401k Plan data: MARGARET MARY HEALTH SAVINGS PLAN plan

MARGARET MARY HEALTH SAVINGS PLAN 401k Plan overview

Plan Name	MARGARET MARY HEALTH SAVINGS PLAN
Plan identification number	004

MARGARET MARY HEALTH SAVINGS PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Offset plan - Plan benefits are subject to offset for retirement benefits provided in another plan or arrangement of the employer.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

MARGARET MARY COMMUNITY HOSPITAL has sponsored the creation of one or more 401k plans.

Company Name: MARGARET MARY COMMUNITY HOSPITAL

Employer identification number (EIN): 356067049

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MARGARET MARY HEALTH SAVINGS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
004 2022-01-01
004 2021-01-01
004 2020-01-01
004 2019-01-01
004 2018-01-01
004 2017-01-01 KIM INSCHO KIM INSCHO 2018-10-15
004 2017-01-01 KIM INSCHO KIM INSCHO 2018-10-15
004 2016-01-01 KIMBERLY INSCHO KIMBERLY INSCHO 2018-03-21

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
004	2022-01-01
004	2021-01-01
004	2020-01-01
004	2019-01-01
004	2018-01-01
004	2017-01-01	KIM INSCHO	KIM INSCHO	2018-10-15
004	2017-01-01	KIM INSCHO	KIM INSCHO	2018-10-15
004	2016-01-01	KIMBERLY INSCHO	KIMBERLY INSCHO	2018-03-21

Plan Statistics for MARGARET MARY HEALTH SAVINGS PLAN

401k plan membership statisitcs for MARGARET MARY HEALTH SAVINGS PLAN

Measure Date Value
2022: MARGARET MARY HEALTH SAVINGS PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 1,030
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 765
Number of retired or separated participants receiving benefits 2022-01-01 5
Number of other retired or separated participants entitled to future benefits 2022-01-01 193
Total of all active and inactive participants 2022-01-01 963
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 963
Number of participants with account balances 2022-01-01 808
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 4
2021: MARGARET MARY HEALTH SAVINGS PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 996
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 799
Number of retired or separated participants receiving benefits 2021-01-01 5
Number of other retired or separated participants entitled to future benefits 2021-01-01 219
Total of all active and inactive participants 2021-01-01 1,023
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 1,023
Number of participants with account balances 2021-01-01 795
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 12
2020: MARGARET MARY HEALTH SAVINGS PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 969
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 808
Number of retired or separated participants receiving benefits 2020-01-01 5
Number of other retired or separated participants entitled to future benefits 2020-01-01 174
Total of all active and inactive participants 2020-01-01 987
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 987
Number of participants with account balances 2020-01-01 768
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 2
2019: MARGARET MARY HEALTH SAVINGS PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 912
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 825
Number of retired or separated participants receiving benefits 2019-01-01 11
Number of other retired or separated participants entitled to future benefits 2019-01-01 133
Total of all active and inactive participants 2019-01-01 969
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 969
Number of participants with account balances 2019-01-01 475
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: MARGARET MARY HEALTH SAVINGS PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 971
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 803
Number of retired or separated participants receiving benefits 2018-01-01 3
Number of other retired or separated participants entitled to future benefits 2018-01-01 106
Total of all active and inactive participants 2018-01-01 912
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 912
Number of participants with account balances 2018-01-01 703
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 9
2017: MARGARET MARY HEALTH SAVINGS PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 811
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 855
Number of retired or separated participants receiving benefits 2017-01-01 1
Number of other retired or separated participants entitled to future benefits 2017-01-01 115
Total of all active and inactive participants 2017-01-01 971
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 971
Number of participants with account balances 2017-01-01 650
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: MARGARET MARY HEALTH SAVINGS PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 680
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 737
Number of retired or separated participants receiving benefits 2016-01-01 3
Number of other retired or separated participants entitled to future benefits 2016-01-01 71
Total of all active and inactive participants 2016-01-01 811
Total participants 2016-01-01 811
Number of participants with account balances 2016-01-01 542
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 9

