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PUEBLO COMMUNITY HEALTH CENTER, INC. 403(B) PLAN 401k Plan overview

Plan NamePUEBLO COMMUNITY HEALTH CENTER, INC. 403(B) PLAN
Plan identification number 001

PUEBLO COMMUNITY HEALTH CENTER, INC. 403(B) PLAN Benefits

401k Plan TypeDefined 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)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.

401k Sponsoring company profile

PUEBLO COMMUNITY HEALTH CENTER, INC has sponsored the creation of one or more 401k plans.

Company Name:PUEBLO COMMUNITY HEALTH CENTER, INC
Employer identification number (EIN):840921521
NAIC Classification:813000
NAIC Description: Religious, Grantmaking, Civic, Professional, and Similar Organizations

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PUEBLO COMMUNITY HEALTH CENTER, INC. 403(B) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01
0012021-01-01
0012020-01-01
0012019-01-01
0012018-01-01
0012017-01-01CINDY PRATT CINDY PRATT2018-10-12
0012016-01-01CINDY PRATT CINDY PRATT2017-10-06
0012015-01-01CINDY PRATT CINDY PRATT2016-09-27
0012014-01-01CINDY PRATT
0012013-01-01CINDY PRATT CINDY PRATT2014-10-09
0012012-01-01BRENT STANLEY BRENT STANLEY2013-07-25
0012011-01-01BRENT STANLEY BRENT STANLEY2012-09-13
0012010-01-01DONALD MOORE
0012009-01-01DONALD MOORE DONALD MOORE2010-10-14

Plan Statistics for PUEBLO COMMUNITY HEALTH CENTER, INC. 403(B) PLAN

401k plan membership statisitcs for PUEBLO COMMUNITY HEALTH CENTER, INC. 403(B) PLAN

Measure Date Value
2022: PUEBLO COMMUNITY HEALTH CENTER, INC. 403(B) PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01414
Total number of active participants reported on line 7a of the Form 55002022-01-01284
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-01144
Total of all active and inactive participants2022-01-01428
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-014
Total participants2022-01-01432
Number of participants with account balances2022-01-01425
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010
2021: PUEBLO COMMUNITY HEALTH CENTER, INC. 403(B) PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01424
Total number of active participants reported on line 7a of the Form 55002021-01-01265
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-01147
Total of all active and inactive participants2021-01-01412
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-014
Total participants2021-01-01416
Number of participants with account balances2021-01-01411
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: PUEBLO COMMUNITY HEALTH CENTER, INC. 403(B) PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01413
Total number of active participants reported on line 7a of the Form 55002020-01-01302
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-01121
Total of all active and inactive participants2020-01-01423
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-012
Total participants2020-01-01425
Number of participants with account balances2020-01-01421
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: PUEBLO COMMUNITY HEALTH CENTER, INC. 403(B) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01378
Total number of active participants reported on line 7a of the Form 55002019-01-01298
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-01114
Total of all active and inactive participants2019-01-01412
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-012
Total participants2019-01-01414
Number of participants with account balances2019-01-01412
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: PUEBLO COMMUNITY HEALTH CENTER, INC. 403(B) PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01396
Total number of active participants reported on line 7a of the Form 55002018-01-01288
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-0188
Total of all active and inactive participants2018-01-01376
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-012
Total participants2018-01-01378
Number of participants with account balances2018-01-01372
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: PUEBLO COMMUNITY HEALTH CENTER, INC. 403(B) PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01370
Total number of active participants reported on line 7a of the Form 55002017-01-01280
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-01114
Total of all active and inactive participants2017-01-01394
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-012
Total participants2017-01-01396
Number of participants with account balances2017-01-01387
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: PUEBLO COMMUNITY HEALTH CENTER, INC. 403(B) PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01369
Total number of active participants reported on line 7a of the Form 55002016-01-01288
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-0180
Total of all active and inactive participants2016-01-01368
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-012
Total participants2016-01-01370
Number of participants with account balances2016-01-01362
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: PUEBLO COMMUNITY HEALTH CENTER, INC. 403(B) PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01545
Total number of active participants reported on line 7a of the Form 55002015-01-01378
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-01177
Total of all active and inactive participants2015-01-01555
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-013
Total participants2015-01-01558
Number of participants with account balances2015-01-01540
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: PUEBLO COMMUNITY HEALTH CENTER, INC. 403(B) PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01472
Total number of active participants reported on line 7a of the Form 55002014-01-01389
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-01152
Total of all active and inactive participants2014-01-01541
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-014
Total participants2014-01-01545
Number of participants with account balances2014-01-01523
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: PUEBLO COMMUNITY HEALTH CENTER, INC. 403(B) PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01447
Total number of active participants reported on line 7a of the Form 55002013-01-01345
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-01126
Total of all active and inactive participants2013-01-01471
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-015
Total participants2013-01-01476
Number of participants with account balances2013-01-01461
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: PUEBLO COMMUNITY HEALTH CENTER, INC. 403(B) PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01433
Total number of active participants reported on line 7a of the Form 55002012-01-01349
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-0197
Total of all active and inactive participants2012-01-01446
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-012
Total participants2012-01-01448
Number of participants with account balances2012-01-01428
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: PUEBLO COMMUNITY HEALTH CENTER, INC. 403(B) PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01431
Total number of active participants reported on line 7a of the Form 55002011-01-01344
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-0189
Total of all active and inactive participants2011-01-01433
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-01433
Number of participants with account balances2011-01-01413
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2010: PUEBLO COMMUNITY HEALTH CENTER, INC. 403(B) PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01419
Total number of active participants reported on line 7a of the Form 55002010-01-01353
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-0179
Total of all active and inactive participants2010-01-01432
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-01432
Number of participants with account balances2010-01-01409
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-010
2009: PUEBLO COMMUNITY HEALTH CENTER, INC. 403(B) PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01401
Total number of active participants reported on line 7a of the Form 55002009-01-01346
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-0169
Total of all active and inactive participants2009-01-01415
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-01415
Number of participants with account balances2009-01-01397
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on PUEBLO COMMUNITY HEALTH CENTER, INC. 403(B) PLAN

