant contributions at end of year	2017-06-30	$1,692
Participant contributions at beginning of year	2017-06-30	$1,692
Income. Received or receivable in cash from other sources (including rollovers)	2017-06-30	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-06-30	No
Income. Non cash contributions	2017-06-30	$0
Value of net income/loss	2017-06-30	$339,802
Value of net assets at end of year (total assets less liabilities)	2017-06-30	$2,647,100
Value of net assets at beginning of year (total assets less liabilities)	2017-06-30	$2,307,298
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-06-30	No
Were any leases to which the plan was party in default or uncollectible	2017-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-06-30	$2,276,121
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-06-30	$2,038,227
Value of interest in pooled separate accounts at end of year	2017-06-30	$259,637
Value of interest in pooled separate accounts at beginning of year	2017-06-30	$220,378
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-06-30	$74,684
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-06-30	$47,001
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-06-30	$165,730
Net investment gain/loss from pooled separate accounts	2017-06-30	$39,368
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-06-30	No
Was there a failure to transmit to the plan any participant contributions	2017-06-30	Yes
Has the plan failed to provide any benefit when due under the plan	2017-06-30	No
Contributions received in cash from employer	2017-06-30	$51,396
Employer contributions (assets) at end of year	2017-06-30	$34,966
Employer contributions (assets) at beginning of year	2017-06-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-06-30	$168,745
Contract administrator fees	2017-06-30	$21,431
Did the plan have assets held for investment	2017-06-30	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	2017-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2017-06-30	Disclaimer
Accountancy firm name	2017-06-30	ARNETT CARBIS TOOTHMAN, LLP
Accountancy firm EIN	2017-06-30	550486667
2016 : COMMUNITY HEALTH NET 403B RETIREMENT PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-06-30	$0
Total income from all sources (including contributions)	2016-06-30	$142,989
Total loss/gain on sale of assets	2016-06-30	$0
Total of all expenses incurred	2016-06-30	$104,274
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-06-30	$94,224
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-06-30	$159,296
Value of total assets at end of year	2016-06-30	$2,307,298
Value of total assets at beginning of year	2016-06-30	$2,268,583
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-06-30	$10,050
Total interest from all sources	2016-06-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2016-06-30	$89,320
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-06-30	$89,320
Was this plan covered by a fidelity bond	2016-06-30	Yes
Value of fidelity bond cover	2016-06-30	$500,000
If this is an individual account plan, was there a blackout period	2016-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2016-06-30	No
Contributions received from participants	2016-06-30	$159,296
Participant contributions at end of year	2016-06-30	$1,692
Participant contributions at beginning of year	2016-06-30	$1,692
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-06-30	No
Value of net income/loss	2016-06-30	$38,715
Value of net assets at end of year (total assets less liabilities)	2016-06-30	$2,307,298
Value of net assets at beginning of year (total assets less liabilities)	2016-06-30	$2,268,583
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-06-30	No
Were any leases to which the plan was party in default or uncollectible	2016-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-06-30	$2,038,227
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-06-30	$0
Value of interest in pooled separate accounts at end of year	2016-06-30	$220,378
Value of interest in pooled separate accounts at beginning of year	2016-06-30	$2,214,045
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-06-30	$47,001
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-06-30	$52,846
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-06-30	$-92,202
Net investment gain/loss from pooled separate accounts	2016-06-30	$-13,425
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-06-30	No
Was there a failure to transmit to the plan any participant contributions	2016-06-30	Yes
Has the plan failed to provide any benefit when due under the plan	2016-06-30	No
Employer contributions (assets) at end of year	2016-06-30	$0
Employer contributions (assets) at beginning of year	2016-06-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-06-30	$94,224
Contract administrator fees	2016-06-30	$10,050
Did the plan have assets held for investment	2016-06-30	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	2016-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2016-06-30	Disclaimer
Accountancy firm name	2016-06-30	ARNETT CARBIS TOOTHMAN, LLP
Accountancy firm EIN	2016-06-30	550486667
2015 : COMMUNITY HEALTH NET 403B RETIREMENT PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-06-30	$0
Total income from all sources (including contributions)	2015-06-30	$198,614
Total loss/gain on sale of assets	2015-06-30	$0
Total of all expenses incurred	2015-06-30	$385,331
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-06-30	$383,630
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-06-30	$143,696
Value of total assets at end of year	2015-06-30	$2,268,583
Value of total assets at beginning of year	2015-06-30	$2,455,300
