401k Plan data: INDIANA UNIVERSITY HEALTH TIPTON HOSPITAL TAX DEFERRAL ANNUITY PLAN plan

INDIANA UNIVERSITY HEALTH TIPTON HOSPITAL TAX DEFERRAL ANNUITY PLAN 401k Plan overview

Plan Name	INDIANA UNIVERSITY HEALTH TIPTON HOSPITAL TAX DEFERRAL ANNUITY PLAN
Plan identification number	002

INDIANA UNIVERSITY HEALTH TIPTON HOSPITAL TAX DEFERRAL ANNUITY PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.
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

TIPTON HOSPITAL, INC. has sponsored the creation of one or more 401k plans.

Company Name: TIPTON HOSPITAL, INC.

Employer identification number (EIN): 262772226

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan INDIANA UNIVERSITY HEALTH TIPTON HOSPITAL TAX DEFERRAL ANNUITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2014-01-01 SHELLEY HUFF SHELLEY HUFF 2015-07-17
002 2014-01-01 SHELLEY HUFF SHELLEY HUFF 2015-07-17
002 2013-01-01 SHELLEY HUFF SHELLEY HUFF 2014-09-16
002 2012-01-01 SHELLEY HUFF SHELLEY HUFF 2013-08-14
002 2011-01-01 SHELLEY HUFF SHELLEY HUFF 2012-10-01
002 2009-01-01 SHELLEY HUFF SHELLEY HUFF 2011-02-03
002 2009-01-01 SHELLEY HUFF SHELLEY HUFF 2010-10-15

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
002	2014-01-01	SHELLEY HUFF	SHELLEY HUFF	2015-07-17
002	2014-01-01	SHELLEY HUFF	SHELLEY HUFF	2015-07-17
002	2013-01-01	SHELLEY HUFF	SHELLEY HUFF	2014-09-16
002	2012-01-01	SHELLEY HUFF	SHELLEY HUFF	2013-08-14
002	2011-01-01	SHELLEY HUFF	SHELLEY HUFF	2012-10-01
002	2009-01-01	SHELLEY HUFF	SHELLEY HUFF	2011-02-03
002	2009-01-01	SHELLEY HUFF	SHELLEY HUFF	2010-10-15

Plan Statistics for INDIANA UNIVERSITY HEALTH TIPTON HOSPITAL TAX DEFERRAL ANNUITY PLAN

401k plan membership statisitcs for INDIANA UNIVERSITY HEALTH TIPTON HOSPITAL TAX DEFERRAL ANNUITY PLAN

Measure Date Value
2014: INDIANA UNIVERSITY HEALTH TIPTON HOSPITAL TAX DEFERRAL ANNUITY PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 398
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 0
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 0
Number of participants with account balances 2014-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: INDIANA UNIVERSITY HEALTH TIPTON HOSPITAL TAX DEFERRAL ANNUITY PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 389
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 349
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 26
Total of all active and inactive participants 2013-01-01 375
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 375
Number of participants with account balances 2013-01-01 318
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: INDIANA UNIVERSITY HEALTH TIPTON HOSPITAL TAX DEFERRAL ANNUITY PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 393
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 376
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 13
Total of all active and inactive participants 2012-01-01 389
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 389
Number of participants with account balances 2012-01-01 316
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: INDIANA UNIVERSITY HEALTH TIPTON HOSPITAL TAX DEFERRAL ANNUITY PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 385
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 375
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 14
Total of all active and inactive participants 2011-01-01 389
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 389
Number of participants with account balances 2011-01-01 301
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: INDIANA UNIVERSITY HEALTH TIPTON HOSPITAL TAX DEFERRAL ANNUITY PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 398
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 387
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 13
Total of all active and inactive participants 2009-01-01 400
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 400
Number of participants with account balances 2009-01-01 264
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2014: INDIANA UNIVERSITY HEALTH TIPTON HOSPITAL TAX DEFERRAL ANNUITY PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	398
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	0
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	0
Number of participants with account balances	2014-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: INDIANA UNIVERSITY HEALTH TIPTON HOSPITAL TAX DEFERRAL ANNUITY PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	389
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	349
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	26
Total of all active and inactive participants	2013-01-01	375
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	375
Number of participants with account balances	2013-01-01	318
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: INDIANA UNIVERSITY HEALTH TIPTON HOSPITAL TAX DEFERRAL ANNUITY PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	393
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	376
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	13
Total of all active and inactive participants	2012-01-01	389
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	389
Number of participants with account balances	2012-01-01	316
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: INDIANA UNIVERSITY HEALTH TIPTON HOSPITAL TAX DEFERRAL ANNUITY PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	385
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	375
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	14
Total of all active and inactive participants	2011-01-01	389
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	389
Number of participants with account balances	2011-01-01	301
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: INDIANA UNIVERSITY HEALTH TIPTON HOSPITAL TAX DEFERRAL ANNUITY PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	398
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	387
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	13
Total of all active and inactive participants	2009-01-01	400
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	400
Number of participants with account balances	2009-01-01	264
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on INDIANA UNIVERSITY HEALTH TIPTON HOSPITAL TAX DEFERRAL ANNUITY PLAN

