401k Plan data: COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST plan

COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST 401k Plan overview

Plan Name	COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST
Plan identification number	001

COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

BISBEE HOSPITAL ASSOCIATION INC has sponsored the creation of one or more 401k plans.

Company Name: BISBEE HOSPITAL ASSOCIATION INC

Employer identification number (EIN): 860334996

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2020-01-01
001 2019-01-01
001 2019-01-01
001 2018-01-01
001 2018-01-01
001 2017-01-01 HEATHER LUNDSTROM
001 2016-01-01 JAMES EHASZ
001 2015-01-01 JAMES EHASZ
001 2014-01-01 JAMES EHASZ
001 2013-01-01 ERIC L. HUGHES
001 2012-10-01 ERIC L. HUGHES
001 2011-10-01 ERIC L. HUGHES
001 2009-10-01 JAMES DICKSON
001 2008-10-01

Plan Statistics for COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST

401k plan membership statisitcs for COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST

Measure Date Value
2020: COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST 2020 401k membership
Total participants, beginning-of-year 2020-01-01 414
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 0
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 0
Total of all active and inactive participants 2020-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 0
Number of participants with account balances 2020-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST 2019 401k membership
Total participants, beginning-of-year 2019-01-01 409
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 352
Number of retired or separated participants receiving benefits 2019-01-01 2
Number of other retired or separated participants entitled to future benefits 2019-01-01 60
Total of all active and inactive participants 2019-01-01 414
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 414
Number of participants with account balances 2019-01-01 252
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 3
2018: COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST 2018 401k membership
Total participants, beginning-of-year 2018-01-01 388
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 352
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 10
Total of all active and inactive participants 2018-01-01 362
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 1
Total participants 2018-01-01 363
Number of participants with account balances 2018-01-01 248
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST 2017 401k membership
Total participants, beginning-of-year 2017-01-01 322
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 373
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 15
Total of all active and inactive participants 2017-01-01 388
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 388
Number of participants with account balances 2017-01-01 238
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 5
2016: COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST 2016 401k membership
Total participants, beginning-of-year 2016-01-01 167
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 318
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 4
Total of all active and inactive participants 2016-01-01 322
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 322
Number of participants with account balances 2016-01-01 212
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST 2015 401k membership
Total participants, beginning-of-year 2015-01-01 213
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 132
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 35
Total of all active and inactive participants 2015-01-01 167
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 167
Number of participants with account balances 2015-01-01 166
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST 2014 401k membership
Total participants, beginning-of-year 2014-01-01 282
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 209
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 4
Total of all active and inactive participants 2014-01-01 213
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 213
Number of participants with account balances 2014-01-01 213
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST 2013 401k membership
Total participants, beginning-of-year 2013-01-01 260
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 214
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 68
Total of all active and inactive participants 2013-01-01 282
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 282
Number of participants with account balances 2013-01-01 184
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST 2012 401k membership
Total participants, beginning-of-year 2012-10-01 261
Total number of active participants reported on line 7a of the Form 5500 2012-10-01 202
Number of retired or separated participants receiving benefits 2012-10-01 0
Number of other retired or separated participants entitled to future benefits 2012-10-01 58
Total of all active and inactive participants 2012-10-01 260
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-10-01 0
Total participants 2012-10-01 260
Number of participants with account balances 2012-10-01 183
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-10-01 0
2011: COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST 2011 401k membership
Total participants, beginning-of-year 2011-10-01 251
Total number of active participants reported on line 7a of the Form 5500 2011-10-01 200
Number of retired or separated participants receiving benefits 2011-10-01 0
Number of other retired or separated participants entitled to future benefits 2011-10-01 61
Total of all active and inactive participants 2011-10-01 261
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-10-01 0
Total participants 2011-10-01 261
Number of participants with account balances 2011-10-01 192
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-10-01 3
2009: COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST 2009 401k membership
Total participants, beginning-of-year 2009-10-01 241
Total number of active participants reported on line 7a of the Form 5500 2009-10-01 158
Number of retired or separated participants receiving benefits 2009-10-01 0
Number of other retired or separated participants entitled to future benefits 2009-10-01 46
Total of all active and inactive participants 2009-10-01 204
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-10-01 0
Total participants 2009-10-01 204
Number of participants with account balances 2009-10-01 158
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-10-01 2

