401k Plan data: RUSSELL HOSPITAL CORPORATION HEALTH AND DENTAL PLAN CAFETERIA plan

RUSSELL HOSPITAL CORPORATION HEALTH AND DENTAL PLAN CAFETERIA 401k Plan overview

Plan Name	RUSSELL HOSPITAL CORPORATION HEALTH AND DENTAL PLAN CAFETERIA
Plan identification number	531

RUSSELL HOSPITAL CORPORATION HEALTH AND DENTAL PLAN CAFETERIA Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Dental Other welfare benefit cover

401k Sponsoring company profile

RUSSELL HOSPITAL CORPORATION has sponsored the creation of one or more 401k plans.

Company Name: RUSSELL HOSPITAL CORPORATION

Employer identification number (EIN): 630385130

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan RUSSELL HOSPITAL CORPORATION HEALTH AND DENTAL PLAN CAFETERIA

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
531 2015-01-01 L. E. PEACE III
531 2013-12-01 L.E. PEACE III
531 2012-12-01 L.E. PEACE III
531 2011-12-01 L.E. PEACE III
531 2011-01-01 L.E. PEACE III
531 2009-01-01 L.E. PEACE III

Plan id#	Filing Submission Date	Name of Administrator
531	2015-01-01	L. E. PEACE III
531	2013-12-01	L.E. PEACE III
531	2012-12-01	L.E. PEACE III
531	2011-12-01	L.E. PEACE III
531	2011-01-01	L.E. PEACE III
531	2009-01-01	L.E. PEACE III

Plan Statistics for RUSSELL HOSPITAL CORPORATION HEALTH AND DENTAL PLAN CAFETERIA

401k plan membership statisitcs for RUSSELL HOSPITAL CORPORATION HEALTH AND DENTAL PLAN CAFETERIA

Measure Date Value
2015: RUSSELL HOSPITAL CORPORATION HEALTH AND DENTAL PLAN CAFETERIA 2015 401k membership
Total participants, beginning-of-year 2015-01-01 186
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
2013: RUSSELL HOSPITAL CORPORATION HEALTH AND DENTAL PLAN CAFETERIA 2013 401k membership
Total participants, beginning-of-year 2013-12-01 389
Total number of active participants reported on line 7a of the Form 5500 2013-12-01 368
Number of retired or separated participants receiving benefits 2013-12-01 0
Number of other retired or separated participants entitled to future benefits 2013-12-01 0
Total of all active and inactive participants 2013-12-01 368
2012: RUSSELL HOSPITAL CORPORATION HEALTH AND DENTAL PLAN CAFETERIA 2012 401k membership
Total participants, beginning-of-year 2012-12-01 400
Total number of active participants reported on line 7a of the Form 5500 2012-12-01 389
Number of retired or separated participants receiving benefits 2012-12-01 0
Number of other retired or separated participants entitled to future benefits 2012-12-01 0
Total of all active and inactive participants 2012-12-01 389
2011: RUSSELL HOSPITAL CORPORATION HEALTH AND DENTAL PLAN CAFETERIA 2011 401k membership
Total participants, beginning-of-year 2011-12-01 392
Total number of active participants reported on line 7a of the Form 5500 2011-12-01 400
Number of retired or separated participants receiving benefits 2011-12-01 0
Number of other retired or separated participants entitled to future benefits 2011-12-01 0
Total of all active and inactive participants 2011-12-01 400
Total participants, beginning-of-year 2011-01-01 376
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 392
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 2011-01-01 392
2009: RUSSELL HOSPITAL CORPORATION HEALTH AND DENTAL PLAN CAFETERIA 2009 401k membership
Total participants, beginning-of-year 2009-01-01 345
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 367
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 2009-01-01 367

Measure	Date	Value
2015: RUSSELL HOSPITAL CORPORATION HEALTH AND DENTAL PLAN CAFETERIA 2015 401k membership
Total participants, beginning-of-year	2015-01-01	186
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
2013: RUSSELL HOSPITAL CORPORATION HEALTH AND DENTAL PLAN CAFETERIA 2013 401k membership
Total participants, beginning-of-year	2013-12-01	389
Total number of active participants reported on line 7a of the Form 5500	2013-12-01	368
Number of retired or separated participants receiving benefits	2013-12-01	0
Number of other retired or separated participants entitled to future benefits	2013-12-01	0
Total of all active and inactive participants	2013-12-01	368
2012: RUSSELL HOSPITAL CORPORATION HEALTH AND DENTAL PLAN CAFETERIA 2012 401k membership
Total participants, beginning-of-year	2012-12-01	400
Total number of active participants reported on line 7a of the Form 5500	2012-12-01	389
Number of retired or separated participants receiving benefits	2012-12-01	0
Number of other retired or separated participants entitled to future benefits	2012-12-01	0
Total of all active and inactive participants	2012-12-01	389
2011: RUSSELL HOSPITAL CORPORATION HEALTH AND DENTAL PLAN CAFETERIA 2011 401k membership
Total participants, beginning-of-year	2011-12-01	392
Total number of active participants reported on line 7a of the Form 5500	2011-12-01	400
Number of retired or separated participants receiving benefits	2011-12-01	0
Number of other retired or separated participants entitled to future benefits	2011-12-01	0
Total of all active and inactive participants	2011-12-01	400
Total participants, beginning-of-year	2011-01-01	376
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	392
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	392
2009: RUSSELL HOSPITAL CORPORATION HEALTH AND DENTAL PLAN CAFETERIA 2009 401k membership
Total participants, beginning-of-year	2009-01-01	345
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	367
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	367