Measure	Date	Value
2022: MARGARET MARY HEALTH SAVINGS PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	1,030
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	765
Number of retired or separated participants receiving benefits	2022-01-01	5
Number of other retired or separated participants entitled to future benefits	2022-01-01	193
Total of all active and inactive participants	2022-01-01	963
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	963
Number of participants with account balances	2022-01-01	808
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	4
2021: MARGARET MARY HEALTH SAVINGS PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	996
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	799
Number of retired or separated participants receiving benefits	2021-01-01	5
Number of other retired or separated participants entitled to future benefits	2021-01-01	219
Total of all active and inactive participants	2021-01-01	1,023
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	1,023
Number of participants with account balances	2021-01-01	795
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	12
2020: MARGARET MARY HEALTH SAVINGS PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	969
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	808
Number of retired or separated participants receiving benefits	2020-01-01	5
Number of other retired or separated participants entitled to future benefits	2020-01-01	174
Total of all active and inactive participants	2020-01-01	987
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	987
Number of participants with account balances	2020-01-01	768
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	2
2019: MARGARET MARY HEALTH SAVINGS PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	912
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	825
Number of retired or separated participants receiving benefits	2019-01-01	11
Number of other retired or separated participants entitled to future benefits	2019-01-01	133
Total of all active and inactive participants	2019-01-01	969
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	969
Number of participants with account balances	2019-01-01	475
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: MARGARET MARY HEALTH SAVINGS PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	971
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	803
Number of retired or separated participants receiving benefits	2018-01-01	3
Number of other retired or separated participants entitled to future benefits	2018-01-01	106
Total of all active and inactive participants	2018-01-01	912
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	912
Number of participants with account balances	2018-01-01	703
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	9
2017: MARGARET MARY HEALTH SAVINGS PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	811
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	855
Number of retired or separated participants receiving benefits	2017-01-01	1
Number of other retired or separated participants entitled to future benefits	2017-01-01	115
Total of all active and inactive participants	2017-01-01	971
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	971
Number of participants with account balances	2017-01-01	650
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: MARGARET MARY HEALTH SAVINGS PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	680
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	737
Number of retired or separated participants receiving benefits	2016-01-01	3
Number of other retired or separated participants entitled to future benefits	2016-01-01	71
Total of all active and inactive participants	2016-01-01	811
Total participants	2016-01-01	811
Number of participants with account balances	2016-01-01	542
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	9

