401k Plan data: UPMC HAMOT SURGERY CENTER 401(K) RETIREMENT PLAN plan

UPMC HAMOT SURGERY CENTER 401(K) RETIREMENT PLAN 401k Plan overview

Plan Name	UPMC HAMOT SURGERY CENTER 401(K) RETIREMENT PLAN
Plan identification number	001

UPMC HAMOT SURGERY CENTER 401(K) RETIREMENT PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

UPMC HAMOT SURGERY CENTER, L.L.C. has sponsored the creation of one or more 401k plans.

Company Name: UPMC HAMOT SURGERY CENTER, L.L.C.

Employer identification number (EIN): 251863661

NAIC Classification: 621493
NAIC Description: Freestanding Ambulatory Surgical and Emergency Centers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan UPMC HAMOT SURGERY CENTER 401(K) 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 TEVA EILER
001 2017-07-01
001 2016-07-01 TEVA EILER
001 2016-07-01
001 2015-07-01 PETER OGDEN
001 2014-07-01 TEVA EILER
001 2013-07-01 TEVA EILER
001 2012-07-01 TEVA EILER TEVA EILER 2014-01-21
001 2011-07-01 TEVA EILER
001 2010-07-01 TEVA EILER 2011-11-14 TEVA EILER 2011-11-14

Plan Statistics for UPMC HAMOT SURGERY CENTER 401(K) RETIREMENT PLAN

401k plan membership statisitcs for UPMC HAMOT SURGERY CENTER 401(K) RETIREMENT PLAN

Measure Date Value
2022: UPMC HAMOT SURGERY CENTER 401(K) RETIREMENT PLAN 2022 401k membership
Total participants, beginning-of-year 2022-07-01 117
Total number of active participants reported on line 7a of the Form 5500 2022-07-01 86
Number of retired or separated participants receiving benefits 2022-07-01 1
Number of other retired or separated participants entitled to future benefits 2022-07-01 46
Total of all active and inactive participants 2022-07-01 133
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-07-01 0
Total participants 2022-07-01 133
Number of participants with account balances 2022-07-01 117
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-07-01 7
2021: UPMC HAMOT SURGERY CENTER 401(K) RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year 2021-07-01 120
Total number of active participants reported on line 7a of the Form 5500 2021-07-01 79
Number of retired or separated participants receiving benefits 2021-07-01 1
Number of other retired or separated participants entitled to future benefits 2021-07-01 37
Total of all active and inactive participants 2021-07-01 117
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-07-01 0
Total participants 2021-07-01 117
Number of participants with account balances 2021-07-01 85
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-07-01 3
2020: UPMC HAMOT SURGERY CENTER 401(K) RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year 2020-07-01 103
Total number of active participants reported on line 7a of the Form 5500 2020-07-01 87
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 32
Total of all active and inactive participants 2020-07-01 119
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-07-01 1
Total participants 2020-07-01 120
Number of participants with account balances 2020-07-01 83
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-07-01 1
2019: UPMC HAMOT SURGERY CENTER 401(K) RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year 2019-07-01 91
Total number of active participants reported on line 7a of the Form 5500 2019-07-01 75
Number of retired or separated participants receiving benefits 2019-07-01 1
Number of other retired or separated participants entitled to future benefits 2019-07-01 27
Total of all active and inactive participants 2019-07-01 103
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-07-01 0
Total participants 2019-07-01 103
Number of participants with account balances 2019-07-01 78
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-07-01 2
2018: UPMC HAMOT SURGERY CENTER 401(K) RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year 2018-07-01 94
Total number of active participants reported on line 7a of the Form 5500 2018-07-01 80
Number of retired or separated participants receiving benefits 2018-07-01 1
