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ST. JOSEPH'S COMMUNITY HOSPITAL OF WEST BEND, INC. 403(B) PLAN 401k Plan overview

Plan NameST. JOSEPH'S COMMUNITY HOSPITAL OF WEST BEND, INC. 403(B) PLAN
Plan identification number 001

ST. JOSEPH'S COMMUNITY HOSPITAL OF WEST BEND, INC. 403(B) PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • 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 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
  • Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.

401k Sponsoring company profile

ST JOSEPHS COMMUNITY HOSPITAL OF WEST BEND has sponsored the creation of one or more 401k plans.

Company Name:ST JOSEPHS COMMUNITY HOSPITAL OF WEST BEND
Employer identification number (EIN):390806302
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ST. JOSEPH'S COMMUNITY HOSPITAL OF WEST BEND, INC. 403(B) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012011-01-01JEFFREY VAN DE KREEKE
0012009-01-01JEFFREY VAN DE KREEKE JEFFREY VAN DE KREEKE2010-09-21

Plan Statistics for ST. JOSEPH'S COMMUNITY HOSPITAL OF WEST BEND, INC. 403(B) PLAN

401k plan membership statisitcs for ST. JOSEPH'S COMMUNITY HOSPITAL OF WEST BEND, INC. 403(B) PLAN

Measure Date Value
2011: ST. JOSEPH'S COMMUNITY HOSPITAL OF WEST BEND, INC. 403(B) PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-010
Total number of active participants reported on line 7a of the Form 55002011-01-010
Total of all active and inactive participants2011-01-010
Total participants2011-01-010
Number of participants with account balances2011-01-010
2009: ST. JOSEPH'S COMMUNITY HOSPITAL OF WEST BEND, INC. 403(B) PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01735
Total number of active participants reported on line 7a of the Form 55002009-01-01595
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-01129
Total of all active and inactive participants2009-01-01724
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-01724
Number of participants with account balances2009-01-01468
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on ST. JOSEPH'S COMMUNITY HOSPITAL OF WEST BEND, INC. 403(B) PLAN

Measure Date Value
2011 : ST. JOSEPH'S COMMUNITY HOSPITAL OF WEST BEND, INC. 403(B) PLAN 2011 401k financial data
Total transfer of assets from this plan2011-02-28$83,616
Total income from all sources (including contributions)2011-02-28$438
Total of all expenses incurred2011-02-28$3,877
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-02-28$3,877
Value of total assets at beginning of year2011-02-28$87,055
Total interest from all sources2011-02-28$438
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-02-28No
Was this plan covered by a fidelity bond2011-02-28Yes
Value of fidelity bond cover2011-02-28$5,000,000
If this is an individual account plan, was there a blackout period2011-02-28No
Were there any nonexempt tranactions with any party-in-interest2011-02-28No
Assets. Other investments not covered elsewhere at beginning of year2011-02-28$87,055
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-02-28No
Value of net income/loss2011-02-28$-3,439
Value of net assets at beginning of year (total assets less liabilities)2011-02-28$87,055
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-02-28No
Were any loans by the plan or fixed income obligations due to the plan in default2011-02-28No
Were any leases to which the plan was party in default or uncollectible2011-02-28No
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-02-28$438
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-02-28No
Was there a failure to transmit to the plan any participant contributions2011-02-28No
Has the plan failed to provide any benefit when due under the plan2011-02-28No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-02-28$3,877
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32011-02-28No
Did the plan have assets held for investment2011-02-28Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-02-28No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-02-28Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-02-28Yes
Opinion of an independent qualified public accountant for this plan2011-02-28Disclaimer
Accountancy firm name2011-02-28SCHENCK SC
Accountancy firm EIN2011-02-28391173131
2010 : ST. JOSEPH'S COMMUNITY HOSPITAL OF WEST BEND, INC. 403(B) PLAN 2010 401k financial data
Unrealized appreciation/depreciation of real estate assets2010-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2010-12-31$0
Total unrealized appreciation/depreciation of assets2010-12-31$0
Total transfer of assets to this plan2010-12-31$0
Total transfer of assets from this plan2010-12-31$19,551,439
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
Expenses. Interest paid2010-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022010-12-31$0
Total income from all sources (including contributions)2010-12-31$-217,396
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$2,609,479
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$2,528,558
Expenses. Certain deemed distributions of participant loans2010-12-31$0
Value of total corrective distributions2010-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$0
Value of total assets at end of year2010-12-31$87,055
Value of total assets at beginning of year2010-12-31$22,465,369
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$80,921
Total income from rents2010-12-31$0
Total interest from all sources2010-12-31$71,073
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$2,170
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2010-12-31$2,170
Administrative expenses professional fees incurred2010-12-31$0
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$5,000,000
If this is an individual account plan, was there a blackout period2010-12-31Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Amount of non-exempt transactions with any party-in-interest2010-12-31$0
Contributions received from participants2010-12-31$0
Participant contributions at end of year2010-12-31$0
Participant contributions at beginning of year2010-12-31$363,742
Participant contributions at end of year2010-12-31$0
Participant contributions at beginning of year2010-12-31$0
Assets. Other investments not covered elsewhere at end of year2010-12-31$87,055
Assets. Other investments not covered elsewhere at beginning of year2010-12-31$172,086
Income. Received or receivable in cash from other sources (including rollovers)2010-12-31$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2010-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2010-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2010-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2010-12-31$0
Other income not declared elsewhere2010-12-31$0
Administrative expenses (other) incurred2010-12-31$0
Liabilities. Value of operating payables at beginning of year2010-12-31$0
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
Income. Non cash contributions2010-12-31$0
Value of net income/loss2010-12-31$-2,826,875
Value of net assets at end of year (total assets less liabilities)2010-12-31$87,055
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$22,465,369
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
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year2010-12-31$0
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year2010-12-31$0
Investment advisory and management fees2010-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2010-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$17,428,066
Interest on participant loans2010-12-31$664
Income. Interest from loans (other than to participants)2010-12-31$0
Interest earned on other investments2010-12-31$70,409
Income. Interest from US Government securities2010-12-31$0
Income. Interest from corporate debt instruments2010-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$0
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$4,501,438
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2010-12-31$-290,639
Net investment gain/loss from pooled separate accounts2010-12-31$0
Net investment gain or loss from common/collective trusts2010-12-31$0
Net gain/loss from 103.12 investment entities2010-12-31$0
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$0
Employer contributions (assets) at end of year2010-12-31$0
Employer contributions (assets) at beginning of year2010-12-31$37
Income. Dividends from preferred stock2010-12-31$0
Income. Dividends from common stock2010-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$2,528,558
Contract administrator fees2010-12-31$80,921
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32010-12-31Yes
Liabilities. Value of benefit claims payable at beginning of year2010-12-31$0
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party 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
Aggregate proceeds on sale of assets2010-12-31$0
Aggregate carrying amount (costs) on sale of assets2010-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2010-12-31$0
2009 : ST. JOSEPH'S COMMUNITY HOSPITAL OF WEST BEND, INC. 403(B) PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2009-12-31$0

Form 5500 Responses for ST. JOSEPH'S COMMUNITY HOSPITAL OF WEST BEND, INC. 403(B) PLAN

2011: ST. JOSEPH'S COMMUNITY HOSPITAL OF WEST BEND, INC. 403(B) PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01This submission is the final filingYes
2011-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2009: ST. JOSEPH'S COMMUNITY HOSPITAL OF WEST BEND, INC. 403(B) PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
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 benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

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