401k Plan data: RUSSELL HOSPITAL CORPORATION GROUP LIFE DISABILITY ACCIDENTAL DEATH DISMEMBERMENT plan

RUSSELL HOSPITAL CORPORATION GROUP LIFE DISABILITY ACCIDENTAL DEATH DISMEMBERMENT 401k Plan overview

Plan Name	RUSSELL HOSPITAL CORPORATION GROUP LIFE DISABILITY ACCIDENTAL DEATH DISMEMBERMENT
Plan identification number	540

RUSSELL HOSPITAL CORPORATION GROUP LIFE DISABILITY ACCIDENTAL DEATH DISMEMBERMENT Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance Temporary disability (accident and sickness) Long-term disability 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 GROUP LIFE DISABILITY ACCIDENTAL DEATH DISMEMBERMENT

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
540 2012-01-01 L.E. PEACE III
540 2011-01-01 L.E. PEACE III
540 2010-01-01 L.E. PEACE III
540 2009-01-01 L.E. PEACE III

Plan id#	Filing Submission Date	Name of Administrator
540	2012-01-01	L.E. PEACE III
540	2011-01-01	L.E. PEACE III
540	2010-01-01	L.E. PEACE III
540	2009-01-01	L.E. PEACE III

Plan Statistics for RUSSELL HOSPITAL CORPORATION GROUP LIFE DISABILITY ACCIDENTAL DEATH DISMEMBERMENT

401k plan membership statisitcs for RUSSELL HOSPITAL CORPORATION GROUP LIFE DISABILITY ACCIDENTAL DEATH DISMEMBERMENT

Measure Date Value
2012: RUSSELL HOSPITAL CORPORATION GROUP LIFE DISABILITY ACCIDENTAL DEATH DISMEMBERMENT 2012 401k membership
Total participants, beginning-of-year 2012-01-01 432
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 433
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 0
Total of all active and inactive participants 2012-01-01 433
2011: RUSSELL HOSPITAL CORPORATION GROUP LIFE DISABILITY ACCIDENTAL DEATH DISMEMBERMENT 2011 401k membership
Total participants, beginning-of-year 2011-01-01 417
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 432
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 2011-01-01 432
2010: RUSSELL HOSPITAL CORPORATION GROUP LIFE DISABILITY ACCIDENTAL DEATH DISMEMBERMENT 2010 401k membership
Total participants, beginning-of-year 2010-01-01 420
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 417
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 0
Total of all active and inactive participants 2010-01-01 417
2009: RUSSELL HOSPITAL CORPORATION GROUP LIFE DISABILITY ACCIDENTAL DEATH DISMEMBERMENT 2009 401k membership
Total participants, beginning-of-year 2009-01-01 405
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 420
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 2009-01-01 420

Measure	Date	Value
2012: RUSSELL HOSPITAL CORPORATION GROUP LIFE DISABILITY ACCIDENTAL DEATH DISMEMBERMENT 2012 401k membership
Total participants, beginning-of-year	2012-01-01	432
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	433
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	0
Total of all active and inactive participants	2012-01-01	433
2011: RUSSELL HOSPITAL CORPORATION GROUP LIFE DISABILITY ACCIDENTAL DEATH DISMEMBERMENT 2011 401k membership
Total participants, beginning-of-year	2011-01-01	417
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	432
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	432
2010: RUSSELL HOSPITAL CORPORATION GROUP LIFE DISABILITY ACCIDENTAL DEATH DISMEMBERMENT 2010 401k membership
Total participants, beginning-of-year	2010-01-01	420
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	417
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	0
Total of all active and inactive participants	2010-01-01	417
2009: RUSSELL HOSPITAL CORPORATION GROUP LIFE DISABILITY ACCIDENTAL DEATH DISMEMBERMENT 2009 401k membership
Total participants, beginning-of-year	2009-01-01	405
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	420
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	420