Number of other retired or separated participants entitled to future benefits 2018-07-01 10
Total of all active and inactive participants 2018-07-01 91
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-07-01 0
Total participants 2018-07-01 91
Number of participants with account balances 2018-07-01 67
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-07-01 1
2017: UPMC HAMOT SURGERY CENTER 401(K) RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-07-01 97
Total number of active participants reported on line 7a of the Form 5500 2017-07-01 85
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 9
Total of all active and inactive participants 2017-07-01 94
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-07-01 0
Total participants 2017-07-01 94
Number of participants with account balances 2017-07-01 65
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-07-01 0
2016: UPMC HAMOT SURGERY CENTER 401(K) RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-07-01 97
Total number of active participants reported on line 7a of the Form 5500 2016-07-01 91
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 6
Total of all active and inactive participants 2016-07-01 97
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-07-01 0
Total participants 2016-07-01 97
Number of participants with account balances 2016-07-01 64
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-07-01 0
2015: UPMC HAMOT SURGERY CENTER 401(K) RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-07-01 88
Total number of active participants reported on line 7a of the Form 5500 2015-07-01 89
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 8
Total of all active and inactive participants 2015-07-01 97
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-07-01 0
Total participants 2015-07-01 97
Number of participants with account balances 2015-07-01 67
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-07-01 0
2014: UPMC HAMOT SURGERY CENTER 401(K) RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-07-01 90
Total number of active participants reported on line 7a of the Form 5500 2014-07-01 82
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 6
Total of all active and inactive participants 2014-07-01 88
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-07-01 0
Total participants 2014-07-01 88
Number of participants with account balances 2014-07-01 69
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-07-01 0
2013: UPMC HAMOT SURGERY CENTER 401(K) RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-07-01 94
Total number of active participants reported on line 7a of the Form 5500 2013-07-01 84
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 6
Total of all active and inactive participants 2013-07-01 90
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-07-01 0
Total participants 2013-07-01 90
Number of participants with account balances 2013-07-01 74
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-07-01 0
2012: UPMC HAMOT SURGERY CENTER 401(K) RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-07-01 105
Total number of active participants reported on line 7a of the Form 5500 2012-07-01 88
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 6
Total of all active and inactive participants 2012-07-01 94
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-07-01 0
Total participants 2012-07-01 94
Number of participants with account balances 2012-07-01 73
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-07-01 0
2011: UPMC HAMOT SURGERY CENTER 401(K) RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-07-01 86
Total number of active participants reported on line 7a of the Form 5500 2011-07-01 83
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 22
Total of all active and inactive participants 2011-07-01 105
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-07-01 0
Total participants 2011-07-01 105
Number of participants with account balances 2011-07-01 95
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-07-01 0

