SIOUX CENTER HEALTH has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan SIOUX CENTER HEALTH 403(B) PLAN
| Measure | Date | Value |
|---|
| 2012 : SIOUX CENTER HEALTH 403(B) PLAN 2012 401k financial data |
|---|
| Unrealized appreciation/depreciation of real estate assets | 2012-12-31 | $0 |
| Unrealized appreciation/depreciation of other (non real estate) assets | 2012-12-31 | $0 |
| Total unrealized appreciation/depreciation of assets | 2012-12-31 | $0 |
| 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 |
| Expenses. Interest paid | 2012-12-31 | $0 |
| Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102 | 2012-12-31 | $0 |
| Total income from all sources (including contributions) | 2012-12-31 | $166,143 |
| Total loss/gain on sale of assets | 2012-12-31 | $0 |
| Total of all expenses incurred | 2012-12-31 | $100,328 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2012-12-31 | $95,396 |
| Value of total corrective distributions | 2012-12-31 | $0 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2012-12-31 | $117,655 |
| Value of total assets at end of year | 2012-12-31 | $460,255 |
| Value of total assets at beginning of year | 2012-12-31 | $394,440 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2012-12-31 | $4,932 |
| Total income from rents | 2012-12-31 | $0 |
| Total interest from all sources | 2012-12-31 | $155 |
| Total dividends received (eg from common stock, registered investment company shares) | 2012-12-31 | $6,280 |
| 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 | $6,280 |
| Administrative expenses professional fees incurred | 2012-12-31 | $0 |
| Was this plan covered by a fidelity bond | 2012-12-31 | Yes |
| Value of fidelity bond cover | 2012-12-31 | $1,000,000 |
| If this is an individual account plan, was there a blackout period | 2012-12-31 | Yes |
| 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 |
| Amount of non-exempt transactions with any party-in-interest | 2012-12-31 | $0 |
| Contributions received from participants | 2012-12-31 | $117,655 |
| Participant contributions at end of year | 2012-12-31 | $9,813 |
| Participant contributions at beginning of year | 2012-12-31 | $0 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2012-12-31 | $0 |
| Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries) | 2012-12-31 | $0 |
| Value of other receiveables (less allowance for doubtful accounts) at end of year | 2012-12-31 | $0 |
| Value of other receiveables (less allowance for doubtful accounts) at beginning of year | 2012-12-31 | $0 |
| Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year | 2012-12-31 | $0 |
| Other income not declared elsewhere | 2012-12-31 | $0 |
| Administrative expenses (other) incurred | 2012-12-31 | $0 |
| Liabilities. Value of operating payables at beginning of year | 2012-12-31 | $0 |
| Total non interest bearing cash at end of year | 2012-12-31 | $0 |
| Total non interest bearing cash at beginning of year | 2012-12-31 | $0 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-12-31 | No |
| Income. Non cash contributions | 2012-12-31 | $0 |
| Value of net income/loss | 2012-12-31 | $65,815 |
| Value of net assets at end of year (total assets less liabilities) | 2012-12-31 | $460,255 |
| Value of net assets at beginning of year (total assets less liabilities) | 2012-12-31 | $394,440 |
| 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 |
| 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 year | 2012-12-31 | $0 |
| Were any leases to which the plan was party in default or uncollectible | 2012-12-31 | No |
| Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year | 2012-12-31 | $0 |
| Investment advisory and management fees | 2012-12-31 | $0 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2012-12-31 | $414,821 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2012-12-31 | $392,237 |
| Income. Interest from loans (other than to participants) | 2012-12-31 | $0 |
| Interest earned on other investments | 2012-12-31 | $155 |
| Income. Interest from US Government securities | 2012-12-31 | $0 |
| Income. Interest from corporate debt instruments | 2012-12-31 | $0 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2012-12-31 | $0 |
| Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2012-12-31 | $2,203 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2012-12-31 | $2,203 |
| Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2012-12-31 | $0 |
| Value of funds held in insurance company general accounts (unallocated contracts) at end of year | 2012-12-31 | $35,621 |
| Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year | 2012-12-31 | $0 |
| Expenses. Payments to insurance carriers foe the provision of benefits | 2012-12-31 | $0 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2012-12-31 | $42,053 |
| Net investment gain/loss from pooled separate accounts | 2012-12-31 | $0 |
| Net investment gain or loss from common/collective trusts | 2012-12-31 | $0 |
| Net gain/loss from 103.12 investment entities | 2012-12-31 | $0 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2012-12-31 | No |
| 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 | $0 |
| Employer contributions (assets) at end of year | 2012-12-31 | $0 |
| Employer contributions (assets) at beginning of year | 2012-12-31 | $0 |
| Income. Dividends from preferred stock | 2012-12-31 | $0 |
