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

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

FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN Benefits

401k Plan TypeDefined 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 SignedName of Company SponsorDate Sponsor Signed
0032017-01-01HAYLEE CAVINS
0032016-01-01HAYLEE CAVINS
0032015-01-01RHONDA MCPHERSON
0032014-01-01RHONDA MCPHERSON
0032013-01-01RHONDA MCPHERSON
0032012-01-01RHONDA MCPHERSON
0032011-01-01RHONDA MCPHERSON
0032010-01-01RHONDA MCPHERSON
0032009-01-01RHONDA MCPHERSON RHONDA MCPHERSON2010-10-15
0032009-01-01RHNDA MCPHERSON RHONDA MCPHERSON2010-10-15

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-year2017-01-01987
Total number of active participants reported on line 7a of the Form 55002017-01-01473
Number of retired or separated participants receiving benefits2017-01-0111
Number of other retired or separated participants entitled to future benefits2017-01-01516
Total of all active and inactive participants2017-01-011,000
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-015
Total participants2017-01-011,005
Number of participants with account balances2017-01-01906
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-0110
2016: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-011,008
Total number of active participants reported on line 7a of the Form 55002016-01-01461
Number of retired or separated participants receiving benefits2016-01-0110
Number of other retired or separated participants entitled to future benefits2016-01-01510
Total of all active and inactive participants2016-01-01981
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-016
Total participants2016-01-01987
Number of participants with account balances2016-01-01904
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-0125
2015: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-011,058
Total number of active participants reported on line 7a of the Form 55002015-01-01495
Number of retired or separated participants receiving benefits2015-01-0110
Number of other retired or separated participants entitled to future benefits2015-01-01496
Total of all active and inactive participants2015-01-011,001
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-017
Total participants2015-01-011,008
Number of participants with account balances2015-01-01945
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-0140
2014: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-011,116
Total number of active participants reported on line 7a of the Form 55002014-01-01527
Number of retired or separated participants receiving benefits2014-01-0113
Number of other retired or separated participants entitled to future benefits2014-01-01512
Total of all active and inactive participants2014-01-011,052
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-015
Total participants2014-01-011,057
Number of participants with account balances2014-01-011,001
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-0116
2013: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-011,059
Total number of active participants reported on line 7a of the Form 55002013-01-01597
Number of retired or separated participants receiving benefits2013-01-0111
Number of other retired or separated participants entitled to future benefits2013-01-01503
Total of all active and inactive participants2013-01-011,111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-015
Total participants2013-01-011,116
Number of participants with account balances2013-01-011,036
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-0112
2012: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-011,041
Total number of active participants reported on line 7a of the Form 55002012-01-01581
Number of retired or separated participants receiving benefits2012-01-017
Number of other retired or separated participants entitled to future benefits2012-01-01466
Total of all active and inactive participants2012-01-011,054
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-015
Total participants2012-01-011,059
Number of participants with account balances2012-01-011,023
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-0141
2011: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-011,007
Total number of active participants reported on line 7a of the Form 55002011-01-01570
Number of retired or separated participants receiving benefits2011-01-017
Number of other retired or separated participants entitled to future benefits2011-01-01460
Total of all active and inactive participants2011-01-011,037
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-013
Total participants2011-01-011,040
Number of participants with account balances2011-01-011,023
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-0149
2010: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-011,025
Total number of active participants reported on line 7a of the Form 55002010-01-01595
Number of retired or separated participants receiving benefits2010-01-015
Number of other retired or separated participants entitled to future benefits2010-01-01404
Total of all active and inactive participants2010-01-011,004
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-013
Total participants2010-01-011,007
Number of participants with account balances2010-01-011,007
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-0149
2009: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-011,005
Total number of active participants reported on line 7a of the Form 55002009-01-01571
Number of retired or separated participants receiving benefits2009-01-013
Number of other retired or separated participants entitled to future benefits2009-01-01448
Total of all active and inactive participants2009-01-011,022
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-013
Total participants2009-01-011,025
Number of participants with account balances2009-01-011,025
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-0111

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 incurred2017-12-31$3,931,048
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$3,744,351
Expenses. Certain deemed distributions of participant loans2017-12-31$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 year2017-12-31$18,787,817
Value of total assets at beginning of year2017-12-31$19,729,352
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$137,958
Total interest from all sources2017-12-31$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 year2017-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2017-12-31$190,467
Administrative expenses professional fees incurred2017-12-31$7,000
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$500,000
If this is an individual account plan, was there a blackout period2017-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$588,123
Participant contributions at end of year2017-12-31$493,596
Participant contributions at beginning of year2017-12-31$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 year2017-12-31$911
Administrative expenses (other) incurred2017-12-31$130,958
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$-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)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$13,914,125
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$14,196,994
Interest on participant loans2017-12-31$15,669
Interest earned on other investments2017-12-31$59,637
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-12-31$4,380,096