Measure	Date	Value
2020: COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST 2020 401k membership
Total participants, beginning-of-year	2020-01-01	414
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	0
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	0
Total of all active and inactive participants	2020-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	0
Number of participants with account balances	2020-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST 2019 401k membership
Total participants, beginning-of-year	2019-01-01	409
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	352
Number of retired or separated participants receiving benefits	2019-01-01	2
Number of other retired or separated participants entitled to future benefits	2019-01-01	60
Total of all active and inactive participants	2019-01-01	414
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	414
Number of participants with account balances	2019-01-01	252
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	3
2018: COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST 2018 401k membership
Total participants, beginning-of-year	2018-01-01	388
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	352
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	10
Total of all active and inactive participants	2018-01-01	362
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	1
Total participants	2018-01-01	363
Number of participants with account balances	2018-01-01	248
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST 2017 401k membership
Total participants, beginning-of-year	2017-01-01	322
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	373
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	15
Total of all active and inactive participants	2017-01-01	388
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	388
Number of participants with account balances	2017-01-01	238
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	5
2016: COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST 2016 401k membership
Total participants, beginning-of-year	2016-01-01	167
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	318
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	4
Total of all active and inactive participants	2016-01-01	322
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	322
Number of participants with account balances	2016-01-01	212
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST 2015 401k membership
Total participants, beginning-of-year	2015-01-01	213
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	132
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	35
Total of all active and inactive participants	2015-01-01	167
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	167
Number of participants with account balances	2015-01-01	166
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST 2014 401k membership
Total participants, beginning-of-year	2014-01-01	282
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	209
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	4
Total of all active and inactive participants	2014-01-01	213
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	213
Number of participants with account balances	2014-01-01	213
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST 2013 401k membership
Total participants, beginning-of-year	2013-01-01	260
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	214
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	68
Total of all active and inactive participants	2013-01-01	282
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	282
Number of participants with account balances	2013-01-01	184
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST 2012 401k membership
Total participants, beginning-of-year	2012-10-01	261
Total number of active participants reported on line 7a of the Form 5500	2012-10-01	202
Number of retired or separated participants receiving benefits	2012-10-01	0
Number of other retired or separated participants entitled to future benefits	2012-10-01	58
Total of all active and inactive participants	2012-10-01	260
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-10-01	0
Total participants	2012-10-01	260
Number of participants with account balances	2012-10-01	183
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-10-01	0
2011: COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST 2011 401k membership
Total participants, beginning-of-year	2011-10-01	251
Total number of active participants reported on line 7a of the Form 5500	2011-10-01	200
Number of retired or separated participants receiving benefits	2011-10-01	0
Number of other retired or separated participants entitled to future benefits	2011-10-01	61
Total of all active and inactive participants	2011-10-01	261
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-10-01	0
Total participants	2011-10-01	261
Number of participants with account balances	2011-10-01	192
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-10-01	3
2009: COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST 2009 401k membership
Total participants, beginning-of-year	2009-10-01	241
Total number of active participants reported on line 7a of the Form 5500	2009-10-01	158
Number of retired or separated participants receiving benefits	2009-10-01	0
Number of other retired or separated participants entitled to future benefits	2009-10-01	46
Total of all active and inactive participants	2009-10-01	204
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-10-01	0
Total participants	2009-10-01	204
Number of participants with account balances	2009-10-01	158
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-10-01	2

