401k Plan data: CHATHAM HOSPITAL RETIREMENT SAVINGS PLAN plan

CHATHAM HOSPITAL RETIREMENT SAVINGS PLAN 401k Plan overview

Plan Name	CHATHAM HOSPITAL RETIREMENT SAVINGS PLAN
Plan identification number	002

CHATHAM HOSPITAL RETIREMENT SAVINGS PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 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.
Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

CHATHAM HOSPITAL, INC. has sponsored the creation of one or more 401k plans.

Company Name: CHATHAM HOSPITAL, INC.

Employer identification number (EIN): 560611546

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CHATHAM HOSPITAL RETIREMENT SAVINGS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2019-07-01 THOMAS CANTWELL 2020-10-05
002 2018-07-01 ROBERT STRICKLER 2020-04-16
002 2017-07-01 ROBERT ENDERS
002 2016-07-01 ROBERT ENDERS
002 2015-07-01 ROBERT ENDERS
002 2014-07-01 ROBERT ENDERS
002 2013-07-01 ROBERT ENDERS
002 2012-07-01 ROBERT ENDERS
002 2011-07-01 BROCK SIMONDS
002 2009-10-01 BOB BLACKWELL

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
002	2019-07-01	THOMAS CANTWELL	2020-10-05
002	2018-07-01	ROBERT STRICKLER	2020-04-16
002	2017-07-01	ROBERT ENDERS
002	2016-07-01	ROBERT ENDERS
002	2015-07-01	ROBERT ENDERS
002	2014-07-01	ROBERT ENDERS
002	2013-07-01	ROBERT ENDERS
002	2012-07-01	ROBERT ENDERS
002	2011-07-01	BROCK SIMONDS
002	2009-10-01	BOB BLACKWELL

Plan Statistics for CHATHAM HOSPITAL RETIREMENT SAVINGS PLAN

401k plan membership statisitcs for CHATHAM HOSPITAL RETIREMENT SAVINGS PLAN

Measure Date Value
2019: CHATHAM HOSPITAL RETIREMENT SAVINGS PLAN 2019 401k membership
Total participants, beginning-of-year 2019-07-01 229
Total number of active participants reported on line 7a of the Form 5500 2019-07-01 0
Number of retired or separated participants receiving benefits 2019-07-01 0
Number of other retired or separated participants entitled to future benefits 2019-07-01 0
Total of all active and inactive participants 2019-07-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-07-01 0
Total participants 2019-07-01 0
Number of participants with account balances 2019-07-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-07-01 0
2018: CHATHAM HOSPITAL RETIREMENT SAVINGS PLAN 2018 401k membership
Total participants, beginning-of-year 2018-07-01 221
Total number of active participants reported on line 7a of the Form 5500 2018-07-01 199
Number of retired or separated participants receiving benefits 2018-07-01 0
Number of other retired or separated participants entitled to future benefits 2018-07-01 22
Total of all active and inactive participants 2018-07-01 221
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-07-01 0
Total participants 2018-07-01 221
Number of participants with account balances 2018-07-01 109
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-07-01 4
2017: CHATHAM HOSPITAL RETIREMENT SAVINGS PLAN 2017 401k membership
Total participants, beginning-of-year 2017-07-01 228
Total number of active participants reported on line 7a of the Form 5500 2017-07-01 199
Number of retired or separated participants receiving benefits 2017-07-01 0
Number of other retired or separated participants entitled to future benefits 2017-07-01 20
Total of all active and inactive participants 2017-07-01 219
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-07-01 0
Total participants 2017-07-01 219
Number of participants with account balances 2017-07-01 99
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-07-01 3
2016: CHATHAM HOSPITAL RETIREMENT SAVINGS PLAN 2016 401k membership
Total participants, beginning-of-year 2016-07-01 206
Total number of active participants reported on line 7a of the Form 5500 2016-07-01 204
Number of retired or separated participants receiving benefits 2016-07-01 0
Number of other retired or separated participants entitled to future benefits 2016-07-01 24
Total of all active and inactive participants 2016-07-01 228
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-07-01 0
Total participants 2016-07-01 228
Number of participants with account balances 2016-07-01 97
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-07-01 2
2015: CHATHAM HOSPITAL RETIREMENT SAVINGS PLAN 2015 401k membership
Total participants, beginning-of-year 2015-07-01 189
Total number of active participants reported on line 7a of the Form 5500 2015-07-01 180
Number of retired or separated participants receiving benefits 2015-07-01 0
Number of other retired or separated participants entitled to future benefits 2015-07-01 18
Total of all active and inactive participants 2015-07-01 198
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-07-01 0
Total participants 2015-07-01 198
Number of participants with account balances 2015-07-01 93
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-07-01 3
2014: CHATHAM HOSPITAL RETIREMENT SAVINGS PLAN 2014 401k membership
Total participants, beginning-of-year 2014-07-01 207
Total number of active participants reported on line 7a of the Form 5500 2014-07-01 168
Number of retired or separated participants receiving benefits 2014-07-01 0
Number of other retired or separated participants entitled to future benefits 2014-07-01 20
Total of all active and inactive participants 2014-07-01 188
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-07-01 0
Total participants 2014-07-01 188
Number of participants with account balances 2014-07-01 93
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-07-01 4
2013: CHATHAM HOSPITAL RETIREMENT SAVINGS PLAN 2013 401k membership
Total participants, beginning-of-year 2013-07-01 216
Total number of active participants reported on line 7a of the Form 5500 2013-07-01 182
Number of retired or separated participants receiving benefits 2013-07-01 0
Number of other retired or separated participants entitled to future benefits 2013-07-01 28
Total of all active and inactive participants 2013-07-01 210
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-07-01 0
Total participants 2013-07-01 210
Number of participants with account balances 2013-07-01 95
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-07-01 4
2012: CHATHAM HOSPITAL RETIREMENT SAVINGS PLAN 2012 401k membership
Total participants, beginning-of-year 2012-07-01 219
Total number of active participants reported on line 7a of the Form 5500 2012-07-01 174
Number of retired or separated participants receiving benefits 2012-07-01 0
Number of other retired or separated participants entitled to future benefits 2012-07-01 32
Total of all active and inactive participants 2012-07-01 206
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-07-01 0
Total participants 2012-07-01 206
Number of participants with account balances 2012-07-01 100
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-07-01 1
2011: CHATHAM HOSPITAL RETIREMENT SAVINGS PLAN 2011 401k membership
Total participants, beginning-of-year 2011-07-01 230
Total number of active participants reported on line 7a of the Form 5500 2011-07-01 179
Number of retired or separated participants receiving benefits 2011-07-01 0
Number of other retired or separated participants entitled to future benefits 2011-07-01 34
Total of all active and inactive participants 2011-07-01 213
Total participants 2011-07-01 213
Number of participants with account balances 2011-07-01 109
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-07-01 3
2009: CHATHAM HOSPITAL RETIREMENT SAVINGS PLAN 2009 401k membership
Total participants, beginning-of-year 2009-10-01 209
Total number of active participants reported on line 7a of the Form 5500 2009-10-01 196
Number of other retired or separated participants entitled to future benefits 2009-10-01 27
Total of all active and inactive participants 2009-10-01 223
Total participants 2009-10-01 223
Number of participants with account balances 2009-10-01 110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-10-01 2

