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HILLS & DALES GENERAL HOSPITAL, INC. TAX DEFERRED RETIREMENT SAVINGS PLAN 401k Plan overview

Plan NameHILLS & DALES GENERAL HOSPITAL, INC. TAX DEFERRED RETIREMENT SAVINGS PLAN
Plan identification number 007

HILLS & DALES GENERAL HOSPITAL, INC. TAX DEFERRED RETIREMENT SAVINGS PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Participant-directed brokerage accounts provided as an investment option under the plan.
  • Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

HILLS & DALES GENERAL HOSPITAL, INC. has sponsored the creation of one or more 401k plans.

Company Name:HILLS & DALES GENERAL HOSPITAL, INC.
Employer identification number (EIN):381619577
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HILLS & DALES GENERAL HOSPITAL, INC. TAX DEFERRED RETIREMENT SAVINGS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0072022-01-01
0072022-01-01
0072021-01-01
0072020-01-01
0072019-01-01
0072018-01-01
0072017-01-01WILLIAM CASTLE WILLIAM CASTLE2018-10-11
0072016-01-01KEN BARANSKI KEN BARANSKI2017-08-21
0072015-01-01KEN BARANSKI KEN BARANSKI2016-09-13
0072014-01-01KENNETH E. BARANSKI KENNETH E. BARANSKI2015-10-02
0072014-01-012015-10-02
0072013-01-01JEAN ANTHONY JEAN ANTHONY2014-07-08
0072012-01-01MICHAEL J. FALATKO MICHAEL J. FALATKO2013-07-23
0072011-01-01MICHAEL J. FALATKO MICHAEL J. FALATKO2012-08-29
0072009-01-01KENNETH BARANSKI

Plan Statistics for HILLS & DALES GENERAL HOSPITAL, INC. TAX DEFERRED RETIREMENT SAVINGS PLAN

401k plan membership statisitcs for HILLS & DALES GENERAL HOSPITAL, INC. TAX DEFERRED RETIREMENT SAVINGS PLAN

Measure Date Value
2022: HILLS & DALES GENERAL HOSPITAL, INC. TAX DEFERRED RETIREMENT SAVINGS PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01464
Total number of active participants reported on line 7a of the Form 55002022-01-01421
Number of retired or separated participants receiving benefits2022-01-011
Number of other retired or separated participants entitled to future benefits2022-01-01104
Total of all active and inactive participants2022-01-01526
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01526
Number of participants with account balances2022-01-01510
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010
2021: HILLS & DALES GENERAL HOSPITAL, INC. TAX DEFERRED RETIREMENT SAVINGS PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01464
Total number of active participants reported on line 7a of the Form 55002021-01-01392
Number of retired or separated participants receiving benefits2021-01-012
Number of other retired or separated participants entitled to future benefits2021-01-0170
Total of all active and inactive participants2021-01-01464
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01464
Number of participants with account balances2021-01-01440
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: HILLS & DALES GENERAL HOSPITAL, INC. TAX DEFERRED RETIREMENT SAVINGS PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01449
Total number of active participants reported on line 7a of the Form 55002020-01-01404
Number of retired or separated participants receiving benefits2020-01-011
Number of other retired or separated participants entitled to future benefits2020-01-0158
Total of all active and inactive participants2020-01-01463
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01463
Number of participants with account balances2020-01-01439
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: HILLS & DALES GENERAL HOSPITAL, INC. TAX DEFERRED RETIREMENT SAVINGS PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01442
Total number of active participants reported on line 7a of the Form 55002019-01-01406
Number of retired or separated participants receiving benefits2019-01-011
Number of other retired or separated participants entitled to future benefits2019-01-0142
Total of all active and inactive participants2019-01-01449
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01449
Number of participants with account balances2019-01-01437
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: HILLS & DALES GENERAL HOSPITAL, INC. TAX DEFERRED RETIREMENT SAVINGS PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01412
Total number of active participants reported on line 7a of the Form 55002018-01-01409
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-0133
Total of all active and inactive participants2018-01-01442
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01442
Number of participants with account balances2018-01-01393
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: HILLS & DALES GENERAL HOSPITAL, INC. TAX DEFERRED RETIREMENT SAVINGS PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01404
Total number of active participants reported on line 7a of the Form 55002017-01-01384
Number of retired or separated participants receiving benefits2017-01-011
Number of other retired or separated participants entitled to future benefits2017-01-0127
Total of all active and inactive participants2017-01-01412
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-01412
Number of participants with account balances2017-01-01375
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: HILLS & DALES GENERAL HOSPITAL, INC. TAX DEFERRED RETIREMENT SAVINGS PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01408
Total number of active participants reported on line 7a of the Form 55002016-01-01357
Number of retired or separated participants receiving benefits2016-01-011
Number of other retired or separated participants entitled to future benefits2016-01-0121
Total of all active and inactive participants2016-01-01379
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-01379
Number of participants with account balances2016-01-01342
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: HILLS & DALES GENERAL HOSPITAL, INC. TAX DEFERRED RETIREMENT SAVINGS PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01401
Total number of active participants reported on line 7a of the Form 55002015-01-01363
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01363
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-01363
Number of participants with account balances2015-01-01333
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: HILLS & DALES GENERAL HOSPITAL, INC. TAX DEFERRED RETIREMENT SAVINGS PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01359
Total number of active participants reported on line 7a of the Form 55002014-01-01273
Number of retired or separated participants receiving benefits2014-01-014
Number of other retired or separated participants entitled to future benefits2014-01-0174
Total of all active and inactive participants2014-01-01351
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-01351
Number of participants with account balances2014-01-01297
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-014
2013: HILLS & DALES GENERAL HOSPITAL, INC. TAX DEFERRED RETIREMENT SAVINGS PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01308
