401k Plan data: THE HSC HEALTH CARE SYSTEM CASH BALANCE PLAN plan

THE HSC HEALTH CARE SYSTEM CASH BALANCE PLAN 401k Plan overview

Plan Name	THE HSC HEALTH CARE SYSTEM CASH BALANCE PLAN
Plan identification number	001

THE HSC HEALTH CARE SYSTEM CASH BALANCE PLAN Benefits

401k Plan Type

Defined Benefit Pension

Plan Features/Benefits

Benefits are primarily pay related
Cash balance or similar plan - Plan has a "cash balance" formula. For this purpose, a "cash balance" formula is a benefit formula in a defined benefit plan by whatever name (for example, personal account plan, pension equity plan, life cycle plan, cash account plan, etc.) that rather than, or in addition to, expressing the accrued benefit as a life annuity commencing at normal retirement age, defines benefits for each employee in terms more common to a defined contribution plan such as a single sum distribution amount (for example, 10 percent of final average pay times years of service, or the amount of the employee's hypothetical account balance).
Covered by PBGC - Plan is covered under the PBGC insurance program (see ERISA section 4021).
Plan covered by PBGC that was terminated and closed out for PBGC purposes - Before the end of the plan year (or a prior plan year), (1) the plan terminated in a standard (or distress) termination and completed the distribution of plan assets in satisfaction of all benefit liabilities (or all ERISA Title IV benefits for distress termination); or (2) a trustee was appointed for a terminated plan pursuant to ERISA section 4042.
Frozen Plan - As of the last day of the plan year, the plan provides that no participant will get any new benefit accrual (whether because of service or compensation).

401k Sponsoring company profile

THE HOSPITAL FOR SICK CHILDREN has sponsored the creation of one or more 401k plans.

Company Name: THE HOSPITAL FOR SICK CHILDREN

Employer identification number (EIN): 530204670

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE HSC HEALTH CARE SYSTEM CASH BALANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2015-01-01 LYNNE HOSTETTER
001 2014-01-01 LYNNE HOSTETTER
001 2014-01-01 LYNNE HOSTETTER
001 2013-01-01 LYNNE HOSTETTER
001 2012-01-01 LYNNE HOSTETTER
001 2011-01-01 LYNNE HOSTETTER
001 2010-01-01 LYNNE HOSTETTER
001 2009-01-01 LYNNE HOSTETTER
001 2009-01-01 ERIKA BODE
001 2009-01-01 LYNNE HOSTETTER
001 2009-01-01 LYNNE HOSTETTER

Plan id#	Filing Submission Date	Name of Administrator
001	2015-01-01	LYNNE HOSTETTER
001	2014-01-01	LYNNE HOSTETTER
001	2014-01-01	LYNNE HOSTETTER
001	2013-01-01	LYNNE HOSTETTER
001	2012-01-01	LYNNE HOSTETTER
001	2011-01-01	LYNNE HOSTETTER
001	2010-01-01	LYNNE HOSTETTER
001	2009-01-01	LYNNE HOSTETTER
001	2009-01-01	ERIKA BODE
001	2009-01-01	LYNNE HOSTETTER
001	2009-01-01	LYNNE HOSTETTER

