401k Plan data: PRESCRIPTION DRUG, DENTAL PLAN, 125 CAFETERIA PLAN plan

PRESCRIPTION DRUG, DENTAL PLAN, 125 CAFETERIA PLAN 401k Plan overview

Plan Name	PRESCRIPTION DRUG, DENTAL PLAN, 125 CAFETERIA PLAN
Plan identification number	501

PRESCRIPTION DRUG, DENTAL PLAN, 125 CAFETERIA PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Dental

401k Sponsoring company profile

SHORE MEMORIAL HOSPITAL DBA SHORE MEDICAL CENTER has sponsored the creation of one or more 401k plans.

Company Name: SHORE MEMORIAL HOSPITAL DBA SHORE MEDICAL CENTER

Employer identification number (EIN): 210660835

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PRESCRIPTION DRUG, DENTAL PLAN, 125 CAFETERIA PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2011-01-01 ALAN L. BEATTY ALAN L. BEATTY 2012-10-11
501 2009-01-01 ALAN BEATTY
501 2009-01-01 ALAN BEATTY 2010-07-29
501 2009-01-01 ALAN BEATTY 2010-07-29

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
501	2011-01-01	ALAN L. BEATTY	ALAN L. BEATTY	2012-10-11
501	2009-01-01	ALAN BEATTY
501	2009-01-01		ALAN BEATTY	2010-07-29
501	2009-01-01		ALAN BEATTY	2010-07-29

Plan Statistics for PRESCRIPTION DRUG, DENTAL PLAN, 125 CAFETERIA PLAN

401k plan membership statisitcs for PRESCRIPTION DRUG, DENTAL PLAN, 125 CAFETERIA PLAN

Measure Date Value
2011: PRESCRIPTION DRUG, DENTAL PLAN, 125 CAFETERIA PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 1,387
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 0
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 0
Total of all active and inactive participants 2011-01-01 0
2009: PRESCRIPTION DRUG, DENTAL PLAN, 125 CAFETERIA PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 1,409
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 1,190
Number of retired or separated participants receiving benefits 2009-01-01 199
Number of other retired or separated participants entitled to future benefits 2009-01-01 7
Total of all active and inactive participants 2009-01-01 1,396
Total participants 2009-01-01 1,396

Measure	Date	Value
2011: PRESCRIPTION DRUG, DENTAL PLAN, 125 CAFETERIA PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	1,387
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	0
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	0
Total of all active and inactive participants	2011-01-01	0
2009: PRESCRIPTION DRUG, DENTAL PLAN, 125 CAFETERIA PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	1,409
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	1,190
Number of retired or separated participants receiving benefits	2009-01-01	199
Number of other retired or separated participants entitled to future benefits	2009-01-01	7
Total of all active and inactive participants	2009-01-01	1,396
Total participants	2009-01-01	1,396

Form 5500 Responses for PRESCRIPTION DRUG, DENTAL PLAN, 125 CAFETERIA PLAN

2011: PRESCRIPTION DRUG, DENTAL PLAN, 125 CAFETERIA 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	Yes
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	Yes
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: PRESCRIPTION DRUG, DENTAL PLAN, 125 CAFETERIA PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	Yes
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 – General assets of the sponsor	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

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Company Name:	SHORE MEMORIAL HOSPITAL DBA SHORE MEDICAL CENTER
Employer identification number (EIN):	210660835
NAIC Classification:	622000
NAIC Description:	Hospitals