401k Plan data: SUTTER LAKESIDE HOSPITAL 403(B) RETIREMENT PLAN plan

SUTTER LAKESIDE HOSPITAL 403(B) RETIREMENT PLAN 401k Plan overview

Plan Name	SUTTER LAKESIDE HOSPITAL 403(B) RETIREMENT PLAN
Plan identification number	014

SUTTER LAKESIDE HOSPITAL 403(B) RETIREMENT PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

SUTTER BAY HOSPITALS has sponsored the creation of one or more 401k plans.

Company Name: SUTTER BAY HOSPITALS

Employer identification number (EIN): 940562680

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SUTTER LAKESIDE HOSPITAL 403(B) RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
014 2014-01-01 VICTORIA FLEMMING
014 2013-01-01 VICTORIA FLEMMING
014 2012-01-01 VICTORIA FLEMMING

Plan id#	Filing Submission Date	Name of Administrator
014	2014-01-01	VICTORIA FLEMMING
014	2013-01-01	VICTORIA FLEMMING
014	2012-01-01	VICTORIA FLEMMING

Plan Statistics for SUTTER LAKESIDE HOSPITAL 403(B) RETIREMENT PLAN

401k plan membership statisitcs for SUTTER LAKESIDE HOSPITAL 403(B) RETIREMENT PLAN

Measure Date Value
2014: SUTTER LAKESIDE HOSPITAL 403(B) RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 218
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 0
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 0
Number of participants with account balances 2014-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: SUTTER LAKESIDE HOSPITAL 403(B) RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 236
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 105
Number of retired or separated participants receiving benefits 2013-01-01 4
Number of other retired or separated participants entitled to future benefits 2013-01-01 108
Total of all active and inactive participants 2013-01-01 217
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 1
Total participants 2013-01-01 218
Number of participants with account balances 2013-01-01 218
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: SUTTER LAKESIDE HOSPITAL 403(B) RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 251
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 129
Number of retired or separated participants receiving benefits 2012-01-01 4
Number of other retired or separated participants entitled to future benefits 2012-01-01 103
Total of all active and inactive participants 2012-01-01 236
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 236
Number of participants with account balances 2012-01-01 236
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0

Measure	Date	Value
2014: SUTTER LAKESIDE HOSPITAL 403(B) RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	218
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	0
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	0
Number of participants with account balances	2014-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: SUTTER LAKESIDE HOSPITAL 403(B) RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	236
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	105
Number of retired or separated participants receiving benefits	2013-01-01	4
Number of other retired or separated participants entitled to future benefits	2013-01-01	108
Total of all active and inactive participants	2013-01-01	217
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	1
Total participants	2013-01-01	218
Number of participants with account balances	2013-01-01	218
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: SUTTER LAKESIDE HOSPITAL 403(B) RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	251
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	129
Number of retired or separated participants receiving benefits	2012-01-01	4
Number of other retired or separated participants entitled to future benefits	2012-01-01	103
Total of all active and inactive participants	2012-01-01	236
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	236
Number of participants with account balances	2012-01-01	236
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0

