401k Plan data: SIOUXLAND COMMUNITY HEALTH CENTER RET PLAN plan

SIOUXLAND COMMUNITY HEALTH CENTER RET PLAN 401k Plan overview

Plan Name	SIOUXLAND COMMUNITY HEALTH CENTER RET PLAN
Plan identification number	002

SIOUXLAND COMMUNITY HEALTH CENTER RET PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
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 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.

401k Sponsoring company profile

SIOUXLAND COMMUNITY HEALTH CENTER has sponsored the creation of one or more 401k plans.

Company Name: SIOUXLAND COMMUNITY HEALTH CENTER

Employer identification number (EIN): 421374894

NAIC Classification: 621498
NAIC Description: All Other Outpatient Care Centers

Additional information about SIOUXLAND COMMUNITY HEALTH CENTER

Jurisdiction of Incorporation: Iowa Secretary of State Business Entities

Incorporation Date: 1991-07-15

Company Identification Number: 151619

Legal Registered Office Address: 1021 NEBRASKA ST

SIOUX CITY
United States of America (USA)
51105

More information about SIOUXLAND COMMUNITY HEALTH CENTER

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SIOUXLAND COMMUNITY HEALTH CENTER RET PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2013-01-01 JAN ANDERSON
002 2012-01-01 JAN ANDERSON
002 2011-01-01 MICHELLE STEPHAN
002 2010-01-01 MICHELLE STEPHAN
002 2009-01-01 MICHELLE STEPHAN

Plan id#	Filing Submission Date	Name of Administrator
002	2013-01-01	JAN ANDERSON
002	2012-01-01	JAN ANDERSON
002	2011-01-01	MICHELLE STEPHAN
002	2010-01-01	MICHELLE STEPHAN
002	2009-01-01	MICHELLE STEPHAN

Plan Statistics for SIOUXLAND COMMUNITY HEALTH CENTER RET PLAN

401k plan membership statisitcs for SIOUXLAND COMMUNITY HEALTH CENTER RET PLAN

Measure Date Value
2013: SIOUXLAND COMMUNITY HEALTH CENTER RET PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 212
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 187
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 42
Total of all active and inactive participants 2013-01-01 229
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 229
Number of participants with account balances 2013-01-01 175
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: SIOUXLAND COMMUNITY HEALTH CENTER RET PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 196
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 180
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 29
Total of all active and inactive participants 2012-01-01 209
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 209
Number of participants with account balances 2012-01-01 163
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: SIOUXLAND COMMUNITY HEALTH CENTER RET PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 177
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 177
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 19
Total of all active and inactive participants 2011-01-01 196
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 196
Number of participants with account balances 2011-01-01 147
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: SIOUXLAND COMMUNITY HEALTH CENTER RET PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 167
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 153
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 22
Total of all active and inactive participants 2010-01-01 175
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 175
Number of participants with account balances 2010-01-01 137
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: SIOUXLAND COMMUNITY HEALTH CENTER RET PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 170
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 156
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 11
Total of all active and inactive participants 2009-01-01 167
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 167
Number of participants with account balances 2009-01-01 107
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2013: SIOUXLAND COMMUNITY HEALTH CENTER RET PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	212
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	187
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	42
Total of all active and inactive participants	2013-01-01	229
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	229
Number of participants with account balances	2013-01-01	175
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: SIOUXLAND COMMUNITY HEALTH CENTER RET PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	196
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	180
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	29
Total of all active and inactive participants	2012-01-01	209
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	209
Number of participants with account balances	2012-01-01	163
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: SIOUXLAND COMMUNITY HEALTH CENTER RET PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	177
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	177
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	19
Total of all active and inactive participants	2011-01-01	196
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	196
Number of participants with account balances	2011-01-01	147
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: SIOUXLAND COMMUNITY HEALTH CENTER RET PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	167
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	153
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	22
Total of all active and inactive participants	2010-01-01	175
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	175
Number of participants with account balances	2010-01-01	137
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: SIOUXLAND COMMUNITY HEALTH CENTER RET PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	170
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	156
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	11
Total of all active and inactive participants	2009-01-01	167
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	167
Number of participants with account balances	2009-01-01	107
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on SIOUXLAND COMMUNITY HEALTH CENTER RET PLAN