Measure	Date	Value
2014 : INDIANA UNIVERSITY HEALTH TIPTON HOSPITAL TAX DEFERRAL ANNUITY PLAN 2014 401k financial data
Unrealized appreciation/depreciation of real estate assets	2014-10-13	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2014-10-13	$0
Total unrealized appreciation/depreciation of assets	2014-10-13	$0
Total transfer of assets to this plan	2014-10-13	$0
Total transfer of assets from this plan	2014-10-13	$6,534,306
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-10-13	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-10-13	$0
Total income from all sources (including contributions)	2014-10-13	$27,064
Total loss/gain on sale of assets	2014-10-13	$0
Total of all expenses incurred	2014-10-13	$2,026,561
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-10-13	$2,022,305
Value of total corrective distributions	2014-10-13	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-10-13	$3,578
Value of total assets at end of year	2014-10-13	$0
Value of total assets at beginning of year	2014-10-13	$8,533,803
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-10-13	$4,256
Total income from rents	2014-10-13	$0
Total interest from all sources	2014-10-13	$15,903
Total dividends received (eg from common stock, registered investment company shares)	2014-10-13	$27,315
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-10-13	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-10-13	$27,315
Administrative expenses professional fees incurred	2014-10-13	$0
Was this plan covered by a fidelity bond	2014-10-13	Yes
Value of fidelity bond cover	2014-10-13	$20,000,000
If this is an individual account plan, was there a blackout period	2014-10-13	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-10-13	$0
Were there any nonexempt tranactions with any party-in-interest	2014-10-13	No
Amount of non-exempt transactions with any party-in-interest	2014-10-13	$0
Contributions received from participants	2014-10-13	$0
Participant contributions at end of year	2014-10-13	$0
Participant contributions at beginning of year	2014-10-13	$0
Income. Received or receivable in cash from other sources (including rollovers)	2014-10-13	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2014-10-13	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2014-10-13	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2014-10-13	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2014-10-13	$0
Other income not declared elsewhere	2014-10-13	$502
Administrative expenses (other) incurred	2014-10-13	$0
Liabilities. Value of operating payables at beginning of year	2014-10-13	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-10-13	No
Value of net income/loss	2014-10-13	$-1,999,497
Value of net assets at end of year (total assets less liabilities)	2014-10-13	$0
Value of net assets at beginning of year (total assets less liabilities)	2014-10-13	$8,533,803
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-10-13	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-10-13	No
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year	2014-10-13	$0
Were any leases to which the plan was party in default or uncollectible	2014-10-13	No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year	2014-10-13	$0
Investment advisory and management fees	2014-10-13	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-10-13	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-10-13	$7,666,620
Income. Interest from loans (other than to participants)	2014-10-13	$0
Interest earned on other investments	2014-10-13	$15,903
Income. Interest from US Government securities	2014-10-13	$0
Income. Interest from corporate debt instruments	2014-10-13	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2014-10-13	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-10-13	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-10-13	$867,183
Expenses. Payments to insurance carriers foe the provision of benefits	2014-10-13	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-10-13	$-20,234
Net investment gain/loss from pooled separate accounts	2014-10-13	$0
Net investment gain or loss from common/collective trusts	2014-10-13	$0
Net gain/loss from 103.12 investment entities	2014-10-13	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-10-13	No
Was there a failure to transmit to the plan any participant contributions	2014-10-13	No
Has the plan failed to provide any benefit when due under the plan	2014-10-13	No
Contributions received in cash from employer	2014-10-13	$3,578
Employer contributions (assets) at end of year	2014-10-13	$0
Employer contributions (assets) at beginning of year	2014-10-13	$0
Income. Dividends from preferred stock	2014-10-13	$0
Income. Dividends from common stock	2014-10-13	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-10-13	$2,022,305
Contract administrator fees	2014-10-13	$4,256
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2014-10-13	Yes
Liabilities. Value of benefit claims payable at beginning of year	2014-10-13	$0
Did the plan have assets held for investment	2014-10-13	No
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	2014-10-13	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-10-13	Yes
Aggregate proceeds on sale of assets	2014-10-13	$0
Aggregate carrying amount (costs) on sale of assets	2014-10-13	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2014-10-13	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-10-13	Yes
Opinion of an independent qualified public accountant for this plan	2014-10-13	Disclaimer
Accountancy firm name	2014-10-13	BKD, LLP
Accountancy firm EIN	2014-10-13	440160260
2013 : INDIANA UNIVERSITY HEALTH TIPTON HOSPITAL TAX DEFERRAL ANNUITY PLAN 2013 401k financial data