Financial Data on COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST

Measure	Date	Value
2020 : COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST 2020 401k financial data
Total transfer of assets from this plan	2020-06-30	$4,131,343
Total income from all sources (including contributions)	2020-06-30	$96,597
Total of all expenses incurred	2020-06-30	$2,119,462
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-06-30	$2,115,505
Value of total corrective distributions	2020-06-30	$2,465
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-06-30	$178,215
Value of total assets at end of year	2020-06-30	$0
Value of total assets at beginning of year	2020-06-30	$6,154,208
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-06-30	$1,492
Total interest from all sources	2020-06-30	$4,428
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-06-30	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2020-06-30	$0
Was this plan covered by a fidelity bond	2020-06-30	Yes
Value of fidelity bond cover	2020-06-30	$450,000
If this is an individual account plan, was there a blackout period	2020-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2020-06-30	No
Contributions received from participants	2020-06-30	$141,589
Participant contributions at end of year	2020-06-30	$0
Participant contributions at beginning of year	2020-06-30	$17,927
Assets. Loans (other than to participants) at end of year	2020-06-30	$0
Assets. Loans (other than to participants) at beginning of year	2020-06-30	$152,551
Total non interest bearing cash at end of year	2020-06-30	$0
Total non interest bearing cash at beginning of year	2020-06-30	$12,807
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-06-30	No
Value of net income/loss	2020-06-30	$-2,022,865
Value of net assets at end of year (total assets less liabilities)	2020-06-30	$0
Value of net assets at beginning of year (total assets less liabilities)	2020-06-30	$6,154,208
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-06-30	No
Were any leases to which the plan was party in default or uncollectible	2020-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-06-30	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-06-30	$5,960,271
Interest on participant loans	2020-06-30	$4,428
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-06-30	$-86,046
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-06-30	No
Was there a failure to transmit to the plan any participant contributions	2020-06-30	No
Has the plan failed to provide any benefit when due under the plan	2020-06-30	No
Contributions received in cash from employer	2020-06-30	$36,626
Employer contributions (assets) at end of year	2020-06-30	$0
Employer contributions (assets) at beginning of year	2020-06-30	$10,652
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-06-30	$2,115,505
Contract administrator fees	2020-06-30	$1,492
Did the plan have assets held for investment	2020-06-30	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2020-06-30	Disclaimer
Accountancy firm name	2020-06-30	WIPFLI LLP
Accountancy firm EIN	2020-06-30	390758449
2019 : COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST 2019 401k financial data
Total income from all sources (including contributions)	2019-12-31	$1,891,258
Total income from all sources (including contributions)	2019-12-31	$1,891,258
Total of all expenses incurred	2019-12-31	$1,665,885
Total of all expenses incurred	2019-12-31	$1,665,885
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$1,623,276
Expenses. Certain deemed distributions of participant loans	2019-12-31	$11,444
Expenses. Certain deemed distributions of participant loans	2019-12-31	$11,444
Value of total corrective distributions	2019-12-31	$5,506
Value of total corrective distributions	2019-12-31	$5,506
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$860,931
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$860,931
Value of total assets at end of year	2019-12-31	$6,125,629
Value of total assets at end of year	2019-12-31	$6,125,629
Value of total assets at beginning of year	2019-12-31	$5,900,256
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$25,659
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$25,659
Total interest from all sources	2019-12-31	$8,693
Total interest from all sources	2019-12-31	$8,693
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	Yes
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2019-12-31	$0
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2019-12-31	$0
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$0
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$0
Was this plan covered by a fidelity bond	2019-12-31	Yes
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$450,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$567,343
Contributions received from participants	2019-12-31	$567,343
Participant contributions at end of year	2019-12-31	$152,551
Participant contributions at end of year	2019-12-31	$152,551
Participant contributions at beginning of year	2019-12-31	$143,368
Participant contributions at end of year	2019-12-31	$0
Participant contributions at end of year	2019-12-31	$0
Participant contributions at beginning of year	2019-12-31	$0
Participant contributions at beginning of year	2019-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$67,213
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$67,213
Value of other receiveables (less allowance for doubtful accounts) at end of year	2019-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2019-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2019-12-31	$0
Administrative expenses (other) incurred	2019-12-31	$0
Administrative expenses (other) incurred	2019-12-31	$0
Total non interest bearing cash at end of year	2019-12-31	$12,807
Total non interest bearing cash at beginning of year	2019-12-31	$20,124
Total non interest bearing cash at beginning of year	2019-12-31	$20,124
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$225,373
Value of net income/loss	2019-12-31	$225,373
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$6,125,629
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$6,125,629
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$5,900,256
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$5,900,256
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$5,960,271
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$5,960,271
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$5,736,764
Interest on participant loans	2019-12-31	$8,693
Interest on participant loans	2019-12-31	$8,693
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2019-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2019-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$1,021,634
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$226,375
Contributions received in cash from employer	2019-12-31	$226,375
Employer contributions (assets) at end of year	2019-12-31	$0
Employer contributions (assets) at end of year	2019-12-31	$0
Employer contributions (assets) at beginning of year	2019-12-31	$0
Employer contributions (assets) at beginning of year	2019-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$1,623,276
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$1,623,276
Contract administrator fees	2019-12-31	$25,659
Contract administrator fees	2019-12-31	$25,659
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	WIPFLI LLP
Accountancy firm name	2019-12-31	WIPFLI LLP
Accountancy firm EIN	2019-12-31	390758449