Financial Data on MARGARET MARY HEALTH SAVINGS PLAN

Measure	Date	Value
2022 : MARGARET MARY HEALTH SAVINGS PLAN 2022 401k financial data
Total income from all sources (including contributions)	2022-12-31	$-1,251,415
Total of all expenses incurred	2022-12-31	$2,254,370
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$2,213,578
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$3,595,544
Value of total assets at end of year	2022-12-31	$33,613,732
Value of total assets at beginning of year	2022-12-31	$37,119,517
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$40,792
Total interest from all sources	2022-12-31	$1,750,425
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Administrative expenses professional fees incurred	2022-12-31	$21,870
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$500,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$2,686,058
Participant contributions at end of year	2022-12-31	$0
Participant contributions at beginning of year	2022-12-31	$6,455
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$411,527
Value of other receiveables (less allowance for doubtful accounts) at end of year	2022-12-31	$40,518
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2022-12-31	$0
Administrative expenses (other) incurred	2022-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$-3,505,785
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$33,613,732
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$37,119,517
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Investment advisory and management fees	2022-12-31	$18,922
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$25,001,387
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$29,589,490
Interest earned on other investments	2022-12-31	$1,750,425
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$8,093,066
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$7,055,847
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-4,552,375
Net investment gain/loss from pooled separate accounts	2022-12-31	$-2,045,009
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$497,959
Employer contributions (assets) at end of year	2022-12-31	$478,761
Employer contributions (assets) at beginning of year	2022-12-31	$467,725
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$2,213,578
Did the plan have assets held for investment	2022-12-31	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	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	BLUE & CO
Accountancy firm EIN	2022-12-31	351178661
2021 : MARGARET MARY HEALTH SAVINGS PLAN 2021 401k financial data
Total income from all sources (including contributions)	2021-12-31	$7,108,757
Total of all expenses incurred	2021-12-31	$3,139,348
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$3,093,694
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$3,469,968
Value of total assets at end of year	2021-12-31	$37,119,517
Value of total assets at beginning of year	2021-12-31	$33,150,108
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$45,654
Total interest from all sources	2021-12-31	$223,371
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Administrative expenses professional fees incurred	2021-12-31	$17,790
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$2,443,946
Participant contributions at end of year	2021-12-31	$6,455
Participant contributions at beginning of year	2021-12-31	$3,210
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$540,974
Value of other receiveables (less allowance for doubtful accounts) at end of year	2021-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2021-12-31	$8,320
Administrative expenses (other) incurred	2021-12-31	$21,809
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$3,969,409
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$37,119,517
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$33,150,108
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$29,589,490
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$24,855,550
Interest earned on other investments	2021-12-31	$223,371
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$7,055,847
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$7,830,085
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$132,941
Net investment gain/loss from pooled separate accounts	2021-12-31	$3,282,477
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$485,048
Employer contributions (assets) at end of year	2021-12-31	$467,725
Employer contributions (assets) at beginning of year	2021-12-31	$452,943
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$3,093,694
Contract administrator fees	2021-12-31	$6,055
Did the plan have assets held for investment	2021-12-31	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	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	BLUE & CO
Accountancy firm EIN	2021-12-31	351178661
2020 : MARGARET MARY HEALTH SAVINGS PLAN 2020 401k financial data
Total income from all sources (including contributions)	2020-12-31	$6,994,277
Total of all expenses incurred	2020-12-31	$3,307,493
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$3,262,772
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$3,453,993
Value of total assets at end of year	2020-12-31	$33,150,108
Value of total assets at beginning of year	2020-12-31	$29,463,324
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$44,721
Total interest from all sources	2020-12-31	$192,981
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Administrative expenses professional fees incurred	2020-12-31	$20,560
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$2,353,740
Participant contributions at end of year	2020-12-31	$3,210
Participant contributions at beginning of year	2020-12-31	$80,020
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$626,158
Value of other receiveables (less allowance for doubtful accounts) at end of year	2020-12-31	$8,320
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2020-12-31	$0
Administrative expenses (other) incurred	2020-12-31	$19,402
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$3,686,784
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$33,150,108
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$29,463,324
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$24,855,550
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$22,944,554
Interest earned on other investments	2020-12-31	$192,981
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$7,830,085
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$5,983,653
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$149,669
Net investment gain/loss from pooled separate accounts	2020-12-31	$3,197,634
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$474,095
Employer contributions (assets) at end of year	2020-12-31	$452,943
Employer contributions (assets) at beginning of year	2020-12-31	$455,097
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$3,262,772
Contract administrator fees	2020-12-31	$4,759
Did the plan have assets held for investment	2020-12-31	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	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	BLUE & CO
Accountancy firm EIN	2020-12-31	351178661
2019 : MARGARET MARY HEALTH SAVINGS PLAN 2019 401k financial data
Total income from all sources (including contributions)	2019-12-31	$7,782,527
Total of all expenses incurred	2019-12-31	$2,568,320
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$2,515,748
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$3,831,392
Value of total assets at end of year	2019-12-31	$29,463,324
Value of total assets at beginning of year	2019-12-31	$24,249,117
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$52,572
Total interest from all sources	2019-12-31	$175,597
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Administrative expenses professional fees incurred	2019-12-31	$23,981
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$2,271,816
Participant contributions at end of year	2019-12-31	$80,020
Participant contributions at beginning of year	2019-12-31	$73,713