Total number of active participants reported on line 7a of the Form 55002013-01-01314
Number of retired or separated participants receiving benefits2013-01-012
Number of other retired or separated participants entitled to future benefits2013-01-0143
Total of all active and inactive participants2013-01-01359
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-01359
Number of participants with account balances2013-01-01277
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: HILLS & DALES GENERAL HOSPITAL, INC. TAX DEFERRED RETIREMENT SAVINGS PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01210
Total number of active participants reported on line 7a of the Form 55002012-01-01260
Number of retired or separated participants receiving benefits2012-01-012
Number of other retired or separated participants entitled to future benefits2012-01-0146
Total of all active and inactive participants2012-01-01308
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-01308
Number of participants with account balances2012-01-01243
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-011
2011: HILLS & DALES GENERAL HOSPITAL, INC. TAX DEFERRED RETIREMENT SAVINGS PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01294
Total number of active participants reported on line 7a of the Form 55002011-01-01235
Number of retired or separated participants receiving benefits2011-01-0110
Number of other retired or separated participants entitled to future benefits2011-01-0138
Total of all active and inactive participants2011-01-01283
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-01283
Number of participants with account balances2011-01-01210
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-0112
2009: HILLS & DALES GENERAL HOSPITAL, INC. TAX DEFERRED RETIREMENT SAVINGS PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01335
Total number of active participants reported on line 7a of the Form 55002009-01-01233
Number of retired or separated participants receiving benefits2009-01-0118
Number of other retired or separated participants entitled to future benefits2009-01-0161
Total of all active and inactive participants2009-01-01312
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-011
Total participants2009-01-01313
Number of participants with account balances2009-01-01264
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-014

Financial Data on HILLS & DALES GENERAL HOSPITAL, INC. TAX DEFERRED RETIREMENT SAVINGS PLAN

Measure Date Value
2022 : HILLS & DALES GENERAL HOSPITAL, INC. TAX DEFERRED RETIREMENT SAVINGS PLAN 2022 401k financial data
Unrealized appreciation/depreciation of real estate assets2022-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2022-12-31$0
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Expenses. Interest paid2022-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022022-12-31$0
Total income from all sources (including contributions)2022-12-31$-277,243
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$2,210,820
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$2,174,689
Expenses. Certain deemed distributions of participant loans2022-12-31$1,316
Value of total corrective distributions2022-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$2,127,898
Value of total assets at end of year2022-12-31$14,411,799
Value of total assets at beginning of year2022-12-31$16,899,862
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$34,815
Total income from rents2022-12-31$0
Total interest from all sources2022-12-31$23,177
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$902,614
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-12-31$902,614
Assets. Real estate other than employer real property at end of year2022-12-31$0
Assets. Real estate other than employer real property at beginning of year2022-12-31$0
Administrative expenses professional fees incurred2022-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2022-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2022-12-31$0
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$500,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$1,320,406
Participant contributions at end of year2022-12-31$313,718
Participant contributions at beginning of year2022-12-31$311,232
Participant contributions at end of year2022-12-31$0
Participant contributions at beginning of year2022-12-31$0
Assets. Other investments not covered elsewhere at end of year2022-12-31$69,173
Assets. Other investments not covered elsewhere at beginning of year2022-12-31$147,761
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$26,594
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2022-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-12-31$0
Assets. Loans (other than to participants) at end of year2022-12-31$0
Assets. Loans (other than to participants) at beginning of year2022-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-12-31$0
Other income not declared elsewhere2022-12-31$-78,588
Administrative expenses (other) incurred2022-12-31$0
Total non interest bearing cash at end of year2022-12-31$0
Total non interest bearing cash at beginning of year2022-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Income. Non cash contributions2022-12-31$0
Value of net income/loss2022-12-31$-2,488,063
Value of net assets at end of year (total assets less liabilities)2022-12-31$14,411,799
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$16,899,862
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Assets. partnership/joint venture interests at end of year2022-12-31$0
Assets. partnership/joint venture interests at beginning of year2022-12-31$0
Investment advisory and management fees2022-12-31$26,065
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$13,129,374
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$15,186,362
Interest on participant loans2022-12-31$13,286
Income. Interest from loans (other than to participants)2022-12-31$0
Interest earned on other investments2022-12-31$9,891
Income. Interest from US Government securities2022-12-31$0
Income. Interest from corporate debt instruments2022-12-31$0
Value of interest in master investment trust accounts at end of year2022-12-31$0
Value of interest in master investment trust accounts at beginning of year2022-12-31$0
Value of interest in common/collective trusts at end of year2022-12-31$0
Value of interest in common/collective trusts at beginning of year2022-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-12-31$0
Assets. Value of investments in 103.12 investment entities at end of year2022-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2022-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$880,326
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$1,233,899
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$0
Asset value of US Government securities at end of year2022-12-31$0
Asset value of US Government securities at beginning of year2022-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-3,252,344