Measure	Date	Value
2019: CHATHAM HOSPITAL RETIREMENT SAVINGS PLAN 2019 401k membership
Total participants, beginning-of-year	2019-07-01	229
Total number of active participants reported on line 7a of the Form 5500	2019-07-01	0
Number of retired or separated participants receiving benefits	2019-07-01	0
Number of other retired or separated participants entitled to future benefits	2019-07-01	0
Total of all active and inactive participants	2019-07-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-07-01	0
Total participants	2019-07-01	0
Number of participants with account balances	2019-07-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-07-01	0
2018: CHATHAM HOSPITAL RETIREMENT SAVINGS PLAN 2018 401k membership
Total participants, beginning-of-year	2018-07-01	221
Total number of active participants reported on line 7a of the Form 5500	2018-07-01	199
Number of retired or separated participants receiving benefits	2018-07-01	0
Number of other retired or separated participants entitled to future benefits	2018-07-01	22
Total of all active and inactive participants	2018-07-01	221
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-07-01	0
Total participants	2018-07-01	221
Number of participants with account balances	2018-07-01	109
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-07-01	4
2017: CHATHAM HOSPITAL RETIREMENT SAVINGS PLAN 2017 401k membership
Total participants, beginning-of-year	2017-07-01	228
Total number of active participants reported on line 7a of the Form 5500	2017-07-01	199
Number of retired or separated participants receiving benefits	2017-07-01	0
Number of other retired or separated participants entitled to future benefits	2017-07-01	20
Total of all active and inactive participants	2017-07-01	219
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-07-01	0
Total participants	2017-07-01	219
Number of participants with account balances	2017-07-01	99
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-07-01	3
2016: CHATHAM HOSPITAL RETIREMENT SAVINGS PLAN 2016 401k membership
Total participants, beginning-of-year	2016-07-01	206
Total number of active participants reported on line 7a of the Form 5500	2016-07-01	204
Number of retired or separated participants receiving benefits	2016-07-01	0
Number of other retired or separated participants entitled to future benefits	2016-07-01	24
Total of all active and inactive participants	2016-07-01	228
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-07-01	0
Total participants	2016-07-01	228
Number of participants with account balances	2016-07-01	97
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-07-01	2
2015: CHATHAM HOSPITAL RETIREMENT SAVINGS PLAN 2015 401k membership
Total participants, beginning-of-year	2015-07-01	189
Total number of active participants reported on line 7a of the Form 5500	2015-07-01	180
Number of retired or separated participants receiving benefits	2015-07-01	0
Number of other retired or separated participants entitled to future benefits	2015-07-01	18
Total of all active and inactive participants	2015-07-01	198
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-07-01	0
Total participants	2015-07-01	198
Number of participants with account balances	2015-07-01	93
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-07-01	3
2014: CHATHAM HOSPITAL RETIREMENT SAVINGS PLAN 2014 401k membership
Total participants, beginning-of-year	2014-07-01	207
Total number of active participants reported on line 7a of the Form 5500	2014-07-01	168
Number of retired or separated participants receiving benefits	2014-07-01	0
Number of other retired or separated participants entitled to future benefits	2014-07-01	20
Total of all active and inactive participants	2014-07-01	188
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-07-01	0
Total participants	2014-07-01	188
Number of participants with account balances	2014-07-01	93
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-07-01	4
2013: CHATHAM HOSPITAL RETIREMENT SAVINGS PLAN 2013 401k membership
Total participants, beginning-of-year	2013-07-01	216
Total number of active participants reported on line 7a of the Form 5500	2013-07-01	182
Number of retired or separated participants receiving benefits	2013-07-01	0
Number of other retired or separated participants entitled to future benefits	2013-07-01	28
Total of all active and inactive participants	2013-07-01	210
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-07-01	0
Total participants	2013-07-01	210
Number of participants with account balances	2013-07-01	95
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-07-01	4
2012: CHATHAM HOSPITAL RETIREMENT SAVINGS PLAN 2012 401k membership
Total participants, beginning-of-year	2012-07-01	219
Total number of active participants reported on line 7a of the Form 5500	2012-07-01	174
Number of retired or separated participants receiving benefits	2012-07-01	0
Number of other retired or separated participants entitled to future benefits	2012-07-01	32
Total of all active and inactive participants	2012-07-01	206
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-07-01	0
Total participants	2012-07-01	206
Number of participants with account balances	2012-07-01	100
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-07-01	1
2011: CHATHAM HOSPITAL RETIREMENT SAVINGS PLAN 2011 401k membership
Total participants, beginning-of-year	2011-07-01	230
Total number of active participants reported on line 7a of the Form 5500	2011-07-01	179
Number of retired or separated participants receiving benefits	2011-07-01	0
Number of other retired or separated participants entitled to future benefits	2011-07-01	34
Total of all active and inactive participants	2011-07-01	213
Total participants	2011-07-01	213
Number of participants with account balances	2011-07-01	109
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-07-01	3
2009: CHATHAM HOSPITAL RETIREMENT SAVINGS PLAN 2009 401k membership
Total participants, beginning-of-year	2009-10-01	209
Total number of active participants reported on line 7a of the Form 5500	2009-10-01	196
Number of other retired or separated participants entitled to future benefits	2009-10-01	27
Total of all active and inactive participants	2009-10-01	223
Total participants	2009-10-01	223
Number of participants with account balances	2009-10-01	110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-10-01	2