2018 : COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$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	$668,055
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$995,264
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$929,715
Expenses. Certain deemed distributions of participant loans	2018-12-31	$4,257
Value of total corrective distributions	2018-12-31	$20,746
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$987,863
Value of total assets at end of year	2018-12-31	$5,900,256
Value of total assets at beginning of year	2018-12-31	$6,227,465
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$40,546
Total interest from all sources	2018-12-31	$6,848
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$600,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$613,987
Participant contributions at end of year	2018-12-31	$143,368
Participant contributions at beginning of year	2018-12-31	$138,359
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$99,152
Total non interest bearing cash at end of year	2018-12-31	$20,124
Total non interest bearing cash at beginning of year	2018-12-31	$10,796
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$-327,209
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$5,900,256
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$6,227,465
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$5,736,764
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$6,078,310
Value of interest in pooled separate accounts at end of year	2018-12-31	$5,736,764
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$6,078,310
Interest on participant loans	2018-12-31	$6,848
Net investment gain/loss from pooled separate accounts	2018-12-31	$-326,656
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$274,724
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$929,715
Contract administrator fees	2018-12-31	$40,546
Did the plan have assets held for investment	2018-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	REIGER CARR & MONROE
Accountancy firm EIN	2018-12-31	480573184
2017 : COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$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	$1,619,663
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$782,221
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$712,310
Expenses. Certain deemed distributions of participant loans	2017-12-31	$8,219
Value of total corrective distributions	2017-12-31	$24,945
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$871,245
Value of total assets at end of year	2017-12-31	$6,227,465
Value of total assets at beginning of year	2017-12-31	$5,390,023
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$36,747
Total interest from all sources	2017-12-31	$5,025
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$600,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$608,485
Participant contributions at end of year	2017-12-31	$138,359
Participant contributions at beginning of year	2017-12-31	$158,244
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$33,842
Total non interest bearing cash at end of year	2017-12-31	$10,796
Total non interest bearing cash at beginning of year	2017-12-31	$7,153
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$837,442
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$6,227,465
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$5,390,023
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in pooled separate accounts at end of year	2017-12-31	$6,078,310
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$5,224,626
Interest on participant loans	2017-12-31	$5,025
Net investment gain/loss from pooled separate accounts	2017-12-31	$743,393
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$228,918
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$712,310
Contract administrator fees	2017-12-31	$36,747
Did the plan have assets held for investment	2017-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	REIGER CARR & MONROE
Accountancy firm EIN	2017-12-31	480573184
2016 : COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$1,206,928
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$257,375
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$209,567
Value of total corrective distributions	2016-12-31	$17,059
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$899,604
Value of total assets at end of year	2016-12-31	$5,390,023
Value of total assets at beginning of year	2016-12-31	$4,440,470
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$30,749
Total interest from all sources	2016-12-31	$4,709
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Administrative expenses professional fees incurred	2016-12-31	$30,749
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$450,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$548,904
Participant contributions at end of year	2016-12-31	$158,244
Participant contributions at beginning of year	2016-12-31	$164,126
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$131,517
Total non interest bearing cash at end of year	2016-12-31	$7,153
Total non interest bearing cash at beginning of year	2016-12-31	$32,455
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$949,553
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$5,390,023
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$4,440,470
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in pooled separate accounts at end of year	2016-12-31	$5,224,626
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$4,243,889
Interest on participant loans	2016-12-31	$4,709
Net investment gain/loss from pooled separate accounts	2016-12-31	$302,615
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$219,183
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$209,567
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	REIGER CARR & MONROE
Accountancy firm EIN	2016-12-31	480573184
2015 : COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$631,933
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$765,820
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$735,721
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$682,053
Value of total assets at end of year	2015-12-31	$4,440,470
Value of total assets at beginning of year	2015-12-31	$4,574,357
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$30,099
Total interest from all sources	2015-12-31	$5,956
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 year	2015-12-31	No
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$450,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$474,602
Participant contributions at end of year	2015-12-31	$164,126
Participant contributions at beginning of year	2015-12-31	$104,555
Participant contributions at end of year	2015-12-31	$0
Participant contributions at beginning of year	2015-12-31	$0
Total non interest bearing cash at end of year	2015-12-31	$32,455
Total non interest bearing cash at beginning of year	2015-12-31	$37,018
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$-133,887
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$4,440,470
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$4,574,357
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in pooled separate accounts at end of year	2015-12-31	$4,243,889
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$4,432,784
Interest on participant loans	2015-12-31	$5,956
Net investment gain/loss from pooled separate accounts	2015-12-31	$-56,076
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$207,451
