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NORTHWESTERN LAKE FOREST HOSPITAL EMPLOYEE 401(K) SAVINGS PLAN 401k Plan overview

Plan NameNORTHWESTERN LAKE FOREST HOSPITAL EMPLOYEE 401(K) SAVINGS PLAN
Plan identification number 003

NORTHWESTERN LAKE FOREST HOSPITAL EMPLOYEE 401(K) SAVINGS PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

NORTHWESTERN LAKE FOREST HOSPITAL has sponsored the creation of one or more 401k plans.

Company Name:NORTHWESTERN LAKE FOREST HOSPITAL
Employer identification number (EIN):362179779
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NORTHWESTERN LAKE FOREST HOSPITAL EMPLOYEE 401(K) SAVINGS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0032012-01-01DEAN MANHEIMER
0032011-01-03DEAN MANHEIMER

Financial Data on NORTHWESTERN LAKE FOREST HOSPITAL EMPLOYEE 401(K) SAVINGS PLAN

Measure Date Value
2012 : NORTHWESTERN LAKE FOREST HOSPITAL EMPLOYEE 401(K) SAVINGS PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-12-31$0
Total transfer of assets from this plan2012-12-31$21,153,252
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$13,207,432
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$715,979
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$714,147
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$11,794,009
Value of total assets at end of year2012-12-31$0
Value of total assets at beginning of year2012-12-31$8,661,799
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$1,832
Total interest from all sources2012-12-31$3,710
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$522,560
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan2012-12-31$0
Total dividends received from registered investment company shares (eg mutual funds)2012-12-31$522,560
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$15,000,000
If this is an individual account plan, was there a blackout period2012-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$5,765,423
Income. Received or receivable in cash from other sources (including rollovers)2012-12-31$4,265,423
Administrative expenses (other) incurred2012-12-31$1,832
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$12,491,453
Value of net assets at end of year (total assets less liabilities)2012-12-31$0
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$8,661,799
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$8,490,818
Interest on participant loans2012-12-31$3,710
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-12-31$887,153
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$1,763,163
Employer contributions (assets) at end of year2012-12-31$0
Employer contributions (assets) at beginning of year2012-12-31$170,981
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$714,147
Did the plan have assets held for investment2012-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31Yes
Opinion of an independent qualified public accountant for this plan2012-12-31Disclaimer
Accountancy firm name2012-12-31ERNST & YOUNG LLP
Accountancy firm EIN2012-12-31346565596
2011 : NORTHWESTERN LAKE FOREST HOSPITAL EMPLOYEE 401(K) SAVINGS PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-12-31$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$8,727,010
Total loss/gain on sale of assets2011-12-31$0
Total of all expenses incurred2011-12-31$65,211
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$65,046
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$8,968,817
Value of total assets at end of year2011-12-31$8,661,799
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$165
Total interest from all sources2011-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$239,879
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2011-12-31$239,879
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$15,000,000
If this is an individual account plan, was there a blackout period2011-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$5,250,469
Income. Received or receivable in cash from other sources (including rollovers)2011-12-31$2,170,586
Administrative expenses (other) incurred2011-12-31$165
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$8,661,799
Value of net assets at end of year (total assets less liabilities)2011-12-31$8,661,799
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$0
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 interest in registered invesment companies (eg mutual funds) at end of year2011-12-31$8,490,818
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-12-31$-481,686
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$1,547,762
Employer contributions (assets) at end of year2011-12-31$170,981
Employer contributions (assets) at beginning of year2011-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$65,046
Did the plan have assets held for investment2011-12-31Yes
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)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31ERNST & YOUNG LLP
Accountancy firm EIN2011-12-31346565596

Form 5500 Responses for NORTHWESTERN LAKE FOREST HOSPITAL EMPLOYEE 401(K) SAVINGS PLAN

2012: NORTHWESTERN LAKE FOREST HOSPITAL EMPLOYEE 401(K) SAVINGS PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingYes
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement - TrustYes
2011: NORTHWESTERN LAKE FOREST HOSPITAL EMPLOYEE 401(K) SAVINGS PLAN 2011 form 5500 responses
2011-01-03Type of plan entitySingle employer plan
2011-01-03First time form 5500 has been submittedYes
2011-01-03Submission has been amendedNo
2011-01-03This submission is the final filingNo
2011-01-03This return/report is a short plan year return/report (less than 12 months)Yes
2011-01-03Plan is a collectively bargained planNo
2011-01-03Plan funding arrangement – TrustYes
2011-01-03Plan benefit arrangement - TrustYes

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