401k Plan data: NORTHEAST HEALTH EMPLOYER RETIREMENT PLAN plan

NORTHEAST HEALTH EMPLOYER RETIREMENT PLAN 401k Plan overview

Plan Name	NORTHEAST HEALTH EMPLOYER RETIREMENT PLAN
Plan identification number	001

NORTHEAST HEALTH EMPLOYER RETIREMENT PLAN Benefits

401k Plan Type

Defined Benefit Pension

Plan Features/Benefits

Benefits are primarily pay related
Cash balance or similar plan - Plan has a "cash balance" formula. For this purpose, a "cash balance" formula is a benefit formula in a defined benefit plan by whatever name (for example, personal account plan, pension equity plan, life cycle plan, cash account plan, etc.) that rather than, or in addition to, expressing the accrued benefit as a life annuity commencing at normal retirement age, defines benefits for each employee in terms more common to a defined contribution plan such as a single sum distribution amount (for example, 10 percent of final average pay times years of service, or the amount of the employee's hypothetical account balance).
Covered by PBGC - Plan is covered under the PBGC insurance program (see ERISA section 4021).
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

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

Company Name: SAMARITAN HOSPITAL

Employer identification number (EIN): 141338544

NAIC Classification: 622000
NAIC Description: Hospitals

Additional information about SAMARITAN HOSPITAL

Jurisdiction of Incorporation: Missouri Secretary of State

Incorporation Date:

Company Identification Number: B00007810

More information about SAMARITAN HOSPITAL

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NORTHEAST HEALTH EMPLOYER RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2011-01-01 NATALIE CURTIS BARBARA MCCANDLESS 2012-10-12
001 2010-01-01 NATALIE CURTIS BARBARA MCCANDLESS 2011-10-13
001 2009-01-01 NATALIE CURTIS BARBARA MCCANDLESS 2010-10-14

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2011-01-01	NATALIE CURTIS	BARBARA MCCANDLESS	2012-10-12
001	2010-01-01	NATALIE CURTIS	BARBARA MCCANDLESS	2011-10-13
001	2009-01-01	NATALIE CURTIS	BARBARA MCCANDLESS	2010-10-14

Plan Statistics for NORTHEAST HEALTH EMPLOYER RETIREMENT PLAN

401k plan membership statisitcs for NORTHEAST HEALTH EMPLOYER RETIREMENT PLAN

Measure Date Value
2011: NORTHEAST HEALTH EMPLOYER RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 5,506
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 3,571
Number of retired or separated participants receiving benefits 2011-01-01 589
Number of other retired or separated participants entitled to future benefits 2011-01-01 1,388
Total of all active and inactive participants 2011-01-01 5,548
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 80
Total participants 2011-01-01 5,628
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 171
2010: NORTHEAST HEALTH EMPLOYER RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 5,402
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 3,684
Number of retired or separated participants receiving benefits 2010-01-01 564
Number of other retired or separated participants entitled to future benefits 2010-01-01 1,178
Total of all active and inactive participants 2010-01-01 5,426
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 80
Total participants 2010-01-01 5,506
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 175
2009: NORTHEAST HEALTH EMPLOYER RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 5,214
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 3,734
Number of retired or separated participants receiving benefits 2009-01-01 549
Number of other retired or separated participants entitled to future benefits 2009-01-01 1,058
Total of all active and inactive participants 2009-01-01 5,341
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 61
Total participants 2009-01-01 5,402
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 171

Measure	Date	Value
2011: NORTHEAST HEALTH EMPLOYER RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	5,506
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	3,571
Number of retired or separated participants receiving benefits	2011-01-01	589
Number of other retired or separated participants entitled to future benefits	2011-01-01	1,388
Total of all active and inactive participants	2011-01-01	5,548
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	80
Total participants	2011-01-01	5,628
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	171
2010: NORTHEAST HEALTH EMPLOYER RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	5,402
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	3,684
Number of retired or separated participants receiving benefits	2010-01-01	564
Number of other retired or separated participants entitled to future benefits	2010-01-01	1,178
Total of all active and inactive participants	2010-01-01	5,426
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	80
Total participants	2010-01-01	5,506
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	175
2009: NORTHEAST HEALTH EMPLOYER RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	5,214
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	3,734
Number of retired or separated participants receiving benefits	2009-01-01	549
Number of other retired or separated participants entitled to future benefits	2009-01-01	1,058
Total of all active and inactive participants	2009-01-01	5,341
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	61
Total participants	2009-01-01	5,402
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	171