Net investment gain/loss from pooled separate accounts2022-12-31$0
Net investment gain or loss from common/collective trusts2022-12-31$0
Net gain/loss from 103.12 investment entities2022-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Assets. Invements in employer securities at end of year2022-12-31$0
Assets. Invements in employer securities at beginning of year2022-12-31$0
Assets. Value of employer real property at end of year2022-12-31$0
Assets. Value of employer real property at beginning of year2022-12-31$0
Contributions received in cash from employer2022-12-31$780,898
Employer contributions (assets) at end of year2022-12-31$19,208
Employer contributions (assets) at beginning of year2022-12-31$20,608
Income. Dividends from preferred stock2022-12-31$0
Income. Dividends from common stock2022-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$2,174,689
Asset. Corporate debt instrument preferred debt at end of year2022-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2022-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2022-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2022-12-31$0
Contract administrator fees2022-12-31$8,750
Assets. Corporate common stocks other than exployer securities at end of year2022-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2022-12-31$0
Liabilities. Value of benefit claims payable at end of year2022-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2022-12-31$0
Assets. Value of buildings and other operty used in plan operation at end of year2022-12-31$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2022-12-31$0
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Aggregate proceeds on sale of assets2022-12-31$0
Aggregate carrying amount (costs) on sale of assets2022-12-31$0
Liabilities. Value of acquisition indebtedness at end of year2022-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2022-12-31$0
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31EIDE BAILLY, LLP
Accountancy firm EIN2022-12-31450250958
2021 : HILLS & DALES GENERAL HOSPITAL, INC. TAX DEFERRED RETIREMENT SAVINGS PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total income from all sources (including contributions)2021-12-31$4,052,169
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$1,572,194
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$1,536,449
Expenses. Certain deemed distributions of participant loans2021-12-31$3,941
Value of total corrective distributions2021-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$2,017,284
Value of total assets at end of year2021-12-31$16,899,862
Value of total assets at beginning of year2021-12-31$14,419,887
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$31,804
Total interest from all sources2021-12-31$31,156
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$1,272,075
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2021-12-31$1,272,075
Administrative expenses professional fees incurred2021-12-31$0
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$500,000
If this is an individual account plan, was there a blackout period2021-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$1,221,255
Participant contributions at end of year2021-12-31$311,232
Participant contributions at beginning of year2021-12-31$338,438
Assets. Other investments not covered elsewhere at end of year2021-12-31$147,761
Assets. Other investments not covered elsewhere at beginning of year2021-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$83,502
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2021-12-31$0
Other income not declared elsewhere2021-12-31$-54,886
Administrative expenses (other) incurred2021-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$2,479,975
Value of net assets at end of year (total assets less liabilities)2021-12-31$16,899,862
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$14,419,887
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Investment advisory and management fees2021-12-31$25,946
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$15,186,362
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$12,705,359
Value of interest in pooled separate accounts at end of year2021-12-31$0
Value of interest in pooled separate accounts at beginning of year2021-12-31$0
Interest on participant loans2021-12-31$16,912
Interest earned on other investments2021-12-31$14,244
Value of interest in common/collective trusts at end of year2021-12-31$0
Value of interest in common/collective trusts at beginning of year2021-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$1,233,899
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$1,376,090
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$786,540
Net investment gain/loss from pooled separate accounts2021-12-31$0
Net investment gain or loss from common/collective trusts2021-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Assets. Invements in employer securities at end of year2021-12-31$0
Assets. Invements in employer securities at beginning of year2021-12-31$0
Contributions received in cash from employer2021-12-31$712,527
Employer contributions (assets) at end of year2021-12-31$20,608
Income. Dividends from common stock2021-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$1,536,449
Contract administrator fees2021-12-31$5,858
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31EIDE BAILLY LLP
Accountancy firm EIN2021-12-31450250985
2020 : HILLS & DALES GENERAL HOSPITAL, INC. TAX DEFERRED RETIREMENT SAVINGS PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total income from all sources (including contributions)2020-12-31$3,444,859
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$1,256,441
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$1,217,367
Expenses. Certain deemed distributions of participant loans2020-12-31$10,987
Value of total corrective distributions2020-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$1,844,522
Value of total assets at end of year2020-12-31$14,419,887
Value of total assets at beginning of year2020-12-31$12,231,469
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$28,087
Total interest from all sources2020-12-31$40,082
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$385,416
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2020-12-31$385,416
Administrative expenses professional fees incurred2020-12-31$0
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$1,000,000
If this is an individual account plan, was there a blackout period2020-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$1,094,121
Participant contributions at end of year2020-12-31$338,438
Participant contributions at beginning of year2020-12-31$315,363
Assets. Other investments not covered elsewhere at end of year2020-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2020-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$92,020
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2020-12-31$0
Other income not declared elsewhere2020-12-31$0
