401k Plan data: COLUMBUS SPECIALTY HOSPITAL SAVINGS PLAN plan

COLUMBUS SPECIALTY HOSPITAL SAVINGS PLAN 401k Plan overview

Plan Name	COLUMBUS SPECIALTY HOSPITAL SAVINGS PLAN
Plan identification number	001

COLUMBUS SPECIALTY HOSPITAL 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 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.

401k Sponsoring company profile

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

Company Name: COLUMBUS SPECIALTY HOSPITAL, INC.

Employer identification number (EIN): 611428443

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COLUMBUS SPECIALTY HOSPITAL SAVINGS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2020-01-01 WILLIAM ECKSTEIN 2021-04-14
001 2020-01-01 WILLIAM ECKSTEIN 2021-04-13
001 2019-01-01 WILLIAM ECKSTEIN 2020-10-02
001 2018-01-01 WILLIAM ECKSTEIN 2019-10-01
001 2017-01-01 WILLIAM ECKSTEIN
001 2016-01-01 WILLIAM ECKSTEIN
001 2015-01-01 BOBBY SAULNIER
001 2014-01-01 BOBBY SAULNIER
001 2013-01-01 BOBBY SAULNIER
001 2012-01-01 BOBBY SAULNIER
001 2011-01-01 BOBBY SAULNIER
001 2010-01-01 ROBERT SAULNIER 2013-06-12

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2020-01-01	WILLIAM ECKSTEIN	2021-04-14
001	2020-01-01	WILLIAM ECKSTEIN	2021-04-13
001	2019-01-01	WILLIAM ECKSTEIN	2020-10-02
001	2018-01-01	WILLIAM ECKSTEIN	2019-10-01
001	2017-01-01	WILLIAM ECKSTEIN
001	2016-01-01	WILLIAM ECKSTEIN
001	2015-01-01	BOBBY SAULNIER
001	2014-01-01	BOBBY SAULNIER
001	2013-01-01	BOBBY SAULNIER
001	2012-01-01	BOBBY SAULNIER
001	2011-01-01	BOBBY SAULNIER
001	2010-01-01	ROBERT SAULNIER	2013-06-12

Plan Statistics for COLUMBUS SPECIALTY HOSPITAL SAVINGS PLAN

401k plan membership statisitcs for COLUMBUS SPECIALTY HOSPITAL SAVINGS PLAN

Measure Date Value
2017: COLUMBUS SPECIALTY HOSPITAL SAVINGS PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 169
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 0
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 112
Total of all active and inactive participants 2017-01-01 112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 112
Number of participants with account balances 2017-01-01 90
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: COLUMBUS SPECIALTY HOSPITAL SAVINGS PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 181
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 89
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 59
Total of all active and inactive participants 2016-01-01 148
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 148
Number of participants with account balances 2016-01-01 148
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: COLUMBUS SPECIALTY HOSPITAL SAVINGS PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 230
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 98
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 83
Total of all active and inactive participants 2015-01-01 181
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 181
Number of participants with account balances 2015-01-01 162
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: COLUMBUS SPECIALTY HOSPITAL SAVINGS PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 230
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 165
Number of retired or separated participants receiving benefits 2014-01-01 2
Number of other retired or separated participants entitled to future benefits 2014-01-01 63
Total of all active and inactive participants 2014-01-01 230
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 230
Number of participants with account balances 2014-01-01 163
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: COLUMBUS SPECIALTY HOSPITAL SAVINGS PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 231
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 166
Number of retired or separated participants receiving benefits 2013-01-01 2
Number of other retired or separated participants entitled to future benefits 2013-01-01 62
Total of all active and inactive participants 2013-01-01 230
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 230
Number of participants with account balances 2013-01-01 150
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: COLUMBUS SPECIALTY HOSPITAL SAVINGS PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 203
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 189
Number of retired or separated participants receiving benefits 2012-01-01 3
Number of other retired or separated participants entitled to future benefits 2012-01-01 39
Total of all active and inactive participants 2012-01-01 231
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 231
Number of participants with account balances 2012-01-01 138
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: COLUMBUS SPECIALTY HOSPITAL SAVINGS PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 134
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 170
Number of retired or separated participants receiving benefits 2011-01-01 3
Number of other retired or separated participants entitled to future benefits 2011-01-01 30
Total of all active and inactive participants 2011-01-01 203
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 203
Number of participants with account balances 2011-01-01 130
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0

