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METROSOUTH MEDICAL CENTER MEDICAL PLAN 401k Plan overview

Plan NameMETROSOUTH MEDICAL CENTER MEDICAL PLAN
Plan identification number 501

METROSOUTH MEDICAL CENTER MEDICAL PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Other welfare benefit cover

401k Sponsoring company profile

HARRISON HOSPITAL HOLDINGS, LLC has sponsored the creation of one or more 401k plans.

Company Name:HARRISON HOSPITAL HOLDINGS, LLC
Employer identification number (EIN):262587624
NAIC Classification:622000
NAIC Description: Hospitals

Additional information about HARRISON HOSPITAL HOLDINGS, LLC

Jurisdiction of Incorporation: State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number: 4543370

More information about HARRISON HOSPITAL HOLDINGS, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan METROSOUTH MEDICAL CENTER MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012012-10-01NICHOLAS CHERONIS2014-06-10
5012012-01-01NICHOLAS CHERONIS
5012011-01-01NICHOLAS CHERONIS
5012009-01-01BARBARA FIDELI
5012009-01-01BRETT MEHLMAN
5012009-01-01BARBARA FIDELI

Plan Statistics for METROSOUTH MEDICAL CENTER MEDICAL PLAN

401k plan membership statisitcs for METROSOUTH MEDICAL CENTER MEDICAL PLAN

Measure Date Value
2012: METROSOUTH MEDICAL CENTER MEDICAL PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01722
Total number of active participants reported on line 7a of the Form 55002012-01-010
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-010
2011: METROSOUTH MEDICAL CENTER MEDICAL PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01690
Total number of active participants reported on line 7a of the Form 55002011-01-01721
Number of retired or separated participants receiving benefits2011-01-011
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-01722
2009: METROSOUTH MEDICAL CENTER MEDICAL PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01708
Total number of active participants reported on line 7a of the Form 55002009-01-01699
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-01699
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-01699
Number of participants with account balances2009-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on METROSOUTH MEDICAL CENTER MEDICAL PLAN

Measure Date Value
2012 : METROSOUTH MEDICAL CENTER MEDICAL PLAN 2012 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-09-30$301,377
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-09-30$598,524
Total income from all sources (including contributions)2012-09-30$2,089,569
Total of all expenses incurred2012-09-30$1,792,422
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-09-30$1,747,704
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-09-30$2,089,569
Value of total assets at end of year2012-09-30$0
Value of total assets at beginning of year2012-09-30$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-09-30$44,718
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-09-30Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan2012-09-30$0
Was this plan covered by a fidelity bond2012-09-30Yes
Value of fidelity bond cover2012-09-30$2,000,000
Were there any nonexempt tranactions with any party-in-interest2012-09-30No
Contributions received from participants2012-09-30$357,730
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2012-09-30$301,377
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-09-30$598,524
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-09-30No
Value of net income/loss2012-09-30$297,147
Value of net assets at end of year (total assets less liabilities)2012-09-30$-301,377
Value of net assets at beginning of year (total assets less liabilities)2012-09-30$-598,524
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2012-09-30No
Were any leases to which the plan was party in default or uncollectible2012-09-30No
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-09-30$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-09-30$0
Expenses. Payments to insurance carriers foe the provision of benefits2012-09-30$35,169
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-09-30No
Was there a failure to transmit to the plan any participant contributions2012-09-30No
Has the plan failed to provide any benefit when due under the plan2012-09-30No
Contributions received in cash from employer2012-09-30$1,731,839
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-09-30$1,712,535
Contract administrator fees2012-09-30$44,718
Did the plan have assets held for investment2012-09-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-09-30Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-09-30No
Opinion of an independent qualified public accountant for this plan2012-09-30Unqualified
Accountancy firm name2012-09-30MCGLADREY LLP
Accountancy firm EIN2012-09-30420714325
2011 : METROSOUTH MEDICAL CENTER MEDICAL PLAN 2011 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$598,524
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$133,653
Total income from all sources (including contributions)2011-12-31$5,807,855
Total of all expenses incurred2011-12-31$6,272,726
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$5,969,646
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$5,807,855
Value of total assets at end of year2011-12-31$0
Value of total assets at beginning of year2011-12-31$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$303,080
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$2,000,000
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$1,824,885
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2011-12-31$598,524
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2011-12-31$133,653
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-464,871
Value of net assets at end of year (total assets less liabilities)2011-12-31$-598,524
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$-133,653
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$225,304
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$3,982,970
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$5,744,342
Contract administrator fees2011-12-31$303,080
Did the plan have assets held for investment2011-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31No
Opinion of an independent qualified public accountant for this plan2011-12-31Unqualified
Accountancy firm name2011-12-31MCGLADREY LLP
Accountancy firm EIN2011-12-31420714325
2010 : METROSOUTH MEDICAL CENTER MEDICAL PLAN 2010 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$133,653
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$105,800
Total income from all sources (including contributions)2010-12-31$6,491,086
Total of all expenses incurred2010-12-31$6,518,939
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$6,254,308
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$6,491,086
Value of total assets at end of year2010-12-31$0
Value of total assets at beginning of year2010-12-31$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$264,631
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$2,000,000
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$1,570,394
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2010-12-31$133,653
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2010-12-31$105,800
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$-27,853
Value of net assets at end of year (total assets less liabilities)2010-12-31$-133,653
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$-105,800
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$96,550
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$4,920,692
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$6,157,758
Contract administrator fees2010-12-31$264,631
Did the plan have assets held for investment2010-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31No
Opinion of an independent qualified public accountant for this plan2010-12-31Unqualified
Accountancy firm name2010-12-31MCGLADREY LLP
Accountancy firm EIN2010-12-31420714325

Form 5500 Responses for METROSOUTH MEDICAL CENTER MEDICAL PLAN

2012: METROSOUTH MEDICAL CENTER MEDICAL PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedYes
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: METROSOUTH MEDICAL CENTER MEDICAL PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedYes
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: METROSOUTH MEDICAL CENTER MEDICAL PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number000000
Policy instance 1
Insurance contract or identification number000000
Number of Individuals Covered0
Insurance policy start date2012-01-01
Insurance policy end date2012-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $35,169
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number00000
Policy instance 1
Insurance contract or identification number00000
Number of Individuals Covered722
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $225,304
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number000000
Policy instance 1
Insurance contract or identification number000000
Number of Individuals Covered706
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $96,550
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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