Measure Date Value
2022 : PUEBLO COMMUNITY HEALTH CENTER, INC. 403(B) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total income from all sources (including contributions)2022-12-31$-1,558,098
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$2,563,972
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$2,514,026
Expenses. Certain deemed distributions of participant loans2022-12-31$14,855
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$2,036,799
Value of total assets at end of year2022-12-31$21,567,087
Value of total assets at beginning of year2022-12-31$25,689,157
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$35,091
Total interest from all sources2022-12-31$93,188
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$444,081
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-12-31$444,081
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$500,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$1,085,634
Participant contributions at end of year2022-12-31$180,519
Participant contributions at beginning of year2022-12-31$83,749
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$93,637
Other income not declared elsewhere2022-12-31$8,250
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-4,122,070
Value of net assets at end of year (total assets less liabilities)2022-12-31$21,567,087
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$25,689,157
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$18,179,351
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$21,983,944
Value of interest in pooled separate accounts at end of year2022-12-31$178,771
Value of interest in pooled separate accounts at beginning of year2022-12-31$185,626
Interest on participant loans2022-12-31$7,137
Interest earned on other investments2022-12-31$86,051
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$3,028,446
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$3,435,838
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$1,027,130
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-4,155,438
Net investment gain/loss from pooled separate accounts2022-12-31$15,022
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$857,528
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$1,486,896
Contract administrator fees2022-12-31$35,091
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31CLIFTONLARSONALLEN, LLP
Accountancy firm EIN2022-12-31410746749
2021 : PUEBLO COMMUNITY HEALTH CENTER, INC. 403(B) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total income from all sources (including contributions)2021-12-31$4,960,188
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$985,245
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$950,479
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$2,128,841
Value of total assets at end of year2021-12-31$25,689,157
Value of total assets at beginning of year2021-12-31$21,714,214
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$34,766
Total interest from all sources2021-12-31$110,253
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$726,601
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2021-12-31$726,601
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$500,000
If this is an individual account plan, was there a blackout period2021-12-31No
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$1,093,661
Participant contributions at end of year2021-12-31$83,749
Participant contributions at beginning of year2021-12-31$72,482
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$150,177
Other income not declared elsewhere2021-12-31$11,671
Administrative expenses (other) incurred2021-12-31$7,235
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$3,974,943
Value of net assets at end of year (total assets less liabilities)2021-12-31$25,689,157
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$21,714,214
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$21,983,944
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$17,754,521
Value of interest in pooled separate accounts at end of year2021-12-31$185,626
Value of interest in pooled separate accounts at beginning of year2021-12-31$238,434
Interest on participant loans2021-12-31$3,787
Interest earned on other investments2021-12-31$106,466
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$3,435,838
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$3,648,777
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$1,946,885
Net investment gain/loss from pooled separate accounts2021-12-31$35,937
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$885,003
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$950,479
Contract administrator fees2021-12-31$27,531
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31CLIFTONLARSONALLEN, LLP
Accountancy firm EIN2021-12-31410746749
2020 : PUEBLO COMMUNITY HEALTH CENTER, INC. 403(B) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total income from all sources (including contributions)2020-12-31$4,563,409
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$1,069,210
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$975,591
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$1,984,677
Value of total assets at end of year2020-12-31$21,714,214
Value of total assets at beginning of year2020-12-31$18,220,015
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$93,619
Total interest from all sources2020-12-31$114,281
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$276,792
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2020-12-31$276,792
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$500,000
If this is an individual account plan, was there a blackout period2020-12-31No
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$1,011,131
Participant contributions at end of year2020-12-31$72,482
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$140,056
Other income not declared elsewhere2020-12-31$12,441
Administrative expenses (other) incurred2020-12-31$23,666
