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| Plan Name | BELLIN EMPLOYEES' PENSION PLAN |
| Plan identification number | 001 |
| 401k Plan Type | Defined Benefit Pension |
| Plan Features/Benefits |
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| Company Name: | BELLIN MEMORIAL HOSPITAL |
| Employer identification number (EIN): | 390884478 |
| NAIC Classification: | 622000 |
| NAIC Description: | Hospitals |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 001 | 2010-07-01 | KENNETH PETERS | 2011-11-15 | KENNETH PETERS | 2011-11-15 |
| Measure | Date | Value |
|---|---|---|
| 2009 : BELLIN EMPLOYEES' PENSION PLAN 2009 401k financial data | ||
| Total plan liabilities at end of year | 2009-06-30 | $0 |
| Total plan liabilities at beginning of year | 2009-06-30 | $0 |
| Total income from all sources | 2009-06-30 | $39,697 |
| Expenses. Total of all expenses incurred | 2009-06-30 | $71,987 |
| Benefits paid (including direct rollovers) | 2009-06-30 | $37,849 |
| Total plan assets at end of year | 2009-06-30 | $0 |
| Total plan assets at beginning of year | 2009-06-30 | $32,290 |
| Value of fidelity bond covering the plan | 2009-06-30 | $5,000,000 |
| Expenses. Other expenses not covered elsewhere | 2009-06-30 | $34,138 |
| Other income received | 2009-06-30 | $12,195 |
| Net income (gross income less expenses) | 2009-06-30 | $-32,290 |
| Net plan assets at end of year (total assets less liabilities) | 2009-06-30 | $0 |
| Net plan assets at beginning of year (total assets less liabilities) | 2009-06-30 | $32,290 |
| Total contributions received or receivable from employer(s) | 2009-06-30 | $27,502 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2009-06-30 | $0 |
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