Employer contributions (assets) at end of year	2015-12-31	$0
Employer contributions (assets) at beginning of year	2015-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$735,721
Contract administrator fees	2015-12-31	$30,099
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	REIGER CARR & MONROE
Accountancy firm EIN	2015-12-31	480573184
2014 : COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$770,037
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$532,410
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$508,063
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$628,633
Value of total assets at end of year	2014-12-31	$4,574,357
Value of total assets at beginning of year	2014-12-31	$4,336,730
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$24,347
Total interest from all sources	2014-12-31	$6,858
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 year	2014-12-31	No
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$450,000
If this is an individual account plan, was there a blackout period	2014-12-31	Yes
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$385,894
Participant contributions at end of year	2014-12-31	$104,555
Participant contributions at beginning of year	2014-12-31	$127,037
Participant contributions at end of year	2014-12-31	$0
Participant contributions at beginning of year	2014-12-31	$12,922
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$19,063
Administrative expenses (other) incurred	2014-12-31	$24,347
Total non interest bearing cash at end of year	2014-12-31	$37,018
Total non interest bearing cash at beginning of year	2014-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$237,627
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$4,574,357
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$4,336,730
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in pooled separate accounts at end of year	2014-12-31	$4,432,784
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$4,188,656
Interest on participant loans	2014-12-31	$6,858
Net investment gain/loss from pooled separate accounts	2014-12-31	$134,546
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$223,676
Employer contributions (assets) at end of year	2014-12-31	$0
Employer contributions (assets) at beginning of year	2014-12-31	$8,115
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$508,063
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2014-12-31	Yes
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	REIGER CARR & MONROE
Accountancy firm EIN	2014-12-31	480573184
2013 : COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total transfer of assets to this plan	2013-12-31	$0
Total transfer of assets from this plan	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Expenses. Interest paid	2013-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$1,161,021
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$199,631
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$193,991
Expenses. Certain deemed distributions of participant loans	2013-12-31	$5,640
Value of total corrective distributions	2013-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$541,620
Value of total assets at end of year	2013-12-31	$4,336,730
Value of total assets at beginning of year	2013-12-31	$3,375,340
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$0
Total interest from all sources	2013-12-31	$6,854
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 year	2013-12-31	No
Administrative expenses professional fees incurred	2013-12-31	$0
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$450,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$340,644
Participant contributions at end of year	2013-12-31	$127,037
Participant contributions at beginning of year	2013-12-31	$62,068
Participant contributions at end of year	2013-12-31	$12,922
Participant contributions at beginning of year	2013-12-31	$11,815
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2013-12-31	$0
Administrative expenses (other) incurred	2013-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Income. Non cash contributions	2013-12-31	$0
Value of net income/loss	2013-12-31	$961,390
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$4,336,730
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$3,375,340
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Investment advisory and management fees	2013-12-31	$0
Value of interest in pooled separate accounts at end of year	2013-12-31	$4,188,656
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$3,294,055
Interest on participant loans	2013-12-31	$6,854
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2013-12-31	$0
Net investment gain/loss from pooled separate accounts	2013-12-31	$612,547
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$200,976
Employer contributions (assets) at end of year	2013-12-31	$8,115
Employer contributions (assets) at beginning of year	2013-12-31	$7,402
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$193,991
Contract administrator fees	2013-12-31	$0
Did the plan have assets held for investment	2013-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	No
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	REGIER CARR & MONROE, LLP CPAS
Accountancy firm EIN	2013-12-31	480573184
2012 : COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$145,192
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$37,679
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$37,679
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$120,850
Value of total assets at end of year	2012-12-31	$3,389,385
Value of total assets at beginning of year	2012-12-31	$3,281,872
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$0
Total interest from all sources	2012-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$350,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$76,849
Participant contributions at end of year	2012-12-31	$11,815
Participant contributions at beginning of year	2012-12-31	$26,847
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Income. Non cash contributions	2012-12-31	$0
Value of net income/loss	2012-12-31	$107,513
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$3,389,385
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$3,281,872
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in pooled separate accounts at end of year	2012-12-31	$3,370,168
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$3,240,354
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$0
Net investment gain/loss from pooled separate accounts	2012-12-31	$24,342
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$44,001
Employer contributions (assets) at end of year	2012-12-31	$7,402
Employer contributions (assets) at beginning of year	2012-12-31	$14,671
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$37,679
Did the plan have assets held for investment	2012-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Unrealized appreciation/depreciation of real estate assets	2012-09-30	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2012-09-30	$0
Total unrealized appreciation/depreciation of assets	2012-09-30	$0
Total transfer of assets to this plan	2012-09-30	$0
Total transfer of assets from this plan	2012-09-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-09-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-09-30	$0
Expenses. Interest paid	2012-09-30	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2012-09-30	$0
Total income from all sources (including contributions)	2012-09-30	$933,982