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$3,494,199
Value of net assets at end of year (total assets less liabilities)2020-12-31$21,714,214
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$18,220,015
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$17,754,521
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$14,973,362
Value of interest in pooled separate accounts at end of year2020-12-31$238,434
Value of interest in pooled separate accounts at beginning of year2020-12-31$295,051
Interest on participant loans2020-12-31$2,219
Interest earned on other investments2020-12-31$112,062
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$3,648,777
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$2,951,602
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$2,177,253
Net investment gain/loss from pooled separate accounts2020-12-31$-2,035
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$833,490
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$975,591
Contract administrator fees2020-12-31$69,953
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Disclaimer
Accountancy firm name2020-12-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2020-12-31410746749
2019 : PUEBLO COMMUNITY HEALTH CENTER, INC. 403(B) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total income from all sources (including contributions)2019-12-31$4,498,994
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$1,204,235
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$1,195,859
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$1,767,729
Value of total assets at end of year2019-12-31$18,220,015
Value of total assets at beginning of year2019-12-31$14,925,256
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$8,376
Total interest from all sources2019-12-31$94,936
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$256,434
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$256,434
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$500,000
If this is an individual account plan, was there a blackout period2019-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$970,458
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$7,639
Other income not declared elsewhere2019-12-31$55
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$3,294,759
Value of net assets at end of year (total assets less liabilities)2019-12-31$18,220,015
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$14,925,256
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$14,973,362
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$11,693,288
Value of interest in pooled separate accounts at end of year2019-12-31$295,051
Value of interest in pooled separate accounts at beginning of year2019-12-31$327,481
Interest earned on other investments2019-12-31$94,936
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$2,951,602
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$2,904,487
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$7,711
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$2,363,924
Net investment gain/loss from pooled separate accounts2019-12-31$15,916
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$789,632
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$1,188,148
Contract administrator fees2019-12-31$8,376
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2019-12-31410746749
2018 : PUEBLO COMMUNITY HEALTH CENTER, INC. 403(B) PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total income from all sources (including contributions)2018-12-31$944,477
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$399,614
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$399,614
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$1,625,805
Value of total assets at end of year2018-12-31$14,925,256
Value of total assets at beginning of year2018-12-31$14,380,393
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$0
Total interest from all sources2018-12-31$93,356
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$322,808
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2018-12-31$322,808
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$500,000
If this is an individual account plan, was there a blackout period2018-12-31No
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$885,093
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$22,529
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$544,863
Value of net assets at end of year (total assets less liabilities)2018-12-31$14,925,256
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$14,380,393
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$11,693,288
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$11,468,434
Value of interest in pooled separate accounts at end of year2018-12-31$327,481
Value of interest in pooled separate accounts at beginning of year2018-12-31$350,860
Interest earned on other investments2018-12-31$93,356
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$2,904,487
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$2,559,580
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-1,112,922
Net investment gain/loss from pooled separate accounts2018-12-31$15,430
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$718,183
Employer contributions (assets) at beginning of year2018-12-31$1,519
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$399,614
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31CLIFTONLARSONALLEN, LLP
Accountancy firm EIN2018-12-31410746749
2017 : PUEBLO COMMUNITY HEALTH CENTER, INC. 403(B) PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total income from all sources (including contributions)2017-12-31$3,190,806
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$1,163,770
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$1,148,492
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$1,403,932
Value of total assets at end of year2017-12-31$14,380,393
Value of total assets at beginning of year2017-12-31$12,353,357
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$15,278