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-06-30	$1,701
Total interest from all sources	2015-06-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2015-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-06-30	No
Was this plan covered by a fidelity bond	2015-06-30	Yes
Value of fidelity bond cover	2015-06-30	$500,000
If this is an individual account plan, was there a blackout period	2015-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2015-06-30	No
Contributions received from participants	2015-06-30	$141,454
Participant contributions at end of year	2015-06-30	$1,692
Participant contributions at beginning of year	2015-06-30	$12,576
Income. Received or receivable in cash from other sources (including rollovers)	2015-06-30	$2,242
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	$-186,717
Value of net assets at end of year (total assets less liabilities)	2015-06-30	$2,268,583
Value of net assets at beginning of year (total assets less liabilities)	2015-06-30	$2,455,300
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 pooled separate accounts at end of year	2015-06-30	$2,214,045
Value of interest in pooled separate accounts at beginning of year	2015-06-30	$2,400,719
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-06-30	$52,846
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-06-30	$42,005
Net investment gain/loss from pooled separate accounts	2015-06-30	$54,918
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	Yes
Has the plan failed to provide any benefit when due under the plan	2015-06-30	No
Employer contributions (assets) at end of year	2015-06-30	$0
Employer contributions (assets) at beginning of year	2015-06-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-06-30	$383,630
Contract administrator fees	2015-06-30	$1,701
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	ARNETT CARBIS TOOTHMAN, LLP
Accountancy firm EIN	2015-06-30	550486667
2014 : COMMUNITY HEALTH NET 403B RETIREMENT PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-06-30	$0
Total income from all sources (including contributions)	2014-06-30	$463,239
Total loss/gain on sale of assets	2014-06-30	$0
Total of all expenses incurred	2014-06-30	$59,836
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-06-30	$58,806
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-06-30	$112,820
Value of total assets at end of year	2014-06-30	$2,455,300
Value of total assets at beginning of year	2014-06-30	$2,051,897
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-06-30	$1,030
Total interest from all sources	2014-06-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2014-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-06-30	No
Was this plan covered by a fidelity bond	2014-06-30	Yes
Value of fidelity bond cover	2014-06-30	$500,000
If this is an individual account plan, was there a blackout period	2014-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2014-06-30	No
Contributions received from participants	2014-06-30	$112,820
Participant contributions at end of year	2014-06-30	$12,576
Participant contributions at beginning of year	2014-06-30	$36,728
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	$403,403
Value of net assets at end of year (total assets less liabilities)	2014-06-30	$2,455,300
Value of net assets at beginning of year (total assets less liabilities)	2014-06-30	$2,051,897
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 pooled separate accounts at end of year	2014-06-30	$2,400,719
Value of interest in pooled separate accounts at beginning of year	2014-06-30	$1,982,364
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-06-30	$42,005
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-06-30	$32,805
Net investment gain/loss from pooled separate accounts	2014-06-30	$350,419
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	Yes
Has the plan failed to provide any benefit when due under the plan	2014-06-30	No
Employer contributions (assets) at end of year	2014-06-30	$0
Employer contributions (assets) at beginning of year	2014-06-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-06-30	$58,806
Contract administrator fees	2014-06-30	$1,030
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	ARNETT CARBIS TOOTHMAN, LLP
Accountancy firm EIN	2014-06-30	550486667
2013 : COMMUNITY HEALTH NET 403B RETIREMENT PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-06-30	$0
Total income from all sources (including contributions)	2013-06-30	$436,473
Total loss/gain on sale of assets	2013-06-30	$0
Total of all expenses incurred	2013-06-30	$747,775
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-06-30	$747,530
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-06-30	$183,971
Value of total assets at end of year	2013-06-30	$2,051,897
Value of total assets at beginning of year	2013-06-30	$2,363,199
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-06-30	$245
Total interest from all sources	2013-06-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2013-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-06-30	No
Was this plan covered by a fidelity bond	2013-06-30	Yes
Value of fidelity bond cover	2013-06-30	$500,000
If this is an individual account plan, was there a blackout period	2013-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2013-06-30	No
Contributions received from participants	2013-06-30	$183,971
Participant contributions at end of year	2013-06-30	$36,728
Participant contributions at beginning of year	2013-06-30	$39,553
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	$-311,302
Value of net assets at end of year (total assets less liabilities)	2013-06-30	$2,051,897