Financial Data on CHATHAM HOSPITAL RETIREMENT SAVINGS PLAN

Measure	Date	Value
2019 : CHATHAM HOSPITAL RETIREMENT SAVINGS PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total transfer of assets from this plan	2019-12-31	$4,548,551
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	$469,467
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$107,205
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$101,969
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$199,299
Value of total assets at end of year	2019-12-31	$0
Value of total assets at beginning of year	2019-12-31	$4,186,289
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$5,236
Total interest from all sources	2019-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2019-12-31	$0
Administrative expenses professional fees incurred	2019-12-31	$5,236
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
If this is an individual account plan, was there a blackout period	2019-12-31	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$146,136
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$202
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$362,262
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$4,186,289
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$3,969,407
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2019-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2019-12-31	$666
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2019-12-31	$666
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$215,422
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$270,168
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$52,961
Employer contributions (assets) at end of year	2019-12-31	$0
Employer contributions (assets) at beginning of year	2019-12-31	$794
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$101,969
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2019-12-31	Yes
Did the plan have assets held for investment	2019-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	BDO USA, LLP
Accountancy firm EIN	2019-12-31	135381590
Total unrealized appreciation/depreciation of assets	2019-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-06-30	$0
Total income from all sources (including contributions)	2019-06-30	$523,588
Total loss/gain on sale of assets	2019-06-30	$0
Total of all expenses incurred	2019-06-30	$332,353
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-06-30	$323,866
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-06-30	$322,568
Value of total assets at end of year	2019-06-30	$4,186,289
Value of total assets at beginning of year	2019-06-30	$3,995,054
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-06-30	$8,487
Total interest from all sources	2019-06-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2019-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-06-30	No
Administrative expenses professional fees incurred	2019-06-30	$8,487
Was this plan covered by a fidelity bond	2019-06-30	Yes
Value of fidelity bond cover	2019-06-30	$500,000
If this is an individual account plan, was there a blackout period	2019-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2019-06-30	No
Contributions received from participants	2019-06-30	$255,814
Income. Received or receivable in cash from other sources (including rollovers)	2019-06-30	$2,018
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-06-30	No
Value of net income/loss	2019-06-30	$191,235
Value of net assets at end of year (total assets less liabilities)	2019-06-30	$4,186,289
Value of net assets at beginning of year (total assets less liabilities)	2019-06-30	$3,995,054
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-06-30	No
Were any leases to which the plan was party in default or uncollectible	2019-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-06-30	$3,969,407
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-06-30	$3,866,811
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2019-06-30	$666
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2019-06-30	$31,774
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2019-06-30	$31,774
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-06-30	$215,422
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-06-30	$96,469
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-06-30	$201,020
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-06-30	No
Was there a failure to transmit to the plan any participant contributions	2019-06-30	No
Has the plan failed to provide any benefit when due under the plan	2019-06-30	No
Contributions received in cash from employer	2019-06-30	$64,736
Employer contributions (assets) at end of year	2019-06-30	$794
Employer contributions (assets) at beginning of year	2019-06-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-06-30	$323,866
Did the plan have assets held for investment	2019-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2019-06-30	Disclaimer
Accountancy firm name	2019-06-30	BDO USA, LLP
Accountancy firm EIN	2019-06-30	135381590
2018 : CHATHAM HOSPITAL RETIREMENT SAVINGS PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-06-30	$0
Total income from all sources (including contributions)	2018-06-30	$654,139
Total loss/gain on sale of assets	2018-06-30	$0
Total of all expenses incurred	2018-06-30	$209,428
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-06-30	$200,870
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-06-30	$373,877
Value of total assets at end of year	2018-06-30	$3,995,054
Value of total assets at beginning of year	2018-06-30	$3,550,343
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-06-30	$8,558
Total interest from all sources	2018-06-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2018-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-06-30	No
Administrative expenses professional fees incurred	2018-06-30	$8,558
Was this plan covered by a fidelity bond	2018-06-30	Yes
Value of fidelity bond cover	2018-06-30	$500,000
If this is an individual account plan, was there a blackout period	2018-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2018-06-30	No
Contributions received from participants	2018-06-30	$290,654
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-06-30	No
Value of net income/loss	2018-06-30	$444,711
Value of net assets at end of year (total assets less liabilities)	2018-06-30	$3,995,054
Value of net assets at beginning of year (total assets less liabilities)	2018-06-30	$3,550,343
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-06-30	No
Were any leases to which the plan was party in default or uncollectible	2018-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-06-30	$3,866,811
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-06-30	$3,447,387
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2018-06-30	$31,774
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2018-06-30	$27,223
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2018-06-30	$27,223
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-06-30	$96,469
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-06-30	$75,733
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-06-30	$280,262
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-06-30	No
Was there a failure to transmit to the plan any participant contributions	2018-06-30	No
Has the plan failed to provide any benefit when due under the plan	2018-06-30	No
Contributions received in cash from employer	2018-06-30	$83,223