Administrative expenses (other) incurred2020-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$2,188,418
Value of net assets at end of year (total assets less liabilities)2020-12-31$14,419,887
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$12,231,469
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Investment advisory and management fees2020-12-31$22,102
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$12,705,359
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$10,703,207
Value of interest in pooled separate accounts at end of year2020-12-31$0
Value of interest in pooled separate accounts at beginning of year2020-12-31$0
Interest on participant loans2020-12-31$17,958
Interest earned on other investments2020-12-31$22,124
Value of interest in common/collective trusts at end of year2020-12-31$0
Value of interest in common/collective trusts at beginning of year2020-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$1,376,090
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$1,212,899
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$1,174,839
Net investment gain/loss from pooled separate accounts2020-12-31$0
Net investment gain or loss from common/collective trusts2020-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Assets. Invements in employer securities at end of year2020-12-31$0
Assets. Invements in employer securities at beginning of year2020-12-31$0
Contributions received in cash from employer2020-12-31$658,381
Income. Dividends from common stock2020-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$1,217,367
Contract administrator fees2020-12-31$5,985
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Disclaimer
Accountancy firm name2020-12-31ANDERSON, TUCKEY, BURNHARDT, & DOR
Accountancy firm EIN2020-12-31382475073
2019 : HILLS & DALES GENERAL HOSPITAL, INC. TAX DEFERRED RETIREMENT SAVINGS PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total income from all sources (including contributions)2019-12-31$3,947,684
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$1,547,651
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$1,516,424
Expenses. Certain deemed distributions of participant loans2019-12-31$3,369
Value of total corrective distributions2019-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$1,858,544
Value of total assets at end of year2019-12-31$12,231,469
Value of total assets at beginning of year2019-12-31$9,831,436
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$27,858
Total interest from all sources2019-12-31$36,509
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$616,956
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$616,956
Administrative expenses professional fees incurred2019-12-31$0
Was this plan covered by a fidelity bond2019-12-31No
If this is an individual account plan, was there a blackout period2019-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Funding deficiency by the employer to the plan for this plan year2019-12-31$0
Minimum employer required contribution for this plan year2019-12-31$0
Amount contributed by the employer to the plan for this plan year2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$1,146,405
Participant contributions at end of year2019-12-31$315,363
Participant contributions at beginning of year2019-12-31$271,838
Assets. Other investments not covered elsewhere at end of year2019-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2019-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$81,394
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2019-12-31$0
Other income not declared elsewhere2019-12-31$0
Administrative expenses (other) incurred2019-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$2,400,033
Value of net assets at end of year (total assets less liabilities)2019-12-31$12,231,469
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$9,831,436
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Investment advisory and management fees2019-12-31$20,951
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$10,703,207
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$8,417,296
Value of interest in pooled separate accounts at end of year2019-12-31$0
Value of interest in pooled separate accounts at beginning of year2019-12-31$0
Interest on participant loans2019-12-31$14,531
Interest earned on other investments2019-12-31$21,978
Value of interest in common/collective trusts at end of year2019-12-31$0
Value of interest in common/collective trusts at beginning of year2019-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$1,212,899
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$1,142,302
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$1,435,675
Net investment gain/loss from pooled separate accounts2019-12-31$0
Net investment gain or loss from common/collective trusts2019-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Assets. Invements in employer securities at end of year2019-12-31$0
Assets. Invements in employer securities at beginning of year2019-12-31$0
Contributions received in cash from employer2019-12-31$630,745
Income. Dividends from common stock2019-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$1,516,424
Contract administrator fees2019-12-31$6,907
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31ANDERSON, TUCKEY, BERNHARDT, & DOR
Accountancy firm EIN2019-12-31382475073
2018 : HILLS & DALES GENERAL HOSPITAL, INC. TAX DEFERRED RETIREMENT SAVINGS PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total income from all sources (including contributions)2018-12-31$1,202,405
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$1,712,708
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$1,670,799
Expenses. Certain deemed distributions of participant loans2018-12-31$14,647
Value of total corrective distributions2018-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$1,730,543
Value of total assets at end of year2018-12-31$9,831,436
Value of total assets at beginning of year2018-12-31$10,341,739
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$27,262
Total interest from all sources2018-12-31$27,883
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$742,546
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2018-12-31$742,546
Administrative expenses professional fees incurred2018-12-31$0
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$500,000
If this is an individual account plan, was there a blackout period2018-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$1,023,905
Participant contributions at end of year2018-12-31$271,838
Participant contributions at beginning of year2018-12-31$264,188
Assets. Other investments not covered elsewhere at end of year2018-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2018-12-31$180,563
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$151,749
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2018-12-31$0
Other income not declared elsewhere2018-12-31$-18,826
Administrative expenses (other) incurred2018-12-31$15