Value of net assets at beginning of year (total assets less liabilities)	2013-06-30	$2,363,199
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 pooled separate accounts at end of year	2013-06-30	$1,982,364
Value of interest in pooled separate accounts at beginning of year	2013-06-30	$2,001,974
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-06-30	$32,805
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-06-30	$240,624
Net investment gain/loss from pooled separate accounts	2013-06-30	$252,502
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
Employer contributions (assets) at end of year	2013-06-30	$0
Employer contributions (assets) at beginning of year	2013-06-30	$81,048
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-06-30	$747,530
Contract administrator fees	2013-06-30	$245
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	CARBIS WALKER, LLP
Accountancy firm EIN	2013-06-30	250988255
2012 : COMMUNITY HEALTH NET 403B 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	$304,531
Total loss/gain on sale of assets	2012-06-30	$0
Total of all expenses incurred	2012-06-30	$198,843
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-06-30	$198,828
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-06-30	$328,460
Value of total assets at end of year	2012-06-30	$2,363,199
Value of total assets at beginning of year	2012-06-30	$2,257,511
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-06-30	$15
Total interest from all sources	2012-06-30	$7,947
Total dividends received (eg from common stock, registered investment company shares)	2012-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-06-30	No
Was this plan covered by a fidelity bond	2012-06-30	Yes
Value of fidelity bond cover	2012-06-30	$500,000
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	$240,133
Participant contributions at end of year	2012-06-30	$39,553
Participant contributions at beginning of year	2012-06-30	$10,220
Income. Received or receivable in cash from other sources (including rollovers)	2012-06-30	$102
Administrative expenses (other) incurred	2012-06-30	$15
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-06-30	No
Value of net income/loss	2012-06-30	$105,688
Value of net assets at end of year (total assets less liabilities)	2012-06-30	$2,363,199
Value of net assets at beginning of year (total assets less liabilities)	2012-06-30	$2,257,511
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 pooled separate accounts at end of year	2012-06-30	$2,001,974
Value of interest in pooled separate accounts at beginning of year	2012-06-30	$1,989,379
Interest earned on other investments	2012-06-30	$7,947
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-06-30	$240,624
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-06-30	$257,912
Net investment gain/loss from pooled separate accounts	2012-06-30	$-31,876
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	Yes
Has the plan failed to provide any benefit when due under the plan	2012-06-30	No
Contributions received in cash from employer	2012-06-30	$88,225
Employer contributions (assets) at end of year	2012-06-30	$81,048
Employer contributions (assets) at beginning of year	2012-06-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-06-30	$198,828
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	FELIX AND GLOEKLER
Accountancy firm EIN	2012-06-30	260001555
2011 : COMMUNITY HEALTH NET 403B 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	$622,643
Total loss/gain on sale of assets	2011-06-30	$0
Total of all expenses incurred	2011-06-30	$48,926
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-06-30	$48,926
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-06-30	$264,767
Value of total assets at end of year	2011-06-30	$2,257,511
Value of total assets at beginning of year	2011-06-30	$1,683,794
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-06-30	$0
Total interest from all sources	2011-06-30	$7,636
Total dividends received (eg from common stock, registered investment company shares)	2011-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-06-30	No
Was this plan covered by a fidelity bond	2011-06-30	Yes
Value of fidelity bond cover	2011-06-30	$295,000
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	$258,399
Participant contributions at end of year	2011-06-30	$10,220
Participant contributions at beginning of year	2011-06-30	$403
Income. Received or receivable in cash from other sources (including rollovers)	2011-06-30	$6,368
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	$573,717
Value of net assets at end of year (total assets less liabilities)	2011-06-30	$2,257,511
Value of net assets at beginning of year (total assets less liabilities)	2011-06-30	$1,683,794
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 pooled separate accounts at end of year	2011-06-30	$1,989,379
Value of interest in pooled separate accounts at beginning of year	2011-06-30	$1,370,328
Interest earned on other investments	2011-06-30	$7,636
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-06-30	$257,912
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-06-30	$229,316
Net investment gain/loss from pooled separate accounts	2011-06-30	$350,240
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	Yes
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	$0
Employer contributions (assets) at beginning of year	2011-06-30	$83,747
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-06-30	$48,926
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	FELIX AND GLOEKLER
Accountancy firm EIN	2011-06-30	260001555
2010 : COMMUNITY HEALTH NET 403B 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 HEALTH NET 403B RETIREMENT PLAN