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-12-31$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 assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$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 2520.101-32017-12-31No
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31CLARUS PARTNERS, LLC
Accountancy firm EIN2017-12-31261347383
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 incurred2016-12-31$2,969,775
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$2,832,342
Expenses. Certain deemed distributions of participant loans2016-12-31$81
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$676,422
Value of total assets at end of year2016-12-31$19,729,352
Value of total assets at beginning of year2016-12-31$20,840,296
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$137,352
Total interest from all sources2016-12-31$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 year2016-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2016-12-31$203,161
Administrative expenses professional fees incurred2016-12-31$7,000
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$500,000
If this is an individual account plan, was there a blackout period2016-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$642,776
Participant contributions at end of year2016-12-31$541,146
Participant contributions at beginning of year2016-12-31$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 year2016-12-31$911
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-12-31$893
Administrative expenses (other) incurred2016-12-31$130,352
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$-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)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-31$14,196,994
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$14,596,108
Interest on participant loans2016-12-31$18,360
Interest earned on other investments2016-12-31$8,078
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-12-31$4,990,301
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-12-31$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 assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$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 2520.101-32016-12-31No
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31CLARUS PARTNERS, LLC
Accountancy firm EIN2016-12-31261347383
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 incurred2015-12-31$4,294,053
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$4,103,916
Expenses. Certain deemed distributions of participant loans2015-12-31$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 year2015-12-31$20,840,296
Value of total assets at beginning of year2015-12-31$23,718,665
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$148,631
Total interest from all sources2015-12-31$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 year2015-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2015-12-31$181,062
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$500,000
If this is an individual account plan, was there a blackout period2015-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$817,163
Participant contributions at end of year2015-12-31$600,631
Participant contributions at beginning of year2015-12-31$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 year2015-12-31$893
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-12-31$875
Administrative expenses (other) incurred2015-12-31$148,631
Total non interest bearing cash at beginning of year2015-12-31$26,849
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$-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)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$14,596,108
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$16,430,260
Interest on participant loans2015-12-31$23,070
Interest earned on other investments2015-12-31$10,828
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-12-31$5,642,664
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-12-31$6,500,933
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$-13,811
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$327,059
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$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 2520.101-32015-12-31No
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31CLARUS PARTNERS, LLC
Accountancy firm EIN2015-12-31261347383
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 incurred2014-12-31$3,176,124
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$3,018,421
Expenses. Certain deemed distributions of participant loans2014-12-31$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 year2014-12-31$23,718,665
Value of total assets at beginning of year2014-12-31$24,264,212
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$151,414
Total interest from all sources2014-12-31$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 year2014-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2014-12-31$265,521
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$500,000
If this is an individual account plan, was there a blackout period2014-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$946,473
Participant contributions at end of year2014-12-31$759,748
Participant contributions at beginning of year2014-12-31$834,408
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-12-31$875
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-12-31$941
Administrative expenses (other) incurred2014-12-31$151,414
Total non interest bearing cash at end of year2014-12-31$26,849
Total non interest bearing cash at beginning of year2014-12-31$6,327
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$-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)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$16,430,260
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$15,939,217
Value of interest in pooled separate accounts at beginning of year2014-12-31$7,201,621
Interest on participant loans2014-12-31$26,600
Interest earned on other investments2014-12-31$10,629
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-12-31$6,500,933
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-12-31$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 accounts2014-12-31$60,850
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$443,845
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$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 2520.101-32014-12-31No
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31CLARUS PARTNERS, LLC
Accountancy firm EIN2014-12-31261347383
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 incurred2013-12-31$1,935,121
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$1,858,983
Expenses. Certain deemed distributions of participant loans2013-12-31$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 year2013-12-31$24,264,212
Value of total assets at beginning of year2013-12-31$21,656,539
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$74,305
Total interest from all sources2013-12-31$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 year2013-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2013-12-31$315,982
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$500,000
If this is an individual account plan, was there a blackout period2013-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$994,523
Participant contributions at end of year2013-12-31$834,408
Participant contributions at beginning of year2013-12-31$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 year2013-12-31$941
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-12-31$770
Administrative expenses (other) incurred2013-12-31$74,305