Plan Statistics for THE HSC HEALTH CARE SYSTEM CASH BALANCE PLAN

401k plan membership statisitcs for THE HSC HEALTH CARE SYSTEM CASH BALANCE PLAN

Measure Date Value
2015: THE HSC HEALTH CARE SYSTEM CASH BALANCE PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 168
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 0
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: THE HSC HEALTH CARE SYSTEM CASH BALANCE PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 609
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 38
Number of retired or separated participants receiving benefits 2014-01-01 24
Number of other retired or separated participants entitled to future benefits 2014-01-01 100
Total of all active and inactive participants 2014-01-01 162
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 6
Total participants 2014-01-01 168
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: THE HSC HEALTH CARE SYSTEM CASH BALANCE PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 617
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 246
Number of retired or separated participants receiving benefits 2013-01-01 17
Number of other retired or separated participants entitled to future benefits 2013-01-01 340
Total of all active and inactive participants 2013-01-01 603
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 6
Total participants 2013-01-01 609
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 1
2012: THE HSC HEALTH CARE SYSTEM CASH BALANCE PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 672
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 271
Number of retired or separated participants receiving benefits 2012-01-01 19
Number of other retired or separated participants entitled to future benefits 2012-01-01 322
Total of all active and inactive participants 2012-01-01 612
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 5
Total participants 2012-01-01 617
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 1
2011: THE HSC HEALTH CARE SYSTEM CASH BALANCE PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 682
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 299
Number of retired or separated participants receiving benefits 2011-01-01 14
Number of other retired or separated participants entitled to future benefits 2011-01-01 354
Total of all active and inactive participants 2011-01-01 667
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 5
Total participants 2011-01-01 672
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 4
2010: THE HSC HEALTH CARE SYSTEM CASH BALANCE PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 690
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 316
Number of retired or separated participants receiving benefits 2010-01-01 14
Number of other retired or separated participants entitled to future benefits 2010-01-01 348
Total of all active and inactive participants 2010-01-01 678
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 4
Total participants 2010-01-01 682
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 3
2009: THE HSC HEALTH CARE SYSTEM CASH BALANCE PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 661
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 335
Number of retired or separated participants receiving benefits 2009-01-01 14
Number of other retired or separated participants entitled to future benefits 2009-01-01 338
Total of all active and inactive participants 2009-01-01 687
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 3
Total participants 2009-01-01 690
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 10

Measure	Date	Value
2015: THE HSC HEALTH CARE SYSTEM CASH BALANCE PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	168
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	0
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: THE HSC HEALTH CARE SYSTEM CASH BALANCE PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	609
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	38
Number of retired or separated participants receiving benefits	2014-01-01	24
Number of other retired or separated participants entitled to future benefits	2014-01-01	100
Total of all active and inactive participants	2014-01-01	162
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	6
Total participants	2014-01-01	168
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: THE HSC HEALTH CARE SYSTEM CASH BALANCE PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	617
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	246
Number of retired or separated participants receiving benefits	2013-01-01	17
Number of other retired or separated participants entitled to future benefits	2013-01-01	340
Total of all active and inactive participants	2013-01-01	603
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	6
Total participants	2013-01-01	609
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	1
2012: THE HSC HEALTH CARE SYSTEM CASH BALANCE PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	672
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	271
Number of retired or separated participants receiving benefits	2012-01-01	19
Number of other retired or separated participants entitled to future benefits	2012-01-01	322
Total of all active and inactive participants	2012-01-01	612
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	5
Total participants	2012-01-01	617
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	1
2011: THE HSC HEALTH CARE SYSTEM CASH BALANCE PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	682
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	299
Number of retired or separated participants receiving benefits	2011-01-01	14
Number of other retired or separated participants entitled to future benefits	2011-01-01	354
Total of all active and inactive participants	2011-01-01	667
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	5
Total participants	2011-01-01	672
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	4
2010: THE HSC HEALTH CARE SYSTEM CASH BALANCE PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	690
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	316
Number of retired or separated participants receiving benefits	2010-01-01	14
Number of other retired or separated participants entitled to future benefits	2010-01-01	348
Total of all active and inactive participants	2010-01-01	678
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	4
Total participants	2010-01-01	682
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	3
2009: THE HSC HEALTH CARE SYSTEM CASH BALANCE PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	661
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	335
Number of retired or separated participants receiving benefits	2009-01-01	14
Number of other retired or separated participants entitled to future benefits	2009-01-01	338
Total of all active and inactive participants	2009-01-01	687
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	3
Total participants	2009-01-01	690
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	10