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-06-30	$200,870
Did the plan have assets held for investment	2018-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2018-06-30	Disclaimer
Accountancy firm name	2018-06-30	CLIFTONLARSONALLEN LLP
Accountancy firm EIN	2018-06-30	410746749
2017 : CHATHAM HOSPITAL RETIREMENT SAVINGS PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-06-30	$0
Total income from all sources (including contributions)	2017-06-30	$793,241
Total loss/gain on sale of assets	2017-06-30	$0
Total of all expenses incurred	2017-06-30	$311,602
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-06-30	$301,480
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-06-30	$337,094
Value of total assets at end of year	2017-06-30	$3,550,343
Value of total assets at beginning of year	2017-06-30	$3,068,704
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-06-30	$10,122
Total interest from all sources	2017-06-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2017-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-06-30	No
Administrative expenses professional fees incurred	2017-06-30	$10,122
Was this plan covered by a fidelity bond	2017-06-30	Yes
Value of fidelity bond cover	2017-06-30	$500,000
If this is an individual account plan, was there a blackout period	2017-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2017-06-30	No
Contributions received from participants	2017-06-30	$252,739
Income. Received or receivable in cash from other sources (including rollovers)	2017-06-30	$3,090
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-06-30	No
Value of net income/loss	2017-06-30	$481,639
Value of net assets at end of year (total assets less liabilities)	2017-06-30	$3,550,343
Value of net assets at beginning of year (total assets less liabilities)	2017-06-30	$3,068,704
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-06-30	No
Were any leases to which the plan was party in default or uncollectible	2017-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-06-30	$3,447,387
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-06-30	$2,925,950
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2017-06-30	$27,223
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2017-06-30	$36,328
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2017-06-30	$36,328
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-06-30	$75,733
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-06-30	$106,426
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-06-30	$456,147
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-06-30	No
Was there a failure to transmit to the plan any participant contributions	2017-06-30	No
Has the plan failed to provide any benefit when due under the plan	2017-06-30	No
Contributions received in cash from employer	2017-06-30	$81,265
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-06-30	$301,480
Did the plan have assets held for investment	2017-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2017-06-30	Disclaimer
Accountancy firm name	2017-06-30	CLIFTONLARSONALLEN LLP
Accountancy firm EIN	2017-06-30	410746749
2016 : CHATHAM HOSPITAL RETIREMENT SAVINGS PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-06-30	$0
Total income from all sources (including contributions)	2016-06-30	$264,517
Total loss/gain on sale of assets	2016-06-30	$0
Total of all expenses incurred	2016-06-30	$153,704
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-06-30	$141,809
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-06-30	$316,552
Value of total assets at end of year	2016-06-30	$3,068,704
Value of total assets at beginning of year	2016-06-30	$2,957,891
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-06-30	$11,895
Total interest from all sources	2016-06-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2016-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-06-30	No
Administrative expenses professional fees incurred	2016-06-30	$11,895
Was this plan covered by a fidelity bond	2016-06-30	Yes
Value of fidelity bond cover	2016-06-30	$500,000
If this is an individual account plan, was there a blackout period	2016-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2016-06-30	No
Contributions received from participants	2016-06-30	$232,821
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-06-30	No
Value of net income/loss	2016-06-30	$110,813
Value of net assets at end of year (total assets less liabilities)	2016-06-30	$3,068,704
Value of net assets at beginning of year (total assets less liabilities)	2016-06-30	$2,957,891
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-06-30	No
Were any leases to which the plan was party in default or uncollectible	2016-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-06-30	$2,925,950
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-06-30	$2,821,745
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2016-06-30	$36,328
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2016-06-30	$44,726
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2016-06-30	$44,726
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-06-30	$106,426
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-06-30	$91,420
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-06-30	$-52,035
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-06-30	No
Was there a failure to transmit to the plan any participant contributions	2016-06-30	No
Has the plan failed to provide any benefit when due under the plan	2016-06-30	No
Contributions received in cash from employer	2016-06-30	$83,731
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-06-30	$141,809
Did the plan have assets held for investment	2016-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2016-06-30	Disclaimer
Accountancy firm name	2016-06-30	CLIFTONLARSONALLEN LLP
Accountancy firm EIN	2016-06-30	410746749
2015 : CHATHAM HOSPITAL RETIREMENT SAVINGS PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-06-30	$0
Total income from all sources (including contributions)	2015-06-30	$475,808
Total loss/gain on sale of assets	2015-06-30	$0
Total of all expenses incurred	2015-06-30	$294,569
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-06-30	$282,547
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-06-30	$417,644
Value of total assets at end of year	2015-06-30	$2,957,891
Value of total assets at beginning of year	2015-06-30	$2,776,652
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-06-30	$12,022
Total interest from all sources	2015-06-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2015-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-06-30	No
Administrative expenses professional fees incurred	2015-06-30	$12,022
Was this plan covered by a fidelity bond	2015-06-30	Yes
Value of fidelity bond cover	2015-06-30	$500,000
If this is an individual account plan, was there a blackout period	2015-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2015-06-30	No
Contributions received from participants	2015-06-30	$259,786
Participant contributions at end of year	2015-06-30	$0
Participant contributions at beginning of year	2015-06-30	$136
Income. Received or receivable in cash from other sources (including rollovers)	2015-06-30	$80,227
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-06-30	No
Value of net income/loss	2015-06-30	$181,239
Value of net assets at end of year (total assets less liabilities)	2015-06-30	$2,957,891
Value of net assets at beginning of year (total assets less liabilities)	2015-06-30	$2,776,652