Measure	Date	Value
2017: COLUMBUS SPECIALTY HOSPITAL SAVINGS PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	169
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	0
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	112
Total of all active and inactive participants	2017-01-01	112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	112
Number of participants with account balances	2017-01-01	90
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: COLUMBUS SPECIALTY HOSPITAL SAVINGS PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	181
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	89
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	59
Total of all active and inactive participants	2016-01-01	148
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	148
Number of participants with account balances	2016-01-01	148
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: COLUMBUS SPECIALTY HOSPITAL SAVINGS PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	230
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	98
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	83
Total of all active and inactive participants	2015-01-01	181
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	181
Number of participants with account balances	2015-01-01	162
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: COLUMBUS SPECIALTY HOSPITAL SAVINGS PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	230
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	165
Number of retired or separated participants receiving benefits	2014-01-01	2
Number of other retired or separated participants entitled to future benefits	2014-01-01	63
Total of all active and inactive participants	2014-01-01	230
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	230
Number of participants with account balances	2014-01-01	163
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: COLUMBUS SPECIALTY HOSPITAL SAVINGS PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	231
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	166
Number of retired or separated participants receiving benefits	2013-01-01	2
Number of other retired or separated participants entitled to future benefits	2013-01-01	62
Total of all active and inactive participants	2013-01-01	230
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	230
Number of participants with account balances	2013-01-01	150
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: COLUMBUS SPECIALTY HOSPITAL SAVINGS PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	203
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	189
Number of retired or separated participants receiving benefits	2012-01-01	3
Number of other retired or separated participants entitled to future benefits	2012-01-01	39
Total of all active and inactive participants	2012-01-01	231
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	231
Number of participants with account balances	2012-01-01	138
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: COLUMBUS SPECIALTY HOSPITAL SAVINGS PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	134
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	170
Number of retired or separated participants receiving benefits	2011-01-01	3
Number of other retired or separated participants entitled to future benefits	2011-01-01	30
Total of all active and inactive participants	2011-01-01	203
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	203
Number of participants with account balances	2011-01-01	130
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0