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$-510,303
Value of net assets at end of year (total assets less liabilities)2018-12-31$9,831,436
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$10,341,739
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Investment advisory and management fees2018-12-31$20,071
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$8,417,296
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$8,889,186
Value of interest in pooled separate accounts at end of year2018-12-31$0
Value of interest in pooled separate accounts at beginning of year2018-12-31$0
Interest on participant loans2018-12-31$12,327
Interest earned on other investments2018-12-31$15,556
Value of interest in common/collective trusts at end of year2018-12-31$0
Value of interest in common/collective trusts at beginning of year2018-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$1,142,302
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$1,007,802
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-1,279,741
Net investment gain/loss from pooled separate accounts2018-12-31$0
Net investment gain or loss from common/collective trusts2018-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Assets. Invements in employer securities at end of year2018-12-31$0
Assets. Invements in employer securities at beginning of year2018-12-31$0
Contributions received in cash from employer2018-12-31$554,889
Income. Dividends from common stock2018-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$1,670,799
Contract administrator fees2018-12-31$7,176
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31ANDERSON, TUCKEY, BERNHARDT, AND DO
Accountancy firm EIN2018-12-31382475073
2017 : HILLS & DALES GENERAL HOSPITAL, INC. TAX DEFERRED RETIREMENT SAVINGS PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total income from all sources (including contributions)2017-12-31$2,842,144
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$776,749
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$752,323
Expenses. Certain deemed distributions of participant loans2017-12-31$0
Value of total corrective distributions2017-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$1,562,758
Value of total assets at end of year2017-12-31$10,341,739
Value of total assets at beginning of year2017-12-31$8,276,344
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$24,426
Total interest from all sources2017-12-31$26,695
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$370,001
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$370,001
Administrative expenses professional fees incurred2017-12-31$0
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$972,783
Participant contributions at end of year2017-12-31$264,188
Participant contributions at beginning of year2017-12-31$268,993
Assets. Other investments not covered elsewhere at end of year2017-12-31$180,563
Assets. Other investments not covered elsewhere at beginning of year2017-12-31$69,393
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$52,168
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2017-12-31$0
Other income not declared elsewhere2017-12-31$1,409
Administrative expenses (other) incurred2017-12-31$15
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$2,065,395
Value of net assets at end of year (total assets less liabilities)2017-12-31$10,341,739
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$8,276,344
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
Investment advisory and management fees2017-12-31$18,670
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$8,889,186
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$7,064,800
Value of interest in pooled separate accounts at end of year2017-12-31$0
Value of interest in pooled separate accounts at beginning of year2017-12-31$0
Interest on participant loans2017-12-31$12,154
Interest earned on other investments2017-12-31$14,541
Value of interest in common/collective trusts at end of year2017-12-31$0
Value of interest in common/collective trusts at beginning of year2017-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-12-31$1,007,802
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-12-31$873,158
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-12-31$881,281
Net investment gain/loss from pooled separate accounts2017-12-31$0
Net investment gain or loss from common/collective trusts2017-12-31$0
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
Assets. Invements in employer securities at end of year2017-12-31$0
Assets. Invements in employer securities at beginning of year2017-12-31$0
Contributions received in cash from employer2017-12-31$537,807
Income. Dividends from common stock2017-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$752,323
Contract administrator fees2017-12-31$5,741
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)2017-12-31No
Opinion of an independent qualified public accountant for this plan2017-12-31Qualified
Accountancy firm name2017-12-31ANDERSON, TUCKEY, BERNHARDT, & DOR
Accountancy firm EIN2017-12-31382475073
2016 : HILLS & DALES GENERAL HOSPITAL, INC. TAX DEFERRED RETIREMENT SAVINGS PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total income from all sources (including contributions)2016-12-31$1,890,364
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$2,261,493
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$2,231,640
Expenses. Certain deemed distributions of participant loans2016-12-31$5,316
Value of total corrective distributions2016-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$1,395,240
Value of total assets at end of year2016-12-31$8,276,344
Value of total assets at beginning of year2016-12-31$8,647,473
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$24,537
Total interest from all sources2016-12-31$21,971
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$146,505
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$146,505
Administrative expenses professional fees incurred2016-12-31$0
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$852,009
Participant contributions at end of year2016-12-31$268,993
Participant contributions at beginning of year2016-12-31$287,008
Assets. Other investments not covered elsewhere at end of year2016-12-31$69,393
Assets. Other investments not covered elsewhere at beginning of year2016-12-31$35,411
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$67,058
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2016-12-31$0
Other income not declared elsewhere2016-12-31$-3,445
Administrative expenses (other) incurred2016-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$-371,129
Value of net assets at end of year (total assets less liabilities)2016-12-31$8,276,344
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$8,647,473
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
Investment advisory and management fees2016-12-31$17,436
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-31$7,064,800