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-06-30	No
Were any leases to which the plan was party in default or uncollectible	2015-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-06-30	$2,821,745
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-06-30	$2,610,486
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2015-06-30	$44,726
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2015-06-30	$42,624
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2015-06-30	$42,624
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-06-30	$91,420
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-06-30	$121,802
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-06-30	$58,164
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-06-30	No
Was there a failure to transmit to the plan any participant contributions	2015-06-30	No
Has the plan failed to provide any benefit when due under the plan	2015-06-30	No
Contributions received in cash from employer	2015-06-30	$77,631
Employer contributions (assets) at end of year	2015-06-30	$0
Employer contributions (assets) at beginning of year	2015-06-30	$1,604
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-06-30	$282,547
Did the plan have assets held for investment	2015-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2015-06-30	Disclaimer
Accountancy firm name	2015-06-30	CLIFTONLARSONALLEN LLP
Accountancy firm EIN	2015-06-30	410746749
2014 : CHATHAM HOSPITAL RETIREMENT SAVINGS PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-06-30	$3,152
Total income from all sources (including contributions)	2014-06-30	$757,880
Total loss/gain on sale of assets	2014-06-30	$0
Total of all expenses incurred	2014-06-30	$392,023
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-06-30	$380,154
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-06-30	$310,866
Value of total assets at end of year	2014-06-30	$2,776,652
Value of total assets at beginning of year	2014-06-30	$2,413,947
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-06-30	$11,869
Total interest from all sources	2014-06-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2014-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-06-30	No
Was this plan covered by a fidelity bond	2014-06-30	Yes
Value of fidelity bond cover	2014-06-30	$500,000
If this is an individual account plan, was there a blackout period	2014-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2014-06-30	No
Contributions received from participants	2014-06-30	$212,221
Participant contributions at end of year	2014-06-30	$136
Participant contributions at beginning of year	2014-06-30	$0
Income. Received or receivable in cash from other sources (including rollovers)	2014-06-30	$21,610
Value of other receiveables (less allowance for doubtful accounts) at end of year	2014-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2014-06-30	$6,333
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-06-30	No
Value of net income/loss	2014-06-30	$365,857
Value of net assets at end of year (total assets less liabilities)	2014-06-30	$2,776,652
Value of net assets at beginning of year (total assets less liabilities)	2014-06-30	$2,410,795
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-06-30	No
Were any leases to which the plan was party in default or uncollectible	2014-06-30	No
Investment advisory and management fees	2014-06-30	$11,869
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-06-30	$2,610,486
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-06-30	$2,247,266
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2014-06-30	$42,624
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2014-06-30	$46,406
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2014-06-30	$46,406
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-06-30	$121,802
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-06-30	$104,513
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-06-30	$447,014
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-06-30	No
Was there a failure to transmit to the plan any participant contributions	2014-06-30	No
Has the plan failed to provide any benefit when due under the plan	2014-06-30	No
Contributions received in cash from employer	2014-06-30	$77,035
Employer contributions (assets) at end of year	2014-06-30	$1,604
Employer contributions (assets) at beginning of year	2014-06-30	$9,429
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-06-30	$380,154
Liabilities. Value of benefit claims payable at end of year	2014-06-30	$0
Liabilities. Value of benefit claims payable at beginning of year	2014-06-30	$3,152
Did the plan have assets held for investment	2014-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2014-06-30	Disclaimer
Accountancy firm name	2014-06-30	CLIFTONLARSONALLEN LLP
Accountancy firm EIN	2014-06-30	410746749
2013 : CHATHAM HOSPITAL RETIREMENT SAVINGS PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-06-30	$3,152
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-06-30	$2,784
Total income from all sources (including contributions)	2013-06-30	$603,113
Total loss/gain on sale of assets	2013-06-30	$0
Total of all expenses incurred	2013-06-30	$276,124
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-06-30	$262,120
Value of total corrective distributions	2013-06-30	$4,542
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-06-30	$318,699
Value of total assets at end of year	2013-06-30	$2,413,947
Value of total assets at beginning of year	2013-06-30	$2,086,590
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-06-30	$9,462
Total interest from all sources	2013-06-30	$136
Total dividends received (eg from common stock, registered investment company shares)	2013-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-06-30	No
Was this plan covered by a fidelity bond	2013-06-30	Yes
Value of fidelity bond cover	2013-06-30	$500,000
If this is an individual account plan, was there a blackout period	2013-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2013-06-30	No
Contributions received from participants	2013-06-30	$245,595
Participant contributions at end of year	2013-06-30	$0
Participant contributions at beginning of year	2013-06-30	$8,075
Income. Received or receivable in cash from other sources (including rollovers)	2013-06-30	$518
Value of other receiveables (less allowance for doubtful accounts) at end of year	2013-06-30	$6,333
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2013-06-30	$6,093
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-06-30	No
Value of net income/loss	2013-06-30	$326,989
Value of net assets at end of year (total assets less liabilities)	2013-06-30	$2,410,795
Value of net assets at beginning of year (total assets less liabilities)	2013-06-30	$2,083,806
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-06-30	No
Were any leases to which the plan was party in default or uncollectible	2013-06-30	No
Investment advisory and management fees	2013-06-30	$9,462
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-06-30	$2,247,266
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-06-30	$2,026,596
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2013-06-30	$46,406
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2013-06-30	$42,690
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2013-06-30	$42,690
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2013-06-30	$136
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-06-30	$104,513