Measure	Date	Value
2013 : SIOUXLAND COMMUNITY HEALTH CENTER RET PLAN 2013 401k financial data
Total income from all sources (including contributions)	2013-12-31	$2,201,508
Total of all expenses incurred	2013-12-31	$614,888
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$583,473
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$1,126,897
Value of total assets at end of year	2013-12-31	$7,833,055
Value of total assets at beginning of year	2013-12-31	$6,246,435
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$31,415
Total interest from all sources	2013-12-31	$6
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$179,428
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-12-31	$179,428
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$500,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$580,791
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$178,460
Total non interest bearing cash at beginning of year	2013-12-31	$30,222
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$1,586,620
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$7,833,055
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$6,246,435
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Investment advisory and management fees	2013-12-31	$31,415
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$7,750,012
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$6,161,910
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2013-12-31	$83,043
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2013-12-31	$54,303
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2013-12-31	$54,303
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2013-12-31	$6
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$895,177
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$367,646
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$583,473
Did the plan have assets held for investment	2013-12-31	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	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	BKD, LLP
Accountancy firm EIN	2013-12-31	440160260
2012 : SIOUXLAND COMMUNITY HEALTH CENTER RET PLAN 2012 401k financial data
Total income from all sources (including contributions)	2012-12-31	$1,690,999
Total of all expenses incurred	2012-12-31	$428,862
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$400,334
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$953,694
Value of total assets at end of year	2012-12-31	$6,246,435
Value of total assets at beginning of year	2012-12-31	$4,984,298
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$28,528
Total interest from all sources	2012-12-31	$7
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$176,099
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	$176,099
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$500,000
If this is an individual account plan, was there a blackout period	2012-12-31	Yes
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$539,982
Participant contributions at beginning of year	2012-12-31	$18,131
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$58,816
Total non interest bearing cash at end of year	2012-12-31	$30,222
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
Value of net income/loss	2012-12-31	$1,262,137
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$6,246,435
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$4,984,298
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
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Investment advisory and management fees	2012-12-31	$28,528
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$6,161,910
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$4,876,375
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-12-31	$54,303
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-12-31	$77,447
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-12-31	$77,447
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-12-31	$7
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$561,199
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	$354,896
Employer contributions (assets) at beginning of year	2012-12-31	$12,345
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$400,334
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
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
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	BKD, LLP
Accountancy firm EIN	2012-12-31	440160260
2011 : SIOUXLAND COMMUNITY HEALTH CENTER RET PLAN 2011 401k financial data
Total income from all sources (including contributions)	2011-12-31	$684,642
Total of all expenses incurred	2011-12-31	$219,428
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$194,119
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$823,200
Value of total assets at end of year	2011-12-31	$4,984,298
Value of total assets at beginning of year	2011-12-31	$4,519,084
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$25,309
Total interest from all sources	2011-12-31	$8
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$59,115
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2011-12-31	$59,115
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$500,000
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	$465,471
Participant contributions at end of year	2011-12-31	$18,131
Participant contributions at beginning of year	2011-12-31	$30,314
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$54,301
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	$465,214
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$4,984,298
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$4,519,084
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
Investment advisory and management fees	2011-12-31	$25,309
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$4,876,375
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$4,411,377
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-12-31	$77,447
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-12-31	$55,452
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-12-31	$55,452
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-12-31	$8
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-197,681
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
Contributions received in cash from employer	2011-12-31	$303,428
Employer contributions (assets) at end of year	2011-12-31	$12,345
Employer contributions (assets) at beginning of year	2011-12-31	$21,941
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$194,119
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	2011-12-31	No
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	BKD, LLP
Accountancy firm EIN	2011-12-31	440160260
2010 : SIOUXLAND COMMUNITY HEALTH CENTER RET PLAN 2010 401k financial data
Total income from all sources (including contributions)	2010-12-31	$1,287,911
Total of all expenses incurred	2010-12-31	$93,758
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$71,603
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$743,818
Value of total assets at end of year	2010-12-31	$4,519,084
Value of total assets at beginning of year	2010-12-31	$3,324,931
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$22,155
Total interest from all sources	2010-12-31	$7
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$39,516
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2010-12-31	$39,516
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$500,000
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	$403,247
Participant contributions at end of year	2010-12-31	$30,314
Participant contributions at beginning of year	2010-12-31	$14,873
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$73,692
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	$1,194,153
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$4,519,084
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$3,324,931
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	$22,155
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$4,411,377
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$3,251,104
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2010-12-31	$55,452
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2010-12-31	$50,574
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2010-12-31	$50,574
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2010-12-31	$7
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$504,570
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	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$266,879
Employer contributions (assets) at end of year	2010-12-31	$21,941
Employer contributions (assets) at beginning of year	2010-12-31	$8,380
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$71,603
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	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	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	BKD LLP
Accountancy firm EIN	2010-12-31	440160260

Form 5500 Responses for SIOUXLAND COMMUNITY HEALTH CENTER RET PLAN

2013: SIOUXLAND COMMUNITY HEALTH CENTER RET PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: SIOUXLAND COMMUNITY HEALTH CENTER RET PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: SIOUXLAND COMMUNITY HEALTH CENTER RET PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: SIOUXLAND COMMUNITY HEALTH CENTER RET PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: SIOUXLAND COMMUNITY HEALTH CENTER RET PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	This submission is the final filing	No
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	SIOUXLAND COMMUNITY HEALTH CENTER
Employer identification number (EIN):	421374894
NAIC Classification:	621498
NAIC Description:	All Other Outpatient Care Centers

Jurisdiction of Incorporation:	Iowa Secretary of State Business Entities
Incorporation Date:	1991-07-15
Company Identification Number:	151619
Legal Registered Office Address:	1021 NEBRASKA ST SIOUX CITY United States of America (USA) 51105