401k Plan data: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN plan

FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 401k Plan overview

Plan Name	FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN
Plan identification number	003

FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.
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

FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. has sponsored the creation of one or more 401k plans.

Company Name: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC.

Employer identification number (EIN): 350900741

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
003 2017-01-01 HAYLEE CAVINS
003 2016-01-01 HAYLEE CAVINS
003 2015-01-01 RHONDA MCPHERSON
003 2014-01-01 RHONDA MCPHERSON
003 2013-01-01 RHONDA MCPHERSON
003 2012-01-01 RHONDA MCPHERSON
003 2011-01-01 RHONDA MCPHERSON
003 2010-01-01 RHONDA MCPHERSON
003 2009-01-01 RHONDA MCPHERSON RHONDA MCPHERSON 2010-10-15
003 2009-01-01 RHNDA MCPHERSON RHONDA MCPHERSON 2010-10-15

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
003	2017-01-01	HAYLEE CAVINS
003	2016-01-01	HAYLEE CAVINS
003	2015-01-01	RHONDA MCPHERSON
003	2014-01-01	RHONDA MCPHERSON
003	2013-01-01	RHONDA MCPHERSON
003	2012-01-01	RHONDA MCPHERSON
003	2011-01-01	RHONDA MCPHERSON
003	2010-01-01	RHONDA MCPHERSON
003	2009-01-01	RHONDA MCPHERSON	RHONDA MCPHERSON	2010-10-15
003	2009-01-01	RHNDA MCPHERSON	RHONDA MCPHERSON	2010-10-15

Plan Statistics for FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN

401k plan membership statisitcs for FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN

Measure Date Value
2017: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 987
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 473
Number of retired or separated participants receiving benefits 2017-01-01 11
Number of other retired or separated participants entitled to future benefits 2017-01-01 516
Total of all active and inactive participants 2017-01-01 1,000
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 5
Total participants 2017-01-01 1,005
Number of participants with account balances 2017-01-01 906
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 10
2016: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 1,008
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 461
Number of retired or separated participants receiving benefits 2016-01-01 10
Number of other retired or separated participants entitled to future benefits 2016-01-01 510
Total of all active and inactive participants 2016-01-01 981
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 6
Total participants 2016-01-01 987
Number of participants with account balances 2016-01-01 904
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 25
2015: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 1,058
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 495
Number of retired or separated participants receiving benefits 2015-01-01 10
Number of other retired or separated participants entitled to future benefits 2015-01-01 496
Total of all active and inactive participants 2015-01-01 1,001
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 7
Total participants 2015-01-01 1,008
Number of participants with account balances 2015-01-01 945
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 40
2014: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 1,116
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 527
Number of retired or separated participants receiving benefits 2014-01-01 13
Number of other retired or separated participants entitled to future benefits 2014-01-01 512
Total of all active and inactive participants 2014-01-01 1,052
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 5
Total participants 2014-01-01 1,057
Number of participants with account balances 2014-01-01 1,001
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 16
2013: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 1,059
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 597
Number of retired or separated participants receiving benefits 2013-01-01 11
Number of other retired or separated participants entitled to future benefits 2013-01-01 503
Total of all active and inactive participants 2013-01-01 1,111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 5
Total participants 2013-01-01 1,116
Number of participants with account balances 2013-01-01 1,036
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 12
2012: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 1,041
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 581
Number of retired or separated participants receiving benefits 2012-01-01 7
Number of other retired or separated participants entitled to future benefits 2012-01-01 466
Total of all active and inactive participants 2012-01-01 1,054
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 5
Total participants 2012-01-01 1,059
Number of participants with account balances 2012-01-01 1,023
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 41
2011: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 1,007
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 570
Number of retired or separated participants receiving benefits 2011-01-01 7
Number of other retired or separated participants entitled to future benefits 2011-01-01 460
Total of all active and inactive participants 2011-01-01 1,037
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 3
Total participants 2011-01-01 1,040
Number of participants with account balances 2011-01-01 1,023
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 49
2010: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 1,025
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 595
Number of retired or separated participants receiving benefits 2010-01-01 5
Number of other retired or separated participants entitled to future benefits 2010-01-01 404
Total of all active and inactive participants 2010-01-01 1,004
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 3
Total participants 2010-01-01 1,007
Number of participants with account balances 2010-01-01 1,007
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 49
2009: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 1,005
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 571
Number of retired or separated participants receiving benefits 2009-01-01 3
Number of other retired or separated participants entitled to future benefits 2009-01-01 448
Total of all active and inactive participants 2009-01-01 1,022
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 3
Total participants 2009-01-01 1,025
Number of participants with account balances 2009-01-01 1,025
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 11

