401k Plan data: LICKING MEMORIAL HEALTH SYSTEMS MEDICAL PLAN plan

LICKING MEMORIAL HEALTH SYSTEMS MEDICAL PLAN 401k Plan overview

Plan Name	LICKING MEMORIAL HEALTH SYSTEMS MEDICAL PLAN
Plan identification number	502

LICKING MEMORIAL HEALTH SYSTEMS MEDICAL PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Long-term disability cover Other welfare benefit cover

401k Sponsoring company profile

LICKING MEMORIAL HOSPITAL has sponsored the creation of one or more 401k plans.

Company Name: LICKING MEMORIAL HOSPITAL

Employer identification number (EIN): 314379519

NAIC Classification: 622000
NAIC Description: Hospitals

Additional information about LICKING MEMORIAL HOSPITAL

Jurisdiction of Incorporation: Ohio Secretary of State Business Services Division

Incorporation Date: 1899-01-13

Company Identification Number: 12665

Legal Registered Office Address: 1320 W. MAIN STREET
-
NEWARK
United States of America (USA)
43055

More information about LICKING MEMORIAL HOSPITAL

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LICKING MEMORIAL HEALTH SYSTEMS MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
502 2011-01-01 CYNTHIA WEBSTER
502 2010-01-01 CYNTHIA WEBSTER
502 2009-01-01 CYNTHIA WEBSTER

Plan id#	Filing Submission Date	Name of Administrator
502	2011-01-01	CYNTHIA WEBSTER
502	2010-01-01	CYNTHIA WEBSTER
502	2009-01-01	CYNTHIA WEBSTER

Plan Statistics for LICKING MEMORIAL HEALTH SYSTEMS MEDICAL PLAN

401k plan membership statisitcs for LICKING MEMORIAL HEALTH SYSTEMS MEDICAL PLAN

Measure Date Value
2011: LICKING MEMORIAL HEALTH SYSTEMS MEDICAL PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 1,553
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 1,525
Number of retired or separated participants receiving benefits 2011-01-01 51
Number of other retired or separated participants entitled to future benefits 2011-01-01 0
Total of all active and inactive participants 2011-01-01 1,576
2010: LICKING MEMORIAL HEALTH SYSTEMS MEDICAL PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 1,552
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 1,491
Number of retired or separated participants receiving benefits 2010-01-01 57
Number of other retired or separated participants entitled to future benefits 2010-01-01 0
Total of all active and inactive participants 2010-01-01 1,548
2009: LICKING MEMORIAL HEALTH SYSTEMS MEDICAL PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 1,596
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 1,500
Number of retired or separated participants receiving benefits 2009-01-01 52
Number of other retired or separated participants entitled to future benefits 2009-01-01 0
Total of all active and inactive participants 2009-01-01 1,552

Measure	Date	Value
2011: LICKING MEMORIAL HEALTH SYSTEMS MEDICAL PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	1,553
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	1,525
Number of retired or separated participants receiving benefits	2011-01-01	51
Number of other retired or separated participants entitled to future benefits	2011-01-01	0
Total of all active and inactive participants	2011-01-01	1,576
2010: LICKING MEMORIAL HEALTH SYSTEMS MEDICAL PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	1,552
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	1,491
Number of retired or separated participants receiving benefits	2010-01-01	57
Number of other retired or separated participants entitled to future benefits	2010-01-01	0
Total of all active and inactive participants	2010-01-01	1,548
2009: LICKING MEMORIAL HEALTH SYSTEMS MEDICAL PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	1,596
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	1,500
Number of retired or separated participants receiving benefits	2009-01-01	52
Number of other retired or separated participants entitled to future benefits	2009-01-01	0
Total of all active and inactive participants	2009-01-01	1,552

Form 5500 Responses for LICKING MEMORIAL HEALTH SYSTEMS MEDICAL PLAN

2011: LICKING MEMORIAL HEALTH SYSTEMS MEDICAL 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 – General assets of the sponsor	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2010: LICKING MEMORIAL HEALTH SYSTEMS MEDICAL 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 – General assets of the sponsor	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: LICKING MEMORIAL HEALTH SYSTEMS MEDICAL 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 – General assets of the sponsor	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

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Company Name:	LICKING MEMORIAL HOSPITAL
Employer identification number (EIN):	314379519
NAIC Classification:	622000
NAIC Description:	Hospitals

Jurisdiction of Incorporation:	Ohio Secretary of State Business Services Division
Incorporation Date:	1899-01-13
Company Identification Number:	12665
Legal Registered Office Address:	1320 W. MAIN STREET - NEWARK United States of America (USA) 43055