2022: COMMUNITY HEALTH NET 403B RETIREMENT PLAN 2022 form 5500 responses
2022-07-01	Type of plan entity	Single employer plan
2022-07-01	Submission has been amended	No
2022-07-01	This submission is the final filing	No
2022-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-07-01	Plan is a collectively bargained plan	No
2022-07-01	Plan funding arrangement – Insurance	Yes
2022-07-01	Plan funding arrangement – Trust	Yes
2022-07-01	Plan benefit arrangement – Insurance	Yes
2022-07-01	Plan benefit arrangement - Trust	Yes
2021: COMMUNITY HEALTH NET 403B RETIREMENT PLAN 2021 form 5500 responses
2021-07-01	Type of plan entity	Single employer plan
2021-07-01	Submission has been amended	No
2021-07-01	This submission is the final filing	No
2021-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-07-01	Plan is a collectively bargained plan	No
2021-07-01	Plan funding arrangement – Insurance	Yes
2021-07-01	Plan funding arrangement – Trust	Yes
2021-07-01	Plan benefit arrangement – Insurance	Yes
2021-07-01	Plan benefit arrangement - Trust	Yes
2020: COMMUNITY HEALTH NET 403B RETIREMENT PLAN 2020 form 5500 responses
2020-07-01	Type of plan entity	Single employer plan
2020-07-01	Submission has been amended	No
2020-07-01	This submission is the final filing	No
2020-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-07-01	Plan is a collectively bargained plan	No
2020-07-01	Plan funding arrangement – Insurance	Yes
2020-07-01	Plan funding arrangement – Trust	Yes
2020-07-01	Plan benefit arrangement – Insurance	Yes
2020-07-01	Plan benefit arrangement - Trust	Yes
2019: COMMUNITY HEALTH NET 403B RETIREMENT PLAN 2019 form 5500 responses
2019-07-01	Type of plan entity	Single employer plan
2019-07-01	Submission has been amended	No
2019-07-01	This submission is the final filing	No
2019-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-07-01	Plan is a collectively bargained plan	No
2019-07-01	Plan funding arrangement – Insurance	Yes
2019-07-01	Plan funding arrangement – Trust	Yes
2019-07-01	Plan benefit arrangement – Insurance	Yes
2019-07-01	Plan benefit arrangement - Trust	Yes
2018: COMMUNITY HEALTH NET 403B RETIREMENT PLAN 2018 form 5500 responses
2018-07-01	Type of plan entity	Single employer plan
2018-07-01	Submission has been amended	No
2018-07-01	This submission is the final filing	No
2018-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-07-01	Plan is a collectively bargained plan	No
2018-07-01	Plan funding arrangement – Insurance	Yes
2018-07-01	Plan funding arrangement – Trust	Yes
2018-07-01	Plan benefit arrangement – Insurance	Yes
2018-07-01	Plan benefit arrangement - Trust	Yes
2017: COMMUNITY HEALTH NET 403B RETIREMENT PLAN 2017 form 5500 responses
2017-07-01	Type of plan entity	Single employer plan
2017-07-01	Submission has been amended	No
2017-07-01	This submission is the final filing	No
2017-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-07-01	Plan is a collectively bargained plan	No
2017-07-01	Plan funding arrangement – Insurance	Yes
2017-07-01	Plan funding arrangement – Trust	Yes
2017-07-01	Plan benefit arrangement – Insurance	Yes
2017-07-01	Plan benefit arrangement - Trust	Yes
2016: COMMUNITY HEALTH NET 403B RETIREMENT PLAN 2016 form 5500 responses
2016-07-01	Type of plan entity	Single employer plan
2016-07-01	Submission has been amended	No
2016-07-01	This submission is the final filing	No
2016-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-07-01	Plan is a collectively bargained plan	No
2016-07-01	Plan funding arrangement – Insurance	Yes
2016-07-01	Plan funding arrangement – Trust	Yes
2016-07-01	Plan benefit arrangement – Insurance	Yes
2016-07-01	Plan benefit arrangement - Trust	Yes
2015: COMMUNITY HEALTH NET 403B RETIREMENT PLAN 2015 form 5500 responses
2015-07-01	Type of plan entity	Single employer plan
2015-07-01	Submission has been amended	No
2015-07-01	This submission is the final filing	No
2015-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-07-01	Plan is a collectively bargained plan	No
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 HEALTH NET 403B RETIREMENT PLAN 2014 form 5500 responses
2014-07-01	Type of plan entity	Single employer plan
2014-07-01	Submission has been amended	No
2014-07-01	This submission is the final filing	No
2014-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-07-01	Plan is a collectively bargained plan	No
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 HEALTH NET 403B RETIREMENT PLAN 2013 form 5500 responses
2013-07-01	Type of plan entity	Single employer plan
2013-07-01	Submission has been amended	No
2013-07-01	This submission is the final filing	No
2013-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-07-01	Plan is a collectively bargained plan	No
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 HEALTH NET 403B RETIREMENT PLAN 2012 form 5500 responses
2012-07-01	Type of plan entity	Single employer plan
2012-07-01	Submission has been amended	No
2012-07-01	This submission is the final filing	No
2012-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-07-01	Plan is a collectively bargained plan	No
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 HEALTH NET 403B 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 HEALTH NET 403B 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