Measure	Date	Value
2022: UPMC HAMOT SURGERY CENTER 401(K) RETIREMENT PLAN 2022 401k membership
Total participants, beginning-of-year	2022-07-01	117
Total number of active participants reported on line 7a of the Form 5500	2022-07-01	86
Number of retired or separated participants receiving benefits	2022-07-01	1
Number of other retired or separated participants entitled to future benefits	2022-07-01	46
Total of all active and inactive participants	2022-07-01	133
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-07-01	0
Total participants	2022-07-01	133
Number of participants with account balances	2022-07-01	117
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-07-01	7
2021: UPMC HAMOT SURGERY CENTER 401(K) RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year	2021-07-01	120
Total number of active participants reported on line 7a of the Form 5500	2021-07-01	79
Number of retired or separated participants receiving benefits	2021-07-01	1
Number of other retired or separated participants entitled to future benefits	2021-07-01	37
Total of all active and inactive participants	2021-07-01	117
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-07-01	0
Total participants	2021-07-01	117
Number of participants with account balances	2021-07-01	85
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-07-01	3
2020: UPMC HAMOT SURGERY CENTER 401(K) RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year	2020-07-01	103
Total number of active participants reported on line 7a of the Form 5500	2020-07-01	87
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	32
Total of all active and inactive participants	2020-07-01	119
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-07-01	1
Total participants	2020-07-01	120
Number of participants with account balances	2020-07-01	83
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-07-01	1
2019: UPMC HAMOT SURGERY CENTER 401(K) RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year	2019-07-01	91
Total number of active participants reported on line 7a of the Form 5500	2019-07-01	75
Number of retired or separated participants receiving benefits	2019-07-01	1
Number of other retired or separated participants entitled to future benefits	2019-07-01	27
Total of all active and inactive participants	2019-07-01	103
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-07-01	0
Total participants	2019-07-01	103
Number of participants with account balances	2019-07-01	78
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-07-01	2
2018: UPMC HAMOT SURGERY CENTER 401(K) RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year	2018-07-01	94
Total number of active participants reported on line 7a of the Form 5500	2018-07-01	80
Number of retired or separated participants receiving benefits	2018-07-01	1
Number of other retired or separated participants entitled to future benefits	2018-07-01	10
Total of all active and inactive participants	2018-07-01	91
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-07-01	0
Total participants	2018-07-01	91
Number of participants with account balances	2018-07-01	67
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-07-01	1
2017: UPMC HAMOT SURGERY CENTER 401(K) RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-07-01	97
Total number of active participants reported on line 7a of the Form 5500	2017-07-01	85
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	9
Total of all active and inactive participants	2017-07-01	94
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-07-01	0
Total participants	2017-07-01	94
Number of participants with account balances	2017-07-01	65
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-07-01	0
2016: UPMC HAMOT SURGERY CENTER 401(K) RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-07-01	97
Total number of active participants reported on line 7a of the Form 5500	2016-07-01	91
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	6
Total of all active and inactive participants	2016-07-01	97
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-07-01	0
Total participants	2016-07-01	97
Number of participants with account balances	2016-07-01	64
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-07-01	0
2015: UPMC HAMOT SURGERY CENTER 401(K) RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-07-01	88
Total number of active participants reported on line 7a of the Form 5500	2015-07-01	89
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	8
Total of all active and inactive participants	2015-07-01	97
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-07-01	0
Total participants	2015-07-01	97
Number of participants with account balances	2015-07-01	67
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-07-01	0
2014: UPMC HAMOT SURGERY CENTER 401(K) RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-07-01	90
Total number of active participants reported on line 7a of the Form 5500	2014-07-01	82
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	6
Total of all active and inactive participants	2014-07-01	88
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-07-01	0
Total participants	2014-07-01	88
Number of participants with account balances	2014-07-01	69
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-07-01	0
2013: UPMC HAMOT SURGERY CENTER 401(K) RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-07-01	94
Total number of active participants reported on line 7a of the Form 5500	2013-07-01	84
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	6
Total of all active and inactive participants	2013-07-01	90
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-07-01	0
Total participants	2013-07-01	90
Number of participants with account balances	2013-07-01	74
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-07-01	0
2012: UPMC HAMOT SURGERY CENTER 401(K) RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-07-01	105
Total number of active participants reported on line 7a of the Form 5500	2012-07-01	88
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	6
Total of all active and inactive participants	2012-07-01	94
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-07-01	0
Total participants	2012-07-01	94
Number of participants with account balances	2012-07-01	73
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-07-01	0
2011: UPMC HAMOT SURGERY CENTER 401(K) RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-07-01	86
Total number of active participants reported on line 7a of the Form 5500	2011-07-01	83
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	22
Total of all active and inactive participants	2011-07-01	105
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-07-01	0
Total participants	2011-07-01	105
Number of participants with account balances	2011-07-01	95
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-07-01	0