Total interest from all sources2017-12-31$83,430
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$193,826
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2017-12-31$193,826
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$500,000
If this is an individual account plan, was there a blackout period2017-12-31No
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$758,585
Participant contributions at beginning of year2017-12-31$32,581
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$14,735
Other income not declared elsewhere2017-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$2,027,036
Value of net assets at end of year (total assets less liabilities)2017-12-31$14,380,393
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$12,353,357
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$11,468,434
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$9,167,924
Value of interest in pooled separate accounts at end of year2017-12-31$350,860
Value of interest in pooled separate accounts at beginning of year2017-12-31$567,646
Interest on participant loans2017-12-31$0
Interest earned on other investments2017-12-31$83,430
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-12-31$2,559,580
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-12-31$2,558,803
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-12-31$1,490,498
Net investment gain/loss from pooled separate accounts2017-12-31$19,120
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$630,612
Employer contributions (assets) at end of year2017-12-31$1,519
Employer contributions (assets) at beginning of year2017-12-31$26,403
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$1,148,492
Contract administrator fees2017-12-31$15,278
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31CLIFTONLARSONALLEN LLP
Accountancy firm EIN2017-12-31410746749
2016 : PUEBLO COMMUNITY HEALTH CENTER, INC. 403(B) PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total transfer of assets to this plan2016-12-31$229,805
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$2,140,311
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$578,371
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$566,686
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$1,465,046
Value of total assets at end of year2016-12-31$12,353,357
Value of total assets at beginning of year2016-12-31$10,561,612
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$11,685
Total interest from all sources2016-12-31$89,434
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$107,438
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2016-12-31$107,438
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$500,000
If this is an individual account plan, was there a blackout period2016-12-31No
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$779,876
Participant contributions at end of year2016-12-31$32,581
Income. Received or receivable in cash from other sources (including rollovers)2016-12-31$117,063
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$1,561,940
Value of net assets at end of year (total assets less liabilities)2016-12-31$12,353,357
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$10,561,612
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-31$9,167,924
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$7,406,123
Value of interest in pooled separate accounts at end of year2016-12-31$567,646
Value of interest in pooled separate accounts at beginning of year2016-12-31$655,929
Interest on participant loans2016-12-31$11
Interest earned on other investments2016-12-31$89,423
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-12-31$2,558,803
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-12-31$2,499,560
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$8,066
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-12-31$446,694
Net investment gain/loss from pooled separate accounts2016-12-31$31,699
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$568,107
Employer contributions (assets) at end of year2016-12-31$26,403
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$558,620
Contract administrator fees2016-12-31$11,685
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31MCPHERSON, BREYFOGLE, DAVELINE & GO
Accountancy firm EIN2016-12-31840628988
2015 : PUEBLO COMMUNITY HEALTH CENTER, INC. 403(B) PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total income from all sources (including contributions)2015-12-31$971,603
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$494,163
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$493,127
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$835,003
Value of total assets at end of year2015-12-31$10,561,612
Value of total assets at beginning of year2015-12-31$10,084,172
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$1,036
Total interest from all sources2015-12-31$79,909
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$520,000
If this is an individual account plan, was there a blackout period2015-12-31No
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$515,186
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$218
Other income not declared elsewhere2015-12-31$2
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$477,440
Value of net assets at end of year (total assets less liabilities)2015-12-31$10,561,612
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$10,084,172
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$7,406,123
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$7,065,215
Value of interest in pooled separate accounts at end of year2015-12-31$655,929
Value of interest in pooled separate accounts at beginning of year2015-12-31$588,154
Interest earned on other investments2015-12-31$79,909
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-12-31$2,499,560
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-12-31$2,421,135
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$7,454
