401k Plan data: RUSSELL HOSPITAL CORPORATION LINCOLN-LONG TERM DISABILITY INS plan

RUSSELL HOSPITAL CORPORATION LINCOLN-LONG TERM DISABILITY INS 401k Plan overview

Plan Name	RUSSELL HOSPITAL CORPORATION LINCOLN-LONG TERM DISABILITY INS
Plan identification number	549

RUSSELL HOSPITAL CORPORATION LINCOLN-LONG TERM DISABILITY INS Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Long-term disability cover

401k Sponsoring company profile

RUSSELL HOSPITAL CORPORATION has sponsored the creation of one or more 401k plans.

Company Name: RUSSELL HOSPITAL CORPORATION

Employer identification number (EIN): 630385130

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan RUSSELL HOSPITAL CORPORATION LINCOLN-LONG TERM DISABILITY INS

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
549 2015-02-01 L. E. PEACE III
549 2014-02-01 L.E. PEACE III
549 2013-02-01 L.E. PEACE III
549 2012-02-01 L.E. PEACE III

Plan id#	Filing Submission Date	Name of Administrator
549	2015-02-01	L. E. PEACE III
549	2014-02-01	L.E. PEACE III
549	2013-02-01	L.E. PEACE III
549	2012-02-01	L.E. PEACE III

Plan Statistics for RUSSELL HOSPITAL CORPORATION LINCOLN-LONG TERM DISABILITY INS

401k plan membership statisitcs for RUSSELL HOSPITAL CORPORATION LINCOLN-LONG TERM DISABILITY INS

Measure Date Value
2015: RUSSELL HOSPITAL CORPORATION LINCOLN-LONG TERM DISABILITY INS 2015 401k membership
Total participants, beginning-of-year 2015-02-01 186
Total number of active participants reported on line 7a of the Form 5500 2015-02-01 0
Number of retired or separated participants receiving benefits 2015-02-01 0
Number of other retired or separated participants entitled to future benefits 2015-02-01 0
Total of all active and inactive participants 2015-02-01 0
2014: RUSSELL HOSPITAL CORPORATION LINCOLN-LONG TERM DISABILITY INS 2014 401k membership
Total participants, beginning-of-year 2014-02-01 165
Total number of active participants reported on line 7a of the Form 5500 2014-02-01 157
Number of retired or separated participants receiving benefits 2014-02-01 0
Number of other retired or separated participants entitled to future benefits 2014-02-01 0
Total of all active and inactive participants 2014-02-01 157
2013: RUSSELL HOSPITAL CORPORATION LINCOLN-LONG TERM DISABILITY INS 2013 401k membership
Total participants, beginning-of-year 2013-02-01 176
Total number of active participants reported on line 7a of the Form 5500 2013-02-01 165
Number of retired or separated participants receiving benefits 2013-02-01 0
Number of other retired or separated participants entitled to future benefits 2013-02-01 0
Total of all active and inactive participants 2013-02-01 165
2012: RUSSELL HOSPITAL CORPORATION LINCOLN-LONG TERM DISABILITY INS 2012 401k membership
Total participants, beginning-of-year 2012-02-01 0
Total number of active participants reported on line 7a of the Form 5500 2012-02-01 176
Number of retired or separated participants receiving benefits 2012-02-01 0
Number of other retired or separated participants entitled to future benefits 2012-02-01 0
Total of all active and inactive participants 2012-02-01 176

Measure	Date	Value
2015: RUSSELL HOSPITAL CORPORATION LINCOLN-LONG TERM DISABILITY INS 2015 401k membership
Total participants, beginning-of-year	2015-02-01	186
Total number of active participants reported on line 7a of the Form 5500	2015-02-01	0
Number of retired or separated participants receiving benefits	2015-02-01	0
Number of other retired or separated participants entitled to future benefits	2015-02-01	0
Total of all active and inactive participants	2015-02-01	0
2014: RUSSELL HOSPITAL CORPORATION LINCOLN-LONG TERM DISABILITY INS 2014 401k membership
Total participants, beginning-of-year	2014-02-01	165
Total number of active participants reported on line 7a of the Form 5500	2014-02-01	157
Number of retired or separated participants receiving benefits	2014-02-01	0
Number of other retired or separated participants entitled to future benefits	2014-02-01	0
Total of all active and inactive participants	2014-02-01	157
2013: RUSSELL HOSPITAL CORPORATION LINCOLN-LONG TERM DISABILITY INS 2013 401k membership
Total participants, beginning-of-year	2013-02-01	176
Total number of active participants reported on line 7a of the Form 5500	2013-02-01	165
Number of retired or separated participants receiving benefits	2013-02-01	0
Number of other retired or separated participants entitled to future benefits	2013-02-01	0
Total of all active and inactive participants	2013-02-01	165
2012: RUSSELL HOSPITAL CORPORATION LINCOLN-LONG TERM DISABILITY INS 2012 401k membership
Total participants, beginning-of-year	2012-02-01	0
Total number of active participants reported on line 7a of the Form 5500	2012-02-01	176
Number of retired or separated participants receiving benefits	2012-02-01	0
Number of other retired or separated participants entitled to future benefits	2012-02-01	0
Total of all active and inactive participants	2012-02-01	176