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

744496-01

Policy instance

Insurance contract or identification number	744496-01
Number of Individuals Covered	3
Insurance policy start date	2022-07-01
Insurance policy end date	2023-06-30
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?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

374040-01

Policy instance

Insurance contract or identification number	374040-01
Number of Individuals Covered	11
Insurance policy start date	2022-07-01
Insurance policy end date	2023-06-30
Total amount of commissions paid to insurance broker	USD $335
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $168
Insurance broker organization code?	3

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

Policy contract number

933645

Policy instance

Insurance contract or identification number	933645
Number of Individuals Covered	10
Insurance policy start date	2022-07-01
Insurance policy end date	2023-06-30
Total amount of commissions paid to insurance broker	USD $927
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Commission paid to Insurance Broker	USD $927
Insurance broker organization code?	3

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

Policy contract number

933645

Policy instance

Insurance contract or identification number	933645
Number of Individuals Covered	12
Insurance policy start date	2021-07-01
Insurance policy end date	2022-06-30
Total amount of commissions paid to insurance broker	USD $1,055
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Commission paid to Insurance Broker	USD $1,055
Insurance broker organization code?	3

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

374040-01

Policy instance

Insurance contract or identification number	374040-01
Number of Individuals Covered	12
Insurance policy start date	2021-07-01
Insurance policy end date	2022-06-30
Total amount of commissions paid to insurance broker	USD $344
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $344
Insurance broker organization code?	3

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

744496-01

Policy instance

Insurance contract or identification number	744496-01
Number of Individuals Covered	3
Insurance policy start date	2021-07-01
Insurance policy end date	2022-06-30
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?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-750089

Policy instance

Insurance contract or identification number	GA-750089
Number of Individuals Covered	3
Insurance policy start date	2020-07-01
Insurance policy end date	2021-06-30
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

374040-01

Policy instance

Insurance contract or identification number	374040-01
Number of Individuals Covered	10
Insurance policy start date	2019-07-01
Insurance policy end date	2020-06-30
Total amount of commissions paid to insurance broker	USD $229
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $229
Insurance broker organization code?	3

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

Policy contract number

933645

Policy instance

Insurance contract or identification number	933645
Number of Individuals Covered	11
Insurance policy start date	2020-07-01
Insurance policy end date	2021-06-30
Total amount of commissions paid to insurance broker	USD $1,038
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,038
Insurance broker organization code?	3