Unrealized appreciation/depreciation of real estate assets	2013-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2013-12-31	$0
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total transfer of assets to this plan	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$2,389,050
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$903,007
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$899,254
Value of total corrective distributions	2013-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$910,428
Value of total assets at end of year	2013-12-31	$8,533,803
Value of total assets at beginning of year	2013-12-31	$7,047,760
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$3,753
Total income from rents	2013-12-31	$0
Total interest from all sources	2013-12-31	$26,259
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$76,220
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-12-31	$76,220
Administrative expenses professional fees incurred	2013-12-31	$0
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$20,000,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Amount of non-exempt transactions with any party-in-interest	2013-12-31	$0
Contributions received from participants	2013-12-31	$808,338
Participant contributions at end of year	2013-12-31	$0
Participant contributions at beginning of year	2013-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2013-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2013-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2013-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2013-12-31	$0
Other income not declared elsewhere	2013-12-31	$12
Administrative expenses (other) incurred	2013-12-31	$0
Liabilities. Value of operating payables at beginning of year	2013-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$1,486,043
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$8,533,803
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$7,047,760
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year	2013-12-31	$0
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year	2013-12-31	$0
Investment advisory and management fees	2013-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$7,666,620
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$6,385,805
Income. Interest from loans (other than to participants)	2013-12-31	$0
Interest earned on other investments	2013-12-31	$26,259
Income. Interest from US Government securities	2013-12-31	$0
Income. Interest from corporate debt instruments	2013-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2013-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$867,183
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$661,955
Expenses. Payments to insurance carriers foe the provision of benefits	2013-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$1,376,131
Net investment gain/loss from pooled separate accounts	2013-12-31	$0
Net investment gain or loss from common/collective trusts	2013-12-31	$0
Net gain/loss from 103.12 investment entities	2013-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$102,090
Employer contributions (assets) at end of year	2013-12-31	$0
Employer contributions (assets) at beginning of year	2013-12-31	$0
Income. Dividends from preferred stock	2013-12-31	$0
Income. Dividends from common stock	2013-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$899,254
Contract administrator fees	2013-12-31	$3,753
Liabilities. Value of benefit claims payable at beginning of year	2013-12-31	$0
Did the plan have assets held for investment	2013-12-31	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	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Aggregate proceeds on sale of assets	2013-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2013-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2013-12-31	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	ERNST & YOUNG LLP
Accountancy firm EIN	2013-12-31	346565596
2012 : INDIANA UNIVERSITY HEALTH TIPTON HOSPITAL TAX DEFERRAL ANNUITY PLAN 2012 401k financial data
Unrealized appreciation/depreciation of real estate assets	2012-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2012-12-31	$0
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total transfer of assets to this plan	2012-12-31	$0
Total transfer of assets from this plan	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	$1,715,674
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$282,067
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$280,210
Value of total corrective distributions	2012-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$968,976
Value of total assets at end of year	2012-12-31	$7,047,760
Value of total assets at beginning of year	2012-12-31	$5,614,153
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$1,857
Total income from rents	2012-12-31	$0
Total interest from all sources	2012-12-31	$18,695
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$82,894
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	$82,894
Administrative expenses professional fees incurred	2012-12-31	$0
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$20,000,000
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
Amount of non-exempt transactions with any party-in-interest	2012-12-31	$0
Contributions received from participants	2012-12-31	$857,446
Participant contributions at end of year	2012-12-31	$0
Participant contributions at beginning of year	2012-12-31	$26,599
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$12,234
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2012-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2012-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2012-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2012-12-31	$0
Other income not declared elsewhere	2012-12-31	$20