Financial Data on RUSSELL HOSPITAL CORPORATION LINCOLN-LONG TERM DISABILITY INS

Measure	Date	Value
2015 : RUSSELL HOSPITAL CORPORATION LINCOLN-LONG TERM DISABILITY INS 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-01-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-01-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-01-31	$0
Total income from all sources (including contributions)	2015-01-31	$0
Total loss/gain on sale of assets	2015-01-31	$0
Total of all expenses incurred	2015-01-31	$0
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-01-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-01-31	$0
Value of total assets at end of year	2015-01-31	$0
Value of total assets at beginning of year	2015-01-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-01-31	$0
Total interest from all sources	2015-01-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2015-01-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-01-31	No
Was this plan covered by a fidelity bond	2015-01-31	No
If this is an individual account plan, was there a blackout period	2015-01-31	No
Were there any nonexempt tranactions with any party-in-interest	2015-01-31	No
Total non interest bearing cash at end of year	2015-01-31	$0
Total non interest bearing cash at beginning of year	2015-01-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-01-31	No
Value of net income/loss	2015-01-31	$0
Value of net assets at end of year (total assets less liabilities)	2015-01-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2015-01-31	$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-01-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-01-31	No
Were any leases to which the plan was party in default or uncollectible	2015-01-31	No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-01-31	No
Was there a failure to transmit to the plan any participant contributions	2015-01-31	No
Has the plan failed to provide any benefit when due under the plan	2015-01-31	No
Contributions received in cash from employer	2015-01-31	$0
Did the plan have assets held for investment	2015-01-31	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	2015-01-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-01-31	No
2014 : RUSSELL HOSPITAL CORPORATION LINCOLN-LONG TERM DISABILITY INS 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-01-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-01-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-01-31	$0
Total income from all sources (including contributions)	2014-01-31	$0
Total loss/gain on sale of assets	2014-01-31	$0
Total of all expenses incurred	2014-01-31	$0
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-01-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-01-31	$0
Value of total assets at end of year	2014-01-31	$0
Value of total assets at beginning of year	2014-01-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-01-31	$0
Total interest from all sources	2014-01-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2014-01-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-01-31	No
Was this plan covered by a fidelity bond	2014-01-31	No
If this is an individual account plan, was there a blackout period	2014-01-31	No
Were there any nonexempt tranactions with any party-in-interest	2014-01-31	No
Total non interest bearing cash at end of year	2014-01-31	$0
Total non interest bearing cash at beginning of year	2014-01-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-01-31	No
Value of net income/loss	2014-01-31	$0
Value of net assets at end of year (total assets less liabilities)	2014-01-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2014-01-31	$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-01-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-01-31	No
Were any leases to which the plan was party in default or uncollectible	2014-01-31	No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-01-31	No
Was there a failure to transmit to the plan any participant contributions	2014-01-31	No
Has the plan failed to provide any benefit when due under the plan	2014-01-31	No
Did the plan have assets held for investment	2014-01-31	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	2014-01-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-01-31	No
2012 : RUSSELL HOSPITAL CORPORATION LINCOLN-LONG TERM DISABILITY INS 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	$0
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$0
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$0
Value of total assets at end of year	2012-12-31	$0
Value of total assets at beginning of year	2012-12-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$0
Total interest from all sources	2012-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$0
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	No
If this is an individual account plan, was there a blackout period	2012-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Total non interest bearing cash at end of year	2012-12-31	$0
Total non interest bearing cash at beginning of year	2012-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$0
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$0
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
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	No
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	$0
Did the plan have assets held for investment	2012-12-31	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	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

Form 5500 Responses for RUSSELL HOSPITAL CORPORATION LINCOLN-LONG TERM DISABILITY INS