Financial Data on UPMC HAMOT SURGERY CENTER 401(K) RETIREMENT PLAN

Measure	Date	Value
2023 : UPMC HAMOT SURGERY CENTER 401(K) RETIREMENT PLAN 2023 401k financial data
Transfers to/from the plan	2023-06-30	$0
Total plan liabilities at end of year	2023-06-30	$0
Total plan liabilities at beginning of year	2023-06-30	$0
Total income from all sources	2023-06-30	$589,891
Expenses. Total of all expenses incurred	2023-06-30	$35,785
Benefits paid (including direct rollovers)	2023-06-30	$35,510
Total plan assets at end of year	2023-06-30	$3,299,494
Total plan assets at beginning of year	2023-06-30	$2,745,388
Assets. Value of tangible personal property	2023-06-30	$0
Total contributions received or receivable from participants	2023-06-30	$203,290
Assets. Value of loans (other than to participants)	2023-06-30	$0
Expenses. Other expenses not covered elsewhere	2023-06-30	$0
Contributions received from other sources (not participants or employers)	2023-06-30	$8,819
Other income received	2023-06-30	$324,563
Noncash contributions received	2023-06-30	$0
Net income (gross income less expenses)	2023-06-30	$554,106
Net plan assets at end of year (total assets less liabilities)	2023-06-30	$3,299,494
Net plan assets at beginning of year (total assets less liabilities)	2023-06-30	$2,745,388
Assets. Value of participant loans	2023-06-30	$11,476
Assets. Value of assets in partnership/joint-venture interests	2023-06-30	$0
Assets. Value of real-estate (other than employer real property)	2023-06-30	$0
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2023-06-30	$14,285
Assets. Value of employer securities	2023-06-30	$0
Assets. Value of employer real property	2023-06-30	$0
Total contributions received or receivable from employer(s)	2023-06-30	$53,219
Value of certain deemed distributions of participant loans	2023-06-30	$0
Value of corrective distributions	2023-06-30	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2023-06-30	$275
2022 : UPMC HAMOT SURGERY CENTER 401(K) RETIREMENT PLAN 2022 401k financial data
Transfers to/from the plan	2022-06-30	$0
Total plan liabilities at end of year	2022-06-30	$0
Total plan liabilities at beginning of year	2022-06-30	$0
Total income from all sources	2022-06-30	$-249,750
Expenses. Total of all expenses incurred	2022-06-30	$992,764
Benefits paid (including direct rollovers)	2022-06-30	$992,533
Total plan assets at end of year	2022-06-30	$2,745,388
Total plan assets at beginning of year	2022-06-30	$3,987,902
Assets. Value of tangible personal property	2022-06-30	$0
Total contributions received or receivable from participants	2022-06-30	$169,428
Assets. Value of loans (other than to participants)	2022-06-30	$0
Expenses. Other expenses not covered elsewhere	2022-06-30	$0
Contributions received from other sources (not participants or employers)	2022-06-30	$53,376
Other income received	2022-06-30	$-527,282
Noncash contributions received	2022-06-30	$0
Net income (gross income less expenses)	2022-06-30	$-1,242,514
Net plan assets at end of year (total assets less liabilities)	2022-06-30	$2,745,388
Net plan assets at beginning of year (total assets less liabilities)	2022-06-30	$3,987,902
Assets. Value of participant loans	2022-06-30	$19,308
Assets. Value of assets in partnership/joint-venture interests	2022-06-30	$0
Assets. Value of real-estate (other than employer real property)	2022-06-30	$0
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2022-06-30	$14,285
Assets. Value of employer securities	2022-06-30	$0
Assets. Value of employer real property	2022-06-30	$0
Total contributions received or receivable from employer(s)	2022-06-30	$54,728
Value of certain deemed distributions of participant loans	2022-06-30	$0
Value of corrective distributions	2022-06-30	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2022-06-30	$231
2021 : UPMC HAMOT SURGERY CENTER 401(K) RETIREMENT PLAN 2021 401k financial data
Transfers to/from the plan	2021-06-30	$0
Total plan liabilities at end of year	2021-06-30	$0
Total plan liabilities at beginning of year	2021-06-30	$0
Total income from all sources	2021-06-30	$1,209,675
Expenses. Total of all expenses incurred	2021-06-30	$355,013
Benefits paid (including direct rollovers)	2021-06-30	$354,813
Total plan assets at end of year	2021-06-30	$3,987,902
Total plan assets at beginning of year	2021-06-30	$3,133,240
Total contributions received or receivable from participants	2021-06-30	$157,587
Expenses. Other expenses not covered elsewhere	2021-06-30	$0
Contributions received from other sources (not participants or employers)	2021-06-30	$78,866