Financial Data on RUSSELL HOSPITAL CORPORATION HEALTH AND DENTAL PLAN CAFETERIA

Measure	Date	Value
2014 : RUSSELL HOSPITAL CORPORATION HEALTH AND DENTAL PLAN CAFETERIA 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-11-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-11-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-11-30	$0
Total income from all sources (including contributions)	2014-11-30	$0
Total loss/gain on sale of assets	2014-11-30	$0
Total of all expenses incurred	2014-11-30	$0
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-11-30	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-11-30	$0
Value of total assets at end of year	2014-11-30	$0
Value of total assets at beginning of year	2014-11-30	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-11-30	$0
Total interest from all sources	2014-11-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2014-11-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-11-30	No
Was this plan covered by a fidelity bond	2014-11-30	No
If this is an individual account plan, was there a blackout period	2014-11-30	No
Were there any nonexempt tranactions with any party-in-interest	2014-11-30	No
Total non interest bearing cash at end of year	2014-11-30	$0
Total non interest bearing cash at beginning of year	2014-11-30	$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	2014-11-30	No
Value of net income/loss	2014-11-30	$0
Value of net assets at end of year (total assets less liabilities)	2014-11-30	$0
Value of net assets at beginning of year (total assets less liabilities)	2014-11-30	$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-11-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-11-30	No
Were any leases to which the plan was party in default or uncollectible	2014-11-30	No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-11-30	No
Was there a failure to transmit to the plan any participant contributions	2014-11-30	No
Has the plan failed to provide any benefit when due under the plan	2014-11-30	No
Assets. Invements in employer securities at end of year	2014-11-30	$0
Assets. Invements in employer securities at beginning of year	2014-11-30	$0
Assets. Value of employer real property at end of year	2014-11-30	$0
Assets. Value of employer real property at beginning of year	2014-11-30	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2014-11-30	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2014-11-30	$0
Did the plan have assets held for investment	2014-11-30	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	2014-11-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-11-30	No
2013 : RUSSELL HOSPITAL CORPORATION HEALTH AND DENTAL PLAN CAFETERIA 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-11-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-11-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-11-30	$0
Total income from all sources (including contributions)	2013-11-30	$0
Total loss/gain on sale of assets	2013-11-30	$0
Total of all expenses incurred	2013-11-30	$0
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-11-30	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-11-30	$0
Value of total assets at end of year	2013-11-30	$0
Value of total assets at beginning of year	2013-11-30	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-11-30	$0
Total interest from all sources	2013-11-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2013-11-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-11-30	No
Was this plan covered by a fidelity bond	2013-11-30	No
If this is an individual account plan, was there a blackout period	2013-11-30	No
Were there any nonexempt tranactions with any party-in-interest	2013-11-30	No
Total non interest bearing cash at end of year	2013-11-30	$0
Total non interest bearing cash at beginning of year	2013-11-30	$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	2013-11-30	No
Value of net income/loss	2013-11-30	$0
Value of net assets at end of year (total assets less liabilities)	2013-11-30	$0
Value of net assets at beginning of year (total assets less liabilities)	2013-11-30	$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-11-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-11-30	No
Were any leases to which the plan was party in default or uncollectible	2013-11-30	No
Net investment gain/loss from pooled separate accounts	2013-11-30	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-11-30	No
Was there a failure to transmit to the plan any participant contributions	2013-11-30	No
Has the plan failed to provide any benefit when due under the plan	2013-11-30	No
Assets. Invements in employer securities at end of year	2013-11-30	$0
Assets. Invements in employer securities at beginning of year	2013-11-30	$0
Assets. Value of employer real property at end of year	2013-11-30	$0
Assets. Value of employer real property at beginning of year	2013-11-30	$0
Contributions received in cash from employer	2013-11-30	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2013-11-30	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2013-11-30	$0
Did the plan have assets held for investment	2013-11-30	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	2013-11-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-11-30	No
2012 : RUSSELL HOSPITAL CORPORATION HEALTH AND DENTAL PLAN CAFETERIA 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-11-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-11-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-11-30	$0
Total income from all sources (including contributions)	2012-11-30	$0
Total loss/gain on sale of assets	2012-11-30	$0
Total of all expenses incurred	2012-11-30	$0
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-11-30	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-11-30	$0
Value of total assets at end of year	2012-11-30	$0
Value of total assets at beginning of year	2012-11-30	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-11-30	$0
Total interest from all sources	2012-11-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2012-11-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-11-30	No
Was this plan covered by a fidelity bond	2012-11-30	No
If this is an individual account plan, was there a blackout period	2012-11-30	No
Were there any nonexempt tranactions with any party-in-interest	2012-11-30	No
Total non interest bearing cash at end of year	2012-11-30	$0
Total non interest bearing cash at beginning of year	2012-11-30	$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	2012-11-30	No
Value of net income/loss	2012-11-30	$0
Value of net assets at end of year (total assets less liabilities)	2012-11-30	$0
Value of net assets at beginning of year (total assets less liabilities)	2012-11-30	$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-11-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-11-30	No
Were any leases to which the plan was party in default or uncollectible	2012-11-30	No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-11-30	No
Was there a failure to transmit to the plan any participant contributions	2012-11-30	No
Has the plan failed to provide any benefit when due under the plan	2012-11-30	No
Assets. Invements in employer securities at end of year	2012-11-30	$0
Assets. Invements in employer securities at beginning of year	2012-11-30	$0
Assets. Value of employer real property at end of year	2012-11-30	$0
Assets. Value of employer real property at beginning of year	2012-11-30	$0
Contributions received in cash from employer	2012-11-30	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2012-11-30	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2012-11-30	$0
Did the plan have assets held for investment	2012-11-30	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	2012-11-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-11-30	No
2011 : RUSSELL HOSPITAL CORPORATION HEALTH AND DENTAL PLAN CAFETERIA 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	$0
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$0
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$0
Value of total assets at end of year	2011-12-31	$0
Value of total assets at beginning of year	2011-12-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$0
Total interest from all sources	2011-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Was this plan covered by a fidelity bond	2011-12-31	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
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	$0
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	$0
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
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
Assets. Invements in employer securities at end of year	2011-12-31	$0
Assets. Invements in employer securities at beginning of year	2011-12-31	$0
Assets. Value of employer real property at end of year	2011-12-31	$0
Assets. Value of employer real property at beginning of year	2011-12-31	$0
Contributions received in cash from employer	2011-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2011-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2011-12-31	$0
Did the plan have assets held for investment	2011-12-31	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	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
2010 : RUSSELL HOSPITAL CORPORATION HEALTH AND DENTAL PLAN CAFETERIA 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	$0
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$0
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$0
Value of total assets at end of year	2010-12-31	$0
Value of total assets at beginning of year	2010-12-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$0
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
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	$0
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$0
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
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
Assets. Invements in employer securities at end of year	2010-12-31	$0
Assets. Invements in employer securities at beginning of year	2010-12-31	$0
Assets. Value of employer real property at end of year	2010-12-31	$0
Assets. Value of employer real property at beginning of year	2010-12-31	$0
Contributions received in cash from employer	2010-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2010-12-31	$0
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	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	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