Net investment gain/loss from pooled separate accounts2015-12-31$49,235
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$319,599
Employer contributions (assets) at beginning of year2015-12-31$9,668
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$493,127
Contract administrator fees2015-12-31$1,036
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31MCPHERSON, BREYFOGLE, DAVELINE & GO
Accountancy firm EIN2015-12-31840628988
2014 : PUEBLO COMMUNITY HEALTH CENTER, INC. 403(B) PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-12-31$0
Total transfer of assets to this plan2014-12-31$3,074
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total income from all sources (including contributions)2014-12-31$1,435,773
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$221,915
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$221,915
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$851,471
Value of total assets at end of year2014-12-31$10,084,172
Value of total assets at beginning of year2014-12-31$8,867,240
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$0
Total interest from all sources2014-12-31$78,457
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$520,000
If this is an individual account plan, was there a blackout period2014-12-31No
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$492,454
Income. Received or receivable in cash from other sources (including rollovers)2014-12-31$42,506
Other income not declared elsewhere2014-12-31$2
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$1,213,858
Value of net assets at end of year (total assets less liabilities)2014-12-31$10,084,172
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$8,867,240
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$7,065,215
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$6,194,702
Value of interest in pooled separate accounts at end of year2014-12-31$588,154
Value of interest in pooled separate accounts at beginning of year2014-12-31$483,776
Interest earned on other investments2014-12-31$78,457
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-12-31$2,421,135
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-12-31$2,181,827
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$74
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-12-31$445,910
Net investment gain/loss from pooled separate accounts2014-12-31$59,933
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$316,511
Employer contributions (assets) at end of year2014-12-31$9,668
Employer contributions (assets) at beginning of year2014-12-31$6,935
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$221,841
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31MCPHERSON, BREYFOGLE, DAVELINE & GO
Accountancy firm EIN2014-12-31840628988
2013 : PUEBLO COMMUNITY HEALTH CENTER, INC. 403(B) PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total income from all sources (including contributions)2013-12-31$2,004,510
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$346,380
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$346,240
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$852,058
Value of total assets at end of year2013-12-31$8,867,240
Value of total assets at beginning of year2013-12-31$7,209,110
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$140
Total interest from all sources2013-12-31$69,549
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Was this plan covered by a fidelity bond2013-12-31No
If this is an individual account plan, was there a blackout period2013-12-31No
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$439,543
Income. Received or receivable in cash from other sources (including rollovers)2013-12-31$109,052
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$1,658,130
Value of net assets at end of year (total assets less liabilities)2013-12-31$8,867,240
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$7,209,110
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-12-31$6,194,702
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$4,903,281
Value of interest in pooled separate accounts at end of year2013-12-31$483,776
Value of interest in pooled separate accounts at beginning of year2013-12-31$423,200
Interest earned on other investments2013-12-31$69,549
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-12-31$2,181,827
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-12-31$1,882,629
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-12-31$1,041,016
Net investment gain/loss from pooled separate accounts2013-12-31$41,887
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$303,463
Employer contributions (assets) at end of year2013-12-31$6,935
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$346,240
Contract administrator fees2013-12-31$140
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31Yes
Opinion of an independent qualified public accountant for this plan2013-12-31Disclaimer
Accountancy firm name2013-12-31MCPHERSON, BREYFOGLE, DAVELIN & GOO
Accountancy firm EIN2013-12-31840628988
2012 : PUEBLO COMMUNITY HEALTH CENTER, INC. 403(B) PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total income from all sources (including contributions)2012-12-31$1,406,811
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$94,239
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$93,774
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$759,954
Value of total assets at end of year2012-12-31$7,209,110
Value of total assets at beginning of year2012-12-31$5,896,538
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$465
Total interest from all sources2012-12-31$66,258
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 year2012-12-31No
Was this plan covered by a fidelity bond2012-12-31No
If this is an individual account plan, was there a blackout period2012-12-31No
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$444,015
Income. Received or receivable in cash from other sources (including rollovers)2012-12-31$36,378
