401k Plan data: THE AMERIHEALTH MERCY FAMILY OF COMPANIES 401(K) PLAN plan

THE AMERIHEALTH MERCY FAMILY OF COMPANIES 401(K) PLAN 401k Plan overview

Plan Name	THE AMERIHEALTH MERCY FAMILY OF COMPANIES 401(K) PLAN
Plan identification number	001

THE AMERIHEALTH MERCY FAMILY OF COMPANIES 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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.
Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

KEYSTONE MERCY HEALTH PLAN has sponsored the creation of one or more 401k plans.

Company Name: KEYSTONE MERCY HEALTH PLAN

Employer identification number (EIN): 232842344

NAIC Classification: 524140

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE AMERIHEALTH MERCY FAMILY OF COMPANIES 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2012-01-01 KAREN SCHLENNER
001 2011-01-01 KAREN SCHLENNER
001 2009-01-01 KAREN SCHLENNER KAREN SCHLENNER 2010-10-14

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2012-01-01	KAREN SCHLENNER
001	2011-01-01	KAREN SCHLENNER
001	2009-01-01	KAREN SCHLENNER	KAREN SCHLENNER	2010-10-14

Plan Statistics for THE AMERIHEALTH MERCY FAMILY OF COMPANIES 401(K) PLAN

401k plan membership statisitcs for THE AMERIHEALTH MERCY FAMILY OF COMPANIES 401(K) PLAN

Measure Date Value
2012: THE AMERIHEALTH MERCY FAMILY OF COMPANIES 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 2,941
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 3,030
Number of retired or separated participants receiving benefits 2012-01-01 4
Number of other retired or separated participants entitled to future benefits 2012-01-01 610
Total of all active and inactive participants 2012-01-01 3,644
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 3
Total participants 2012-01-01 3,647
Number of participants with account balances 2012-01-01 3,559
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 222
2011: THE AMERIHEALTH MERCY FAMILY OF COMPANIES 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 2,927
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 2,406
Number of retired or separated participants receiving benefits 2011-01-01 4
Number of other retired or separated participants entitled to future benefits 2011-01-01 528
Total of all active and inactive participants 2011-01-01 2,938
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 3
Total participants 2011-01-01 2,941
Number of participants with account balances 2011-01-01 2,912
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 248
2009: THE AMERIHEALTH MERCY FAMILY OF COMPANIES 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 2,773
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 2,532
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 346
Total of all active and inactive participants 2009-01-01 2,878
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 4
Total participants 2009-01-01 2,882
Number of participants with account balances 2009-01-01 2,826
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 169

Measure	Date	Value
2012: THE AMERIHEALTH MERCY FAMILY OF COMPANIES 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	2,941
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	3,030
Number of retired or separated participants receiving benefits	2012-01-01	4
Number of other retired or separated participants entitled to future benefits	2012-01-01	610
Total of all active and inactive participants	2012-01-01	3,644
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	3
Total participants	2012-01-01	3,647
Number of participants with account balances	2012-01-01	3,559
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	222
2011: THE AMERIHEALTH MERCY FAMILY OF COMPANIES 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	2,927
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	2,406
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	528
Total of all active and inactive participants	2011-01-01	2,938
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	3
Total participants	2011-01-01	2,941
Number of participants with account balances	2011-01-01	2,912
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	248
2009: THE AMERIHEALTH MERCY FAMILY OF COMPANIES 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	2,773
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	2,532
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	346
Total of all active and inactive participants	2009-01-01	2,878
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	4
Total participants	2009-01-01	2,882
Number of participants with account balances	2009-01-01	2,826
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	169