Form 5500 Responses for RUSSELL HOSPITAL CORPORATION HEALTH AND DENTAL PLAN CAFETERIA

2015: RUSSELL HOSPITAL CORPORATION HEALTH AND DENTAL PLAN CAFETERIA 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)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: RUSSELL HOSPITAL CORPORATION HEALTH AND DENTAL PLAN CAFETERIA 2013 form 5500 responses
2013-12-01	Type of plan entity	Single employer plan
2013-12-01	Submission has been amended	No
2013-12-01	This submission is the final filing	No
2013-12-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-12-01	Plan is a collectively bargained plan	No
2013-12-01	Plan funding arrangement – Insurance	Yes
2013-12-01	Plan benefit arrangement – Insurance	Yes
2012: RUSSELL HOSPITAL CORPORATION HEALTH AND DENTAL PLAN CAFETERIA 2012 form 5500 responses
2012-12-01	Type of plan entity	Single employer plan
2012-12-01	Submission has been amended	No
2012-12-01	This submission is the final filing	No
2012-12-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-12-01	Plan is a collectively bargained plan	No
2012-12-01	Plan funding arrangement – Insurance	Yes
2012-12-01	Plan benefit arrangement – Insurance	Yes
2011: RUSSELL HOSPITAL CORPORATION HEALTH AND DENTAL PLAN CAFETERIA 2011 form 5500 responses
2011-12-01	Type of plan entity	Single employer plan
2011-12-01	Submission has been amended	No
2011-12-01	This submission is the final filing	No
2011-12-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-12-01	Plan is a collectively bargained plan	No
2011-12-01	Plan funding arrangement – Insurance	Yes
2011-12-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	Yes
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 – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2009: RUSSELL HOSPITAL CORPORATION HEALTH AND DENTAL PLAN CAFETERIA 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 – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )

Policy contract number

00000

Policy instance

Insurance contract or identification number	00000
Number of Individuals Covered	329
Insurance policy start date	2014-12-01
Insurance policy end date	2015-11-30
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
Welfare Benefit Premiums Paid to Carrier	USD $44,123
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	RUSSELL HOSPITAL CORPORATION
Employer identification number (EIN):	630385130
NAIC Classification:	622000
NAIC Description:	Hospitals