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PHOEBE WORTH MEDICAL CENTER 403(B) PLAN 401k Plan overview

Plan NamePHOEBE WORTH MEDICAL CENTER 403(B) PLAN
Plan identification number 001

PHOEBE WORTH MEDICAL CENTER 403(B) PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.

401k Sponsoring company profile

PHOEBE WORTH MEDICAL CENTER, INC. has sponsored the creation of one or more 401k plans.

Company Name:PHOEBE WORTH MEDICAL CENTER, INC.
Employer identification number (EIN):383647394
NAIC Classification:622000
NAIC Description: Hospitals

Additional information about PHOEBE WORTH MEDICAL CENTER, INC.

Jurisdiction of Incorporation: Georgia Department of States Corporations Division
Incorporation Date: 2002-01-23
Company Identification Number: 116784
Legal Registered Office Address: 807 S ISABELLA ST

SYLVESTER
United States of America (USA)
31791-7554

More information about PHOEBE WORTH MEDICAL CENTER, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PHOEBE WORTH MEDICAL CENTER 403(B) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012023-01-01JENNIFER KRISTI MASSEY2024-10-08
0012022-01-01JENNIFER KRISTI MASSEY2023-09-22
0012021-01-01JENNIFER KRISTI MASSEY2022-10-06
0012020-01-01JILL UPDIKE2021-09-21
0012019-01-01JILL UPDIKE2020-09-15
0012018-01-01WILLIAM PETERSON2019-04-30
0012017-01-01WILLIAM PETERSON2018-06-18
0012016-01-01WILLIAM PETERSON2017-07-27
0012015-01-01WILLIAM PETERSON2016-07-13
0012014-01-01WILLIAM PETERSON2015-07-28
0012013-01-01WILLIAM PETERSON2014-08-04
0012012-01-01WILLIAM PETERSON2013-07-31
0012011-01-01CHRIS FOREMAN2012-05-16 CHRIS FOREMAN2012-05-16
0012010-01-01CHRIS FOREMAN
0012009-01-01CHRIS FOREMAN
0012009-01-01CHRIS FOREMAN
0012009-01-01CHRIS FOREMAN
0012008-01-01CHRIS FOREMAN
0012007-01-01CHRIS FOREMAN
0012006-01-01CHRIS FOREMAN
0012005-01-01CHRIS FOREMAN
0012004-01-01CHRIS FOREMAN
0012003-01-01CHRIS FOREMAN
0012002-05-01CHRIS FOREMAN

Plan Statistics for PHOEBE WORTH MEDICAL CENTER 403(B) PLAN

401k plan membership statisitcs for PHOEBE WORTH MEDICAL CENTER 403(B) PLAN

Measure Date Value
2010: PHOEBE WORTH MEDICAL CENTER 403(B) PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01148
Total number of active participants reported on line 7a of the Form 55002010-01-01148
Total of all active and inactive participants2010-01-01148
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-01148
Number of participants with account balances2010-01-0181
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-010
2009: PHOEBE WORTH MEDICAL CENTER 403(B) PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01146
Total number of active participants reported on line 7a of the Form 55002009-01-01139
Total of all active and inactive participants2009-01-01139
Total participants2009-01-01139
Number of participants with account balances2009-01-0187
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-011

