401k Plan data: MEDICAL CENTER 401(K) RETIREMENT PLAN plan

MEDICAL CENTER 401(K) RETIREMENT PLAN 401k Plan overview

Plan Name	MEDICAL CENTER 401(K) RETIREMENT PLAN
Plan identification number	001

MEDICAL CENTER 401(K) RETIREMENT PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
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

MEDICAL CENTER OF NEWARK, LLC has sponsored the creation of one or more 401k plans.

Company Name: MEDICAL CENTER OF NEWARK, LLC

Employer identification number (EIN): 204365725

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MEDICAL CENTER 401(K) RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2011-01-01 DAVID SHEPPARD
001 2010-01-01 DAVID SHEPPARD DAVID SHEPPARD 2011-10-17
001 2009-01-01 DAVID SHEPPARD DAVID SHEPPARD 2010-10-11

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2011-01-01	DAVID SHEPPARD
001	2010-01-01	DAVID SHEPPARD	DAVID SHEPPARD	2011-10-17
001	2009-01-01	DAVID SHEPPARD	DAVID SHEPPARD	2010-10-11

Plan Statistics for MEDICAL CENTER 401(K) RETIREMENT PLAN

401k plan membership statisitcs for MEDICAL CENTER 401(K) RETIREMENT PLAN

Measure Date Value
2011: MEDICAL CENTER 401(K) RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 177
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 146
Number of retired or separated participants receiving benefits 2011-01-01 4
Number of other retired or separated participants entitled to future benefits 2011-01-01 10
Total of all active and inactive participants 2011-01-01 160
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 160
Number of participants with account balances 2011-01-01 52
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: MEDICAL CENTER 401(K) RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 173
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 167
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 10
Total of all active and inactive participants 2010-01-01 177
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 177
Number of participants with account balances 2010-01-01 60
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: MEDICAL CENTER 401(K) RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 137
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 147
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 12
Total of all active and inactive participants 2009-01-01 159
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 159
Number of participants with account balances 2009-01-01 62
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 2

Measure	Date	Value
2011: MEDICAL CENTER 401(K) RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	177
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	146
Number of retired or separated participants receiving benefits	2011-01-01	4
Number of other retired or separated participants entitled to future benefits	2011-01-01	10
Total of all active and inactive participants	2011-01-01	160
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	160
Number of participants with account balances	2011-01-01	52
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: MEDICAL CENTER 401(K) RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	173
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	167
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	10
Total of all active and inactive participants	2010-01-01	177
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	177
Number of participants with account balances	2010-01-01	60
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: MEDICAL CENTER 401(K) RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	137
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	147
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	12
Total of all active and inactive participants	2009-01-01	159
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	159
Number of participants with account balances	2009-01-01	62
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	2

Financial Data on MEDICAL CENTER 401(K) RETIREMENT PLAN

Measure	Date	Value
2011 : MEDICAL CENTER 401(K) RETIREMENT PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$91,764
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$147,672
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$130,898
Expenses. Certain deemed distributions of participant loans	2011-12-31	$2,176
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$98,786
Value of total assets at end of year	2011-12-31	$862,588
Value of total assets at beginning of year	2011-12-31	$918,496
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$14,598
Total interest from all sources	2011-12-31	$697
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$100,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
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
Contributions received from participants	2011-12-31	$85,693
Participant contributions at end of year	2011-12-31	$24,228
Participant contributions at beginning of year	2011-12-31	$8,091
Participant contributions at end of year	2011-12-31	$2,608
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$93
Administrative expenses (other) incurred	2011-12-31	$13,837
Total non interest bearing cash at end of year	2011-12-31	$0
Total non interest bearing cash at beginning of year	2011-12-31	$1,421
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	$-55,908
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$862,588
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$918,496
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
Value of interest in pooled separate accounts at end of year	2011-12-31	$835,275
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$908,984
Interest on participant loans	2011-12-31	$697
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-7,719
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	Yes
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	$13,000
Employer contributions (assets) at end of year	2011-12-31	$477
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$130,898
Contract administrator fees	2011-12-31	$761
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
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	SCOTT SKIBBIE, INC.
Accountancy firm EIN	2011-12-31	270851321
2010 : MEDICAL CENTER 401(K) RETIREMENT PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total income from all sources (including contributions)	2010-12-31	$213,039
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$39,699
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$37,075
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$124,724
Value of total assets at end of year	2010-12-31	$918,496
Value of total assets at beginning of year	2010-12-31	$745,156
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$2,624
Total interest from all sources	2010-12-31	$464
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$5,000,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
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
Contributions received from participants	2010-12-31	$107,734
Participant contributions at end of year	2010-12-31	$8,091
Participant contributions at beginning of year	2010-12-31	$12,753
Participant contributions at end of year	2010-12-31	$0
Participant contributions at beginning of year	2010-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$1,101
Value of other receiveables (less allowance for doubtful accounts) at end of year	2010-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2010-12-31	$0
Administrative expenses (other) incurred	2010-12-31	$1,764
Total non interest bearing cash at end of year	2010-12-31	$1,421
Total non interest bearing cash at beginning of year	2010-12-31	$831
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	$173,340
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$918,496
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$745,156
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$908,984
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$731,572
Interest on participant loans	2010-12-31	$464
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$87,851
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	Yes
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	$15,889
Employer contributions (assets) at end of year	2010-12-31	$0
Employer contributions (assets) at beginning of year	2010-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$37,075
Contract administrator fees	2010-12-31	$860
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
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	SCOTT SKIBBIE, INC.
Accountancy firm EIN	2010-12-31	270851321
2009 : MEDICAL CENTER 401(K) 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 MEDICAL CENTER 401(K) RETIREMENT PLAN

2011: MEDICAL CENTER 401(K) RETIREMENT PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: MEDICAL CENTER 401(K) RETIREMENT PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: MEDICAL CENTER 401(K) 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 – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	MEDICAL CENTER OF NEWARK, LLC
Employer identification number (EIN):	204365725
NAIC Classification:	622000
NAIC Description:	Hospitals