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$1,081,993
Administrative expenses (other) incurred	2019-12-31	$22,778
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$5,214,207
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$29,463,324
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$24,249,117
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$22,944,554
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$18,284,346
Interest earned on other investments	2019-12-31	$175,597
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$5,983,653
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$5,453,949
Net investment gain/loss from pooled separate accounts	2019-12-31	$3,536,896
Net gain/loss from 103.12 investment entities	2019-12-31	$238,642
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$477,583
Employer contributions (assets) at end of year	2019-12-31	$455,097
Employer contributions (assets) at beginning of year	2019-12-31	$437,109
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$2,515,748
Contract administrator fees	2019-12-31	$5,813
Did the plan have assets held for investment	2019-12-31	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	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	BLUE & CO
Accountancy firm EIN	2019-12-31	351178661
2018 : MARGARET MARY HEALTH SAVINGS PLAN 2018 401k financial data
Total income from all sources (including contributions)	2018-12-31	$2,180,535
Total of all expenses incurred	2018-12-31	$1,727,681
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$1,707,303
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$3,115,296
Value of total assets at end of year	2018-12-31	$24,249,117
Value of total assets at beginning of year	2018-12-31	$23,796,263
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$20,378
Total interest from all sources	2018-12-31	$160,591
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$500,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$2,195,995
Participant contributions at end of year	2018-12-31	$73,713
Participant contributions at beginning of year	2018-12-31	$77,551
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$475,866
Administrative expenses (other) incurred	2018-12-31	$20,078
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$452,854
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$24,249,117
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$23,796,263
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$18,284,346
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$18,212,569
Interest earned on other investments	2018-12-31	$160,591
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$5,453,949
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$5,130,173
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-1,095,352
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$443,435
Employer contributions (assets) at end of year	2018-12-31	$437,109
Employer contributions (assets) at beginning of year	2018-12-31	$375,970
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$1,707,303
Contract administrator fees	2018-12-31	$300
Did the plan have assets held for investment	2018-12-31	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	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	BLUE & CO
Accountancy firm EIN	2018-12-31	351178661
2017 : MARGARET MARY HEALTH SAVINGS PLAN 2017 401k financial data
Total income from all sources (including contributions)	2017-12-31	$5,168,863
Total of all expenses incurred	2017-12-31	$387,501
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$387,501
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$2,670,568
Value of total assets at end of year	2017-12-31	$23,796,263
Value of total assets at beginning of year	2017-12-31	$19,014,901
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$0
Total interest from all sources	2017-12-31	$150,631
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
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
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$1,932,715
Participant contributions at beginning of year	2017-12-31	$0
Participant contributions at end of year	2017-12-31	$77,551
Participant contributions at beginning of year	2017-12-31	$3,089
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$356,440
Administrative expenses (other) incurred	2017-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$4,781,362
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$23,796,263
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$19,014,901
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
Investment advisory and management fees	2017-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$18,212,569
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$14,172,307
Interest earned on other investments	2017-12-31	$150,631
Assets. Value of investments in 103.12 investment entities at beginning of year	2017-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$5,130,173
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$4,503,131
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$2,347,664
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
Contributions received in cash from employer	2017-12-31	$381,413
Employer contributions (assets) at end of year	2017-12-31	$375,970
Employer contributions (assets) at beginning of year	2017-12-31	$336,374
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$387,501
Contract administrator fees	2017-12-31	$0
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	BLUE & CO
Accountancy firm EIN	2017-12-31	351178661
2016 : MARGARET MARY HEALTH SAVINGS PLAN 2016 401k financial data
Total income from all sources (including contributions)	2016-12-31	$3,683,487
Total of all expenses incurred	2016-12-31	$1,237,458
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$1,234,901
Value of total corrective distributions	2016-12-31	$2,557
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$2,535,794
Value of total assets at end of year	2016-12-31	$19,014,901
Value of total assets at beginning of year	2016-12-31	$16,568,872
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$0
Total interest from all sources	2016-12-31	$137,614
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
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
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$1,822,539
Participant contributions at end of year	2016-12-31	$0
Participant contributions at beginning of year	2016-12-31	$0
Participant contributions at end of year	2016-12-31	$3,089
Participant contributions at beginning of year	2016-12-31	$46,571
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$372,496
Administrative expenses (other) incurred	2016-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$2,446,029
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$19,014,901
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$16,568,872
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
Investment advisory and management fees	2016-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$14,172,307
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$12,416,582
Interest on participant loans	2016-12-31	$0
Interest earned on other investments	2016-12-31	$137,614
Assets. Value of investments in 103.12 investment entities at end of year	2016-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2016-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$4,503,131
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$4,105,719
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$0
Net investment gain/loss from pooled separate accounts	2016-12-31	$1,010,079
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
Contributions received in cash from employer	2016-12-31	$340,759
Employer contributions (assets) at end of year	2016-12-31	$336,374
Employer contributions (assets) at beginning of year	2016-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$1,234,901
Contract administrator fees	2016-12-31	$0
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	BLUE & CO
Accountancy firm EIN	2016-12-31	351178661