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$1,312,572
Value of net assets at end of year (total assets less liabilities)2012-12-31$7,209,110
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$5,896,538
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-12-31$4,903,281
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$3,747,353
Value of interest in pooled separate accounts at end of year2012-12-31$423,200
Value of interest in pooled separate accounts at beginning of year2012-12-31$388,421
Interest earned on other investments2012-12-31$66,258
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-12-31$1,882,629
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-12-31$1,755,338
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-12-31$542,357
Net investment gain/loss from pooled separate accounts2012-12-31$38,242
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$279,561
Employer contributions (assets) at beginning of year2012-12-31$5,426
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$93,774
Contract administrator fees2012-12-31$465
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31Yes
Opinion of an independent qualified public accountant for this plan2012-12-31Disclaimer
Accountancy firm name2012-12-31MCPHERSON, BREYFOGLE, DAVELIN & GOO
Accountancy firm EIN2012-12-31840628988
2011 : PUEBLO COMMUNITY HEALTH CENTER, INC. 403(B) PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-12-31$0
Total transfer of assets to this plan2011-12-31$4,810
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$721,321
Total loss/gain on sale of assets2011-12-31$0
Total of all expenses incurred2011-12-31$174,005
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$174,005
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$657,017
Value of total assets at end of year2011-12-31$5,896,538
Value of total assets at beginning of year2011-12-31$5,344,412
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$0
Total interest from all sources2011-12-31$57,005
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Was this plan covered by a fidelity bond2011-12-31No
If this is an individual account plan, was there a blackout period2011-12-31No
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$400,270
Income. Received or receivable in cash from other sources (including rollovers)2011-12-31$7,134
Other income not declared elsewhere2011-12-31$11,538
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$547,316
Value of net assets at end of year (total assets less liabilities)2011-12-31$5,896,538
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$5,344,412
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-12-31$3,747,353
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-12-31$3,480,182
Value of interest in pooled separate accounts at end of year2011-12-31$388,421
Value of interest in pooled separate accounts at beginning of year2011-12-31$311,519
Interest earned on other investments2011-12-31$57,005
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-12-31$1,755,338
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-12-31$1,546,294
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-12-31$-46,576
Net investment gain/loss from pooled separate accounts2011-12-31$42,337
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$249,613
Employer contributions (assets) at end of year2011-12-31$5,426
Employer contributions (assets) at beginning of year2011-12-31$6,417
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$174,005
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31MCPHERSON, BREYFOGLE, DAVELIN & GOO
Accountancy firm EIN2011-12-31840628988
2010 : PUEBLO COMMUNITY HEALTH CENTER, INC. 403(B) PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets2010-12-31$0
Total transfer of assets to this plan2010-12-31$15,694
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total income from all sources (including contributions)2010-12-31$1,102,171
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$157,238
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$157,238
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$625,665
Value of total assets at end of year2010-12-31$5,344,412
Value of total assets at beginning of year2010-12-31$4,383,785
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$0
Total interest from all sources2010-12-31$48,020
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Was this plan covered by a fidelity bond2010-12-31No
If this is an individual account plan, was there a blackout period2010-12-31No
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$377,742
Assets. Other investments not covered elsewhere at beginning of year2010-12-31$10,351
Income. Received or receivable in cash from other sources (including rollovers)2010-12-31$690
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2010-12-31$10,351
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$944,933
Value of net assets at end of year (total assets less liabilities)2010-12-31$5,344,412
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$4,383,785
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2010-12-31$3,480,182
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$2,814,979
Value of interest in pooled separate accounts at end of year2010-12-31$311,519
Value of interest in pooled separate accounts at beginning of year2010-12-31$251,445
Interest earned on other investments2010-12-31$48,020
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$1,546,294
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$1,307,010
Net investment gain/loss from registered investment companies (e.g. mutual funds)2010-12-31$392,733
Net investment gain/loss from pooled separate accounts2010-12-31$35,753
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$247,233
Employer contributions (assets) at end of year2010-12-31$6,417
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$146,887
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31MCPHERSON, BREYFOGLE, DAVELIN & GOO
Accountancy firm EIN2010-12-31840628988

