401k Plan data: MARY LANNING MEMORIAL HOSPITAL 403(B) PLAN plan

MARY LANNING MEMORIAL HOSPITAL 403(B) PLAN 401k Plan overview

Plan Name	MARY LANNING MEMORIAL HOSPITAL 403(B) PLAN
Plan identification number	003

MARY LANNING MEMORIAL HOSPITAL 403(B) PLAN Benefits

401k Plan Type	Defined Contribution Pension
Plan Features/Benefits	Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.

401k Sponsoring company profile

MARY LANNING MEMORIAL HOSPITAL ASSOCIATION has sponsored the creation of one or more 401k plans.

Company Name: MARY LANNING MEMORIAL HOSPITAL ASSOCIATION

Employer identification number (EIN): 470378779

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MARY LANNING MEMORIAL HOSPITAL 403(B) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
003 2011-01-01 BETH SCHLICHTMAN BETH SCHLICHTMAN 2012-07-30
003 2010-01-01 BETH SCHLICHTMAN BETH SCHLICHTMAN 2011-10-07
003 2009-01-01 BETH SCHLICHTMAN BETH SCHLICHTMAN 2010-10-13

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
003	2011-01-01	BETH SCHLICHTMAN	BETH SCHLICHTMAN	2012-07-30
003	2010-01-01	BETH SCHLICHTMAN	BETH SCHLICHTMAN	2011-10-07
003	2009-01-01	BETH SCHLICHTMAN	BETH SCHLICHTMAN	2010-10-13

Plan Statistics for MARY LANNING MEMORIAL HOSPITAL 403(B) PLAN

401k plan membership statisitcs for MARY LANNING MEMORIAL HOSPITAL 403(B) PLAN

Measure Date Value
2011: MARY LANNING MEMORIAL HOSPITAL 403(B) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 1,116
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 0
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 0
Total of all active and inactive participants 2011-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 0
Number of participants with account balances 2011-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: MARY LANNING MEMORIAL HOSPITAL 403(B) PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 100
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 1,112
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 4
Total of all active and inactive participants 2010-01-01 1,116
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 1,116
Number of participants with account balances 2010-01-01 42
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: MARY LANNING MEMORIAL HOSPITAL 403(B) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 100
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 100
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 0
Total of all active and inactive participants 2009-01-01 100
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 100
Number of participants with account balances 2009-01-01 39
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2011: MARY LANNING MEMORIAL HOSPITAL 403(B) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	1,116
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	0
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	0
Total of all active and inactive participants	2011-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	0
Number of participants with account balances	2011-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: MARY LANNING MEMORIAL HOSPITAL 403(B) PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	100
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	1,112
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	4
Total of all active and inactive participants	2010-01-01	1,116
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	1,116
Number of participants with account balances	2010-01-01	42
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: MARY LANNING MEMORIAL HOSPITAL 403(B) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	100
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	100
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	0
Total of all active and inactive participants	2009-01-01	100
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	100
Number of participants with account balances	2009-01-01	39
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on MARY LANNING MEMORIAL HOSPITAL 403(B) PLAN

Measure	Date	Value
2011 : MARY LANNING MEMORIAL HOSPITAL 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	$17,476
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$466,592
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$461,542
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$26,660
Value of total assets at end of year	2011-12-31	$0
Value of total assets at beginning of year	2011-12-31	$449,116
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$5,050
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	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2011-12-31	$0
Was this plan covered by a fidelity bond	2011-12-31	No
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	$26,660
Administrative expenses (other) incurred	2011-12-31	$5,050
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	$-449,116
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$449,116
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	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$449,116
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-9,184
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	$461,542
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	No
Opinion of an independent qualified public accountant for this plan	2011-12-31	Unqualified
Accountancy firm name	2011-12-31	MCDERMOTT & MILLER, P.C.
Accountancy firm EIN	2011-12-31	470608676
2010 : MARY LANNING MEMORIAL HOSPITAL 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	$313,297
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$18,058
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$15,621
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$273,224
Value of total assets at end of year	2010-12-31	$449,116
Value of total assets at beginning of year	2010-12-31	$153,877
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$2,437
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	No
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	$273,224
Administrative expenses (other) incurred	2010-12-31	$2,437
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	$295,239
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$449,116
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$153,877
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$449,116
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$153,877
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$40,073
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$15,621
Assets. Value of buildings and other operty used in plan operation at beginning of year	2010-12-31	$0
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	Unqualified
Accountancy firm name	2010-12-31	MCDERMOTT & MILLER, P.C.
Accountancy firm EIN	2010-12-31	470608676

Form 5500 Responses for MARY LANNING MEMORIAL HOSPITAL 403(B) PLAN

2011: MARY LANNING MEMORIAL HOSPITAL 403(B) PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	Yes
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: MARY LANNING MEMORIAL HOSPITAL 403(B) PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: MARY LANNING MEMORIAL HOSPITAL 403(B) PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	First time form 5500 has been submitted	Yes
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	MARY LANNING MEMORIAL HOSPITAL ASSOCIATION
Employer identification number (EIN):	470378779
NAIC Classification:	622000
NAIC Description:	Hospitals