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-06-30	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-06-30	$284,278
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-06-30	No
Was there a failure to transmit to the plan any participant contributions	2013-06-30	Yes
Has the plan failed to provide any benefit when due under the plan	2013-06-30	No
Contributions received in cash from employer	2013-06-30	$72,586
Employer contributions (assets) at end of year	2013-06-30	$9,429
Employer contributions (assets) at beginning of year	2013-06-30	$3,136
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-06-30	$262,120
Liabilities. Value of benefit claims payable at end of year	2013-06-30	$3,152
Liabilities. Value of benefit claims payable at beginning of year	2013-06-30	$2,784
Did the plan have assets held for investment	2013-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2013-06-30	Disclaimer
Accountancy firm name	2013-06-30	CLIFTONLARSONALLEN LLP
Accountancy firm EIN	2013-06-30	410746749
2012 : CHATHAM HOSPITAL RETIREMENT SAVINGS PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-06-30	$2,784
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-06-30	$0
Total income from all sources (including contributions)	2012-06-30	$318,452
Total loss/gain on sale of assets	2012-06-30	$0
Total of all expenses incurred	2012-06-30	$338,099
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-06-30	$326,189
Value of total corrective distributions	2012-06-30	$2,784
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-06-30	$352,862
Value of total assets at end of year	2012-06-30	$2,086,590
Value of total assets at beginning of year	2012-06-30	$2,103,453
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-06-30	$9,126
Total interest from all sources	2012-06-30	$2
Total dividends received (eg from common stock, registered investment company shares)	2012-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-06-30	No
Was this plan covered by a fidelity bond	2012-06-30	Yes
Value of fidelity bond cover	2012-06-30	$500,000
If this is an individual account plan, was there a blackout period	2012-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2012-06-30	No
Contributions received from participants	2012-06-30	$252,616
Participant contributions at end of year	2012-06-30	$8,075
Participant contributions at beginning of year	2012-06-30	$9,593
Income. Received or receivable in cash from other sources (including rollovers)	2012-06-30	$14,591
Value of other receiveables (less allowance for doubtful accounts) at end of year	2012-06-30	$6,093
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-06-30	No
Value of net income/loss	2012-06-30	$-19,647
Value of net assets at end of year (total assets less liabilities)	2012-06-30	$2,083,806
Value of net assets at beginning of year (total assets less liabilities)	2012-06-30	$2,103,453
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-06-30	No
Were any leases to which the plan was party in default or uncollectible	2012-06-30	No
Investment advisory and management fees	2012-06-30	$9,126
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-06-30	$2,026,596
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-06-30	$2,053,136
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-06-30	$42,690
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-06-30	$40,098
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-06-30	$40,098
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-06-30	$2
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-06-30	$-34,412
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-06-30	No
Was there a failure to transmit to the plan any participant contributions	2012-06-30	Yes
Has the plan failed to provide any benefit when due under the plan	2012-06-30	No
Contributions received in cash from employer	2012-06-30	$85,655
Employer contributions (assets) at end of year	2012-06-30	$3,136
Employer contributions (assets) at beginning of year	2012-06-30	$626
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-06-30	$326,189
Liabilities. Value of benefit claims payable at end of year	2012-06-30	$2,784
Did the plan have assets held for investment	2012-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2012-06-30	Disclaimer
Accountancy firm name	2012-06-30	CLIFTONLARSONALLEN LLP
Accountancy firm EIN	2012-06-30	410746749
2011 : CHATHAM HOSPITAL RETIREMENT SAVINGS PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-06-30	$0
Total income from all sources (including contributions)	2011-06-30	$719,636
Total loss/gain on sale of assets	2011-06-30	$0
Total of all expenses incurred	2011-06-30	$89,574
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-06-30	$82,259
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-06-30	$378,559
Value of total assets at end of year	2011-06-30	$2,103,453
Value of total assets at beginning of year	2011-06-30	$1,473,391
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-06-30	$7,315
Total interest from all sources	2011-06-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2011-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-06-30	No
Was this plan covered by a fidelity bond	2011-06-30	Yes
Value of fidelity bond cover	2011-06-30	$500,000
If this is an individual account plan, was there a blackout period	2011-06-30	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2011-06-30	No
Contributions received from participants	2011-06-30	$247,798
Participant contributions at end of year	2011-06-30	$9,593
Participant contributions at beginning of year	2011-06-30	$0
Income. Received or receivable in cash from other sources (including rollovers)	2011-06-30	$42,668
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-06-30	No
Value of net income/loss	2011-06-30	$630,062
Value of net assets at end of year (total assets less liabilities)	2011-06-30	$2,103,453
Value of net assets at beginning of year (total assets less liabilities)	2011-06-30	$1,473,391
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-06-30	No
Were any leases to which the plan was party in default or uncollectible	2011-06-30	No
Investment advisory and management fees	2011-06-30	$7,315
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-06-30	$2,053,136
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-06-30	$1,383,613
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-06-30	$40,098
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-06-30	$33,633
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-06-30	$33,633
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-06-30	$341,077
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-06-30	No
Was there a failure to transmit to the plan any participant contributions	2011-06-30	Yes
Has the plan failed to provide any benefit when due under the plan	2011-06-30	No
Contributions received in cash from employer	2011-06-30	$88,093
Employer contributions (assets) at end of year	2011-06-30	$626
Employer contributions (assets) at beginning of year	2011-06-30	$56,145
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-06-30	$82,259
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2011-06-30	Yes
Did the plan have assets held for investment	2011-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2011-06-30	Disclaimer
Accountancy firm name	2011-06-30	CLIFTONLARSONALLEN LLP
Accountancy firm EIN	2011-06-30	410746749
2010 : CHATHAM HOSPITAL RETIREMENT SAVINGS PLAN 2010 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-06-30	$0