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$8,277,070
Value of interest in pooled separate accounts at end of year2016-12-31$0
Value of interest in pooled separate accounts at beginning of year2016-12-31$0
Interest on participant loans2016-12-31$12,157
Interest earned on other investments2016-12-31$9,814
Value of interest in common/collective trusts at end of year2016-12-31$0
Value of interest in common/collective trusts at beginning of year2016-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-12-31$873,158
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-12-31$47,984
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-12-31$330,093
Net investment gain/loss from pooled separate accounts2016-12-31$0
Net investment gain or loss from common/collective trusts2016-12-31$0
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
Assets. Invements in employer securities at end of year2016-12-31$0
Assets. Invements in employer securities at beginning of year2016-12-31$0
Contributions received in cash from employer2016-12-31$476,173
Income. Dividends from common stock2016-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$2,231,640
Contract administrator fees2016-12-31$7,101
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 name2016-12-31ANDERSON, TUCKEY, BERNHARDT, & DOR
Accountancy firm EIN2016-12-31382475073
2015 : HILLS & DALES GENERAL HOSPITAL, INC. TAX DEFERRED RETIREMENT SAVINGS PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total income from all sources (including contributions)2015-12-31$1,337,391
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$1,095,895
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$1,075,689
Expenses. Certain deemed distributions of participant loans2015-12-31$0
Value of total corrective distributions2015-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$1,187,395
Value of total assets at end of year2015-12-31$8,647,473
Value of total assets at beginning of year2015-12-31$8,405,977
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$20,206
Total interest from all sources2015-12-31$11,798
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$319,440
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$319,440
Administrative expenses professional fees incurred2015-12-31$0
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$746,086
Participant contributions at end of year2015-12-31$287,008
Participant contributions at beginning of year2015-12-31$272,558
Assets. Other investments not covered elsewhere at end of year2015-12-31$35,411
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$36,257
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2015-12-31$0
Other income not declared elsewhere2015-12-31$-4,366
Administrative expenses (other) incurred2015-12-31$19,876
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$241,496
Value of net assets at end of year (total assets less liabilities)2015-12-31$8,647,473
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$8,405,977
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
Investment advisory and management fees2015-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$8,277,070
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$4,921,061
Interest on participant loans2015-12-31$11,772
Interest earned on other investments2015-12-31$26
Value of interest in common/collective trusts at end of year2015-12-31$0
Value of interest in common/collective trusts at beginning of year2015-12-31$3,208,708
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-12-31$47,984
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$-169,677
Net investment gain or loss from common/collective trusts2015-12-31$-7,199
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31Yes
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
Assets. Invements in employer securities at end of year2015-12-31$0
Assets. Invements in employer securities at beginning of year2015-12-31$0
Contributions received in cash from employer2015-12-31$405,052
Employer contributions (assets) at beginning of year2015-12-31$3,650
Income. Dividends from common stock2015-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$1,075,689
Contract administrator fees2015-12-31$330
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 name2015-12-31ANDERSON, TUCKEY, BERNHARDT, & DOR
Accountancy firm EIN2015-12-31382475073
2014 : HILLS & DALES GENERAL HOSPITAL, INC. TAX DEFERRED RETIREMENT SAVINGS PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total income from all sources (including contributions)2014-12-31$1,685,473
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$1,138,285
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$1,106,374
Expenses. Certain deemed distributions of participant loans2014-12-31$4,679
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$1,128,749
Value of total assets at end of year2014-12-31$8,405,977
Value of total assets at beginning of year2014-12-31$7,858,789
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$27,232
Total interest from all sources2014-12-31$14,969
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$228,000
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$228,000
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
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$744,372
Participant contributions at end of year2014-12-31$272,558
Participant contributions at beginning of year2014-12-31$351,960
Income. Received or receivable in cash from other sources (including rollovers)2014-12-31$2,632
Administrative expenses (other) incurred2014-12-31$27,232
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$547,188
Value of net assets at end of year (total assets less liabilities)2014-12-31$8,405,977
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$7,858,789
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$4,921,061
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$4,645,569
Interest on participant loans2014-12-31$14,969
Value of interest in common/collective trusts at end of year2014-12-31$3,208,708
Value of interest in common/collective trusts at beginning of year2014-12-31$2,855,431
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-12-31$134,315
Net investment gain or loss from common/collective trusts2014-12-31$179,440
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$381,745
Employer contributions (assets) at end of year2014-12-31$3,650
Employer contributions (assets) at beginning of year2014-12-31$5,829
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$1,106,374
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 name2014-12-31ANDERSON, TUCKEY, BERNHARDT & DORAN
Accountancy firm EIN2014-12-31382475073
2013 : HILLS & DALES GENERAL HOSPITAL, INC. TAX DEFERRED RETIREMENT SAVINGS PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total income from all sources (including contributions)2013-12-31$2,248,482
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$593,116
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$568,363
