401k Plan data: SUSAN B. ALLEN MEMORIAL HOSPITAL RETIREMENT PLAN plan

SUSAN B. ALLEN MEMORIAL HOSPITAL RETIREMENT PLAN 401k Plan overview

Plan Name	SUSAN B. ALLEN MEMORIAL HOSPITAL RETIREMENT PLAN
Plan identification number	001

SUSAN B. ALLEN MEMORIAL HOSPITAL RETIREMENT PLAN Benefits

401k Plan Type

Defined Benefit Pension

Plan Features/Benefits

Cash balance or similar plan - Plan has a "cash balance" formula. For this purpose, a "cash balance" formula is a benefit formula in a defined benefit plan by whatever name (for example, personal account plan, pension equity plan, life cycle plan, cash account plan, etc.) that rather than, or in addition to, expressing the accrued benefit as a life annuity commencing at normal retirement age, defines benefits for each employee in terms more common to a defined contribution plan such as a single sum distribution amount (for example, 10 percent of final average pay times years of service, or the amount of the employee's hypothetical account balance).
Covered by PBGC - Plan is covered under the PBGC insurance program (see ERISA section 4021).
Plan covered by PBGC that was terminated and closed out for PBGC purposes - Before the end of the plan year (or a prior plan year), (1) the plan terminated in a standard (or distress) termination and completed the distribution of plan assets in satisfaction of all benefit liabilities (or all ERISA Title IV benefits for distress termination); or (2) a trustee was appointed for a terminated plan pursuant to ERISA section 4042.
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

SUSAN B. ALLEN MEMORIAL HOSPITAL has sponsored the creation of one or more 401k plans.

Company Name: SUSAN B. ALLEN MEMORIAL HOSPITAL

Employer identification number (EIN): 480581968

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SUSAN B. ALLEN MEMORIAL HOSPITAL RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2013-01-01 GAYLE ARNETT
001 2012-01-01 GAYLE ARNETT
001 2011-01-01 GAYLE ARNETT
001 2010-01-01 GAYLE ARNETT
001 2009-01-01 GAYLE ARNETT

Plan id#	Filing Submission Date	Name of Administrator
001	2013-01-01	GAYLE ARNETT
001	2012-01-01	GAYLE ARNETT
001	2011-01-01	GAYLE ARNETT
001	2010-01-01	GAYLE ARNETT
001	2009-01-01	GAYLE ARNETT

Plan Statistics for SUSAN B. ALLEN MEMORIAL HOSPITAL RETIREMENT PLAN

401k plan membership statisitcs for SUSAN B. ALLEN MEMORIAL HOSPITAL RETIREMENT PLAN

Measure Date Value
2013: SUSAN B. ALLEN MEMORIAL HOSPITAL RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 218
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 0
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 0
Total of all active and inactive participants 2013-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: SUSAN B. ALLEN MEMORIAL HOSPITAL RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 240
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 190
Number of retired or separated participants receiving benefits 2012-01-01 14
Number of other retired or separated participants entitled to future benefits 2012-01-01 14
Total of all active and inactive participants 2012-01-01 218
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 218
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: SUSAN B. ALLEN MEMORIAL HOSPITAL RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 268
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 208
Number of retired or separated participants receiving benefits 2011-01-01 15
Number of other retired or separated participants entitled to future benefits 2011-01-01 17
Total of all active and inactive participants 2011-01-01 240
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 240
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: SUSAN B. ALLEN MEMORIAL HOSPITAL RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 288
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 242
Number of retired or separated participants receiving benefits 2010-01-01 16
Number of other retired or separated participants entitled to future benefits 2010-01-01 10
Total of all active and inactive participants 2010-01-01 268
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 268
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 2
2009: SUSAN B. ALLEN MEMORIAL HOSPITAL RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 309
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 260
Number of retired or separated participants receiving benefits 2009-01-01 17
Number of other retired or separated participants entitled to future benefits 2009-01-01 11
Total of all active and inactive participants 2009-01-01 288
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 288
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 1

Measure	Date	Value
2013: SUSAN B. ALLEN MEMORIAL HOSPITAL RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	218
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	0
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	0
Total of all active and inactive participants	2013-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: SUSAN B. ALLEN MEMORIAL HOSPITAL RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	240
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	190
Number of retired or separated participants receiving benefits	2012-01-01	14
Number of other retired or separated participants entitled to future benefits	2012-01-01	14
Total of all active and inactive participants	2012-01-01	218
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	218
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: SUSAN B. ALLEN MEMORIAL HOSPITAL RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	268
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	208
Number of retired or separated participants receiving benefits	2011-01-01	15
Number of other retired or separated participants entitled to future benefits	2011-01-01	17
Total of all active and inactive participants	2011-01-01	240
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	240
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: SUSAN B. ALLEN MEMORIAL HOSPITAL RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	288
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	242
Number of retired or separated participants receiving benefits	2010-01-01	16
Number of other retired or separated participants entitled to future benefits	2010-01-01	10
Total of all active and inactive participants	2010-01-01	268
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	268
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	2
2009: SUSAN B. ALLEN MEMORIAL HOSPITAL RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	309
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	260
Number of retired or separated participants receiving benefits	2009-01-01	17
Number of other retired or separated participants entitled to future benefits	2009-01-01	11
Total of all active and inactive participants	2009-01-01	288
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	288
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	1