Total non interest bearing cash at end of year2013-12-31$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 appraiser2013-12-31No
Value of net income/loss2013-12-31$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)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-12-31$15,939,217
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$13,532,505
Value of interest in pooled separate accounts at end of year2013-12-31$7,201,621
Value of interest in pooled separate accounts at beginning of year2013-12-31$6,946,152
Interest on participant loans2013-12-31$29,891
Interest earned on other investments2013-12-31$10,541
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-12-31$281,698
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-12-31$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 accounts2013-12-31$103,533
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$436,705
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$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 2520.101-32013-12-31No
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31Yes
Opinion of an independent qualified public accountant for this plan2013-12-31Disclaimer
Accountancy firm name2013-12-31CLARUS PARTNERS, LLC
Accountancy firm EIN2013-12-31261347383
2012 : FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2012 401k financial data
Total transfer of assets to this plan2012-12-31$29,206
Total income from all sources (including contributions)2012-12-31$3,188,280
Total of all expenses incurred2012-12-31$2,136,715
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$2,106,676
Expenses. Certain deemed distributions of participant loans2012-12-31$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 year2012-12-31$21,656,539
Value of total assets at beginning of year2012-12-31$20,575,768
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$3,747
Total interest from all sources2012-12-31$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 year2012-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2012-12-31$238,161
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$500,000
If this is an individual account plan, was there a blackout period2012-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$944,482
Participant contributions at end of year2012-12-31$899,137
Participant contributions at beginning of year2012-12-31$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 year2012-12-31$770
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-12-31$1,805
Administrative expenses (other) incurred2012-12-31$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 appraiser2012-12-31No
Value of net income/loss2012-12-31$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)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-12-31$13,532,505
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$11,698,352
Value of interest in pooled separate accounts at end of year2012-12-31$6,946,152
Value of interest in pooled separate accounts at beginning of year2012-12-31$7,484,991
Interest on participant loans2012-12-31$33,153
Interest earned on other investments2012-12-31$12,080
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-12-31$277,975
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-12-31$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 accounts2012-12-31$107,512
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$440,955
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$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 2520.101-32012-12-31No
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31Yes
Opinion of an independent qualified public accountant for this plan2012-12-31Disclaimer
Accountancy firm name2012-12-31CLARUS PARTNERS, LLC
Accountancy firm EIN2012-12-31261347383
2011 : FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2011 401k financial data
Total transfer of assets to this plan2011-12-31$4,165
Total transfer of assets from this plan2011-12-31$4,165
Total income from all sources (including contributions)2011-12-31$1,650,220
Total of all expenses incurred2011-12-31$2,198,482
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$2,192,035
Expenses. Certain deemed distributions of participant loans2011-12-31$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 year2011-12-31$20,575,768
Value of total assets at beginning of year2011-12-31$21,124,030
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$5,073
Total interest from all sources2011-12-31$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 year2011-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2011-12-31$159,976
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$500,000
If this is an individual account plan, was there a blackout period2011-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$985,549
Participant contributions at end of year2011-12-31$1,011,405
Participant contributions at beginning of year2011-12-31$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 year2011-12-31$1,805
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-12-31$1,649
Administrative expenses (other) incurred2011-12-31$72
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-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)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Investment advisory and management fees2011-12-31$5,001
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-12-31$11,698,352
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-12-31$12,066,402
Value of interest in pooled separate accounts at end of year2011-12-31$7,484,991
Value of interest in pooled separate accounts at beginning of year2011-12-31$7,712,326
Interest on participant loans2011-12-31$36,852
Interest earned on other investments2011-12-31$14,945
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-12-31$379,215
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-12-31$367,793
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-12-31$-354,566
Net investment gain/loss from pooled separate accounts2011-12-31$114,795
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$692,060
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$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 2520.101-32011-12-31No
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31CLARUS PARTNERS, LLC
Accountancy firm EIN2011-12-31261347383
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 incurred2010-12-31$2,227,401
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$2,122,422
Expenses. Certain deemed distributions of participant loans2010-12-31$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 year2010-12-31$21,124,030
Value of total assets at beginning of year2010-12-31$19,293,505
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$16,975
Total interest from all sources2010-12-31$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 year2010-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2010-12-31$157,507
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$500,000
If this is an individual account plan, was there a blackout period2010-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$1,104,903
Participant contributions at end of year2010-12-31$975,860
Participant contributions at beginning of year2010-12-31$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 year2010-12-31$1,649
Administrative expenses (other) incurred2010-12-31$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 appraiser2010-12-31No
Value of net income/loss2010-12-31$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)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2010-12-31$12,066,402
