401k Plan data: EMPLOYEES' DEFINED BENEFIT PENSION PLAN plan

EMPLOYEES' DEFINED BENEFIT PENSION PLAN 401k Plan overview

Plan Name	EMPLOYEES' DEFINED BENEFIT PENSION PLAN
Plan identification number	004

EMPLOYEES' DEFINED BENEFIT PENSION 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

ST BERNARD HOSPITAL AND HEALTH CARE CENTER has sponsored the creation of one or more 401k plans.

Company Name: ST BERNARD HOSPITAL AND HEALTH CARE CENTER

Employer identification number (EIN): 362264414

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEES' DEFINED BENEFIT PENSION PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
004 2012-01-01 GUY ALTON GUY ALTON 2013-11-05
004 2011-01-01 GUY ALTON
004 2010-01-01 GUY ALTON
004 2009-01-01 GUY ALTON

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
004	2012-01-01	GUY ALTON	GUY ALTON	2013-11-05
004	2011-01-01	GUY ALTON
004	2010-01-01	GUY ALTON
004	2009-01-01	GUY ALTON

Plan Statistics for EMPLOYEES' DEFINED BENEFIT PENSION PLAN

401k plan membership statisitcs for EMPLOYEES' DEFINED BENEFIT PENSION PLAN

Measure Date Value
2012: EMPLOYEES' DEFINED BENEFIT PENSION PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 6
Number of other retired or separated participants entitled to future benefits 2012-01-01 6
Total of all active and inactive participants 2012-01-01 6
Total participants 2012-01-01 6
Number of participants with account balances 2012-01-01 6
2011: EMPLOYEES' DEFINED BENEFIT PENSION PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 6
Number of other retired or separated participants entitled to future benefits 2011-01-01 6
Total of all active and inactive participants 2011-01-01 6
Total participants 2011-01-01 6
Number of participants with account balances 2011-01-01 6
2010: EMPLOYEES' DEFINED BENEFIT PENSION PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 6
Number of other retired or separated participants entitled to future benefits 2010-01-01 6
Total of all active and inactive participants 2010-01-01 6
Total participants 2010-01-01 6
Number of participants with account balances 2010-01-01 6
2009: EMPLOYEES' DEFINED BENEFIT PENSION PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 6
Number of other retired or separated participants entitled to future benefits 2009-01-01 6
Total of all active and inactive participants 2009-01-01 6
Total participants 2009-01-01 6
Number of participants with account balances 2009-01-01 6

Measure	Date	Value
2012: EMPLOYEES' DEFINED BENEFIT PENSION PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	6
Number of other retired or separated participants entitled to future benefits	2012-01-01	6
Total of all active and inactive participants	2012-01-01	6
Total participants	2012-01-01	6
Number of participants with account balances	2012-01-01	6
2011: EMPLOYEES' DEFINED BENEFIT PENSION PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	6
Number of other retired or separated participants entitled to future benefits	2011-01-01	6
Total of all active and inactive participants	2011-01-01	6
Total participants	2011-01-01	6
Number of participants with account balances	2011-01-01	6
2010: EMPLOYEES' DEFINED BENEFIT PENSION PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	6
Number of other retired or separated participants entitled to future benefits	2010-01-01	6
Total of all active and inactive participants	2010-01-01	6
Total participants	2010-01-01	6
Number of participants with account balances	2010-01-01	6
2009: EMPLOYEES' DEFINED BENEFIT PENSION PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	6
Number of other retired or separated participants entitled to future benefits	2009-01-01	6
Total of all active and inactive participants	2009-01-01	6
Total participants	2009-01-01	6
Number of participants with account balances	2009-01-01	6

Financial Data on EMPLOYEES' DEFINED BENEFIT PENSION PLAN

Measure	Date	Value
2012 : EMPLOYEES' DEFINED BENEFIT PENSION PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$90
Total plan assets at end of year	2012-12-31	$647,448
Total plan assets at beginning of year	2012-12-31	$647,358
Value of fidelity bond covering the plan	2012-12-31	$1,000,000
Other income received	2012-12-31	$90
Net income (gross income less expenses)	2012-12-31	$90
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$647,448
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$647,358
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
2011 : EMPLOYEES' DEFINED BENEFIT PENSION PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$0
Expenses. Total of all expenses incurred	2011-12-31	$0
Total plan assets at end of year	2011-12-31	$647,358
Total plan assets at beginning of year	2011-12-31	$647,358
Value of fidelity bond covering the plan	2011-12-31	$1,000,000
Other income received	2011-12-31	$0
Net income (gross income less expenses)	2011-12-31	$0
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$647,358
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$647,358
Total contributions received or receivable from employer(s)	2011-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
2010 : EMPLOYEES' DEFINED BENEFIT PENSION PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$45
Expenses. Total of all expenses incurred	2010-12-31	$675
Total plan assets at end of year	2010-12-31	$647,358
Total plan assets at beginning of year	2010-12-31	$647,988
Value of fidelity bond covering the plan	2010-12-31	$1,000,000
Other income received	2010-12-31	$45
Net income (gross income less expenses)	2010-12-31	$-630
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$647,358
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$647,988
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$675
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
2009 : EMPLOYEES' DEFINED BENEFIT PENSION 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 EMPLOYEES' DEFINED BENEFIT PENSION PLAN

2012: EMPLOYEES' DEFINED BENEFIT PENSION PLAN 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	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: EMPLOYEES' DEFINED BENEFIT PENSION 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
2010: EMPLOYEES' DEFINED BENEFIT PENSION PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	Yes
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 – Trust	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: EMPLOYEES' DEFINED BENEFIT PENSION 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

Potentially related plans

EMPLOYEES' DEFINED BENEFIT PENSION PLAN OF NUVISION FEDERAL CREDIT UNION [EIN = 951644517]

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Company Name:	ST BERNARD HOSPITAL AND HEALTH CARE CENTER
Employer identification number (EIN):	362264414
NAIC Classification:	622000
NAIC Description:	Hospitals