Other income received	2021-06-30	$924,464
Noncash contributions received	2021-06-30	$0
Net income (gross income less expenses)	2021-06-30	$854,662
Net plan assets at end of year (total assets less liabilities)	2021-06-30	$3,987,902
Net plan assets at beginning of year (total assets less liabilities)	2021-06-30	$3,133,240
Assets. Value of participant loans	2021-06-30	$32,813
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2021-06-30	$14,285
Total contributions received or receivable from employer(s)	2021-06-30	$48,758
Value of certain deemed distributions of participant loans	2021-06-30	$0
Value of corrective distributions	2021-06-30	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2021-06-30	$200
2020 : UPMC HAMOT SURGERY CENTER 401(K) RETIREMENT PLAN 2020 401k financial data
Transfers to/from the plan	2020-06-30	$0
Total plan liabilities at end of year	2020-06-30	$0
Total plan liabilities at beginning of year	2020-06-30	$0
Total income from all sources	2020-06-30	$243,956
Expenses. Total of all expenses incurred	2020-06-30	$446,590
Benefits paid (including direct rollovers)	2020-06-30	$446,202
Total plan assets at end of year	2020-06-30	$3,133,240
Total plan assets at beginning of year	2020-06-30	$3,335,874
Value of fidelity bond covering the plan	2020-06-30	$0
Assets. Value of tangible personal property	2020-06-30	$0
Total contributions received or receivable from participants	2020-06-30	$152,012
Assets. Value of loans (other than to participants)	2020-06-30	$0
Expenses. Other expenses not covered elsewhere	2020-06-30	$0
Contributions received from other sources (not participants or employers)	2020-06-30	$6,421
Other income received	2020-06-30	$38,855
Noncash contributions received	2020-06-30	$0
Net income (gross income less expenses)	2020-06-30	$-202,634
Net plan assets at end of year (total assets less liabilities)	2020-06-30	$3,133,240
Net plan assets at beginning of year (total assets less liabilities)	2020-06-30	$3,335,874
Assets. Value of participant loans	2020-06-30	$54,372
Value of loans by the plan or fixed income obligations due to the plan which were in default or classified as uncollectible at the close of the plan year	2020-06-30	$0
Value of leases to which the plan was a party in default or classified as uncollectible during the plan year	2020-06-30	$0
Assets. Value of assets in partnership/joint-venture interests	2020-06-30	$0
Assets. Value of real-estate (other than employer real property)	2020-06-30	$0
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2020-06-30	$14,285
Assets. Value of employer securities	2020-06-30	$0
Assets. Value of employer real property	2020-06-30	$0
Total contributions received or receivable from employer(s)	2020-06-30	$46,668
Value of certain deemed distributions of participant loans	2020-06-30	$0
Value of corrective distributions	2020-06-30	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2020-06-30	$388
2019 : UPMC HAMOT SURGERY CENTER 401(K) RETIREMENT PLAN 2019 401k financial data
Transfers to/from the plan	2019-06-30	$0
Total plan liabilities at end of year	2019-06-30	$0
Total plan liabilities at beginning of year	2019-06-30	$0
Total income from all sources	2019-06-30	$425,224
Expenses. Total of all expenses incurred	2019-06-30	$650,379
Benefits paid (including direct rollovers)	2019-06-30	$649,710
Total plan assets at end of year	2019-06-30	$3,335,874
Total plan assets at beginning of year	2019-06-30	$3,561,029
Value of fidelity bond covering the plan	2019-06-30	$0
Total contributions received or receivable from participants	2019-06-30	$157,258
Expenses. Other expenses not covered elsewhere	2019-06-30	$0
Contributions received from other sources (not participants or employers)	2019-06-30	$63,972
Other income received	2019-06-30	$151,069
Noncash contributions received	2019-06-30	$0
Net income (gross income less expenses)	2019-06-30	$-225,155
Net plan assets at end of year (total assets less liabilities)	2019-06-30	$3,335,874
Net plan assets at beginning of year (total assets less liabilities)	2019-06-30	$3,561,029
Assets. Value of participant loans	2019-06-30	$60,788
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2019-06-30	$14,285
Total contributions received or receivable from employer(s)	2019-06-30	$52,925
Value of certain deemed distributions of participant loans	2019-06-30	$0
Value of corrective distributions	2019-06-30	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2019-06-30	$669
2018 : UPMC HAMOT SURGERY CENTER 401(K) RETIREMENT PLAN 2018 401k financial data
Transfers to/from the plan	2018-06-30	$0