Total loss/gain on sale of assets	2012-09-30	$0
Total of all expenses incurred	2012-09-30	$256,273
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-09-30	$256,273
Expenses. Certain deemed distributions of participant loans	2012-09-30	$0
Value of total corrective distributions	2012-09-30	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-09-30	$520,827
Value of total assets at end of year	2012-09-30	$3,281,872
Value of total assets at beginning of year	2012-09-30	$2,604,163
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-09-30	$0
Total income from rents	2012-09-30	$0
Total interest from all sources	2012-09-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2012-09-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-09-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-09-30	$0
Administrative expenses professional fees incurred	2012-09-30	$0
Was this plan covered by a fidelity bond	2012-09-30	Yes
Value of fidelity bond cover	2012-09-30	$350,000
Were there any nonexempt tranactions with any party-in-interest	2012-09-30	No
Contributions received from participants	2012-09-30	$323,529
Participant contributions at end of year	2012-09-30	$26,847
Participant contributions at beginning of year	2012-09-30	$10,799
Income. Received or receivable in cash from other sources (including rollovers)	2012-09-30	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2012-09-30	$0
Administrative expenses (other) incurred	2012-09-30	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-09-30	No
Income. Non cash contributions	2012-09-30	$0
Value of net income/loss	2012-09-30	$677,709
Value of net assets at end of year (total assets less liabilities)	2012-09-30	$3,281,872
Value of net assets at beginning of year (total assets less liabilities)	2012-09-30	$2,604,163
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-09-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-09-30	No
Were any leases to which the plan was party in default or uncollectible	2012-09-30	No
Investment advisory and management fees	2012-09-30	$0
Value of interest in pooled separate accounts at end of year	2012-09-30	$3,240,354
Value of interest in pooled separate accounts at beginning of year	2012-09-30	$2,581,506
Interest on participant loans	2012-09-30	$0
Income. Interest from loans (other than to participants)	2012-09-30	$0
Interest earned on other investments	2012-09-30	$0
Income. Interest from US Government securities	2012-09-30	$0
Income. Interest from corporate debt instruments	2012-09-30	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-09-30	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-09-30	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-09-30	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2012-09-30	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-09-30	$0
Net investment gain/loss from pooled separate accounts	2012-09-30	$413,155
Net investment gain or loss from common/collective trusts	2012-09-30	$0
Net gain/loss from 103.12 investment entities	2012-09-30	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-09-30	No
Was there a failure to transmit to the plan any participant contributions	2012-09-30	No
Has the plan failed to provide any benefit when due under the plan	2012-09-30	No
Contributions received in cash from employer	2012-09-30	$197,298
Employer contributions (assets) at end of year	2012-09-30	$14,671
Employer contributions (assets) at beginning of year	2012-09-30	$11,858
Income. Dividends from preferred stock	2012-09-30	$0
Income. Dividends from common stock	2012-09-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-09-30	$256,273
Contract administrator fees	2012-09-30	$0
Did the plan have assets held for investment	2012-09-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-09-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-09-30	No
Aggregate proceeds on sale of assets	2012-09-30	$0
Aggregate carrying amount (costs) on sale of assets	2012-09-30	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-09-30	No
Opinion of an independent qualified public accountant for this plan	2012-09-30	Unqualified
Accountancy firm name	2012-09-30	STANLEY F. CARPENTER
Accountancy firm EIN	2012-09-30	860695808
2011 : COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST 2011 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2011-09-30	$-62,357
Total unrealized appreciation/depreciation of assets	2011-09-30	$-62,357
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-09-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-09-30	$0
Total income from all sources (including contributions)	2011-09-30	$511,778
Total loss/gain on sale of assets	2011-09-30	$0
Total of all expenses incurred	2011-09-30	$426,235
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-09-30	$426,235
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-09-30	$574,135
Value of total assets at end of year	2011-09-30	$2,604,163
Value of total assets at beginning of year	2011-09-30	$2,518,620
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-09-30	$0
Total interest from all sources	2011-09-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2011-09-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-09-30	No
Was this plan covered by a fidelity bond	2011-09-30	Yes
Value of fidelity bond cover	2011-09-30	$300,000
Were there any nonexempt tranactions with any party-in-interest	2011-09-30	No
Contributions received from participants	2011-09-30	$321,208
Participant contributions at end of year	2011-09-30	$10,799
Income. Received or receivable in cash from other sources (including rollovers)	2011-09-30	$14,406
Administrative expenses (other) incurred	2011-09-30	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-09-30	No
Income. Non cash contributions	2011-09-30	$0
Value of net income/loss	2011-09-30	$85,543
Value of net assets at end of year (total assets less liabilities)	2011-09-30	$2,604,163
Value of net assets at beginning of year (total assets less liabilities)	2011-09-30	$2,518,620
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-09-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-09-30	No
Were any leases to which the plan was party in default or uncollectible	2011-09-30	No
Value of interest in pooled separate accounts at end of year	2011-09-30	$2,581,506
Value of interest in pooled separate accounts at beginning of year	2011-09-30	$2,518,620
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-09-30	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-09-30	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-09-30	No
Was there a failure to transmit to the plan any participant contributions	2011-09-30	No
Has the plan failed to provide any benefit when due under the plan	2011-09-30	No
Contributions received in cash from employer	2011-09-30	$238,521
Employer contributions (assets) at end of year	2011-09-30	$11,858
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-09-30	$426,235
Did the plan have assets held for investment	2011-09-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-09-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-09-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-09-30	No
Opinion of an independent qualified public accountant for this plan	2011-09-30	Unqualified
Accountancy firm name	2011-09-30	STANLEY F. CARPENTER
Accountancy firm EIN	2011-09-30	860695808
2010 : COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST 2010 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-09-30	$0