Financial Data on THE HSC HEALTH CARE SYSTEM CASH BALANCE PLAN

Measure	Date	Value
2015 : THE HSC HEALTH CARE SYSTEM CASH BALANCE PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-06-30	$0
Total income from all sources (including contributions)	2015-06-30	$2,262,297
Total loss/gain on sale of assets	2015-06-30	$0
Total of all expenses incurred	2015-06-30	$5,541,520
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-06-30	$5,525,846
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-06-30	$2,262,107
Value of total assets at end of year	2015-06-30	$0
Value of total assets at beginning of year	2015-06-30	$3,279,223
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-06-30	$15,674
Total interest from all sources	2015-06-30	$190
Total dividends received (eg from common stock, registered investment company shares)	2015-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-06-30	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2015-06-30	$0
Administrative expenses professional fees incurred	2015-06-30	$15,674
Was this plan covered by a fidelity bond	2015-06-30	Yes
Value of fidelity bond cover	2015-06-30	$500,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2015-06-30	No
Total non interest bearing cash at end of year	2015-06-30	$0
Total non interest bearing cash at beginning of year	2015-06-30	$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	2015-06-30	No
Value of net income/loss	2015-06-30	$-3,279,223
Value of net assets at end of year (total assets less liabilities)	2015-06-30	$0
Value of net assets at beginning of year (total assets less liabilities)	2015-06-30	$3,279,223
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-06-30	No
Were any leases to which the plan was party in default or uncollectible	2015-06-30	No
Assets. partnership/joint venture interests at end of year	2015-06-30	$0
Assets. partnership/joint venture interests at beginning of year	2015-06-30	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-06-30	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2015-06-30	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2015-06-30	$3,279,223
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2015-06-30	$3,279,223
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2015-06-30	$190
Expenses. Payments to insurance carriers foe the provision of benefits	2015-06-30	$3,314,575
Asset value of US Government securities at end of year	2015-06-30	$0
Asset value of US Government securities at beginning of year	2015-06-30	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-06-30	Yes
Was there a failure to transmit to the plan any participant contributions	2015-06-30	No
Has the plan failed to provide any benefit when due under the plan	2015-06-30	No
Contributions received in cash from employer	2015-06-30	$2,262,107
Employer contributions (assets) at end of year	2015-06-30	$0
Employer contributions (assets) at beginning of year	2015-06-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-06-30	$2,211,271
Did the plan have assets held for investment	2015-06-30	No
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	2015-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-06-30	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2015-06-30	Disclaimer
Accountancy firm name	2015-06-30	CROWE HORWATH, LLP
Accountancy firm EIN	2015-06-30	350921680
2014 : THE HSC HEALTH CARE SYSTEM CASH BALANCE PLAN 2014 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2014-12-31	$1,346
Total unrealized appreciation/depreciation of assets	2014-12-31	$1,346
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$12,252
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$11,155,280
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$11,143,120
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$0
Value of total assets at end of year	2014-12-31	$3,279,223
Value of total assets at beginning of year	2014-12-31	$14,422,251
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$12,160
Total interest from all sources	2014-12-31	$10,881
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2014-12-31	$0
Administrative expenses professional fees incurred	2014-12-31	$12,160
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$500,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Other income not declared elsewhere	2014-12-31	$25
Total non interest bearing cash at end of year	2014-12-31	$0
Total non interest bearing cash at beginning of year	2014-12-31	$2,449,769
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$-11,143,028
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$3,279,223
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$14,422,251
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Assets. partnership/joint venture interests at end of year	2014-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2014-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$0
Income. Interest from US Government securities	2014-12-31	$10,462
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2014-12-31	$3,279,223
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2014-12-31	$940,665
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2014-12-31	$940,665
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2014-12-31	$419
Asset value of US Government securities at end of year	2014-12-31	$0
Asset value of US Government securities at beginning of year	2014-12-31	$10,987,900
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Employer contributions (assets) at end of year	2014-12-31	$0
Employer contributions (assets) at beginning of year	2014-12-31	$43,917
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$11,143,120
Did the plan have assets held for investment	2014-12-31	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	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	DIXON HUGHES GOODMAN LLP
Accountancy firm EIN	2014-12-31	560747981
2013 : THE HSC HEALTH CARE SYSTEM CASH BALANCE PLAN 2013 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2013-12-31	$-1,206,385
Total unrealized appreciation/depreciation of assets	2013-12-31	$-1,206,385