Total plan liabilities at end of year	2018-06-30	$0
Total plan liabilities at beginning of year	2018-06-30	$0
Total income from all sources	2018-06-30	$525,919
Expenses. Total of all expenses incurred	2018-06-30	$551,017
Benefits paid (including direct rollovers)	2018-06-30	$550,486
Total plan assets at end of year	2018-06-30	$3,561,029
Total plan assets at beginning of year	2018-06-30	$3,586,127
Total contributions received or receivable from participants	2018-06-30	$148,971
Expenses. Other expenses not covered elsewhere	2018-06-30	$0
Contributions received from other sources (not participants or employers)	2018-06-30	$43,957
Other income received	2018-06-30	$275,176
Noncash contributions received	2018-06-30	$0
Net income (gross income less expenses)	2018-06-30	$-25,098
Net plan assets at end of year (total assets less liabilities)	2018-06-30	$3,561,029
Net plan assets at beginning of year (total assets less liabilities)	2018-06-30	$3,586,127
Assets. Value of participant loans	2018-06-30	$55,256
Total contributions received or receivable from employer(s)	2018-06-30	$57,815
Value of certain deemed distributions of participant loans	2018-06-30	$0
Value of corrective distributions	2018-06-30	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2018-06-30	$531
2017 : UPMC HAMOT SURGERY CENTER 401(K) RETIREMENT PLAN 2017 401k financial data
Transfers to/from the plan	2017-06-30	$0
Total plan liabilities at end of year	2017-06-30	$0
Total plan liabilities at beginning of year	2017-06-30	$0
Total income from all sources	2017-06-30	$699,694
Expenses. Total of all expenses incurred	2017-06-30	$587,808
Benefits paid (including direct rollovers)	2017-06-30	$576,701
Total plan assets at end of year	2017-06-30	$3,586,127
Total plan assets at beginning of year	2017-06-30	$3,474,241
Total contributions received or receivable from participants	2017-06-30	$155,448
Expenses. Other expenses not covered elsewhere	2017-06-30	$0
Contributions received from other sources (not participants or employers)	2017-06-30	$58,197
Other income received	2017-06-30	$436,664
Noncash contributions received	2017-06-30	$0
Net income (gross income less expenses)	2017-06-30	$111,886
Net plan assets at end of year (total assets less liabilities)	2017-06-30	$3,586,127
Net plan assets at beginning of year (total assets less liabilities)	2017-06-30	$3,474,241
Assets. Value of participant loans	2017-06-30	$29,139
Total contributions received or receivable from employer(s)	2017-06-30	$49,385
Value of certain deemed distributions of participant loans	2017-06-30	$0
Value of corrective distributions	2017-06-30	$10,563
Expenses. Administrative service providers (salaries,fees and commissions)	2017-06-30	$544
2016 : UPMC HAMOT SURGERY CENTER 401(K) RETIREMENT PLAN 2016 401k financial data
Transfers to/from the plan	2016-06-30	$0
Total plan liabilities at end of year	2016-06-30	$0
Total plan liabilities at beginning of year	2016-06-30	$0
Total income from all sources	2016-06-30	$219,671
Expenses. Total of all expenses incurred	2016-06-30	$122,252
Benefits paid (including direct rollovers)	2016-06-30	$112,075
Total plan assets at end of year	2016-06-30	$3,474,241
Total plan assets at beginning of year	2016-06-30	$3,376,822
Total contributions received or receivable from participants	2016-06-30	$130,537
Expenses. Other expenses not covered elsewhere	2016-06-30	$0
Contributions received from other sources (not participants or employers)	2016-06-30	$75,895
Other income received	2016-06-30	$-40,422
Noncash contributions received	2016-06-30	$0
Net income (gross income less expenses)	2016-06-30	$97,419
Net plan assets at end of year (total assets less liabilities)	2016-06-30	$3,474,241
Net plan assets at beginning of year (total assets less liabilities)	2016-06-30	$3,376,822
Assets. Value of participant loans	2016-06-30	$22,478
Total contributions received or receivable from employer(s)	2016-06-30	$53,661
Value of certain deemed distributions of participant loans	2016-06-30	$0
Value of corrective distributions	2016-06-30	$9,677
Expenses. Administrative service providers (salaries,fees and commissions)	2016-06-30	$500
2015 : UPMC HAMOT SURGERY CENTER 401(K) RETIREMENT PLAN 2015 401k financial data
Transfers to/from the plan	2015-06-30	$0
Total plan liabilities at end of year	2015-06-30	$0
Total plan liabilities at beginning of year	2015-06-30	$0
Total income from all sources	2015-06-30	$307,489
Expenses. Total of all expenses incurred	2015-06-30	$127,304
Benefits paid (including direct rollovers)	2015-06-30	$126,579
