401k Plan data: EMPLOYEE RETIREMENT SAVINGS PLAN

EMPLOYEE RETIREMENT SAVINGS PLAN - FIDELITY HEALTH CARE 401k Plan overview

Plan Name	EMPLOYEE RETIREMENT SAVINGS PLAN - FIDELITY HEALTH CARE
Plan identification number	002

EMPLOYEE RETIREMENT SAVINGS PLAN - FIDELITY HEALTH CARE Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
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.

401k Sponsoring company profile

FIDELITY HEALTH CARE has sponsored the creation of one or more 401k plans.

Company Name: FIDELITY HEALTH CARE

Employer identification number (EIN): 311075381

NAIC Classification: 622000
NAIC Description: Hospitals

Additional information about FIDELITY HEALTH CARE

Jurisdiction of Incorporation: Ohio Secretary of State Business Services Division

Incorporation Date: 1983-09-12

Company Identification Number: 620335

Legal Registered Office Address: 110 N. MAIN ST.
STE 900
DAYTON
United States of America (USA)
45402

More information about FIDELITY HEALTH CARE

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEE RETIREMENT SAVINGS PLAN - FIDELITY HEALTH CARE

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2013-01-01 WILLIAM LINESCH
002 2012-01-01 WILLIAM LINESCH
002 2011-01-01 WILLIAM LINESCH

Plan id#	Filing Submission Date	Name of Administrator
002	2013-01-01	WILLIAM LINESCH
002	2012-01-01	WILLIAM LINESCH
002	2011-01-01	WILLIAM LINESCH

Plan Statistics for EMPLOYEE RETIREMENT SAVINGS PLAN - FIDELITY HEALTH CARE

401k plan membership statisitcs for EMPLOYEE RETIREMENT SAVINGS PLAN - FIDELITY HEALTH CARE

Measure Date Value
2013: EMPLOYEE RETIREMENT SAVINGS PLAN - FIDELITY HEALTH CARE 2013 401k membership
Total participants, beginning-of-year 2013-01-01 346
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 0
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 0
Total of all active and inactive participants 2013-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 0
Number of participants with account balances 2013-01-01 0
2012: EMPLOYEE RETIREMENT SAVINGS PLAN - FIDELITY HEALTH CARE 2012 401k membership
Total participants, beginning-of-year 2012-01-01 457
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 204
Number of retired or separated participants receiving benefits 2012-01-01 8
Number of other retired or separated participants entitled to future benefits 2012-01-01 134
Total of all active and inactive participants 2012-01-01 346
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 346
Number of participants with account balances 2012-01-01 201
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: EMPLOYEE RETIREMENT SAVINGS PLAN - FIDELITY HEALTH CARE 2011 401k membership
Total participants, beginning-of-year 2011-01-01 245
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 241
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 2011-01-01 241
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 241
Number of participants with account balances 2011-01-01 161
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0

Measure	Date	Value
2013: EMPLOYEE RETIREMENT SAVINGS PLAN - FIDELITY HEALTH CARE 2013 401k membership
Total participants, beginning-of-year	2013-01-01	346
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	0
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	0
Total of all active and inactive participants	2013-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	0
Number of participants with account balances	2013-01-01	0
2012: EMPLOYEE RETIREMENT SAVINGS PLAN - FIDELITY HEALTH CARE 2012 401k membership
Total participants, beginning-of-year	2012-01-01	457
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	204
Number of retired or separated participants receiving benefits	2012-01-01	8
Number of other retired or separated participants entitled to future benefits	2012-01-01	134
Total of all active and inactive participants	2012-01-01	346
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	346
Number of participants with account balances	2012-01-01	201
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: EMPLOYEE RETIREMENT SAVINGS PLAN - FIDELITY HEALTH CARE 2011 401k membership
Total participants, beginning-of-year	2011-01-01	245
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	241
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	241
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	241
Number of participants with account balances	2011-01-01	161
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0