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$1,821,132
Total loss/gain on sale of assets	2013-12-31	$2,596,894
Total of all expenses incurred	2013-12-31	$503,852
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$489,280
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$277,228
Value of total assets at end of year	2013-12-31	$14,422,251
Value of total assets at beginning of year	2013-12-31	$13,104,971
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$14,572
Total interest from all sources	2013-12-31	$262
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$153,110
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2013-12-31	$0
Total dividends received from registered investment company shares (eg mutual funds)	2013-12-31	$153,110
Administrative expenses professional fees incurred	2013-12-31	$14,572
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$500,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Other income not declared elsewhere	2013-12-31	$23
Total non interest bearing cash at end of year	2013-12-31	$2,449,769
Total non interest bearing cash at beginning of year	2013-12-31	$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	2013-12-31	No
Value of net income/loss	2013-12-31	$1,317,280
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$14,422,251
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$13,104,971
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
Assets. partnership/joint venture interests at end of year	2013-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2013-12-31	$2,178,318
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$9,509,755
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2013-12-31	$940,665
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2013-12-31	$1,291,599
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2013-12-31	$1,291,599
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2013-12-31	$262
Asset value of US Government securities at end of year	2013-12-31	$10,987,900
Asset value of US Government securities at beginning of year	2013-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	Yes
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	$277,228
Employer contributions (assets) at end of year	2013-12-31	$43,917
Employer contributions (assets) at beginning of year	2013-12-31	$125,299
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$489,280
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
Aggregate proceeds on sale of assets	2013-12-31	$23,274,336
Aggregate carrying amount (costs) on sale of assets	2013-12-31	$20,677,442
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	COHEN, RUTHERFORD & KNIGHT
Accountancy firm EIN	2013-12-31	521202280
2012 : THE HSC HEALTH CARE SYSTEM CASH BALANCE PLAN 2012 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2012-12-31	$642,196
Total unrealized appreciation/depreciation of assets	2012-12-31	$642,196
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
Total income from all sources (including contributions)	2012-12-31	$1,590,064
Total loss/gain on sale of assets	2012-12-31	$477,110
Total of all expenses incurred	2012-12-31	$1,219,484
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$1,209,341
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$273,637
Value of total assets at end of year	2012-12-31	$13,104,971
Value of total assets at beginning of year	2012-12-31	$12,734,391
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$10,143
Total interest from all sources	2012-12-31	$629
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$196,492
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	$196,492
Administrative expenses professional fees incurred	2012-12-31	$10,143
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$500,000
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
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
Value of net income/loss	2012-12-31	$370,580
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$13,104,971
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$12,734,391
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
Assets. partnership/joint venture interests at end of year	2012-12-31	$2,178,318
Assets. partnership/joint venture interests at beginning of year	2012-12-31	$2,188,888
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$9,509,755
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$8,372,274
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-12-31	$1,291,599
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-12-31	$2,062,544
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-12-31	$2,062,544
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-12-31	$629
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	Yes
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	$273,637
Employer contributions (assets) at end of year	2012-12-31	$125,299
Employer contributions (assets) at beginning of year	2012-12-31	$110,685
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$1,209,341
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	$8,419,427
Aggregate carrying amount (costs) on sale of assets	2012-12-31	$7,942,317
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	COHEN, RUTHERFORD & KNIGHT
Accountancy firm EIN	2012-12-31	521202280
2011 : THE HSC HEALTH CARE SYSTEM CASH BALANCE PLAN 2011 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2011-12-31	$-107,672
Total unrealized appreciation/depreciation of assets	2011-12-31	$-107,672
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	$398,055
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$782,860
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$775,123
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$310,870
Value of total assets at end of year	2011-12-31	$12,734,391
Value of total assets at beginning of year	2011-12-31	$13,119,196
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$7,737
Total interest from all sources	2011-12-31	$486
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$194,221