Form 5500 Responses for CHATHAM HOSPITAL RETIREMENT SAVINGS PLAN

2019: CHATHAM HOSPITAL RETIREMENT SAVINGS PLAN 2019 form 5500 responses
2019-07-01	Type of plan entity	Single employer plan
2019-07-01	Submission has been amended	No
2019-07-01	This submission is the final filing	Yes
2019-07-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2019-07-01	Plan is a collectively bargained plan	No
2019-07-01	Plan funding arrangement – Insurance	Yes
2019-07-01	Plan funding arrangement – Trust	Yes
2019-07-01	Plan benefit arrangement – Insurance	Yes
2019-07-01	Plan benefit arrangement - Trust	Yes
2018: CHATHAM HOSPITAL RETIREMENT SAVINGS PLAN 2018 form 5500 responses
2018-07-01	Type of plan entity	Single employer plan
2018-07-01	Submission has been amended	No
2018-07-01	This submission is the final filing	No
2018-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-07-01	Plan is a collectively bargained plan	No
2018-07-01	Plan funding arrangement – Insurance	Yes
2018-07-01	Plan funding arrangement – Trust	Yes
2018-07-01	Plan benefit arrangement – Insurance	Yes
2018-07-01	Plan benefit arrangement - Trust	Yes
2017: CHATHAM HOSPITAL RETIREMENT SAVINGS PLAN 2017 form 5500 responses
2017-07-01	Type of plan entity	Single employer plan
2017-07-01	Submission has been amended	No
2017-07-01	This submission is the final filing	No
2017-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-07-01	Plan is a collectively bargained plan	No
2017-07-01	Plan funding arrangement – Insurance	Yes
2017-07-01	Plan funding arrangement – Trust	Yes
2017-07-01	Plan benefit arrangement – Insurance	Yes
2017-07-01	Plan benefit arrangement - Trust	Yes
2016: CHATHAM HOSPITAL RETIREMENT SAVINGS PLAN 2016 form 5500 responses
2016-07-01	Type of plan entity	Single employer plan
2016-07-01	Submission has been amended	No
2016-07-01	This submission is the final filing	No
2016-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-07-01	Plan is a collectively bargained plan	No
2016-07-01	Plan funding arrangement – Insurance	Yes
2016-07-01	Plan funding arrangement – Trust	Yes
2016-07-01	Plan benefit arrangement – Insurance	Yes
2016-07-01	Plan benefit arrangement - Trust	Yes
2015: CHATHAM HOSPITAL RETIREMENT SAVINGS PLAN 2015 form 5500 responses
2015-07-01	Type of plan entity	Single employer plan
2015-07-01	Submission has been amended	No
2015-07-01	This submission is the final filing	No
2015-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-07-01	Plan is a collectively bargained plan	No
2015-07-01	Plan funding arrangement – Insurance	Yes
2015-07-01	Plan funding arrangement – Trust	Yes
2015-07-01	Plan benefit arrangement – Insurance	Yes
2015-07-01	Plan benefit arrangement - Trust	Yes
2014: CHATHAM HOSPITAL RETIREMENT SAVINGS PLAN 2014 form 5500 responses
2014-07-01	Type of plan entity	Single employer plan
2014-07-01	Submission has been amended	No
2014-07-01	This submission is the final filing	No
2014-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-07-01	Plan is a collectively bargained plan	No
2014-07-01	Plan funding arrangement – Insurance	Yes
2014-07-01	Plan funding arrangement – Trust	Yes
2014-07-01	Plan benefit arrangement – Insurance	Yes
2014-07-01	Plan benefit arrangement - Trust	Yes
2013: CHATHAM HOSPITAL RETIREMENT SAVINGS PLAN 2013 form 5500 responses
2013-07-01	Type of plan entity	Single employer plan
2013-07-01	Submission has been amended	No
2013-07-01	This submission is the final filing	No
2013-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-07-01	Plan is a collectively bargained plan	No
2013-07-01	Plan funding arrangement – Insurance	Yes
2013-07-01	Plan funding arrangement – Trust	Yes
2013-07-01	Plan benefit arrangement – Insurance	Yes
2013-07-01	Plan benefit arrangement - Trust	Yes
2012: CHATHAM HOSPITAL RETIREMENT SAVINGS PLAN 2012 form 5500 responses
2012-07-01	Type of plan entity	Single employer plan
2012-07-01	Submission has been amended	No
2012-07-01	This submission is the final filing	No
2012-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-07-01	Plan is a collectively bargained plan	No
2012-07-01	Plan funding arrangement – Insurance	Yes
2012-07-01	Plan funding arrangement – Trust	Yes
2012-07-01	Plan benefit arrangement – Insurance	Yes
2012-07-01	Plan benefit arrangement - Trust	Yes
2011: CHATHAM HOSPITAL RETIREMENT SAVINGS PLAN 2011 form 5500 responses
2011-07-01	Type of plan entity	Single employer plan
2011-07-01	Submission has been amended	No
2011-07-01	This submission is the final filing	No
2011-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-07-01	Plan is a collectively bargained plan	No
2011-07-01	Plan funding arrangement – Insurance	Yes
2011-07-01	Plan funding arrangement – Trust	Yes
2011-07-01	Plan benefit arrangement – Insurance	Yes
2011-07-01	Plan benefit arrangement - Trust	Yes
2009: CHATHAM HOSPITAL RETIREMENT SAVINGS PLAN 2009 form 5500 responses
2009-10-01	Type of plan entity	Single employer plan
2009-10-01	Submission has been amended	No
2009-10-01	This submission is the final filing	No
2009-10-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2009-10-01	Plan is a collectively bargained plan	No
2009-10-01	Plan funding arrangement – Trust	Yes
2009-10-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