Measure	Date	Value
2017: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	987
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	473
Number of retired or separated participants receiving benefits	2017-01-01	11
Number of other retired or separated participants entitled to future benefits	2017-01-01	516
Total of all active and inactive participants	2017-01-01	1,000
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	5
Total participants	2017-01-01	1,005
Number of participants with account balances	2017-01-01	906
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	10
2016: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	1,008
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	461
Number of retired or separated participants receiving benefits	2016-01-01	10
Number of other retired or separated participants entitled to future benefits	2016-01-01	510
Total of all active and inactive participants	2016-01-01	981
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	6
Total participants	2016-01-01	987
Number of participants with account balances	2016-01-01	904
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	25
2015: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	1,058
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	495
Number of retired or separated participants receiving benefits	2015-01-01	10
Number of other retired or separated participants entitled to future benefits	2015-01-01	496
Total of all active and inactive participants	2015-01-01	1,001
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	7
Total participants	2015-01-01	1,008
Number of participants with account balances	2015-01-01	945
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	40
2014: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	1,116
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	527
Number of retired or separated participants receiving benefits	2014-01-01	13
Number of other retired or separated participants entitled to future benefits	2014-01-01	512
Total of all active and inactive participants	2014-01-01	1,052
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	5
Total participants	2014-01-01	1,057
Number of participants with account balances	2014-01-01	1,001
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	16
2013: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	1,059
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	597
Number of retired or separated participants receiving benefits	2013-01-01	11
Number of other retired or separated participants entitled to future benefits	2013-01-01	503
Total of all active and inactive participants	2013-01-01	1,111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	5
Total participants	2013-01-01	1,116
Number of participants with account balances	2013-01-01	1,036
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	12
2012: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	1,041
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	581
Number of retired or separated participants receiving benefits	2012-01-01	7
Number of other retired or separated participants entitled to future benefits	2012-01-01	466
Total of all active and inactive participants	2012-01-01	1,054
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	5
Total participants	2012-01-01	1,059
Number of participants with account balances	2012-01-01	1,023
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	41
2011: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	1,007
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	570
Number of retired or separated participants receiving benefits	2011-01-01	7
Number of other retired or separated participants entitled to future benefits	2011-01-01	460
Total of all active and inactive participants	2011-01-01	1,037
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	3
Total participants	2011-01-01	1,040
Number of participants with account balances	2011-01-01	1,023
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	49
2010: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	1,025
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	595
Number of retired or separated participants receiving benefits	2010-01-01	5
Number of other retired or separated participants entitled to future benefits	2010-01-01	404
Total of all active and inactive participants	2010-01-01	1,004
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	3
Total participants	2010-01-01	1,007
Number of participants with account balances	2010-01-01	1,007
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	49
2009: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	1,005
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	571
Number of retired or separated participants receiving benefits	2009-01-01	3
Number of other retired or separated participants entitled to future benefits	2009-01-01	448
Total of all active and inactive participants	2009-01-01	1,022
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	3
Total participants	2009-01-01	1,025
Number of participants with account balances	2009-01-01	1,025
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	11