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$10,342,680
Value of interest in pooled separate accounts at end of year2010-12-31$7,712,326
Value of interest in pooled separate accounts at beginning of year2010-12-31$7,578,895
Interest on participant loans2010-12-31$50,291
Interest earned on other investments2010-12-31$15,592
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$367,793
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$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 accounts2010-12-31$579,213
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$921,507
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$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 2520.101-32010-12-31No
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31BKD, LLP
Accountancy firm EIN2010-12-31440160260
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 securities2009-12-31$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
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2010: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes
2009: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. RETIREMENT SAVINGS PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedYes
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )
Policy contract numberTT069161
Policy instance 4
Insurance contract or identification numberTT069161
Number of Individuals Covered889
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
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 number85806-01
Policy instance 3
Insurance contract or identification number85806-01
Number of Individuals Covered2
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
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 numberTT069161
Policy instance 2
Insurance contract or identification numberTT069161
Number of Individuals Covered889
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $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 BrokerUSD $301
Insurance broker organization code?3
Insurance broker nameUBS FINANCIAL SERVICES
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number1005034-01
Policy instance 1
Insurance contract or identification number1005034-01
Number of Individuals Covered15
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
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 numberTT069161
Policy instance 4
Insurance contract or identification numberTT069161
Number of Individuals Covered945
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
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 number85806-01
Policy instance 3
Insurance contract or identification number85806-01
Number of Individuals Covered3
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
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 numberTT069161
Policy instance 2
Insurance contract or identification numberTT069161
Number of Individuals Covered945
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $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 BrokerUSD $192
Insurance broker organization code?3
Insurance broker nameUBS FINANCIAL SERVICES
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number1005034-01
Policy instance 1
Insurance contract or identification number1005034-01
Number of Individuals Covered23
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
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 number85806-01
Policy instance 3
Insurance contract or identification number85806-01
Number of Individuals Covered3
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
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 numberTT069161
Policy instance 4
Insurance contract or identification numberTT069161
Number of Individuals Covered1001
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
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 numberTT069161
Policy instance 2
Insurance contract or identification numberTT069161
Number of Individuals Covered1001
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $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 BrokerUSD $12,615
Insurance broker organization code?3
Insurance broker nameUBS FINANCIAL SERVICES
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number1005034-01
Policy instance 1
Insurance contract or identification number1005034-01
Number of Individuals Covered23
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
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 number85806-01
Policy instance 3
Insurance contract or identification number85806-01
Number of Individuals Covered3
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
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 numberTT069161
Policy instance 2
Insurance contract or identification numberTT069161
Number of Individuals Covered1029
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $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 BrokerUSD $17,455
Insurance broker organization code?3
Insurance broker nameUBS FINANCIAL SERVICES
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number1005034-01
Policy instance 1
Insurance contract or identification number1005034-01
Number of Individuals Covered25
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
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 numberTT069161
Policy instance 2
Insurance contract or identification numberTT069161
Number of Individuals Covered1014
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $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 BrokerUSD $18,318
Insurance broker organization code?3
Insurance broker nameUBS FINANCIAL SERVICES
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number85806-01
Policy instance 3
Insurance contract or identification number85806-01
Number of Individuals Covered3
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
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 number1005034-01
Policy instance 1
Insurance contract or identification number1005034-01
Number of Individuals Covered25
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
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 number1005034-01
Policy instance 1
Insurance contract or identification number1005034-01
Number of Individuals Covered27
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
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 numberTT069161
Policy instance 2
Insurance contract or identification numberTT069161
Number of Individuals Covered1023
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $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 number85806-01
Policy instance 3
Insurance contract or identification number85806-01
Number of Individuals Covered4
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
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 numberTT069161
Policy instance 2
Insurance contract or identification numberTT069161
Number of Individuals Covered1007
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $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 number1005034-01
Policy instance 1
Insurance contract or identification number1005034-01
Number of Individuals Covered35
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
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 number85806-01
Policy instance 3
Insurance contract or identification number85806-01
Number of Individuals Covered4
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
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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