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SUMMARY
ANNUAL REPORT FOR WELFARE PLANS
For Wabash Memorial Hospital Association Health Insurance Plan
This is a summary of the annual report of the Wabash Memorial Hospital
Association, 37-0806462 for the Health Insurance Plan for the year ended
December 31, 2004. The annual report has been filed with the Employee Benefits
Security Administration, formerly known as the Pension and Welfare Benefits
Administration, as required under the Employee Retirement Income Security Act of
1974 (ERISA). Wabash Memorial Hospital Association has committed itself to pay
certain hospital, surgical and dental claims incurred under the terms of the
plan.
Basic Financial Statement The value of plan assets, after subtracting
liabilities of the plan, was $1,086,481 as of December 31, 2004, compared to
$4,422,542 as of January 1, 2004. During the plan year, the plan experienced a
decrease in its net assets of $3,336,061. This decrease includes unrealized
appreciation or depreciation in the value of plan assets; that is, the
difference between the value of the plan's assets at the end of the year and the
value of the assets at the beginning of the year or the cost of assets acquired
during the year. During the plan year, the plan had total income of $12,326,508.
This included employee contributions of $4,590,256, employer contributions of
$6,110,606, reimbursement payments of $1,246,946, income from investments of
$183,216, and unrealized gains on investments of $195,484. Plan expenses were
$15,662,569. These expenses included $705,962 in administrative expenses,
$10,575,542 in benefits paid to participants and beneficiaries, $3,361,580
reserve to provide for overpayments from CMS and $1,019,485 for fees paid to
Blue Cross.
Your Rights To Additional Information You have the right to receive a copy of
the full annual report, or any part thereof, on request. The items listed below
are included in that report:: 1) an accountant's report, 2) assets held for
investment, 3) transactions in excess of 5% of plan assets. To obtain a copy of
the full annual report, or any part thereof, write or call the office of Wabash
Memorial Hospital Association, c/o Mr. Robert Kimmons, who is the plan
administrator, located at 1501 North Water Street, Decatur, Illinois 62526,
(217) 429-5246. A nominal fee to cover copying costs may be charged.
You also have the right to receive from the plan administrator, on request and
at no charge, a statement of the assets and liabilities of the plan and
accompanying notes, or a statement of income and expenses of the plan and
accompanying notes, or both. If you request a copy of the full annual report
from the plan administrator, these two statements and accompanying notes will be
included as part of that report. The charge to cover copying costs given above
does not include a charge for the copying of these portions of the report
because these portions are furnished without charge. You also have the legally
protected right to examine the annual report at the main office of the Plan at
1501 North Water Street, Decatur, Illinois 62526 and at the U.S. Department of
Labor in Washington, DC or to obtain a copy from the U.S. Department of Labor
upon payment of copying costs. Requests to the Department should be addressed
to: Public Disclosure Room, Room N-1513, Employee Benefits Security
Administration, U.S. Department of Labor, 200 Constitution Avenue, N.W.,
Washington, DC 20210. |
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Wabash Management Stephen Speagle Board Chairman,
Robert Kimmons, CMA, MHA Administrator,
Bonnie
Musgrave, Office Manager
Wabash Consulting Staff
Joan Ogden, QHA, FCA, MAA Actuary Services, Rob Mayes, MS IT Services, James Peckert, Esq., JD Legal Services,
Ronald L. Ruecker, M.D., MBA Medical Director,
Thomas Curb, RPh Pharmacy Services
The Banner Blue News is published
quarterly by the Wabash Memorial Hospital Association. Janet Rolofson, Editor, may be contacted at
janet@wabashcannonball.org.
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Wabash Management
Stephen Speagle Board Chairman
Robert Kimmons, CMA, MHA Administrator
Bonnie Hudson Supervisor
Wabash Consulting Staff
Joan Ogden, QHA, FCA, MAA Actuary Services
Rob Mayes, MS IT Services
James Peckert, Esq., JD Legal Services
Ronald L. Ruecker, M.D., MBA Medical Director
Thomas Curb, RPh Pharmacy Services
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