Financial Data on THE AMERIHEALTH MERCY FAMILY OF COMPANIES 401(K) PLAN

Measure	Date	Value
2012 : THE AMERIHEALTH MERCY FAMILY OF COMPANIES 401(K) PLAN 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	$28,271,781
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$10,069,386
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$9,893,267
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$16,597,750
Value of total assets at end of year	2012-12-31	$109,622,733
Value of total assets at beginning of year	2012-12-31	$91,420,338
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$176,119
Total interest from all sources	2012-12-31	$168,727
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$2,457,500
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-12-31	$2,457,500
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$10,000,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$10,122,348
Participant contributions at end of year	2012-12-31	$4,529,955
Participant contributions at beginning of year	2012-12-31	$4,055,772
Participant contributions at end of year	2012-12-31	$348,051
Participant contributions at beginning of year	2012-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$2,008,898
Administrative expenses (other) incurred	2012-12-31	$602
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
Value of net income/loss	2012-12-31	$18,202,395
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$109,622,733
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$91,420,338
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
Investment advisory and management fees	2012-12-31	$33,341
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$99,098,227
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$81,481,676
Interest on participant loans	2012-12-31	$168,727
Value of interest in common/collective trusts at end of year	2012-12-31	$5,483,646
Value of interest in common/collective trusts at beginning of year	2012-12-31	$5,696,383
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$8,911,766
Net investment gain or loss from common/collective trusts	2012-12-31	$136,038
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	$4,466,504
Employer contributions (assets) at end of year	2012-12-31	$162,854
Employer contributions (assets) at beginning of year	2012-12-31	$186,507
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$9,893,267
Contract administrator fees	2012-12-31	$142,176
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
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	KPMG LLP
Accountancy firm EIN	2012-12-31	135565207
2011 : THE AMERIHEALTH MERCY FAMILY OF COMPANIES 401(K) 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	$13,703,036
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$11,513,804
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$11,320,540
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$13,366,632
Value of total assets at end of year	2011-12-31	$91,420,338
Value of total assets at beginning of year	2011-12-31	$89,231,106
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$193,264
Total interest from all sources	2011-12-31	$178,952
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$2,177,289
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	$2,177,289
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$10,000,000
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	$8,609,395
Participant contributions at end of year	2011-12-31	$4,055,772
Participant contributions at beginning of year	2011-12-31	$3,890,690
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$643,657
Administrative expenses (other) incurred	2011-12-31	$41,525
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	$2,189,232
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$91,420,338
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$89,231,106
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	$36,645
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$81,481,676
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$80,055,446
Interest on participant loans	2011-12-31	$178,952
Value of interest in common/collective trusts at end of year	2011-12-31	$5,696,383
Value of interest in common/collective trusts at beginning of year	2011-12-31	$5,284,970
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-2,437,749
Net investment gain or loss from common/collective trusts	2011-12-31	$417,912
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	$4,113,580
Employer contributions (assets) at end of year	2011-12-31	$186,507
Employer contributions (assets) at beginning of year	2011-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$11,320,540
Contract administrator fees	2011-12-31	$115,094
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	KPMG LLP
Accountancy firm EIN	2011-12-31	135565207
2010 : THE AMERIHEALTH MERCY FAMILY OF COMPANIES 401(K) 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	$22,486,364
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$6,043,574
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$5,929,807
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$13,319,597
Value of total assets at end of year	2010-12-31	$89,231,106
Value of total assets at beginning of year	2010-12-31	$72,788,316
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$113,767
Total interest from all sources	2010-12-31	$173,352
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$1,823,857
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	$1,823,857
Administrative expenses professional fees incurred	2010-12-31	$113,767
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$10,000,000
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	$8,432,516
Participant contributions at end of year	2010-12-31	$3,890,690
Participant contributions at beginning of year	2010-12-31	$3,036,510
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	$1,145,372
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	$16,442,790
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$89,231,106
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$72,788,316
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	$80,055,446
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$65,388,588
Interest on participant loans	2010-12-31	$173,352
Value of interest in common/collective trusts at end of year	2010-12-31	$5,284,970
Value of interest in common/collective trusts at beginning of year	2010-12-31	$4,363,218
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$7,031,670
Net investment gain or loss from common/collective trusts	2010-12-31	$137,888
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	$3,741,709
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	$5,929,807
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	KPMG LLP
Accountancy firm EIN	2010-12-31	135565207

Form 5500 Responses for THE AMERIHEALTH MERCY FAMILY OF COMPANIES 401(K) PLAN

2012: THE AMERIHEALTH MERCY FAMILY OF COMPANIES 401(K) PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: THE AMERIHEALTH MERCY FAMILY OF COMPANIES 401(K) 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 – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: THE AMERIHEALTH MERCY FAMILY OF COMPANIES 401(K) 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:	KEYSTONE MERCY HEALTH PLAN
Employer identification number (EIN):	232842344
NAIC Classification:	524140