Financial Data on SUSAN B. ALLEN MEMORIAL HOSPITAL RETIREMENT PLAN

Measure	Date	Value
2013 : SUSAN B. ALLEN MEMORIAL HOSPITAL RETIREMENT PLAN 2013 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2013-12-31	$-383,704
Total unrealized appreciation/depreciation of assets	2013-12-31	$-383,704
Total transfer of assets to this plan	2013-12-31	$0
Total transfer of assets from 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	$1,044,446
Total loss/gain on sale of assets	2013-12-31	$623,468
Total of all expenses incurred	2013-12-31	$7,425,132
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$7,345,312
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$775,172
Value of total assets at end of year	2013-12-31	$0
Value of total assets at beginning of year	2013-12-31	$6,380,686
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$79,820
Total interest from all sources	2013-12-31	$3,037
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$19,180
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2013-12-31	$0
Total dividends received from registered investment company shares (eg mutual funds)	2013-12-31	$1,258
Administrative expenses professional fees incurred	2013-12-31	$35,634
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$1,000,000
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
Assets. Other investments not covered elsewhere at end of year	2013-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2013-12-31	$1,015,245
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	$1,088
Other income not declared elsewhere	2013-12-31	$1,089
Administrative expenses (other) incurred	2013-12-31	$18,095
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	$-6,380,686
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$6,380,686
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
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Investment advisory and management fees	2013-12-31	$26,091
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$323,217
Income. Interest from US Government securities	2013-12-31	$1,460
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2013-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2013-12-31	$1,276,173
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2013-12-31	$1,276,173
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2013-12-31	$1,577
Asset value of US Government securities at end of year	2013-12-31	$0
Asset value of US Government securities at beginning of year	2013-12-31	$282,180
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$6,204
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	Yes
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	$775,172
Income. Dividends from common stock	2013-12-31	$17,922
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$7,345,312
Assets. Corporate common stocks other than exployer securities at end of year	2013-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2013-12-31	$3,482,783
Did the plan have assets held for investment	2013-12-31	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	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	Yes
Aggregate proceeds on sale of assets	2013-12-31	$5,717,483
Aggregate carrying amount (costs) on sale of assets	2013-12-31	$5,094,015
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	No
Opinion of an independent qualified public accountant for this plan	2013-12-31	Unqualified
Accountancy firm name	2013-12-31	BKD, LLP
Accountancy firm EIN	2013-12-31	440160260
2012 : SUSAN B. ALLEN MEMORIAL HOSPITAL RETIREMENT PLAN 2012 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2012-12-31	$397,742
Total unrealized appreciation/depreciation of assets	2012-12-31	$397,742
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	$961,685
Total loss/gain on sale of assets	2012-12-31	$34,950
Total of all expenses incurred	2012-12-31	$526,407
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$443,197
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$298,301
Value of total assets at end of year	2012-12-31	$6,380,686
Value of total assets at beginning of year	2012-12-31	$5,945,408
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$83,210
Total interest from all sources	2012-12-31	$4,457
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$110,161
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	$14,347
Administrative expenses professional fees incurred	2012-12-31	$22,994
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$1,000,000
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
Assets. Other investments not covered elsewhere at end of year	2012-12-31	$1,015,245
Assets. Other investments not covered elsewhere at beginning of year	2012-12-31	$472,307
Value of other receiveables (less allowance for doubtful accounts) at end of year	2012-12-31	$1,088
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2012-12-31	$1,476
Other income not declared elsewhere	2012-12-31	$96,273
Administrative expenses (other) incurred	2012-12-31	$19,173
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	$435,278
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$6,380,686
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$5,945,408
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
Investment advisory and management fees	2012-12-31	$41,043
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$323,217
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$992,109
Income. Interest from US Government securities	2012-12-31	$4,165
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-12-31	$1,276,173
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-12-31	$803,378
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-12-31	$803,378
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-12-31	$292
Asset value of US Government securities at end of year	2012-12-31	$282,180
Asset value of US Government securities at beginning of year	2012-12-31	$229,323
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$19,801
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	$298,301
Income. Dividends from common stock	2012-12-31	$95,814
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$443,197
Assets. Corporate common stocks other than exployer securities at end of year	2012-12-31	$3,482,783
Assets. Corporate common stocks other than exployer securities at beginning of year	2012-12-31	$3,446,815
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	$2,492,952
Aggregate carrying amount (costs) on sale of assets	2012-12-31	$2,458,002
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	No
Opinion of an independent qualified public accountant for this plan	2012-12-31	Unqualified
Accountancy firm name	2012-12-31	BKD, LLP
Accountancy firm EIN	2012-12-31	440160260
2011 : SUSAN B. ALLEN MEMORIAL HOSPITAL RETIREMENT PLAN 2011 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2011-12-31	$-584,846
Total unrealized appreciation/depreciation of assets	2011-12-31	$-584,846
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	$162,617
Total loss/gain on sale of assets	2011-12-31	$364,979
Total of all expenses incurred	2011-12-31	$389,975