Form 5500 Responses for COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST

2020: COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	This submission is the final filing	Yes
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	Yes
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	Yes
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	Yes
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	Yes
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	Yes
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	Yes
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST 2012 form 5500 responses
2012-10-01	Type of plan entity	Single employer plan
2012-10-01	Submission has been amended	No
2012-10-01	This submission is the final filing	No
2012-10-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2012-10-01	Plan is a collectively bargained plan	No
2012-10-01	Plan funding arrangement – Insurance	Yes
2012-10-01	Plan benefit arrangement – Insurance	Yes
2011: COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST 2011 form 5500 responses
2011-10-01	Type of plan entity	Single employer plan
2011-10-01	Submission has been amended	No
2011-10-01	This submission is the final filing	No
2011-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-10-01	Plan is a collectively bargained plan	No
2011-10-01	Plan funding arrangement – Insurance	Yes
2011-10-01	Plan benefit arrangement – Insurance	Yes
2009: COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST 2009 form 5500 responses
2009-10-01	Type of plan entity	Single employer plan
2009-10-01	Submission has been amended	No
2009-10-01	This submission is the final filing	No
2009-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-10-01	Plan is a collectively bargained plan	No
2009-10-01	Plan funding arrangement – Insurance	Yes
2009-10-01	Plan benefit arrangement – Insurance	Yes
2008: COPPER QUEEN COMMUNITY HOSPITAL 401(K) SAVINGS PLAN AND TRUST 2008 form 5500 responses
2008-10-01	Type of plan entity	Single employer plan
2008-10-01	Submission has been amended	No
2008-10-01	This submission is the final filing	No
2008-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2008-10-01	Plan is a collectively bargained plan	No