Form 5500 Responses for PUEBLO COMMUNITY HEALTH CENTER, INC. 403(B) PLAN

2022: PUEBLO COMMUNITY HEALTH CENTER, INC. 403(B) PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: PUEBLO COMMUNITY HEALTH CENTER, INC. 403(B) PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: PUEBLO COMMUNITY HEALTH CENTER, INC. 403(B) PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: PUEBLO COMMUNITY HEALTH CENTER, INC. 403(B) PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: PUEBLO COMMUNITY HEALTH CENTER, INC. 403(B) PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: PUEBLO COMMUNITY HEALTH CENTER, INC. 403(B) PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: PUEBLO COMMUNITY HEALTH CENTER, INC. 403(B) PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: PUEBLO COMMUNITY HEALTH CENTER, INC. 403(B) PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: PUEBLO COMMUNITY HEALTH CENTER, INC. 403(B) PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: PUEBLO COMMUNITY HEALTH CENTER, INC. 403(B) PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: PUEBLO COMMUNITY HEALTH CENTER, INC. 403(B) PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: PUEBLO COMMUNITY HEALTH CENTER, INC. 403(B) PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2010: PUEBLO COMMUNITY HEALTH CENTER, INC. 403(B) PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes
2009: PUEBLO COMMUNITY HEALTH CENTER, INC. 403(B) PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )
Policy contract number369138
Policy instance 1
Insurance contract or identification number369138
Number of Individuals Covered180
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )
Policy contract number369138
Policy instance 1
Insurance contract or identification number369138
Number of Individuals Covered196
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )
Policy contract number369138
Policy instance 1
Insurance contract or identification number369138
Number of Individuals Covered219
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )
Policy contract number369138
Policy instance 1
Insurance contract or identification number369138
Number of Individuals Covered229
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )
Policy contract number369138
Policy instance 1
Insurance contract or identification number369138
Number of Individuals Covered234
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )
Policy contract number369138
Policy instance 1
Insurance contract or identification number369138
Number of Individuals Covered269
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )
Policy contract number369139
Policy instance 2
Insurance contract or identification number369139
Number of Individuals Covered215
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )
Policy contract number369138
Policy instance 1
Insurance contract or identification number369138
Number of Individuals Covered325
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )
Policy contract number369138
Policy instance 2
Insurance contract or identification number369138
Number of Individuals Covered306
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )
Policy contract number369139
Policy instance 1
Insurance contract or identification number369139
Number of Individuals Covered217
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )
Policy contract number369138
Policy instance 2
Insurance contract or identification number369138
Number of Individuals Covered273
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )
Policy contract number369139
Policy instance 1
Insurance contract or identification number369139
Number of Individuals Covered188
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )
Policy contract number369139
Policy instance 1
Insurance contract or identification number369139
Number of Individuals Covered169
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )
Policy contract number369138
Policy instance 2
Insurance contract or identification number369138
Number of Individuals Covered259
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )
Policy contract number369139
Policy instance 2
Insurance contract or identification number369139
Number of Individuals Covered164
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )
Policy contract number369138
Policy instance 1
Insurance contract or identification number369138
Number of Individuals Covered249
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )
Policy contract number369138
Policy instance 1
Insurance contract or identification number369138
Number of Individuals Covered248
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )
Policy contract number369139
Policy instance 2
Insurance contract or identification number369139
Number of Individuals Covered161
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No

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