Financial Data on COLUMBUS SPECIALTY HOSPITAL SAVINGS PLAN

Measure	Date	Value
2017 : COLUMBUS SPECIALTY HOSPITAL SAVINGS PLAN 2017 401k financial data
Total income from all sources (including contributions)	2017-12-31	$187,870
Total of all expenses incurred	2017-12-31	$1,115,621
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$1,114,290
Expenses. Certain deemed distributions of participant loans	2017-12-31	$153
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$10,565
Value of total assets at end of year	2017-12-31	$1,124,768
Value of total assets at beginning of year	2017-12-31	$2,052,519
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$1,178
Total interest from all sources	2017-12-31	$20,887
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$61,213
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$61,213
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$200,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Participant contributions at beginning of year	2017-12-31	$44,184
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$-927,751
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$1,124,768
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$2,052,519
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$635,034
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$1,138,277
Interest on participant loans	2017-12-31	$16
Interest earned on other investments	2017-12-31	$20,871
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$489,734
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$870,058
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$95,205
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$10,565
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$1,114,290
Contract administrator fees	2017-12-31	$1,178
Did the plan have assets held for investment	2017-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	ALBRIGHT, FORTENBERRY, NINAS, LLP
Accountancy firm EIN	2017-12-31	581456534
2016 : COLUMBUS SPECIALTY HOSPITAL SAVINGS PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$391,998
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$542,244
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$540,020
Expenses. Certain deemed distributions of participant loans	2016-12-31	$753
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$255,999
Value of total assets at end of year	2016-12-31	$2,052,519
Value of total assets at beginning of year	2016-12-31	$2,202,765
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$1,471
Total interest from all sources	2016-12-31	$28,111
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$55,065
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2016-12-31	$0
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$55,065
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$200,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$170,352
Participant contributions at end of year	2016-12-31	$44,184
Participant contributions at beginning of year	2016-12-31	$72,437
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$-150,246
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$2,052,519
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$2,202,765
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$1,138,277
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$1,256,367
Interest on participant loans	2016-12-31	$2,289
Interest earned on other investments	2016-12-31	$25,822
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$870,058
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$873,961
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$52,823
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$85,647
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$540,020
Contract administrator fees	2016-12-31	$1,471
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	ALBRIGHT, FORTENBERRY, NINAS, LLP
Accountancy firm EIN	2016-12-31	581456534
2015 : COLUMBUS SPECIALTY HOSPITAL SAVINGS PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$455,200
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$239,337
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$237,393
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$431,081
Value of total assets at end of year	2015-12-31	$2,202,765
Value of total assets at beginning of year	2015-12-31	$1,986,902
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$1,944
Total interest from all sources	2015-12-31	$26,848
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$73,236
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$200,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$204,191
Participant contributions at end of year	2015-12-31	$72,437
Participant contributions at beginning of year	2015-12-31	$33,320
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$63,489
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$215,863
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$2,202,765
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$1,986,902
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$1,256,367
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$1,169,911
Interest on participant loans	2015-12-31	$2,619
Interest earned on other investments	2015-12-31	$24,229
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$873,961
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$783,671
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-75,965
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$163,401
Income. Dividends from common stock	2015-12-31	$73,236
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$237,393
Contract administrator fees	2015-12-31	$1,944
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	ALBRIGHT, FORTENBERRY, NINAS, LLP
Accountancy firm EIN	2015-12-31	581456534
2014 : COLUMBUS SPECIALTY HOSPITAL SAVINGS PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$378,978
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$139,854
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$138,317
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$281,648
Value of total assets at end of year	2014-12-31	$1,986,902
Value of total assets at beginning of year	2014-12-31	$1,747,778
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$1,537
Total interest from all sources	2014-12-31	$23,138
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$88,160
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$88,160
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$200,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$134,874
Assets. Loans (other than to participants) at end of year	2014-12-31	$33,320
Assets. Loans (other than to participants) at beginning of year	2014-12-31	$40,459
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$239,124
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$1,986,902
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$1,747,778
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$1,169,911
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$982,929
Interest on participant loans	2014-12-31	$1,325
Interest earned on other investments	2014-12-31	$21,813
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$783,671
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$724,390
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$-13,968
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$146,774
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$138,317
Contract administrator fees	2014-12-31	$1,537
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	ALBRIGHT, FORTENBERRY & NINAS, LLP
Accountancy firm EIN	2014-12-31	581456534
2013 : COLUMBUS SPECIALTY HOSPITAL SAVINGS PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$468,902
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$125,085
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$117,593
Expenses. Certain deemed distributions of participant loans	2013-12-31	$6,177
Value of total corrective distributions	2013-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$257,325
Value of total assets at end of year	2013-12-31	$1,747,778