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

114682

Policy instance

Insurance contract or identification number	114682
Number of Individuals Covered	0
Insurance policy start date	2020-01-01
Insurance policy end date	2020-06-30
Total amount of fees paid to insurance company	USD $5,460
Are there contracts with allocated funds for types other than group deferred annuity or individual?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Other information about contract	GROUP ANNUITY
Amount paid for insurance broker fees	5075
Additional information about fees paid to insurance broker	TPA FEES
Insurance broker organization code?	5

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

114682

Policy instance

Insurance contract or identification number	114682
Number of Individuals Covered	258
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of fees paid to insurance company	USD $3,230
Are there contracts with allocated funds for types other than group deferred annuity or individual?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Other information about contract	GROUP ANNUITY
Amount paid for insurance broker fees	3230
Additional information about fees paid to insurance broker	TPA FEES
Insurance broker organization code?	5

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

114682

Policy instance

Insurance contract or identification number	114682
Number of Individuals Covered	252
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $2,650
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?	Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Other information about contract	GROUP ANNUITY
Amount paid for insurance broker fees	2650
Additional information about fees paid to insurance broker	TPA FEES
Insurance broker organization code?	5

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

114682

Policy instance

Insurance contract or identification number	114682
Number of Individuals Covered	244
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $5,382
Total amount of fees paid to insurance company	USD $2,475
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?	Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Other information about contract	GROUP ANNUITY
Commission paid to Insurance Broker	USD $5,382
Insurance broker organization code?	3
Amount paid for insurance broker fees	2475
Additional information about fees paid to insurance broker	TPA FEES
Insurance broker name	JOHN HANCOCK RPS LLC

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

114682

Policy instance

Insurance contract or identification number	114682
Number of Individuals Covered	198
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $7,191
Total amount of fees paid to insurance company	USD $3,530
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?	Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Other information about contract	GROUP ANNUITY
Commission paid to Insurance Broker	USD $7,191
Insurance broker organization code?	3
Amount paid for insurance broker fees	3530
Additional information about fees paid to insurance broker	TPA FEES
Insurance broker name	JOHN HANCOCK RPS LLC

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

114682

Policy instance

Insurance contract or identification number	114682
Number of Individuals Covered	211
Insurance policy start date	2014-07-18
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $33,677
Total amount of fees paid to insurance company	USD $1,040
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?	Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Other information about contract	GROUP ANNUITY
Commission paid to Insurance Broker	USD $33,677
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	3
Insurance broker organization code?	3
Insurance broker name	JOHN HANCOCK RPS LLC

GREAT AMERICAN LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 93661 )

Policy contract number

A000454

Policy instance

Insurance contract or identification number	A000454
Number of Individuals Covered	169
Insurance policy start date	2014-01-01
Insurance policy end date	2014-07-17
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Insurance broker organization code?	0
Insurance broker name	VICTOR DENIGRIS

GREAT AMERICAN LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 93661 )

Policy contract number

A000454

Policy instance

Insurance contract or identification number	A000454
Number of Individuals Covered	169
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $30,198
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Amount paid for insurance broker fees	7365
Insurance broker organization code?	4
Insurance broker name	RAPHAEL HOFFMAN

GREAT AMERICAN LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 93661 )

Policy contract number

A000454

Policy instance

Insurance contract or identification number	A000454
Insurance policy start date	2012-10-01
Insurance policy end date	2013-09-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $7,902
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Amount paid for insurance broker fees	7902
Insurance broker organization code?	4
Insurance broker name	TODD DESBERG

GREAT AMERICAN LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 93661 )

Policy contract number

A000454

Policy instance

Insurance contract or identification number	A000454
Number of Individuals Covered	192
Insurance policy start date	2011-10-01
Insurance policy end date	2012-09-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $32,957
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No

GREAT AMERICAN LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 93661 )

Policy contract number

A000454

Policy instance

Insurance contract or identification number	A000454
Insurance policy start date	2010-10-01
Insurance policy end date	2011-09-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No

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Company Name:	BISBEE HOSPITAL ASSOCIATION INC
Employer identification number (EIN):	860334996
NAIC Classification:	622000
NAIC Description:	Hospitals