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$1,066,978
Value of total assets at end of year2013-12-31$7,858,789
Value of total assets at beginning of year2013-12-31$6,203,423
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$24,753
Total interest from all sources2013-12-31$14,923
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$150,851
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$150,851
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$1,000,000
If this is an individual account plan, was there a blackout period2013-12-31No
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$675,290
Participant contributions at end of year2013-12-31$351,960
Participant contributions at beginning of year2013-12-31$355,062
Income. Received or receivable in cash from other sources (including rollovers)2013-12-31$63,314
Administrative expenses (other) incurred2013-12-31$4,632
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$1,655,366
Value of net assets at end of year (total assets less liabilities)2013-12-31$7,858,789
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$6,203,423
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
Investment advisory and management fees2013-12-31$20,121
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-12-31$4,645,569
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$3,446,345
Interest on participant loans2013-12-31$14,923
Value of interest in common/collective trusts at end of year2013-12-31$2,855,431
Value of interest in common/collective trusts at beginning of year2013-12-31$2,397,844
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-12-31$710,721
Net investment gain or loss from common/collective trusts2013-12-31$305,009
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$328,374
Employer contributions (assets) at end of year2013-12-31$5,829
Employer contributions (assets) at beginning of year2013-12-31$4,172
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$568,363
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 name2013-12-31ANDERSON, TUCKEY, BERNHARDT & DORAN
Accountancy firm EIN2013-12-31382475073
2012 : HILLS & DALES GENERAL HOSPITAL, INC. TAX DEFERRED RETIREMENT SAVINGS PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total income from all sources (including contributions)2012-12-31$1,532,738
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$323,501
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$299,375
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$903,153
Value of total assets at end of year2012-12-31$6,203,423
Value of total assets at beginning of year2012-12-31$4,994,186
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$24,126
Total interest from all sources2012-12-31$13,786
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$93,861
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$93,861
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 period2012-12-31Yes
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$558,710
Participant contributions at end of year2012-12-31$355,062
Participant contributions at beginning of year2012-12-31$242,471
Income. Received or receivable in cash from other sources (including rollovers)2012-12-31$70,589
Administrative expenses (other) incurred2012-12-31$3,658
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$1,209,237
Value of net assets at end of year (total assets less liabilities)2012-12-31$6,203,423
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$4,994,186
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
Investment advisory and management fees2012-12-31$20,468
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-12-31$3,446,345
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$2,805,483
Interest on participant loans2012-12-31$13,786
Value of interest in common/collective trusts at end of year2012-12-31$2,397,844
Value of interest in common/collective trusts at beginning of year2012-12-31$1,939,852
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-12-31$339,943
Net investment gain or loss from common/collective trusts2012-12-31$181,995
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$273,854
Employer contributions (assets) at end of year2012-12-31$4,172
Employer contributions (assets) at beginning of year2012-12-31$6,380
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$299,375
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32012-12-31Yes
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 name2012-12-31ANDERSON, TUCKEY, BERNHARDT, & DORA
Accountancy firm EIN2012-12-31382475073
2011 : HILLS & DALES GENERAL HOSPITAL, INC. TAX DEFERRED RETIREMENT SAVINGS PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
Total income from all sources (including contributions)2011-12-31$825,780
Total loss/gain on sale of assets2011-12-31$0
Total of all expenses incurred2011-12-31$473,055
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$432,223
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$851,318
Value of total assets at end of year2011-12-31$4,994,186
Value of total assets at beginning of year2011-12-31$4,641,461
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$40,832
Total interest from all sources2011-12-31$9,033
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$68,539
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$68,539
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
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$411,004
Participant contributions at end of year2011-12-31$242,471
Participant contributions at beginning of year2011-12-31$130,760
Income. Received or receivable in cash from other sources (including rollovers)2011-12-31$248,669
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$352,725
Value of net assets at end of year (total assets less liabilities)2011-12-31$4,994,186
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$4,641,461
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$18,145
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-12-31$2,805,483
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-12-31$3,075,311
Interest on participant loans2011-12-31$9,033
Value of interest in common/collective trusts at end of year2011-12-31$1,939,852
Value of interest in common/collective trusts at beginning of year2011-12-31$1,259,172
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-12-31$-73,180
Net investment gain or loss from common/collective trusts2011-12-31$-29,930
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$191,645
Employer contributions (assets) at end of year2011-12-31$6,380
Employer contributions (assets) at beginning of year2011-12-31$176,218
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$432,223
Contract administrator fees2011-12-31$22,687
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 name2011-12-31ANDERSON, TUCKEY, BERNHARDT & DORAN
Accountancy firm EIN2011-12-31382475073