Total plan assets at end of year	2015-06-30	$3,376,822
Total plan assets at beginning of year	2015-06-30	$3,196,637
Total contributions received or receivable from participants	2015-06-30	$146,680
Expenses. Other expenses not covered elsewhere	2015-06-30	$0
Contributions received from other sources (not participants or employers)	2015-06-30	$29,491
Other income received	2015-06-30	$71,901
Noncash contributions received	2015-06-30	$0
Net income (gross income less expenses)	2015-06-30	$180,185
Net plan assets at end of year (total assets less liabilities)	2015-06-30	$3,376,822
Net plan assets at beginning of year (total assets less liabilities)	2015-06-30	$3,196,637
Assets. Value of participant loans	2015-06-30	$34,016
Total contributions received or receivable from employer(s)	2015-06-30	$59,417
Value of certain deemed distributions of participant loans	2015-06-30	$0
Value of corrective distributions	2015-06-30	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2015-06-30	$725
2014 : UPMC HAMOT SURGERY CENTER 401(K) RETIREMENT PLAN 2014 401k financial data
Transfers to/from the plan	2014-06-30	$0
Total plan liabilities at end of year	2014-06-30	$0
Total income from all sources	2014-06-30	$598,167
Expenses. Total of all expenses incurred	2014-06-30	$89,086
Benefits paid (including direct rollovers)	2014-06-30	$88,686
Total plan assets at end of year	2014-06-30	$3,196,637
Total plan assets at beginning of year	2014-06-30	$2,687,556
Total contributions received or receivable from participants	2014-06-30	$160,945
Expenses. Other expenses not covered elsewhere	2014-06-30	$0
Contributions received from other sources (not participants or employers)	2014-06-30	$0
Other income received	2014-06-30	$389,342
Noncash contributions received	2014-06-30	$0
Net income (gross income less expenses)	2014-06-30	$509,081
Net plan assets at end of year (total assets less liabilities)	2014-06-30	$3,196,637
Net plan assets at beginning of year (total assets less liabilities)	2014-06-30	$2,687,556
Assets. Value of participant loans	2014-06-30	$31,345
Total contributions received or receivable from employer(s)	2014-06-30	$47,880
Value of certain deemed distributions of participant loans	2014-06-30	$0
Value of corrective distributions	2014-06-30	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2014-06-30	$400
2013 : UPMC HAMOT SURGERY CENTER 401(K) RETIREMENT PLAN 2013 401k financial data
Total income from all sources	2013-06-30	$446,827
Expenses. Total of all expenses incurred	2013-06-30	$121,158
Benefits paid (including direct rollovers)	2013-06-30	$120,689
Total plan assets at end of year	2013-06-30	$2,687,556
Total plan assets at beginning of year	2013-06-30	$2,361,887
Total contributions received or receivable from participants	2013-06-30	$156,664
Contributions received from other sources (not participants or employers)	2013-06-30	$4,773
Other income received	2013-06-30	$231,848
Net income (gross income less expenses)	2013-06-30	$325,669
Net plan assets at end of year (total assets less liabilities)	2013-06-30	$2,687,556
Net plan assets at beginning of year (total assets less liabilities)	2013-06-30	$2,361,887
Assets. Value of participant loans	2013-06-30	$14,870
Total contributions received or receivable from employer(s)	2013-06-30	$53,542
Expenses. Administrative service providers (salaries,fees and commissions)	2013-06-30	$469
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-06-30	$0
2012 : UPMC HAMOT SURGERY CENTER 401(K) RETIREMENT PLAN 2012 401k financial data
Total income from all sources	2012-06-30	$386,040
Expenses. Total of all expenses incurred	2012-06-30	$345,976
Benefits paid (including direct rollovers)	2012-06-30	$343,073
Total plan assets at end of year	2012-06-30	$2,361,887
Total plan assets at beginning of year	2012-06-30	$2,321,823
Total contributions received or receivable from participants	2012-06-30	$119,391
Contributions received from other sources (not participants or employers)	2012-06-30	$45,461
Other income received	2012-06-30	$152,081
Net income (gross income less expenses)	2012-06-30	$40,064
Net plan assets at end of year (total assets less liabilities)	2012-06-30	$2,361,887
Net plan assets at beginning of year (total assets less liabilities)	2012-06-30	$2,321,823
Assets. Value of participant loans	2012-06-30	$37,732
Total contributions received or receivable from employer(s)	2012-06-30	$69,107
Expenses. Administrative service providers (salaries,fees and commissions)	2012-06-30	$2,903
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-06-30	$0