Financial Data on NORTHEAST HEALTH EMPLOYER RETIREMENT PLAN

Measure	Date	Value
2011 : NORTHEAST HEALTH EMPLOYER RETIREMENT PLAN 2011 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2011-12-31	$38,308
Total unrealized appreciation/depreciation of assets	2011-12-31	$38,308
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$56,044
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$138,642
Total income from all sources (including contributions)	2011-12-31	$5,499,706
Total loss/gain on sale of assets	2011-12-31	$-1,516,162
Total of all expenses incurred	2011-12-31	$4,396,214
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$3,673,234
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$7,827,912
Value of total assets at end of year	2011-12-31	$78,121,133
Value of total assets at beginning of year	2011-12-31	$77,100,239
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$722,980
Total interest from all sources	2011-12-31	$52
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$1,473,898
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2011-12-31	$1,211,182
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$2,000,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Assets. Other investments not covered elsewhere at end of year	2011-12-31	$16,843,692
Assets. Other investments not covered elsewhere at beginning of year	2011-12-31	$17,391,882
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-12-31	$93,436
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-12-31	$109,343
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2011-12-31	$56,044
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2011-12-31	$138,642
Other income not declared elsewhere	2011-12-31	$-547,603
Administrative expenses (other) incurred	2011-12-31	$392,220
Total non interest bearing cash at end of year	2011-12-31	$104,649
Total non interest bearing cash at beginning of year	2011-12-31	$116,131
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$1,103,492
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$78,065,089
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$76,961,597
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Investment advisory and management fees	2011-12-31	$330,760
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$35,179,836
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$35,778,079
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-12-31	$6,491,756
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-12-31	$2,730,146
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-12-31	$2,730,146
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-12-31	$52
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-1,776,699
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$7,827,912
Employer contributions (assets) at beginning of year	2011-12-31	$132,088
Income. Dividends from common stock	2011-12-31	$262,716
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$3,673,234
Assets. Corporate common stocks other than exployer securities at end of year	2011-12-31	$19,407,764
Assets. Corporate common stocks other than exployer securities at beginning of year	2011-12-31	$20,842,570
Did the plan have assets held for investment	2011-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Aggregate proceeds on sale of assets	2011-12-31	$43,573,835
Aggregate carrying amount (costs) on sale of assets	2011-12-31	$45,089,997
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	KP LYNCH CPA PC
Accountancy firm EIN	2011-12-31	202059984
2010 : NORTHEAST HEALTH EMPLOYER RETIREMENT PLAN 2010 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2010-12-31	$2,838,691
Total unrealized appreciation/depreciation of assets	2010-12-31	$2,838,691
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$138,642
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total income from all sources (including contributions)	2010-12-31	$12,918,738
Total loss/gain on sale of assets	2010-12-31	$458,203
Total of all expenses incurred	2010-12-31	$4,232,074
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$3,708,816
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$5,160,580
Value of total assets at end of year	2010-12-31	$77,100,239
Value of total assets at beginning of year	2010-12-31	$68,274,933
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$523,258
Total interest from all sources	2010-12-31	$43
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$2,292,362
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2010-12-31	$2,009,892
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2010-12-31	$19,918
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$2,000,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Assets. Other investments not covered elsewhere at end of year	2010-12-31	$17,391,882
Assets. Other investments not covered elsewhere at beginning of year	2010-12-31	$11,455,242
Value of other receiveables (less allowance for doubtful accounts) at end of year	2010-12-31	$109,343
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2010-12-31	$221,051
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2010-12-31	$138,642
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2010-12-31	$0
Other income not declared elsewhere	2010-12-31	$1,068,504
Administrative expenses (other) incurred	2010-12-31	$288,201
Total non interest bearing cash at end of year	2010-12-31	$116,131
Total non interest bearing cash at beginning of year	2010-12-31	$220,620
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$8,686,664
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$76,961,597
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$68,274,933
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Investment advisory and management fees	2010-12-31	$235,057
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$35,778,079
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$34,861,680
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2010-12-31	$2,730,146
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2010-12-31	$583,956
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2010-12-31	$583,956
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2010-12-31	$43
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$1,100,355
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$5,160,580
Employer contributions (assets) at end of year	2010-12-31	$132,088
Employer contributions (assets) at beginning of year	2010-12-31	$0
Income. Dividends from common stock	2010-12-31	$282,470
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$3,708,816
Assets. Corporate common stocks other than exployer securities at end of year	2010-12-31	$20,842,570
Assets. Corporate common stocks other than exployer securities at beginning of year	2010-12-31	$20,912,466
Did the plan have assets held for investment	2010-12-31	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	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Aggregate proceeds on sale of assets	2010-12-31	$57,125,663
Aggregate carrying amount (costs) on sale of assets	2010-12-31	$56,667,460
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	KP LYNCH CPA PC
Accountancy firm EIN	2010-12-31	202059984
2009 : NORTHEAST HEALTH EMPLOYER RETIREMENT PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for NORTHEAST HEALTH EMPLOYER RETIREMENT PLAN

2011: NORTHEAST HEALTH EMPLOYER RETIREMENT PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: NORTHEAST HEALTH EMPLOYER RETIREMENT PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: NORTHEAST HEALTH EMPLOYER RETIREMENT PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	SAMARITAN HOSPITAL
Employer identification number (EIN):	141338544
NAIC Classification:	622000
NAIC Description:	Hospitals

Jurisdiction of Incorporation:	Missouri Secretary of State
Incorporation Date:
Company Identification Number:	B00007810