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$302,620
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$295,252
Value of total assets at end of year	2011-12-31	$5,945,408
Value of total assets at beginning of year	2011-12-31	$6,172,766
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$87,355
Total interest from all sources	2011-12-31	$7,096
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$107,058
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	$19,520
Administrative expenses professional fees incurred	2011-12-31	$22,788
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$1,000,000
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
Assets. Other investments not covered elsewhere at end of year	2011-12-31	$472,307
Assets. Other investments not covered elsewhere at beginning of year	2011-12-31	$417,085
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-12-31	$1,476
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-12-31	$1,651
Other income not declared elsewhere	2011-12-31	$7,434
Administrative expenses (other) incurred	2011-12-31	$18,992
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	$-227,358
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$5,945,408
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$6,172,766
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	$45,575
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$992,109
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$928,457
Income. Interest from US Government securities	2011-12-31	$6,627
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-12-31	$803,378
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-12-31	$248,370
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-12-31	$248,370
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-12-31	$469
Asset value of US Government securities at end of year	2011-12-31	$229,323
Asset value of US Government securities at beginning of year	2011-12-31	$216,488
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-34,356
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	$295,252
Income. Dividends from common stock	2011-12-31	$87,538
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$302,620
Assets. Corporate common stocks other than exployer securities at end of year	2011-12-31	$3,446,815
Assets. Corporate common stocks other than exployer securities at beginning of year	2011-12-31	$4,360,715
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	$3,218,163
Aggregate carrying amount (costs) on sale of assets	2011-12-31	$2,853,184
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	No
Opinion of an independent qualified public accountant for this plan	2011-12-31	Unqualified
Accountancy firm name	2011-12-31	BKD, LLP
Accountancy firm EIN	2011-12-31	440160260
2010 : SUSAN B. ALLEN MEMORIAL HOSPITAL RETIREMENT PLAN 2010 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2010-12-31	$283,218
Total unrealized appreciation/depreciation of assets	2010-12-31	$283,218
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	$913,234
Total loss/gain on sale of assets	2010-12-31	$302,329
Total of all expenses incurred	2010-12-31	$486,379
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$375,307
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$171,740
Value of total assets at end of year	2010-12-31	$6,172,766
Value of total assets at beginning of year	2010-12-31	$5,745,911
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$111,072
Total interest from all sources	2010-12-31	$7,627
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$118,129
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	$18,134
Administrative expenses professional fees incurred	2010-12-31	$23,678
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$1,000,000
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
Assets. Other investments not covered elsewhere at end of year	2010-12-31	$417,085
Assets. Other investments not covered elsewhere at beginning of year	2010-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2010-12-31	$1,651
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2010-12-31	$1,052
Other income not declared elsewhere	2010-12-31	$3,039
Administrative expenses (other) incurred	2010-12-31	$29,232
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	$426,855
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$6,172,766
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$5,745,911
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	$58,162
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$928,457
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$687,879
Income. Interest from US Government securities	2010-12-31	$6,280
Income. Interest from corporate debt instruments	2010-12-31	$1,013
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2010-12-31	$248,370
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2010-12-31	$229,632
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2010-12-31	$229,632
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2010-12-31	$334
Asset value of US Government securities at end of year	2010-12-31	$216,488
Asset value of US Government securities at beginning of year	2010-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$27,152
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	$171,740
Income. Dividends from common stock	2010-12-31	$99,995
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$375,307
Asset. Corporate debt instrument debt (other) at end of year	2010-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2010-12-31	$247,177
Assets. Corporate common stocks other than exployer securities at end of year	2010-12-31	$4,360,715
Assets. Corporate common stocks other than exployer securities at beginning of year	2010-12-31	$4,580,171
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	$4,604,335
Aggregate carrying amount (costs) on sale of assets	2010-12-31	$4,302,006
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	Unqualified
Accountancy firm name	2010-12-31	BKD, LLP
Accountancy firm EIN	2010-12-31	440160260
2009 : SUSAN B. ALLEN MEMORIAL 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 SUSAN B. ALLEN MEMORIAL HOSPITAL RETIREMENT PLAN

2013: SUSAN B. ALLEN MEMORIAL HOSPITAL RETIREMENT PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	Yes
2013-01-01	This submission is the final filing	Yes
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 – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: SUSAN B. ALLEN MEMORIAL HOSPITAL RETIREMENT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	Yes
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: SUSAN B. ALLEN MEMORIAL 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 – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: SUSAN B. ALLEN MEMORIAL 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 – Trust	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: SUSAN B. ALLEN MEMORIAL 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 – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	SUSAN B. ALLEN MEMORIAL HOSPITAL
Employer identification number (EIN):	480581968
NAIC Classification:	622000
NAIC Description:	Hospitals