Financial Data on FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN

Measure	Date	Value
2017 : FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2017 401k financial data
Total income from all sources (including contributions)	2017-12-31	$2,989,513
Total of all expenses incurred	2017-12-31	$3,931,048
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$3,744,351
Expenses. Certain deemed distributions of participant loans	2017-12-31	$48,739
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$604,236
Value of total assets at end of year	2017-12-31	$18,787,817
Value of total assets at beginning of year	2017-12-31	$19,729,352
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$137,958
Total interest from all sources	2017-12-31	$75,306
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$190,467
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$190,467
Administrative expenses professional fees incurred	2017-12-31	$7,000
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$500,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$588,123
Participant contributions at end of year	2017-12-31	$493,596
Participant contributions at beginning of year	2017-12-31	$541,146
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$16,113
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2017-12-31	$911
Administrative expenses (other) incurred	2017-12-31	$130,958
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$-941,535
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$18,787,817
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$19,729,352
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$13,914,125
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$14,196,994
Interest on participant loans	2017-12-31	$15,669
Interest earned on other investments	2017-12-31	$59,637
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$4,380,096
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$4,990,301
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$2,119,504
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$3,744,351
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2017-12-31	No
Did the plan have assets held for investment	2017-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	CLARUS PARTNERS, LLC
Accountancy firm EIN	2017-12-31	261347383
2016 : FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2016 401k financial data
Total income from all sources (including contributions)	2016-12-31	$1,858,831
Total of all expenses incurred	2016-12-31	$2,969,775
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$2,832,342
Expenses. Certain deemed distributions of participant loans	2016-12-31	$81
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$676,422
Value of total assets at end of year	2016-12-31	$19,729,352
Value of total assets at beginning of year	2016-12-31	$20,840,296
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$137,352
Total interest from all sources	2016-12-31	$26,438
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$203,161
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$203,161
Administrative expenses professional fees incurred	2016-12-31	$7,000
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$500,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$642,776
Participant contributions at end of year	2016-12-31	$541,146
Participant contributions at beginning of year	2016-12-31	$600,631
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$33,646
Value of other receiveables (less allowance for doubtful accounts) at end of year	2016-12-31	$911
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2016-12-31	$893
Administrative expenses (other) incurred	2016-12-31	$130,352
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$-1,110,944
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$19,729,352
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$20,840,296
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$14,196,994
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$14,596,108
Interest on participant loans	2016-12-31	$18,360
Interest earned on other investments	2016-12-31	$8,078
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$4,990,301
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$5,642,664
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$952,810
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$2,832,342
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2016-12-31	No
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	CLARUS PARTNERS, LLC
Accountancy firm EIN	2016-12-31	261347383
2015 : FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2015 401k financial data
Total income from all sources (including contributions)	2015-12-31	$1,415,684
Total of all expenses incurred	2015-12-31	$4,294,053
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$4,103,916
Expenses. Certain deemed distributions of participant loans	2015-12-31	$41,506
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$1,214,535
Value of total assets at end of year	2015-12-31	$20,840,296
Value of total assets at beginning of year	2015-12-31	$23,718,665
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$148,631
Total interest from all sources	2015-12-31	$33,898
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$181,062
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$181,062
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$500,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$817,163
Participant contributions at end of year	2015-12-31	$600,631
Participant contributions at beginning of year	2015-12-31	$759,748
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$70,313
Value of other receiveables (less allowance for doubtful accounts) at end of year	2015-12-31	$893
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2015-12-31	$875
Administrative expenses (other) incurred	2015-12-31	$148,631
Total non interest bearing cash at beginning of year	2015-12-31	$26,849
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$-2,878,369
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$20,840,296
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$23,718,665
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$14,596,108
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$16,430,260
Interest on participant loans	2015-12-31	$23,070
Interest earned on other investments	2015-12-31	$10,828
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$5,642,664
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$6,500,933
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-13,811
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$327,059
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$4,103,916
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2015-12-31	No
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	CLARUS PARTNERS, LLC
Accountancy firm EIN	2015-12-31	261347383
2014 : FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2014 401k financial data
Total income from all sources (including contributions)	2014-12-31	$2,630,577
Total of all expenses incurred	2014-12-31	$3,176,124
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$3,018,421
Expenses. Certain deemed distributions of participant loans	2014-12-31	$6,289
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$1,390,318
Value of total assets at end of year	2014-12-31	$23,718,665
Value of total assets at beginning of year	2014-12-31	$24,264,212
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$151,414
Total interest from all sources	2014-12-31	$37,229
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$265,521
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$265,521
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$500,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$946,473
Participant contributions at end of year	2014-12-31	$759,748
Participant contributions at beginning of year	2014-12-31	$834,408
Value of other receiveables (less allowance for doubtful accounts) at end of year	2014-12-31	$875
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2014-12-31	$941
Administrative expenses (other) incurred	2014-12-31	$151,414
Total non interest bearing cash at end of year	2014-12-31	$26,849
Total non interest bearing cash at beginning of year	2014-12-31	$6,327
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$-545,547
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$23,718,665
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$24,264,212
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$16,430,260
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$15,939,217
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$7,201,621
Interest on participant loans	2014-12-31	$26,600
Interest earned on other investments	2014-12-31	$10,629
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$6,500,933
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$281,698
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$876,659
Net investment gain/loss from pooled separate accounts	2014-12-31	$60,850
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$443,845
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$3,018,421
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2014-12-31	No
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	CLARUS PARTNERS, LLC
Accountancy firm EIN	2014-12-31	261347383
2013 : FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2013 401k financial data
Total income from all sources (including contributions)	2013-12-31	$4,542,794
Total of all expenses incurred	2013-12-31	$1,935,121
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$1,858,983
Expenses. Certain deemed distributions of participant loans	2013-12-31	$1,833
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$1,578,064
Value of total assets at end of year	2013-12-31	$24,264,212
Value of total assets at beginning of year	2013-12-31	$21,656,539