Form 5500 Responses for UPMC HAMOT SURGERY CENTER 401(K) RETIREMENT PLAN

2022: UPMC HAMOT SURGERY CENTER 401(K) RETIREMENT PLAN 2022 form 5500 responses
2022-07-01	Type of plan entity	Single employer plan
2022-07-01	This submission is the final filing	No
2022-07-01	Plan is a collectively bargained plan	No
2022-07-01	Plan funding arrangement – Trust	Yes
2022-07-01	Plan benefit arrangement - Trust	Yes
2021: UPMC HAMOT SURGERY CENTER 401(K) RETIREMENT PLAN 2021 form 5500 responses
2021-07-01	Type of plan entity	Single employer plan
2021-07-01	This submission is the final filing	No
2021-07-01	Plan is a collectively bargained plan	No
2021-07-01	Plan funding arrangement – Trust	Yes
2021-07-01	Plan benefit arrangement - Trust	Yes
2020: UPMC HAMOT SURGERY CENTER 401(K) RETIREMENT PLAN 2020 form 5500 responses
2020-07-01	Type of plan entity	Single employer plan
2020-07-01	This submission is the final filing	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: UPMC HAMOT SURGERY CENTER 401(K) RETIREMENT PLAN 2019 form 5500 responses
2019-07-01	Type of plan entity	Single employer plan
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: UPMC HAMOT SURGERY CENTER 401(K) 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: UPMC HAMOT SURGERY CENTER 401(K) 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: UPMC HAMOT SURGERY CENTER 401(K) 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: UPMC HAMOT SURGERY CENTER 401(K) 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: UPMC HAMOT SURGERY CENTER 401(K) 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: UPMC HAMOT SURGERY CENTER 401(K) 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: UPMC HAMOT SURGERY CENTER 401(K) 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 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: UPMC HAMOT SURGERY CENTER 401(K) 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 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

Insurance Providers Used on plan

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )

Policy contract number

61814

Policy instance

Insurance contract or identification number	61814
Number of Individuals Covered	0
Insurance policy start date	2020-07-01
Insurance policy end date	2020-07-02
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )

Policy contract number

61814

Policy instance

Insurance contract or identification number	61814
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	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )

Policy contract number

61814

Policy instance

Insurance contract or identification number	61814
Number of Individuals Covered	5
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
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	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )

Policy contract number

61814

Policy instance

Insurance contract or identification number	61814
Number of Individuals Covered	5
Insurance policy start date	2015-07-01
Insurance policy end date	2016-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )

Policy contract number

61814

Policy instance

Insurance contract or identification number	61814
Number of Individuals Covered	5
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )

Policy contract number

61814

Policy instance

Insurance contract or identification number	61814
Number of Individuals Covered	7
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )

Policy contract number

61814

Policy instance

Insurance contract or identification number	61814
Number of Individuals Covered	8
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contracts With Unallocated Funds Deposit Administration	1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )

Policy contract number

61814

Policy instance

Insurance contract or identification number	61814
Number of Individuals Covered	40
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Contracts With Unallocated Funds Deposit Administration	1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	UPMC HAMOT SURGERY CENTER, L.L.C.
Employer identification number (EIN):	251863661
NAIC Classification:	621493
NAIC Description:	Freestanding Ambulatory Surgical and Emergency Centers