2015: RUSSELL HOSPITAL CORPORATION LINCOLN-LONG TERM DISABILITY INS 2015 form 5500 responses
2015-02-01	Type of plan entity	Single employer plan
2015-02-01	Submission has been amended	No
2015-02-01	This submission is the final filing	Yes
2015-02-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-02-01	Plan is a collectively bargained plan	No
2015-02-01	Plan funding arrangement – Insurance	Yes
2015-02-01	Plan benefit arrangement – Insurance	Yes
2014: RUSSELL HOSPITAL CORPORATION LINCOLN-LONG TERM DISABILITY INS 2014 form 5500 responses
2014-02-01	Type of plan entity	Single employer plan
2014-02-01	Submission has been amended	No
2014-02-01	This submission is the final filing	No
2014-02-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-02-01	Plan is a collectively bargained plan	No
2014-02-01	Plan funding arrangement – Insurance	Yes
2014-02-01	Plan benefit arrangement – Insurance	Yes
2013: RUSSELL HOSPITAL CORPORATION LINCOLN-LONG TERM DISABILITY INS 2013 form 5500 responses
2013-02-01	Type of plan entity	Single employer plan
2013-02-01	Submission has been amended	No
2013-02-01	This submission is the final filing	No
2013-02-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-02-01	Plan is a collectively bargained plan	No
2013-02-01	Plan funding arrangement – Insurance	Yes
2013-02-01	Plan benefit arrangement – Insurance	Yes
2012: RUSSELL HOSPITAL CORPORATION LINCOLN-LONG TERM DISABILITY INS 2012 form 5500 responses
2012-02-01	Type of plan entity	Single employer plan
2012-02-01	First time form 5500 has been submitted	Yes
2012-02-01	Submission has been amended	No
2012-02-01	This submission is the final filing	No
2012-02-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2012-02-01	Plan is a collectively bargained plan	No
2012-02-01	Plan funding arrangement – Insurance	Yes
2012-02-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GUPR0AVW2

Policy instance

Insurance contract or identification number	GUPR0AVW2
Number of Individuals Covered	164
Insurance policy start date	2015-02-01
Insurance policy end date	2016-01-31
Total amount of commissions paid to insurance broker	USD $8,555
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	Yes
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	Yes
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
Welfare Benefit Premiums Paid to Carrier	USD $57,034
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $8,555
Insurance broker organization code?	3
Insurance broker name	SS NESBITT AND COMPANY INC

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GLTD0AVW2

Policy instance

Insurance contract or identification number	GLTD0AVW2
Number of Individuals Covered	41
Insurance policy start date	2015-02-01
Insurance policy end date	2016-01-31
Total amount of commissions paid to insurance broker	USD $3,986
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	Yes
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
Welfare Benefit Premiums Paid to Carrier	USD $26,571
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,986
Insurance broker organization code?	3
Insurance broker name	SS NESBITT & CO INC

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )

Policy contract number

000010155795

Policy instance

Insurance contract or identification number	000010155795
Number of Individuals Covered	157
Insurance policy start date	2014-02-01
Insurance policy end date	2015-01-31
Total amount of commissions paid to insurance broker	USD $8,850
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	Yes
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	Yes
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 $8,850
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	COMMISSIONS AND BROKER BONUS
Insurance broker organization code?	3
Insurance broker name	SS NESBITT AND CO INC

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )

Policy contract number

000010155795

Policy instance

Insurance contract or identification number	000010155795
Number of Individuals Covered	165
Insurance policy start date	2013-02-01
Insurance policy end date	2014-01-31
Total amount of commissions paid to insurance broker	USD $10,033
Total amount of fees paid to insurance company	USD $1,856
Are there contracts with allocated funds for individual policies?	Yes
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	Yes
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 $4,697
Amount paid for insurance broker fees	1856
Additional information about fees paid to insurance broker	COMMISSIONS AND BROKER BONUS
Insurance broker organization code?	3
Insurance broker name	SS NESBITT AND COMPANY

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )

Policy contract number

000010155795

Policy instance

Insurance contract or identification number	000010155795
Number of Individuals Covered	176
Insurance policy start date	2012-02-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $8,422
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	Yes
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	Yes
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
Welfare Benefit Premiums Paid to Carrier	USD $56,145
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $8,422
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	NOT GIVEN
Insurance broker organization code?	3
Insurance broker name	COASTAL INS SERVICES INC

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Company Name:	RUSSELL HOSPITAL CORPORATION
Employer identification number (EIN):	630385130
NAIC Classification:	622000
NAIC Description:	Hospitals