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

Policy contract number

933645

Policy instance

Insurance contract or identification number	933645
Number of Individuals Covered	11
Insurance policy start date	2019-07-01
Insurance policy end date	2020-06-30
Total amount of commissions paid to insurance broker	USD $762
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $762
Insurance broker organization code?	3

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

VFB167

Policy instance

Insurance contract or identification number	VFB167
Number of Individuals Covered	0
Insurance policy start date	2019-07-01
Insurance policy end date	2020-06-30
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Insurance broker organization code?	3

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

374040-01

Policy instance

Insurance contract or identification number	374040-01
Number of Individuals Covered	3
Insurance policy start date	2018-07-01
Insurance policy end date	2019-06-30
Total amount of commissions paid to insurance broker	USD $243
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $243
Insurance broker organization code?	3

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-750089

Policy instance

Insurance contract or identification number	GA-750089
Number of Individuals Covered	3
Insurance policy start date	2019-07-01
Insurance policy end date	2020-06-30
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

374040-01

Policy instance

Insurance contract or identification number	374040-01
Number of Individuals Covered	4
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
Total amount of commissions paid to insurance broker	USD $215
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $215
Insurance broker organization code?	3

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

VFB167

Policy instance

Insurance contract or identification number	VFB167
Number of Individuals Covered	2
Insurance policy start date	2018-07-01
Insurance policy end date	2019-06-30
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Insurance broker organization code?	3

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

Policy contract number

933645

Policy instance

Insurance contract or identification number	933645
Number of Individuals Covered	11
Insurance policy start date	2018-07-01
Insurance policy end date	2019-06-30
Total amount of commissions paid to insurance broker	USD $358
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $358
Insurance broker organization code?	3

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-750089

Policy instance

Insurance contract or identification number	GA-750089
Number of Individuals Covered	3
Insurance policy start date	2018-07-01
Insurance policy end date	2019-06-30
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

374040-01

Policy instance

Insurance contract or identification number	374040-01
Number of Individuals Covered	4
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
Total amount of commissions paid to insurance broker	USD $202
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

VFB167

Policy instance

Insurance contract or identification number	VFB167
Number of Individuals Covered	2
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
Total amount of commissions paid to insurance broker	USD $3
Total amount of fees paid to insurance company	USD $1
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

933645

Policy instance

Insurance contract or identification number	933645
Number of Individuals Covered	12
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
Total amount of commissions paid to insurance broker	USD $679
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-750089

Policy instance

Insurance contract or identification number	GA-750089
Number of Individuals Covered	3
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-750089

Policy instance

Insurance contract or identification number	GA-750089
Number of Individuals Covered	5
Insurance policy start date	2015-07-01
Insurance policy end date	2016-06-30
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

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

Policy contract number

933645

Policy instance

Insurance contract or identification number	933645
Number of Individuals Covered	13
Insurance policy start date	2015-07-01
Insurance policy end date	2016-06-30
Total amount of commissions paid to insurance broker	USD $550
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $550
Insurance broker organization code?	3
Insurance broker name	HAIBACH/GARY B/CLU & ASSOC

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

VFB167

Policy instance

Insurance contract or identification number	VFB167
Number of Individuals Covered	4
Insurance policy start date	2015-07-01
Insurance policy end date	2016-06-30
Total amount of commissions paid to insurance broker	USD $2,122
Total amount of fees paid to insurance company	USD $140
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,034
Amount paid for insurance broker fees	140
Additional information about fees paid to insurance broker	CASH PAYMENTS MADE ON THE CONTRACT BUT OUTSIDE OF COMMISSION
Insurance broker organization code?	3
Insurance broker name	LPL FINANCIAL CORP

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

374040-01

Policy instance

Insurance contract or identification number	374040-01
Number of Individuals Covered	3
Insurance policy start date	2015-07-01
Insurance policy end date	2016-06-30
Total amount of commissions paid to insurance broker	USD $86
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $86
Insurance broker organization code?	3
Insurance broker name	JAMES ZBACH LPL FINANCIAL LLC