MR 60442-1

Policy instance

Insurance contract or identification number	MR 60442-1
Number of Individuals Covered	0
Insurance policy start date	2019-07-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $1,615
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Broker	USD $699
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	COMMISSIONS
Insurance broker organization code?	3

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

MR 60442-1

Policy instance

Insurance contract or identification number	MR 60442-1
Number of Individuals Covered	109
Insurance policy start date	2018-07-01
Insurance policy end date	2019-06-30
Total amount of commissions paid to insurance broker	USD $488
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Broker	USD $176
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	COMMISSIONS
Insurance broker organization code?	3

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

MR 60442-1

Policy instance

Insurance contract or identification number	MR 60442-1
Number of Individuals Covered	103
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
Total amount of commissions paid to insurance broker	USD $576
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

MR 60442-1

Policy instance

Insurance contract or identification number	MR 60442-1
Number of Individuals Covered	93
Insurance policy start date	2015-07-01
Insurance policy end date	2016-06-30
Total amount of commissions paid to insurance broker	USD $381
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Broker	USD $330
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	COMMISSIONS
Insurance broker organization code?	3
Insurance broker name	TIMOTHY C FLANAGAN

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

MR 60442-1

Policy instance

Insurance contract or identification number	MR 60442-1
Number of Individuals Covered	93
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Total amount of commissions paid to insurance broker	USD $376
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Broker	USD $326
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	COMMISSIONS
Insurance broker organization code?	3
Insurance broker name	TIMOTHY C FLANAGAN

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

MR 60442-1

Policy instance

Insurance contract or identification number	MR 60442-1
Number of Individuals Covered	95
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
Total amount of commissions paid to insurance broker	USD $398
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Broker	USD $345
Insurance broker organization code?	3
Insurance broker name	TIMOTHY C FLANAGAN

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

MR 60442-1

Policy instance

Insurance contract or identification number	MR 60442-1
Number of Individuals Covered	100
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
Total amount of commissions paid to insurance broker	USD $382
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Broker	USD $331
Insurance broker organization code?	3
Insurance broker name	TIMOTHY C FLANAGAN

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

MR 60442-1

Policy instance

Insurance contract or identification number	MR 60442-1
Number of Individuals Covered	107
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $306
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

MR 60442-1

Policy instance

Insurance contract or identification number	MR 60442-1
Number of Individuals Covered	112
Insurance policy start date	2010-07-01
Insurance policy end date	2011-06-30
Total amount of commissions paid to insurance broker	USD $632
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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

Potentially related plans

CHATHAM HOSPITALISTS, LLC 401K PS PLAN [EIN = 204600494]

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Company Name:	CHATHAM HOSPITAL, INC.
Employer identification number (EIN):	560611546
NAIC Classification:	622000
NAIC Description:	Hospitals