401k Plan data: ST. ANTHONY'S HOSPITAL EMPLOYEE BENEFIT PLAN TRUST plan

ST. ANTHONY'S HOSPITAL EMPLOYEE BENEFIT PLAN TRUST 401k Plan overview

Plan Name	ST. ANTHONY'S HOSPITAL EMPLOYEE BENEFIT PLAN TRUST
Plan identification number	505

ST. ANTHONY'S HOSPITAL EMPLOYEE BENEFIT PLAN TRUST Benefits

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

401k Sponsoring company profile

LTHM HOUSTON OPERATIONS, LLC has sponsored the creation of one or more 401k plans.

Company Name: LTHM HOUSTON OPERATIONS, LLC

Employer identification number (EIN): 264418678

NAIC Classification: 621111
NAIC Description: Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ST. ANTHONY'S HOSPITAL EMPLOYEE BENEFIT PLAN TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
505 2013-01-01 JASON LEDAY
505 2012-01-01 JASON LEDAY

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
505	2013-01-01	JASON LEDAY
505	2012-01-01	JASON LEDAY

Plan Statistics for ST. ANTHONY'S HOSPITAL EMPLOYEE BENEFIT PLAN TRUST

401k plan membership statisitcs for ST. ANTHONY'S HOSPITAL EMPLOYEE BENEFIT PLAN TRUST

Measure Date Value
2013: ST. ANTHONY'S HOSPITAL EMPLOYEE BENEFIT PLAN TRUST 2013 401k membership
Total participants, beginning-of-year 2013-01-01 74
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 58
Total of all active and inactive participants 2013-01-01 58
2012: ST. ANTHONY'S HOSPITAL EMPLOYEE BENEFIT PLAN TRUST 2012 401k membership
Total participants, beginning-of-year 2012-01-01 82
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 70
Total of all active and inactive participants 2012-01-01 70

Measure	Date	Value
2013: ST. ANTHONY'S HOSPITAL EMPLOYEE BENEFIT PLAN TRUST 2013 401k membership
Total participants, beginning-of-year	2013-01-01	74
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	58
Total of all active and inactive participants	2013-01-01	58
2012: ST. ANTHONY'S HOSPITAL EMPLOYEE BENEFIT PLAN TRUST 2012 401k membership
Total participants, beginning-of-year	2012-01-01	82
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	70
Total of all active and inactive participants	2012-01-01	70

Financial Data on ST. ANTHONY'S HOSPITAL EMPLOYEE BENEFIT PLAN TRUST

Measure	Date	Value
2013 : ST. ANTHONY'S HOSPITAL EMPLOYEE BENEFIT PLAN TRUST 2013 401k financial data
Total plan liabilities at end of year	2013-12-31	$25,237
Total income from all sources	2013-12-31	$240,927
Expenses. Total of all expenses incurred	2013-12-31	$320,553
Benefits paid (including direct rollovers)	2013-12-31	$277,013
Total plan assets at end of year	2013-12-31	$0
Total plan assets at beginning of year	2013-12-31	$54,389
Expenses. Other expenses not covered elsewhere	2013-12-31	$43,540
Net income (gross income less expenses)	2013-12-31	$-79,626
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$-25,237
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$54,389
Total contributions received or receivable from employer(s)	2013-12-31	$240,927
2012 : ST. ANTHONY'S HOSPITAL EMPLOYEE BENEFIT PLAN TRUST 2012 401k financial data
Total income from all sources	2012-12-31	$295,661
Expenses. Total of all expenses incurred	2012-12-31	$241,272
Benefits paid (including direct rollovers)	2012-12-31	$198,360
Total plan assets at end of year	2012-12-31	$54,389
Total plan assets at beginning of year	2012-12-31	$0
Total contributions received or receivable from participants	2012-12-31	$7,162
Expenses. Other expenses not covered elsewhere	2012-12-31	$42,912
Net income (gross income less expenses)	2012-12-31	$54,389
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$54,389
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$0
Total contributions received or receivable from employer(s)	2012-12-31	$288,499

Form 5500 Responses for ST. ANTHONY'S HOSPITAL EMPLOYEE BENEFIT PLAN TRUST

2013: ST. ANTHONY'S HOSPITAL EMPLOYEE BENEFIT PLAN TRUST 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: ST. ANTHONY'S HOSPITAL EMPLOYEE BENEFIT PLAN TRUST 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	First time form 5500 has been submitted	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	LTHM HOUSTON OPERATIONS, LLC
Employer identification number (EIN):	264418678
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)