401k Plan data: COMMUNITY HOSPITAL RETIREMENT PLAN plan

COMMUNITY HOSPITAL RETIREMENT PLAN 401k Plan overview

Plan Name	COMMUNITY HOSPITAL RETIREMENT PLAN
Plan identification number	005

COMMUNITY HOSPITAL RETIREMENT PLAN Benefits

401k Plan Type	Defined Benefit Pension
Plan Features/Benefits	Benefits are primarily pay related Covered by PBGC - Plan is covered under the PBGC insurance program (see ERISA section 4021). Frozen Plan - As of the last day of the plan year, the plan provides that no participant will get any new benefit accrual (whether because of service or compensation).

401k Sponsoring company profile

MERCY HEALTH SYSTEM - WESTERN OHIO has sponsored the creation of one or more 401k plans.

Company Name: MERCY HEALTH SYSTEM - WESTERN OHIO

Employer identification number (EIN): 310785684

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COMMUNITY HOSPITAL RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
005 2012-01-01 JOHN H. ALLISON
005 2011-01-01 KATHLEEN GUBSER
005 2010-01-01 KATHLEEN GUBSER
005 2009-01-01 KATHLEEN GUBSER

Plan id#	Filing Submission Date	Name of Administrator
005	2012-01-01	JOHN H. ALLISON
005	2011-01-01	KATHLEEN GUBSER
005	2010-01-01	KATHLEEN GUBSER
005	2009-01-01	KATHLEEN GUBSER

Plan Statistics for COMMUNITY HOSPITAL RETIREMENT PLAN

401k plan membership statisitcs for COMMUNITY HOSPITAL RETIREMENT PLAN

Measure Date Value
2012: COMMUNITY HOSPITAL RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 1,094
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 327
Number of retired or separated participants receiving benefits 2012-01-01 82
Number of other retired or separated participants entitled to future benefits 2012-01-01 653
Total of all active and inactive participants 2012-01-01 1,062
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 10
Total participants 2012-01-01 1,072
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: COMMUNITY HOSPITAL RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 1,143
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 354
Number of retired or separated participants receiving benefits 2011-01-01 77
Number of other retired or separated participants entitled to future benefits 2011-01-01 658
Total of all active and inactive participants 2011-01-01 1,089
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 5
Total participants 2011-01-01 1,094
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: COMMUNITY HOSPITAL RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 1,186
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 385
Number of retired or separated participants receiving benefits 2010-01-01 69
Number of other retired or separated participants entitled to future benefits 2010-01-01 686
Total of all active and inactive participants 2010-01-01 1,140
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 3
Total participants 2010-01-01 1,143
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: COMMUNITY HOSPITAL RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 1,227
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 402
Number of retired or separated participants receiving benefits 2009-01-01 68
Number of other retired or separated participants entitled to future benefits 2009-01-01 714
Total of all active and inactive participants 2009-01-01 1,184
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 2
Total participants 2009-01-01 1,186
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 1

Measure	Date	Value
2012: COMMUNITY HOSPITAL RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	1,094
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	327
Number of retired or separated participants receiving benefits	2012-01-01	82
Number of other retired or separated participants entitled to future benefits	2012-01-01	653
Total of all active and inactive participants	2012-01-01	1,062
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	10
Total participants	2012-01-01	1,072
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: COMMUNITY HOSPITAL RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	1,143
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	354
Number of retired or separated participants receiving benefits	2011-01-01	77
Number of other retired or separated participants entitled to future benefits	2011-01-01	658
Total of all active and inactive participants	2011-01-01	1,089
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	5
Total participants	2011-01-01	1,094
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: COMMUNITY HOSPITAL RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	1,186
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	385
Number of retired or separated participants receiving benefits	2010-01-01	69
Number of other retired or separated participants entitled to future benefits	2010-01-01	686
Total of all active and inactive participants	2010-01-01	1,140
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	3
Total participants	2010-01-01	1,143
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: COMMUNITY HOSPITAL RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	1,227
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	402
Number of retired or separated participants receiving benefits	2009-01-01	68
Number of other retired or separated participants entitled to future benefits	2009-01-01	714
Total of all active and inactive participants	2009-01-01	1,184
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	2
Total participants	2009-01-01	1,186
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	1