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	$194,221
Administrative expenses professional fees incurred	2011-12-31	$7,737
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$500,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Other income not declared elsewhere	2011-12-31	$150
Total non interest bearing cash at end of year	2011-12-31	$0
Total non interest bearing cash at beginning of year	2011-12-31	$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	2011-12-31	No
Value of net income/loss	2011-12-31	$-384,805
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$12,734,391
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$13,119,196
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
Assets. partnership/joint venture interests at end of year	2011-12-31	$2,188,888
Assets. partnership/joint venture interests at beginning of year	2011-12-31	$2,219,570
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$8,372,274
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$7,905,043
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-12-31	$2,062,544
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-12-31	$2,032,583
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-12-31	$2,032,583
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-12-31	$486
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	Yes
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	$310,870
Employer contributions (assets) at end of year	2011-12-31	$110,685
Employer contributions (assets) at beginning of year	2011-12-31	$962,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$775,123
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	COHEN, RUTHERFORD & KNIGHT
Accountancy firm EIN	2011-12-31	521202280
2010 : THE HSC HEALTH CARE SYSTEM CASH BALANCE PLAN 2010 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2010-12-31	$156,758
Total unrealized appreciation/depreciation of assets	2010-12-31	$156,758
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	$2,691,863
Total loss/gain on sale of assets	2010-12-31	$15,647
Total of all expenses incurred	2010-12-31	$373,230
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$366,003
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$1,391,534
Value of total assets at end of year	2010-12-31	$13,119,196
Value of total assets at beginning of year	2010-12-31	$10,800,563
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$7,227
Total interest from all sources	2010-12-31	$758
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$150,058
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	$150,058
Administrative expenses professional fees incurred	2010-12-31	$7,227
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$500,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Other income not declared elsewhere	2010-12-31	$208
Total non interest bearing cash at end of year	2010-12-31	$0
Total non interest bearing cash at beginning of year	2010-12-31	$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	2010-12-31	No
Value of net income/loss	2010-12-31	$2,318,633
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$13,119,196
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$10,800,563
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
Assets. partnership/joint venture interests at end of year	2010-12-31	$2,219,570
Assets. partnership/joint venture interests at beginning of year	2010-12-31	$2,062,812
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$7,905,043
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$6,762,439
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2010-12-31	$2,032,583
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2010-12-31	$1,692,129
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2010-12-31	$1,692,129
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2010-12-31	$758
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$976,900
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	Yes
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	$1,391,534
Employer contributions (assets) at end of year	2010-12-31	$962,000
Employer contributions (assets) at beginning of year	2010-12-31	$283,183
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$366,003
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
Aggregate proceeds on sale of assets	2010-12-31	$773,172
Aggregate carrying amount (costs) on sale of assets	2010-12-31	$757,525
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	COHEN, RUTHERFORD & KNIGHT
Accountancy firm EIN	2010-12-31	521202280
2009 : THE HSC HEALTH CARE SYSTEM CASH BALANCE PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for THE HSC HEALTH CARE SYSTEM CASH BALANCE PLAN

2015: THE HSC HEALTH CARE SYSTEM CASH BALANCE PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	Yes
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: THE HSC HEALTH CARE SYSTEM CASH BALANCE PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	Yes
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: THE HSC HEALTH CARE SYSTEM CASH BALANCE PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: THE HSC HEALTH CARE SYSTEM CASH BALANCE PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: THE HSC HEALTH CARE SYSTEM CASH BALANCE 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	No
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: THE HSC HEALTH CARE SYSTEM CASH BALANCE PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	Yes
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: THE HSC HEALTH CARE SYSTEM CASH BALANCE PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
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

Insurance Providers Used on plan

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

2-21349

Policy instance

Insurance contract or identification number	2-21349
Number of Individuals Covered	72
Insurance policy start date	2015-06-09
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	THE HOSPITAL FOR SICK CHILDREN
Employer identification number (EIN):	530204670
NAIC Classification:	622000
NAIC Description:	Hospitals