Form 5500 Responses for MARGARET MARY HEALTH SAVINGS PLAN

2022: MARGARET MARY HEALTH SAVINGS PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: MARGARET MARY HEALTH SAVINGS PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: MARGARET MARY HEALTH SAVINGS PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: MARGARET MARY HEALTH SAVINGS PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: MARGARET MARY HEALTH SAVINGS PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: MARGARET MARY HEALTH SAVINGS PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
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: MARGARET MARY HEALTH SAVINGS PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	First time form 5500 has been submitted	Yes
2016-01-01	Submission has been amended	Yes
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
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

Insurance Providers Used on plan

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

B01496

Policy instance

Insurance contract or identification number	B01496
Number of Individuals Covered	9
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G73526

Policy instance

Insurance contract or identification number	G73526
Number of Individuals Covered	3
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

716641

Policy instance

Insurance contract or identification number	716641
Number of Individuals Covered	33
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes

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

Policy contract number

GA-752879

Policy instance

Insurance contract or identification number	GA-752879
Number of Individuals Covered	461
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes

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

Policy contract number

GA-752879

Policy instance

Insurance contract or identification number	GA-752879
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $48,495
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $48,495
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

716641

Policy instance

Insurance contract or identification number	716641
Number of Individuals Covered	33
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
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
Insurance broker organization code?	3

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G73526

Policy instance

Insurance contract or identification number	G73526
Number of Individuals Covered	3
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
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

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

B01496

Policy instance

Insurance contract or identification number	B01496
Number of Individuals Covered	9
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
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

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

B01496

Policy instance

Insurance contract or identification number	B01496
Number of Individuals Covered	10
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
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

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G73526

Policy instance

Insurance contract or identification number	G73526
Number of Individuals Covered	3
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
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

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

716641

Policy instance

Insurance contract or identification number	716641
Number of Individuals Covered	40
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
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
Insurance broker organization code?	3

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

Policy contract number

GA-752879

Policy instance

Insurance contract or identification number	GA-752879
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $43,072
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $43,072
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

716641

Policy instance

Insurance contract or identification number	716641
Number of Individuals Covered	44
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Insurance broker organization code?	3

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

Policy contract number

GA-752879

Policy instance

Insurance contract or identification number	GA-752879
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $35,045
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $35,045
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G73526

Policy instance

Insurance contract or identification number	G73526
Number of Individuals Covered	4
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
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

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

B01496

Policy instance

Insurance contract or identification number	B01496
Number of Individuals Covered	11
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
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

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

B01496

Policy instance

Insurance contract or identification number	B01496
Number of Individuals Covered	13
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
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

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

Policy contract number

GA-752879

Policy instance

Insurance contract or identification number	GA-752879
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $31,923
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $31,923
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

716641

Policy instance

Insurance contract or identification number	716641
Number of Individuals Covered	52
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $66
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $33
Insurance broker organization code?	3

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G73526

Policy instance

Insurance contract or identification number	G73526
Number of Individuals Covered	5
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
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

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

B01496

Policy instance

Insurance contract or identification number	B01496
Number of Individuals Covered	13
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $334
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	334
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3
Insurance broker name	GARDNER & WHITE

AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )

Policy contract number

G73526

Policy instance

Insurance contract or identification number	G73526
Number of Individuals Covered	5
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $263
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	263
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3
Insurance broker name	GARDNER & WHITE

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

716641

Policy instance

Insurance contract or identification number	716641
Number of Individuals Covered	52
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes

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

Policy contract number

GA-752879

Policy instance

Insurance contract or identification number	GA-752879
Number of Individuals Covered	464
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $34,534
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $34,534
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	NA
Insurance broker organization code?	3
Insurance broker name	THURSTON SPRINGER MILLER HERD TITAK

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Company Name:	MARGARET MARY COMMUNITY HOSPITAL
Employer identification number (EIN):	356067049
NAIC Classification:	622000
NAIC Description:	Hospitals