Financial Data on COMMUNITY HOSPITAL RETIREMENT PLAN

Measure	Date	Value
2012 : COMMUNITY HOSPITAL RETIREMENT 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	$140,013
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	$8,119,759
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$3,694,282
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$3,599,950
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$3,613,797
Value of total assets at end of year	2012-12-31	$33,165,632
Value of total assets at beginning of year	2012-12-31	$28,600,142
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$94,332
Total interest from all sources	2012-12-31	$168,811
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Administrative expenses professional fees incurred	2012-12-31	$94,332
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$500,000
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
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2012-12-31	$91,097
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2012-12-31	$140,013
Other income not declared elsewhere	2012-12-31	$11,147
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	$4,425,477
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$33,025,619
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$28,600,142
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
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$17,968,193
Value of interest in master investment trust accounts at end of year	2012-12-31	$30,642,107
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-12-31	$347,109
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-12-31	$347,109
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-12-31	$168,811
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$228,525
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$229,322
Asset value of US Government securities at beginning of year	2012-12-31	$4,550,755
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$1,502,170
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	Yes
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	$3,613,797
Employer contributions (assets) at end of year	2012-12-31	$2,295,000
Employer contributions (assets) at beginning of year	2012-12-31	$600,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$3,599,950
Asset. Corporate debt instrument debt (other) at beginning of year	2012-12-31	$4,813,666
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	ERNST & YOUNG
Accountancy firm EIN	2012-12-31	346565596
2011 : COMMUNITY HOSPITAL RETIREMENT PLAN 2011 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2011-12-31	$-1,678,874
Total unrealized appreciation/depreciation of assets	2011-12-31	$-1,678,874
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	$1,535,484
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$3,660,840
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$3,480,612
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$1,837,500
Value of total assets at end of year	2011-12-31	$28,600,159
Value of total assets at beginning of year	2011-12-31	$30,725,515
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$180,228
Total interest from all sources	2011-12-31	$418,899
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$350,944
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	$350,944
Administrative expenses professional fees incurred	2011-12-31	$31,053
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$500,000
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
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-12-31	$91,114
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-12-31	$87,809
Other income not declared elsewhere	2011-12-31	$9,318
Administrative expenses (other) incurred	2011-12-31	$72,637
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	$-2,125,356
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$28,600,159
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$30,725,515
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	$5,904
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$17,968,193
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$20,611,126
Income. Interest from US Government securities	2011-12-31	$203,111
Income. Interest from corporate debt instruments	2011-12-31	$215,561
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-12-31	$347,109
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-12-31	$447,798
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-12-31	$447,798
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-12-31	$227
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$229,322
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$266,877
Asset value of US Government securities at end of year	2011-12-31	$4,550,755
Asset value of US Government securities at beginning of year	2011-12-31	$4,543,404
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$597,697
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	Yes
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	$1,837,500
Employer contributions (assets) at end of year	2011-12-31	$600,000
Employer contributions (assets) at beginning of year	2011-12-31	$412,500
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$3,480,612
Asset. Corporate debt instrument debt (other) at end of year	2011-12-31	$4,813,666
Asset. Corporate debt instrument debt (other) at beginning of year	2011-12-31	$4,356,001
Contract administrator fees	2011-12-31	$70,634
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	ERNST & YOUNG
Accountancy firm EIN	2011-12-31	346565596
2010 : COMMUNITY HOSPITAL RETIREMENT PLAN 2010 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2010-12-31	$50,577
Total unrealized appreciation/depreciation of assets	2010-12-31	$50,577
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	$4,396,202
Total loss/gain on sale of assets	2010-12-31	$-5,630
Total of all expenses incurred	2010-12-31	$2,959,676
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$2,935,089
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$1,450,000
Value of total assets at end of year	2010-12-31	$30,725,515
Value of total assets at beginning of year	2010-12-31	$29,288,989
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$24,587
Total interest from all sources	2010-12-31	$381,710
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$325,569
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	$325,569
Administrative expenses professional fees incurred	2010-12-31	$16,062
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$500,000
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
Value of other receiveables (less allowance for doubtful accounts) at end of year	2010-12-31	$87,809
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2010-12-31	$89,707
Other income not declared elsewhere	2010-12-31	$10,524
Administrative expenses (other) incurred	2010-12-31	$1,000
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	$1,436,526
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$30,725,515
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$29,288,989
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
Investment advisory and management fees	2010-12-31	$5,501
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$20,611,126
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$19,239,634
Income. Interest from US Government securities	2010-12-31	$162,526
Income. Interest from corporate debt instruments	2010-12-31	$218,886
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2010-12-31	$447,798
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2010-12-31	$424,560
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2010-12-31	$424,560
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2010-12-31	$298
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$266,877
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$294,990
Asset value of US Government securities at end of year	2010-12-31	$4,543,404
Asset value of US Government securities at beginning of year	2010-12-31	$4,730,811
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$2,183,452
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	Yes
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	$1,450,000
Employer contributions (assets) at end of year	2010-12-31	$412,500
Employer contributions (assets) at beginning of year	2010-12-31	$200,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$2,935,089
Asset. Corporate debt instrument debt (other) at end of year	2010-12-31	$4,356,001
Asset. Corporate debt instrument debt (other) at beginning of year	2010-12-31	$4,309,287
Contract administrator fees	2010-12-31	$2,024
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	$6,121,756
Aggregate carrying amount (costs) on sale of assets	2010-12-31	$6,127,386
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	ERNST & YOUNG
Accountancy firm EIN	2010-12-31	346565596
2009 : COMMUNITY HOSPITAL 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 COMMUNITY HOSPITAL RETIREMENT PLAN

2012: COMMUNITY HOSPITAL RETIREMENT 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 – 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: COMMUNITY HOSPITAL 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 – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: COMMUNITY HOSPITAL 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 – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: COMMUNITY HOSPITAL 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 – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	MERCY HEALTH SYSTEM - WESTERN OHIO
Employer identification number (EIN):	310785684