Value of total assets at beginning of year	2013-12-31	$1,403,961
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$1,315
Total interest from all sources	2013-12-31	$21,740
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$40,829
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$200,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$123,792
Assets. Loans (other than to participants) at end of year	2013-12-31	$40,459
Assets. Loans (other than to participants) at beginning of year	2013-12-31	$50,063
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$343,817
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$1,747,778
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$1,403,961
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$982,929
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$742,185
Interest on participant loans	2013-12-31	$1,844
Interest earned on other investments	2013-12-31	$19,896
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$724,390
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$611,713
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$149,008
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$133,533
Income. Dividends from common stock	2013-12-31	$40,829
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$117,593
Contract administrator fees	2013-12-31	$1,315
Did the plan have assets held for investment	2013-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	ALBRIGHT, FORTENBERRY & NINAS, LLP
Accountancy firm EIN	2013-12-31	581456534
2012 : COLUMBUS SPECIALTY HOSPITAL SAVINGS PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$439,474
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$305,682
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$301,326
Expenses. Certain deemed distributions of participant loans	2012-12-31	$2,949
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$334,040
Value of total assets at end of year	2012-12-31	$1,403,961
Value of total assets at beginning of year	2012-12-31	$1,270,169
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$1,407
Total interest from all sources	2012-12-31	$18,096
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$22,050
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$200,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$186,267
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$582
Assets. Loans (other than to participants) at end of year	2012-12-31	$50,063
Assets. Loans (other than to participants) at beginning of year	2012-12-31	$19,765
Other income not declared elsewhere	2012-12-31	$-6,558
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$133,792
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$1,403,961
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$1,270,169
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$742,185
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$697,492
Interest on participant loans	2012-12-31	$1,408
Interest earned on other investments	2012-12-31	$16,688
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$611,713
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$552,912
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$71,846
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$147,191
Income. Dividends from common stock	2012-12-31	$22,050
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$301,326
Contract administrator fees	2012-12-31	$1,407
Did the plan have assets held for investment	2012-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	ALBRIGHT, FORTENBERRY & NINAS, LLP
Accountancy firm EIN	2012-12-31	581456534
2011 : COLUMBUS SPECIALTY HOSPITAL SAVINGS PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$394,291
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$255,763
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$253,513
Expenses. Certain deemed distributions of participant loans	2011-12-31	$1,000
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$310,580
Value of total assets at end of year	2011-12-31	$1,270,169
Value of total assets at beginning of year	2011-12-31	$1,131,641
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$1,250
Total interest from all sources	2011-12-31	$15,715
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$16,843
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2011-12-31	$16,843
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$26,363
If this is an individual account plan, was there a blackout period	2011-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$148,457
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$22,953
Assets. Loans (other than to participants) at end of year	2011-12-31	$19,765
Assets. Loans (other than to participants) at beginning of year	2011-12-31	$26,363
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$138,528
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$1,270,169
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$1,131,641
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$697,492
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$655,359
Interest on participant loans	2011-12-31	$526
Interest earned on other investments	2011-12-31	$15,189
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$552,912
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$449,919
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$51,153
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$139,170
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$253,513
Contract administrator fees	2011-12-31	$1,250
Did the plan have assets held for investment	2011-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	ALBRIGHT, FORTENBERRY & NINAS, LLP
Accountancy firm EIN	2011-12-31	581456534

Form 5500 Responses for COLUMBUS SPECIALTY HOSPITAL SAVINGS PLAN

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

Insurance Providers Used on plan

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )

Policy contract number

65781

Policy instance

Insurance contract or identification number	65781
Number of Individuals Covered	114
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )

Policy contract number

65781

Policy instance

Insurance contract or identification number	65781
Number of Individuals Covered	186
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with 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?	Yes
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

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )

Policy contract number

65781

Policy instance

Insurance contract or identification number	65781
Number of Individuals Covered	187
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with 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?	Yes
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

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )

Policy contract number

65781

Policy instance

Insurance contract or identification number	65781
Number of Individuals Covered	183
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with 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?	Yes
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

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )

Policy contract number

65781

Policy instance

Insurance contract or identification number	65781
Number of Individuals Covered	171
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with 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?	Yes
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

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )

Policy contract number

65781

Policy instance

Insurance contract or identification number	65781
Number of Individuals Covered	155
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with 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?	Yes
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

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Company Name:	COLUMBUS SPECIALTY HOSPITAL, INC.
Employer identification number (EIN):	611428443
NAIC Classification:	622000
NAIC Description:	Hospitals