Administrative expenses (other) incurred	2012-12-31	$0
Liabilities. Value of operating payables at beginning of year	2012-12-31	$0
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	$1,433,607
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$7,047,760
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$5,614,153
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
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year	2012-12-31	$0
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year	2012-12-31	$0
Investment advisory and management fees	2012-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$6,385,805
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$4,991,743
Income. Interest from loans (other than to participants)	2012-12-31	$0
Interest earned on other investments	2012-12-31	$18,695
Income. Interest from US Government securities	2012-12-31	$0
Income. Interest from corporate debt instruments	2012-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$661,955
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$592,052
Expenses. Payments to insurance carriers foe the provision of benefits	2012-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$645,089
Net investment gain/loss from pooled separate accounts	2012-12-31	$0
Net investment gain or loss from common/collective trusts	2012-12-31	$0
Net gain/loss from 103.12 investment entities	2012-12-31	$0
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	$99,296
Employer contributions (assets) at end of year	2012-12-31	$0
Employer contributions (assets) at beginning of year	2012-12-31	$3,759
Income. Dividends from preferred stock	2012-12-31	$0
Income. Dividends from common stock	2012-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$280,210
Contract administrator fees	2012-12-31	$1,857
Liabilities. Value of benefit claims payable at beginning of year	2012-12-31	$0
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
Aggregate proceeds on sale of assets	2012-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2012-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2012-12-31	$0
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	ERNST AND YOUNG
Accountancy firm EIN	2012-12-31	346565596
2011 : INDIANA UNIVERSITY HEALTH TIPTON HOSPITAL TAX DEFERRAL ANNUITY PLAN 2011 401k financial data
Unrealized appreciation/depreciation of real estate assets	2011-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2011-12-31	$0
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total transfer of assets to this plan	2011-12-31	$0
Total transfer of assets from this plan	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	$783,381
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$599,030
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$597,598
Value of total corrective distributions	2011-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$900,148
Value of total assets at end of year	2011-12-31	$5,614,153
Value of total assets at beginning of year	2011-12-31	$5,429,802
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$1,432
Total income from rents	2011-12-31	$0
Total interest from all sources	2011-12-31	$16,449
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$60,465
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	$60,465
Administrative expenses professional fees incurred	2011-12-31	$0
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$20,000,000
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
Amount of non-exempt transactions with any party-in-interest	2011-12-31	$0
Contributions received from participants	2011-12-31	$790,915
Participant contributions at end of year	2011-12-31	$26,599
Participant contributions at beginning of year	2011-12-31	$82,808
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$15,303
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2011-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2011-12-31	$0
Other income not declared elsewhere	2011-12-31	$8,000
Administrative expenses (other) incurred	2011-12-31	$0
Liabilities. Value of operating payables at beginning of year	2011-12-31	$0
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	$184,351
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$5,614,153
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$5,429,802
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
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year	2011-12-31	$0
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year	2011-12-31	$0
Investment advisory and management fees	2011-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$4,991,743
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$4,777,251
Income. Interest from loans (other than to participants)	2011-12-31	$0
Interest earned on other investments	2011-12-31	$16,449
Income. Interest from US Government securities	2011-12-31	$0
Income. Interest from corporate debt instruments	2011-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$592,052
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$559,294
Expenses. Payments to insurance carriers foe the provision of benefits	2011-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-201,681
Net investment gain/loss from pooled separate accounts	2011-12-31	$0
Net investment gain or loss from common/collective trusts	2011-12-31	$0
Net gain/loss from 103.12 investment entities	2011-12-31	$0
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	$93,930
Employer contributions (assets) at end of year	2011-12-31	$3,759
Employer contributions (assets) at beginning of year	2011-12-31	$10,449
Income. Dividends from preferred stock	2011-12-31	$0
Income. Dividends from common stock	2011-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$597,598
Contract administrator fees	2011-12-31	$1,432