2010 : HILLS & DALES GENERAL HOSPITAL, INC. TAX DEFERRED RETIREMENT SAVINGS PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets2010-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total income from all sources (including contributions)2010-12-31$1,084,554
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$435,534
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$381,038
Expenses. Certain deemed distributions of participant loans2010-12-31$22,489
Value of total corrective distributions2010-12-31$662
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$582,440
Value of total assets at end of year2010-12-31$4,641,461
Value of total assets at beginning of year2010-12-31$3,992,441
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$31,345
Total interest from all sources2010-12-31$10,142
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$54,832
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$54,832
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
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$325,954
Participant contributions at end of year2010-12-31$130,760
Participant contributions at beginning of year2010-12-31$104,890
Income. Received or receivable in cash from other sources (including rollovers)2010-12-31$80,268
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$649,020
Value of net assets at end of year (total assets less liabilities)2010-12-31$4,641,461
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$3,992,441
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
Investment advisory and management fees2010-12-31$14,637
Value of interest in registered invesment companies (eg mutual funds) at end of year2010-12-31$3,075,311
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$2,649,370
Interest on participant loans2010-12-31$10,142
Value of interest in common/collective trusts at end of year2010-12-31$1,259,172
Value of interest in common/collective trusts at beginning of year2010-12-31$1,063,584
Net investment gain/loss from registered investment companies (e.g. mutual funds)2010-12-31$361,447
Net investment gain or loss from common/collective trusts2010-12-31$75,693
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$176,218
Employer contributions (assets) at end of year2010-12-31$176,218
Employer contributions (assets) at beginning of year2010-12-31$174,597
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$381,038
Contract administrator fees2010-12-31$16,708
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 name2010-12-31ANDERSON, TUCKEY, BERNHARDT, & DORA
Accountancy firm EIN2010-12-31382475073

Form 5500 Responses for HILLS & DALES GENERAL HOSPITAL, INC. TAX DEFERRED RETIREMENT SAVINGS PLAN

2022: HILLS & DALES GENERAL HOSPITAL, INC. TAX DEFERRED RETIREMENT SAVINGS PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: HILLS & DALES GENERAL HOSPITAL, INC. TAX DEFERRED RETIREMENT SAVINGS PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: HILLS & DALES GENERAL HOSPITAL, INC. TAX DEFERRED RETIREMENT SAVINGS PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: HILLS & DALES GENERAL HOSPITAL, INC. TAX DEFERRED RETIREMENT SAVINGS PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: HILLS & DALES GENERAL HOSPITAL, INC. TAX DEFERRED RETIREMENT SAVINGS PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: HILLS & DALES GENERAL HOSPITAL, INC. TAX DEFERRED RETIREMENT SAVINGS PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
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: HILLS & DALES GENERAL HOSPITAL, INC. TAX DEFERRED RETIREMENT SAVINGS PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
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: HILLS & DALES GENERAL HOSPITAL, INC. TAX DEFERRED RETIREMENT SAVINGS PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
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: HILLS & DALES GENERAL HOSPITAL, INC. TAX DEFERRED RETIREMENT SAVINGS PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedYes
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement - TrustYes
2013: HILLS & DALES GENERAL HOSPITAL, INC. TAX DEFERRED RETIREMENT SAVINGS PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement - TrustYes
2012: HILLS & DALES GENERAL HOSPITAL, INC. TAX DEFERRED RETIREMENT SAVINGS PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement - TrustYes
2011: HILLS & DALES GENERAL HOSPITAL, INC. TAX DEFERRED RETIREMENT SAVINGS PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement - TrustYes
2009: HILLS & DALES GENERAL HOSPITAL, INC. TAX DEFERRED RETIREMENT SAVINGS PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
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 – TrustYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number780868-01
Policy instance 1
Insurance contract or identification number780868-01
Number of Individuals Covered526
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $2,010
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,006
Insurance broker organization code?3
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberMR 61973
Policy instance 1
Insurance contract or identification numberMR 61973
Number of Individuals Covered464
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $2,285
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,285
Insurance broker organization code?1
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberMR 61973
Policy instance 1
Insurance contract or identification numberMR 61973
Number of Individuals Covered463
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $2,456
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,456
Insurance broker organization code?1
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberMR 61973
Policy instance 1
Insurance contract or identification numberMR 61973
Number of Individuals Covered449
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $2,233
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,701
Insurance broker organization code?1
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberMR 61973
Policy instance 1
Insurance contract or identification numberMR 61973
Number of Individuals Covered442
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $1,922
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,922
Insurance broker organization code?4
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberMR 61973
Policy instance 1
Insurance contract or identification numberMR 61973
Number of Individuals Covered412
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $1,789
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,485
Insurance broker organization code?4
Insurance broker nameWOODBURY FIN SVCS INC
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberMR 61973
Policy instance 1
Insurance contract or identification numberMR 61973
Number of Individuals Covered363
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $2
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2
Insurance broker organization code?1
Insurance broker nameWOODBURY FIN SVCS INC

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