Financial Data on PHOEBE WORTH MEDICAL CENTER 403(B) PLAN

Measure Date Value
2010 : PHOEBE WORTH MEDICAL CENTER 403(B) 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$57,877
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$154,353
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$148,637
Expenses. Certain deemed distributions of participant loans2010-12-31$4,924
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$0
Value of total assets at end of year2010-12-31$595,489
Value of total assets at beginning of year2010-12-31$691,965
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$792
Total interest from all sources2010-12-31$9,864
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Was this plan covered by a fidelity bond2010-12-31No
If this is an individual account plan, was there a blackout period2010-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Participant contributions at end of year2010-12-31$25,947
Participant contributions at beginning of year2010-12-31$38,140
Administrative expenses (other) incurred2010-12-31$165
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$-96,476
Value of net assets at end of year (total assets less liabilities)2010-12-31$595,489
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$691,965
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2010-12-31$315,684
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$364,332
Interest on participant loans2010-12-31$977
Interest earned on other investments2010-12-31$8,887
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$253,858
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$289,493
Net investment gain/loss from registered investment companies (e.g. mutual funds)2010-12-31$48,013
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$148,637
Contract administrator fees2010-12-31$627
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32010-12-31No
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31DRAFFIN & TUCKER
Accountancy firm EIN2010-12-31580914992
2009 : PHOEBE WORTH MEDICAL CENTER 403(B) PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2009-12-31$0

Form 5500 Responses for PHOEBE WORTH MEDICAL CENTER 403(B) PLAN

2010: PHOEBE WORTH MEDICAL CENTER 403(B) PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: PHOEBE WORTH MEDICAL CENTER 403(B) 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 – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes
2008: PHOEBE WORTH MEDICAL CENTER 403(B) PLAN 2008 form 5500 responses
2008-01-01Type of plan entitySingle employer plan
2008-01-01Submission has been amendedNo
2008-01-01This submission is the final filingNo
2008-01-01This return/report is a short plan year return/report (less than 12 months)No
2008-01-01Plan is a collectively bargained planNo
2007: PHOEBE WORTH MEDICAL CENTER 403(B) PLAN 2007 form 5500 responses
2007-01-01Type of plan entitySingle employer plan
2007-01-01Submission has been amendedNo
2007-01-01This submission is the final filingNo
2007-01-01This return/report is a short plan year return/report (less than 12 months)No
2007-01-01Plan is a collectively bargained planNo
2006: PHOEBE WORTH MEDICAL CENTER 403(B) PLAN 2006 form 5500 responses
2006-01-01Type of plan entitySingle employer plan
2006-01-01Submission has been amendedNo
2006-01-01This submission is the final filingNo
2006-01-01This return/report is a short plan year return/report (less than 12 months)No
2006-01-01Plan is a collectively bargained planNo
2005: PHOEBE WORTH MEDICAL CENTER 403(B) PLAN 2005 form 5500 responses
2005-01-01Type of plan entitySingle employer plan
2005-01-01Submission has been amendedNo
2005-01-01This submission is the final filingNo
2005-01-01This return/report is a short plan year return/report (less than 12 months)No
2005-01-01Plan is a collectively bargained planNo
2004: PHOEBE WORTH MEDICAL CENTER 403(B) PLAN 2004 form 5500 responses
2004-01-01Type of plan entitySingle employer plan
2004-01-01Submission has been amendedNo
2004-01-01This submission is the final filingNo
2004-01-01This return/report is a short plan year return/report (less than 12 months)No
2004-01-01Plan is a collectively bargained planNo
2003: PHOEBE WORTH MEDICAL CENTER 403(B) PLAN 2003 form 5500 responses
2003-01-01Type of plan entitySingle employer plan
2003-01-01Submission has been amendedNo
2003-01-01This submission is the final filingNo
2003-01-01This return/report is a short plan year return/report (less than 12 months)No
2003-01-01Plan is a collectively bargained planNo
2002: PHOEBE WORTH MEDICAL CENTER 403(B) PLAN 2002 form 5500 responses
2002-05-01Type of plan entitySingle employer plan
2002-05-01First time form 5500 has been submittedYes
2002-05-01Submission has been amendedNo
2002-05-01This submission is the final filingNo
2002-05-01This return/report is a short plan year return/report (less than 12 months)Yes
2002-05-01Plan is a collectively bargained planNo

Insurance Providers Used on plan

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number64537
Policy instance 1
Insurance contract or identification number64537
Number of Individuals Covered81
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $242
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 Administration1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare 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 $217
Insurance broker organization code?3
Insurance broker nameHUNT, JENNIFER R

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