Liabilities. Value of benefit claims payable at beginning of year	2011-12-31	$0
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	$0
Aggregate carrying amount (costs) on sale of assets	2011-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2011-12-31	$0
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	ERNST & YOUNG
Accountancy firm EIN	2011-12-31	346565596
2010 : INDIANA UNIVERSITY HEALTH TIPTON HOSPITAL TAX DEFERRAL ANNUITY PLAN 2010 401k financial data
Unrealized appreciation/depreciation of real estate assets	2010-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2010-12-31	$0
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total transfer of assets to this plan	2010-12-31	$0
Total transfer of assets from this plan	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	$1,513,389
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$350,743
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$349,022
Value of total corrective distributions	2010-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$911,993
Value of total assets at end of year	2010-12-31	$5,429,802
Value of total assets at beginning of year	2010-12-31	$4,267,156
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$1,721
Total income from rents	2010-12-31	$0
Total interest from all sources	2010-12-31	$14,536
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$61,588
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	$61,588
Administrative expenses professional fees incurred	2010-12-31	$0
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$20,000,000
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
Amount of non-exempt transactions with any party-in-interest	2010-12-31	$0
Contributions received from participants	2010-12-31	$813,578
Participant contributions at end of year	2010-12-31	$82,808
Participant contributions at beginning of year	2010-12-31	$77,887
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$5,339
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2010-12-31	$0
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
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	$114
Administrative expenses (other) incurred	2010-12-31	$0
Liabilities. Value of operating payables at beginning of year	2010-12-31	$0
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	$1,162,646
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$5,429,802
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$4,267,156
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
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year	2010-12-31	$0
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year	2010-12-31	$0
Investment advisory and management fees	2010-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$4,777,251
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$3,752,003
Income. Interest from loans (other than to participants)	2010-12-31	$0
Interest earned on other investments	2010-12-31	$14,536
Income. Interest from US Government securities	2010-12-31	$0
Income. Interest from corporate debt instruments	2010-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2010-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$559,294
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$426,952
Expenses. Payments to insurance carriers foe the provision of benefits	2010-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$525,158
Net investment gain/loss from pooled separate accounts	2010-12-31	$0
Net investment gain or loss from common/collective trusts	2010-12-31	$0
Net gain/loss from 103.12 investment entities	2010-12-31	$0
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	$93,076
Employer contributions (assets) at end of year	2010-12-31	$10,449
Employer contributions (assets) at beginning of year	2010-12-31	$10,314
Income. Dividends from preferred stock	2010-12-31	$0
Income. Dividends from common stock	2010-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$349,022
Contract administrator fees	2010-12-31	$1,721
Liabilities. Value of benefit claims payable at beginning of year	2010-12-31	$0
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	$0
Aggregate carrying amount (costs) on sale of assets	2010-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2010-12-31	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	No
Opinion of an independent qualified public accountant for this plan	2010-12-31	Qualified
Accountancy firm name	2010-12-31	ERNST AND YOUNG
Accountancy firm EIN	2010-12-31	346565596
2009 : INDIANA UNIVERSITY HEALTH TIPTON HOSPITAL TAX DEFERRAL ANNUITY 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 INDIANA UNIVERSITY HEALTH TIPTON HOSPITAL TAX DEFERRAL ANNUITY PLAN

2014: INDIANA UNIVERSITY HEALTH TIPTON HOSPITAL TAX DEFERRAL ANNUITY PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	This submission is the final filing	Yes
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: INDIANA UNIVERSITY HEALTH TIPTON HOSPITAL TAX DEFERRAL ANNUITY PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: INDIANA UNIVERSITY HEALTH TIPTON HOSPITAL TAX DEFERRAL ANNUITY PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
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 – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: INDIANA UNIVERSITY HEALTH TIPTON HOSPITAL TAX DEFERRAL ANNUITY PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
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 – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: INDIANA UNIVERSITY HEALTH TIPTON HOSPITAL TAX DEFERRAL ANNUITY 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 – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	TIPTON HOSPITAL, INC.
Employer identification number (EIN):	262772226
NAIC Classification:	622000
NAIC Description:	Hospitals