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

Policy contract number

933645

Policy instance

Insurance contract or identification number	933645
Number of Individuals Covered	15
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Total amount of commissions paid to insurance broker	USD $564
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $564
Insurance broker organization code?	3
Insurance broker name	HAIBACH/GARY B/CLU & ASSOC

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

VFB167

Policy instance

Insurance contract or identification number	VFB167
Number of Individuals Covered	70
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Total amount of commissions paid to insurance broker	USD $5,339
Total amount of fees paid to insurance company	USD $237
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,226
Amount paid for insurance broker fees	237
Additional information about fees paid to insurance broker	CASH PAYMENTS MADE ON THE CONTRACT BUT OUTSIDE OF COMMISSION
Insurance broker organization code?	3
Insurance broker name	LPL FINANCIAL CORP

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-750089

Policy instance

Insurance contract or identification number	GA-750089
Number of Individuals Covered	5
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
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

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-750089

Policy instance

Insurance contract or identification number	GA-750089
Number of Individuals Covered	5
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
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

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

Policy contract number

933645

Policy instance

Insurance contract or identification number	933645
Number of Individuals Covered	17
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
Total amount of commissions paid to insurance broker	USD $501
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $501
Insurance broker organization code?	3
Insurance broker name	HAIBACJH/GARY B/CLU & ASSOC

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

VFB167

Policy instance

Insurance contract or identification number	VFB167
Number of Individuals Covered	73
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
Total amount of commissions paid to insurance broker	USD $5,016
Total amount of fees paid to insurance company	USD $9
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,968
Amount paid for insurance broker fees	9
Additional information about fees paid to insurance broker	CASH PAYMENTS MADE ON THE CONTRACT BUT OUTSIDE OF COMMISSION
Insurance broker organization code?	3
Insurance broker name	LPL FINANCIAL CORP

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

Policy contract number

933645

Policy instance

Insurance contract or identification number	933645
Number of Individuals Covered	18
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
Total amount of commissions paid to insurance broker	USD $510
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $255
Insurance broker organization code?	3
Insurance broker name	GARY HAIBACH

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

VFB167

Policy instance

Insurance contract or identification number	VFB167
Number of Individuals Covered	87
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
Total amount of commissions paid to insurance broker	USD $5,253
Total amount of fees paid to insurance company	USD $40
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,253
Amount paid for insurance broker fees	40
Additional information about fees paid to insurance broker	CASH PAYMENTS MADE ON THE CONTRACT BUT OUTSIDE OF COMMISSION
Insurance broker organization code?	3
Insurance broker name	LPL FINANCIAL CORPORATION

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-750089

Policy instance

Insurance contract or identification number	GA-750089
Number of Individuals Covered	5
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
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

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

VFB167

Policy instance

Insurance contract or identification number	VFB167
Number of Individuals Covered	90
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $4,978
Total amount of fees paid to insurance company	USD $53
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

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

Policy contract number

933645

Policy instance

Insurance contract or identification number	933645
Number of Individuals Covered	23
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $508
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

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-750089

Policy instance

Insurance contract or identification number	GA-750089
Number of Individuals Covered	5
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
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

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

VFB167

Policy instance

Insurance contract or identification number	VFB167
Number of Individuals Covered	86
Insurance policy start date	2010-07-01
Insurance policy end date	2011-06-30
Total amount of commissions paid to insurance broker	USD $4,356
Total amount of fees paid to insurance company	USD $36
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

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-750089

Policy instance

Insurance contract or identification number	GA-750089
Number of Individuals Covered	7
Insurance policy start date	2010-07-01
Insurance policy end date	2011-06-30
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

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

Policy contract number

933645

Policy instance

Insurance contract or identification number	933645
Number of Individuals Covered	23
Insurance policy start date	2010-07-01
Insurance policy end date	2011-06-30
Total amount of commissions paid to insurance broker	USD $483
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	COMMUNITY HEALTH NET
Employer identification number (EIN):	251490791
NAIC Classification:	621498
NAIC Description:	All Other Outpatient Care Centers

Jurisdiction of Incorporation:	COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF STATE
Incorporation Date:
Company Identification Number:	854197