Financial Data on RUSSELL HOSPITAL CORPORATION GROUP LIFE DISABILITY ACCIDENTAL DEATH DISMEMBERMENT

Measure	Date	Value
2012 : RUSSELL HOSPITAL CORPORATION GROUP LIFE DISABILITY ACCIDENTAL DEATH DISMEMBERMENT 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-01-31	$0
Total transfer of assets to this plan	2012-01-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-01-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-01-31	$0
Expenses. Interest paid	2012-01-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2012-01-31	$0
Total income from all sources (including contributions)	2012-01-31	$0
Total loss/gain on sale of assets	2012-01-31	$0
Total of all expenses incurred	2012-01-31	$0
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-01-31	$0
Expenses. Certain deemed distributions of participant loans	2012-01-31	$0
Value of total corrective distributions	2012-01-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-01-31	$0
Value of total assets at end of year	2012-01-31	$0
Value of total assets at beginning of year	2012-01-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-01-31	$0
Total interest from all sources	2012-01-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2012-01-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-01-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2012-01-31	$0
Administrative expenses professional fees incurred	2012-01-31	$0
Was this plan covered by a fidelity bond	2012-01-31	No
If this is an individual account plan, was there a blackout period	2012-01-31	No
Were there any nonexempt tranactions with any party-in-interest	2012-01-31	No
Participant contributions at end of year	2012-01-31	$0
Participant contributions at beginning of year	2012-01-31	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2012-01-31	$0
Other income not declared elsewhere	2012-01-31	$0
Administrative expenses (other) incurred	2012-01-31	$0
Total non interest bearing cash at end of year	2012-01-31	$0
Total non interest bearing cash at beginning of year	2012-01-31	$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	2012-01-31	No
Value of net income/loss	2012-01-31	$0
Value of net assets at end of year (total assets less liabilities)	2012-01-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2012-01-31	$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-01-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-01-31	No
Were any leases to which the plan was party in default or uncollectible	2012-01-31	No
Investment advisory and management fees	2012-01-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2012-01-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-01-31	$0
Net investment gain/loss from pooled separate accounts	2012-01-31	$0
Net investment gain or loss from common/collective trusts	2012-01-31	$0
Net gain/loss from 103.12 investment entities	2012-01-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-01-31	No
Was there a failure to transmit to the plan any participant contributions	2012-01-31	No
Has the plan failed to provide any benefit when due under the plan	2012-01-31	No
Employer contributions (assets) at end of year	2012-01-31	$0
Employer contributions (assets) at beginning of year	2012-01-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-01-31	$0
Contract administrator fees	2012-01-31	$0
Did the plan have assets held for investment	2012-01-31	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	2012-01-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-01-31	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-01-31	No
Opinion of an independent qualified public accountant for this plan	2012-01-31	Unqualified
Accountancy firm name	2012-01-31	RUSSELL MEDICAL CENTER
Accountancy firm EIN	2012-01-31	630385130
2011 : RUSSELL HOSPITAL CORPORATION GROUP LIFE DISABILITY ACCIDENTAL DEATH DISMEMBERMENT 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
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 GROUP LIFE DISABILITY ACCIDENTAL DEATH DISMEMBERMENT 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
Contributions received in cash from employer	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 GROUP LIFE DISABILITY ACCIDENTAL DEATH DISMEMBERMENT

2012: RUSSELL HOSPITAL CORPORATION GROUP LIFE DISABILITY ACCIDENTAL DEATH DISMEMBERMENT 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	Yes
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: RUSSELL HOSPITAL CORPORATION GROUP LIFE DISABILITY ACCIDENTAL DEATH DISMEMBERMENT 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 – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2010: RUSSELL HOSPITAL CORPORATION GROUP LIFE DISABILITY ACCIDENTAL DEATH DISMEMBERMENT 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 – Insurance	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2009: RUSSELL HOSPITAL CORPORATION GROUP LIFE DISABILITY ACCIDENTAL DEATH DISMEMBERMENT 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

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