| Income. Dividends from common stock | 2012-12-31 | $0 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2012-12-31 | $95,396 |
| Contract administrator fees | 2012-12-31 | $4,932 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2012-12-31 | Yes |
| Liabilities. Value of benefit claims payable at beginning of year | 2012-12-31 | $0 |
| 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 | $0 |
| Aggregate carrying amount (costs) on sale of assets | 2012-12-31 | $0 |
| Liabilities. Value of acquisition indebtedness at beginning of year | 2012-12-31 | $0 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2012-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2012-12-31 | Disclaimer |
| Accountancy firm name | 2012-12-31 | EIDE BAILLY LLP |
| Accountancy firm EIN | 2012-12-31 | 450250958 |
| 2011 : SIOUX CENTER HEALTH 403(B) PLAN 2011 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 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 | $58,068 |
| Total loss/gain on sale of assets | 2011-12-31 | $0 |
| Total of all expenses incurred | 2011-12-31 | $27,582 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2011-12-31 | $27,582 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2011-12-31 | $71,611 |
| Value of total assets at end of year | 2011-12-31 | $394,440 |
| Value of total assets at beginning of year | 2011-12-31 | $363,954 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2011-12-31 | $0 |
| Total interest from all sources | 2011-12-31 | $0 |
| Total dividends received (eg from common stock, registered investment company shares) | 2011-12-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2011-12-31 | No |
| Was this plan covered by a fidelity bond | 2011-12-31 | Yes |
| Value of fidelity bond cover | 2011-12-31 | $1,000,000 |
| If this is an individual account plan, was there a blackout period | 2011-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2011-12-31 | No |
| Contributions received from participants | 2011-12-31 | $71,611 |
| 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 | $30,486 |
| Value of net assets at end of year (total assets less liabilities) | 2011-12-31 | $394,440 |
| Value of net assets at beginning of year (total assets less liabilities) | 2011-12-31 | $363,954 |
| 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 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2011-12-31 | $392,237 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2011-12-31 | $363,954 |
| Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2011-12-31 | $2,203 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2011-12-31 | $-13,543 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2011-12-31 | No |
| 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 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2011-12-31 | $27,582 |
| 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 |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2011-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2011-12-31 | Disclaimer |
| Accountancy firm name | 2011-12-31 | EIDE BAILLY LLP |
| Accountancy firm EIN | 2011-12-31 | 450250958 |
| 2010 : SIOUX CENTER HEALTH 403(B) PLAN 2010 401k financial data |
|---|
| Total unrealized appreciation/depreciation of assets | 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 | $194,490 |
| Total loss/gain on sale of assets | 2010-12-31 | $0 |
| Total of all expenses incurred | 2010-12-31 | $1,260 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2010-12-31 | $0 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2010-12-31 | $152,624 |
| Value of total assets at end of year | 2010-12-31 | $363,954 |
| Value of total assets at beginning of year | 2010-12-31 | $170,724 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2010-12-31 | $1,260 |
| Total interest from all sources | 2010-12-31 | $0 |
| Total dividends received (eg from common stock, registered investment company shares) | 2010-12-31 | $0 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2010-12-31 | No |
| Was this plan covered by a fidelity bond | 2010-12-31 | Yes |
| Value of fidelity bond cover | 2010-12-31 | $1,000,000 |
| If this is an individual account plan, was there a blackout period | 2010-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2010-12-31 | No |
| Contributions received from participants | 2010-12-31 | $86,793 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2010-12-31 | $65,831 |
| 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 | $193,230 |
| Value of net assets at end of year (total assets less liabilities) | 2010-12-31 | $363,954 |
| Value of net assets at beginning of year (total assets less liabilities) | 2010-12-31 | $170,724 |
| 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 | $1,260 |
| Value of interest in registered invesment companies (eg mutual funds) at end of year | 2010-12-31 | $363,954 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2010-12-31 | $170,724 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2010-12-31 | $41,866 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2010-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2010-12-31 | Yes |
| Has the plan failed to provide any benefit when due under the plan | 2010-12-31 | No |
| 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 |
| 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 | Disclaimer |
| Accountancy firm name | 2010-12-31 | EIDE BAILLY LLP |
| Accountancy firm EIN | 2010-12-31 | 450250958 |