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$74,305
Total interest from all sources	2013-12-31	$40,432
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$315,982
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-12-31	$315,982
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$500,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$994,523
Participant contributions at end of year	2013-12-31	$834,408
Participant contributions at beginning of year	2013-12-31	$899,137
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$146,836
Value of other receiveables (less allowance for doubtful accounts) at end of year	2013-12-31	$941
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2013-12-31	$770
Administrative expenses (other) incurred	2013-12-31	$74,305
Total non interest bearing cash at end of year	2013-12-31	$6,327
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$2,607,673
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$24,264,212
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$21,656,539
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$15,939,217
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$13,532,505
Value of interest in pooled separate accounts at end of year	2013-12-31	$7,201,621
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$6,946,152
Interest on participant loans	2013-12-31	$29,891
Interest earned on other investments	2013-12-31	$10,541
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$281,698
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$277,975
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$2,504,783
Net investment gain/loss from pooled separate accounts	2013-12-31	$103,533
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$436,705
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$1,858,983
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2013-12-31	No
Did the plan have assets held for investment	2013-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	CLARUS PARTNERS, LLC
Accountancy firm EIN	2013-12-31	261347383
2012 : FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2012 401k financial data
Total transfer of assets to this plan	2012-12-31	$29,206
Total income from all sources (including contributions)	2012-12-31	$3,188,280
Total of all expenses incurred	2012-12-31	$2,136,715
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$2,106,676
Expenses. Certain deemed distributions of participant loans	2012-12-31	$26,292
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$1,420,210
Value of total assets at end of year	2012-12-31	$21,656,539
Value of total assets at beginning of year	2012-12-31	$20,575,768
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$3,747
Total interest from all sources	2012-12-31	$45,233
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$238,161
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-12-31	$238,161
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$500,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$944,482
Participant contributions at end of year	2012-12-31	$899,137
Participant contributions at beginning of year	2012-12-31	$1,011,405
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$34,773
Value of other receiveables (less allowance for doubtful accounts) at end of year	2012-12-31	$770
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2012-12-31	$1,805
Administrative expenses (other) incurred	2012-12-31	$3,747
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$1,051,565
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$21,656,539
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$20,575,768
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$13,532,505
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$11,698,352
Value of interest in pooled separate accounts at end of year	2012-12-31	$6,946,152
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$7,484,991
Interest on participant loans	2012-12-31	$33,153
Interest earned on other investments	2012-12-31	$12,080
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$277,975
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$379,215
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$1,377,164
Net investment gain/loss from pooled separate accounts	2012-12-31	$107,512
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$440,955
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$2,106,676
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2012-12-31	No
Did the plan have assets held for investment	2012-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	CLARUS PARTNERS, LLC
Accountancy firm EIN	2012-12-31	261347383
2011 : FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2011 401k financial data
Total transfer of assets to this plan	2011-12-31	$4,165
Total transfer of assets from this plan	2011-12-31	$4,165
Total income from all sources (including contributions)	2011-12-31	$1,650,220
Total of all expenses incurred	2011-12-31	$2,198,482
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$2,192,035
Expenses. Certain deemed distributions of participant loans	2011-12-31	$1,374
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$1,678,218
Value of total assets at end of year	2011-12-31	$20,575,768
Value of total assets at beginning of year	2011-12-31	$21,124,030
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$5,073
Total interest from all sources	2011-12-31	$51,797
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$159,976
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2011-12-31	$159,976
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$500,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$985,549
Participant contributions at end of year	2011-12-31	$1,011,405
Participant contributions at beginning of year	2011-12-31	$975,860
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$609
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-12-31	$1,805
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-12-31	$1,649
Administrative expenses (other) incurred	2011-12-31	$72
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$-548,262
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$20,575,768
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$21,124,030
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Investment advisory and management fees	2011-12-31	$5,001
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$11,698,352
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$12,066,402
Value of interest in pooled separate accounts at end of year	2011-12-31	$7,484,991
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$7,712,326
Interest on participant loans	2011-12-31	$36,852
Interest earned on other investments	2011-12-31	$14,945
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$379,215
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$367,793
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-354,566
Net investment gain/loss from pooled separate accounts	2011-12-31	$114,795
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$692,060
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$2,192,035
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2011-12-31	No
Did the plan have assets held for investment	2011-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	CLARUS PARTNERS, LLC
Accountancy firm EIN	2011-12-31	261347383
2010 : FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2010 401k financial data
Total income from all sources (including contributions)	2010-12-31	$4,057,926
Total of all expenses incurred	2010-12-31	$2,227,401
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$2,122,422
Expenses. Certain deemed distributions of participant loans	2010-12-31	$88,004
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$2,126,410
Value of total assets at end of year	2010-12-31	$21,124,030
Value of total assets at beginning of year	2010-12-31	$19,293,505
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$16,975
Total interest from all sources	2010-12-31	$65,883
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$157,507
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2010-12-31	$157,507
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$500,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$1,104,903
Participant contributions at end of year	2010-12-31	$975,860
Participant contributions at beginning of year	2010-12-31	$898,675
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$100,000
Value of other receiveables (less allowance for doubtful accounts) at end of year	2010-12-31	$1,649
Administrative expenses (other) incurred	2010-12-31	$16,975
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$1,830,525
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$21,124,030
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$19,293,505
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$12,066,402
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$10,342,680
Value of interest in pooled separate accounts at end of year	2010-12-31	$7,712,326
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$7,578,895
Interest on participant loans	2010-12-31	$50,291
Interest earned on other investments	2010-12-31	$15,592
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$367,793
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$473,255
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$1,128,913
Net investment gain/loss from pooled separate accounts	2010-12-31	$579,213
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$921,507
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$2,122,422
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2010-12-31	No
Did the plan have assets held for investment	2010-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	BKD, LLP
Accountancy firm EIN	2010-12-31	440160260
2009 : FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN

2017: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	Yes
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

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

Policy contract number

TT069161

Policy instance

Insurance contract or identification number	TT069161
Number of Individuals Covered	889
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

85806-01

Policy instance

Insurance contract or identification number	85806-01
Number of Individuals Covered	2
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

TT069161

Policy instance

Insurance contract or identification number	TT069161
Number of Individuals Covered	889
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $301
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $301
Insurance broker organization code?	3
Insurance broker name	UBS FINANCIAL SERVICES

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

1005034-01

Policy instance

Insurance contract or identification number	1005034-01
Number of Individuals Covered	15
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

TT069161

Policy instance

Insurance contract or identification number	TT069161
Number of Individuals Covered	945
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

85806-01

Policy instance

Insurance contract or identification number	85806-01
Number of Individuals Covered	3
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

TT069161

Policy instance

Insurance contract or identification number	TT069161
Number of Individuals Covered	945
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $192
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $192
Insurance broker organization code?	3
Insurance broker name	UBS FINANCIAL SERVICES

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

1005034-01

Policy instance

Insurance contract or identification number	1005034-01
Number of Individuals Covered	23
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

85806-01

Policy instance

Insurance contract or identification number	85806-01
Number of Individuals Covered	3
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

TT069161

Policy instance

Insurance contract or identification number	TT069161
Number of Individuals Covered	1001
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

TT069161

Policy instance

Insurance contract or identification number	TT069161
Number of Individuals Covered	1001
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $12,615
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $12,615
Insurance broker organization code?	3
Insurance broker name	UBS FINANCIAL SERVICES

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

1005034-01

Policy instance

Insurance contract or identification number	1005034-01
Number of Individuals Covered	23
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

85806-01

Policy instance

Insurance contract or identification number	85806-01
Number of Individuals Covered	3
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

TT069161

Policy instance

Insurance contract or identification number	TT069161
Number of Individuals Covered	1029
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $17,455
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $17,455
Insurance broker organization code?	3
Insurance broker name	UBS FINANCIAL SERVICES

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

1005034-01

Policy instance

Insurance contract or identification number	1005034-01
Number of Individuals Covered	25
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

TT069161

Policy instance

Insurance contract or identification number	TT069161
Number of Individuals Covered	1014
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $18,318
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $18,318
Insurance broker organization code?	3
Insurance broker name	UBS FINANCIAL SERVICES

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

Policy contract number

85806-01

Policy instance

Insurance contract or identification number	85806-01
Number of Individuals Covered	3
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

1005034-01

Policy instance

Insurance contract or identification number	1005034-01
Number of Individuals Covered	25
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

1005034-01

Policy instance

Insurance contract or identification number	1005034-01
Number of Individuals Covered	27
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

TT069161

Policy instance

Insurance contract or identification number	TT069161
Number of Individuals Covered	1023
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $19,429
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

85806-01

Policy instance

Insurance contract or identification number	85806-01
Number of Individuals Covered	4
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

TT069161

Policy instance

Insurance contract or identification number	TT069161
Number of Individuals Covered	1007
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $19,540
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

1005034-01

Policy instance

Insurance contract or identification number	1005034-01
Number of Individuals Covered	35
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

85806-01

Policy instance

Insurance contract or identification number	85806-01
Number of Individuals Covered	4
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC.
Employer identification number (EIN):	350900741
NAIC Classification:	622000
NAIC Description:	Hospitals