Financial Data on SUTTER LAKESIDE HOSPITAL 403(B) RETIREMENT PLAN

Measure	Date	Value
2014 : SUTTER LAKESIDE HOSPITAL 403(B) RETIREMENT PLAN 2014 401k financial data
Total transfer of assets from this plan	2014-11-01	$7,031,412
Total income from all sources (including contributions)	2014-11-01	$330,356
Total of all expenses incurred	2014-11-01	$355,664
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-11-01	$333,295
Expenses. Certain deemed distributions of participant loans	2014-11-01	$21,575
Value of total assets at end of year	2014-11-01	$0
Value of total assets at beginning of year	2014-11-01	$7,056,720
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-11-01	$794
Total interest from all sources	2014-11-01	$63,307
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-11-01	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2014-11-01	$0
Was this plan covered by a fidelity bond	2014-11-01	Yes
Value of fidelity bond cover	2014-11-01	$10,000,000
If this is an individual account plan, was there a blackout period	2014-11-01	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-11-01	$0
Were there any nonexempt tranactions with any party-in-interest	2014-11-01	No
Participant contributions at end of year	2014-11-01	$0
Participant contributions at beginning of year	2014-11-01	$84,731
Administrative expenses (other) incurred	2014-11-01	$794
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-11-01	No
Value of net income/loss	2014-11-01	$-25,308
Value of net assets at end of year (total assets less liabilities)	2014-11-01	$0
Value of net assets at beginning of year (total assets less liabilities)	2014-11-01	$7,056,720
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-11-01	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-11-01	No
Were any leases to which the plan was party in default or uncollectible	2014-11-01	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-11-01	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-11-01	$4,958,690
Interest on participant loans	2014-11-01	$5,034
Interest earned on other investments	2014-11-01	$58,273
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-11-01	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-11-01	$2,013,299
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-11-01	$267,049
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-11-01	No
Was there a failure to transmit to the plan any participant contributions	2014-11-01	No
Has the plan failed to provide any benefit when due under the plan	2014-11-01	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-11-01	$333,295
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2014-11-01	No
Did the plan have assets held for investment	2014-11-01	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	2014-11-01	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-11-01	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-11-01	No
Opinion of an independent qualified public accountant for this plan	2014-11-01	Disclaimer
Accountancy firm name	2014-11-01	MOSS ADAMS LLP
Accountancy firm EIN	2014-11-01	910189318
2013 : SUTTER LAKESIDE HOSPITAL 403(B) RETIREMENT PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
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	$24,293
Total income from all sources (including contributions)	2013-12-31	$1,056,869
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$816,778
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$817,768
Expenses. Certain deemed distributions of participant loans	2013-12-31	$-2,545
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$0
Value of total assets at end of year	2013-12-31	$7,056,720
Value of total assets at beginning of year	2013-12-31	$6,840,922
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$1,555
Total interest from all sources	2013-12-31	$77,681
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$10,000,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
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
Participant contributions at end of year	2013-12-31	$84,731
Participant contributions at beginning of year	2013-12-31	$115,309
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2013-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2013-12-31	$24,293
Administrative expenses (other) incurred	2013-12-31	$1,555
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	$240,091
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$7,056,720
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$6,816,629
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$4,958,690
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$4,640,276
Interest on participant loans	2013-12-31	$4,865
Interest earned on other investments	2013-12-31	$72,816
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$2,013,299
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$2,085,337
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$979,188
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$817,768
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2013-12-31	No
Did the plan have assets held for investment	2013-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	No
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	ERNST & YOUNG LLP
Accountancy firm EIN	2013-12-31	346565596
2012 : SUTTER LAKESIDE HOSPITAL 403(B) RETIREMENT PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$24,293
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	$628,047
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$345,795
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$331,694
Expenses. Certain deemed distributions of participant loans	2012-12-31	$12,081
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$0
Value of total assets at end of year	2012-12-31	$6,840,922
Value of total assets at beginning of year	2012-12-31	$6,534,377
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$2,020
Total interest from all sources	2012-12-31	$81,817
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$10,000,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
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
Participant contributions at end of year	2012-12-31	$115,309
Participant contributions at beginning of year	2012-12-31	$140,194
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2012-12-31	$24,293
Administrative expenses (other) incurred	2012-12-31	$2,020
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	$282,252
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$6,816,629
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$6,534,377
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$4,640,276
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$4,332,622
Interest on participant loans	2012-12-31	$9,018
Interest earned on other investments	2012-12-31	$72,799
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$2,085,337
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$2,061,561
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$546,230
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$331,694
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2012-12-31	No
Did the plan have assets held for investment	2012-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	No
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	ERNST & YOUNG LLP
Accountancy firm EIN	2012-12-31	346565596

Form 5500 Responses for SUTTER LAKESIDE HOSPITAL 403(B) RETIREMENT PLAN

2014: SUTTER LAKESIDE HOSPITAL 403(B) RETIREMENT PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	This submission is the final filing	Yes
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2014-01-01	Plan is a collectively bargained plan	Yes
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: SUTTER LAKESIDE HOSPITAL 403(B) RETIREMENT 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	Yes
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: SUTTER LAKESIDE HOSPITAL 403(B) RETIREMENT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	Yes
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 – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	CR04151
Policy instance	1
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	CR04151
Policy instance	1
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number	CR04151
Policy instance	1

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Company Name:	SUTTER BAY HOSPITALS
Employer identification number (EIN):	940562680
NAIC Classification:	622000
NAIC Description:	Hospitals