Financial Data on EMPLOYEE RETIREMENT SAVINGS PLAN - FIDELITY HEALTH CARE

Measure	Date	Value
2013 : EMPLOYEE RETIREMENT SAVINGS PLAN - FIDELITY HEALTH CARE 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-06-30	$0
Total transfer of assets from this plan	2013-06-30	$6,126,962
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-06-30	$0
Total income from all sources (including contributions)	2013-06-30	$831,912
Total loss/gain on sale of assets	2013-06-30	$0
Total of all expenses incurred	2013-06-30	$99,215
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-06-30	$92,494
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-06-30	$371,906
Value of total assets at end of year	2013-06-30	$0
Value of total assets at beginning of year	2013-06-30	$5,394,265
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-06-30	$6,721
Total interest from all sources	2013-06-30	$11,377
Total dividends received (eg from common stock, registered investment company shares)	2013-06-30	$10,426
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-06-30	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2013-06-30	$0
Total dividends received from registered investment company shares (eg mutual funds)	2013-06-30	$10,426
Was this plan covered by a fidelity bond	2013-06-30	Yes
Value of fidelity bond cover	2013-06-30	$1,000,000
If this is an individual account plan, was there a blackout period	2013-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2013-06-30	No
Contributions received from participants	2013-06-30	$311,149
Participant contributions at end of year	2013-06-30	$0
Participant contributions at beginning of year	2013-06-30	$164,668
Assets. Other investments not covered elsewhere at end of year	2013-06-30	$0
Assets. Other investments not covered elsewhere at beginning of year	2013-06-30	$1,179,554
Income. Received or receivable in cash from other sources (including rollovers)	2013-06-30	$60,757
Other income not declared elsewhere	2013-06-30	$4,358
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-06-30	No
Value of net income/loss	2013-06-30	$732,697
Value of net assets at end of year (total assets less liabilities)	2013-06-30	$0
Value of net assets at beginning of year (total assets less liabilities)	2013-06-30	$5,394,265
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-06-30	No
Were any leases to which the plan was party in default or uncollectible	2013-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-06-30	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-06-30	$3,437,856
Interest on participant loans	2013-06-30	$3,471
Interest earned on other investments	2013-06-30	$7,906
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-06-30	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-06-30	$612,187
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-06-30	$433,845
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-06-30	No
Was there a failure to transmit to the plan any participant contributions	2013-06-30	No
Has the plan failed to provide any benefit when due under the plan	2013-06-30	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-06-30	$92,494
Contract administrator fees	2013-06-30	$6,721
Did the plan have assets held for investment	2013-06-30	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	2013-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-06-30	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2013-06-30	Disclaimer
Accountancy firm name	2013-06-30	PLANTE & MORAN, PLLC
Accountancy firm EIN	2013-06-30	381357951
2012 : EMPLOYEE RETIREMENT SAVINGS PLAN - FIDELITY HEALTH CARE 2012 401k financial data
Unrealized appreciation/depreciation of real estate assets	2012-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2012-12-31	$0
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	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Expenses. Interest paid	2012-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$1,403,525
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$225,146
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$212,991
Expenses. Certain deemed distributions of participant loans	2012-12-31	$0
Value of total corrective distributions	2012-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$820,834
Value of total assets at end of year	2012-12-31	$5,394,265
Value of total assets at beginning of year	2012-12-31	$4,215,886
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$12,155
Total income from rents	2012-12-31	$0
Total interest from all sources	2012-12-31	$26,034
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$110,224
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	$110,224
Assets. Real estate other than employer real property at end of year	2012-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2012-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2012-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2012-12-31	$0
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$1,000,000
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
Contributions received from participants	2012-12-31	$657,894
Participant contributions at end of year	2012-12-31	$164,668
Participant contributions at beginning of year	2012-12-31	$168,204
Participant contributions at end of year	2012-12-31	$0
Participant contributions at beginning of year	2012-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2012-12-31	$1,179,554
Assets. Other investments not covered elsewhere at beginning of year	2012-12-31	$976,034
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$162,940
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2012-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2012-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2012-12-31	$0
Assets. Loans (other than to participants) at end of year	2012-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2012-12-31	$0
Other income not declared elsewhere	2012-12-31	$14,609
Administrative expenses (other) incurred	2012-12-31	$0
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
Income. Non cash contributions	2012-12-31	$0
Value of net income/loss	2012-12-31	$1,178,379
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$5,394,265
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$4,215,886
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	$0
Assets. partnership/joint venture interests at beginning of year	2012-12-31	$0
Investment advisory and management fees	2012-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$3,437,856
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$2,519,319
Interest on participant loans	2012-12-31	$8,782
Income. Interest from loans (other than to participants)	2012-12-31	$0
Interest earned on other investments	2012-12-31	$17,252
Income. Interest from US Government securities	2012-12-31	$0
Income. Interest from corporate debt instruments	2012-12-31	$0
Value of interest in common/collective trusts at end of year	2012-12-31	$0
Value of interest in common/collective trusts at beginning of year	2012-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$612,187
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$552,329
Expenses. Payments to insurance carriers foe the provision of benefits	2012-12-31	$0
Asset value of US Government securities at end of year	2012-12-31	$0
Asset value of US Government securities at beginning of year	2012-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$431,824
Net investment gain/loss from pooled separate accounts	2012-12-31	$0
Net investment gain or loss from common/collective trusts	2012-12-31	$0
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
Employer contributions (assets) at end of year	2012-12-31	$0
Employer contributions (assets) at beginning of year	2012-12-31	$0
Income. Dividends from preferred stock	2012-12-31	$0
Income. Dividends from common stock	2012-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$212,991
Asset. Corporate debt instrument preferred debt at end of year	2012-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2012-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2012-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2012-12-31	$0
Contract administrator fees	2012-12-31	$12,155
Assets. Corporate common stocks other than exployer securities at end of year	2012-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2012-12-31	$0
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	$0
Aggregate carrying amount (costs) on sale of assets	2012-12-31	$0
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	PLANTE & MORAN PLLC
Accountancy firm EIN	2012-12-31	381357951
2011 : EMPLOYEE RETIREMENT SAVINGS PLAN - FIDELITY HEALTH CARE 2011 401k financial data
Unrealized appreciation/depreciation of real estate assets	2011-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2011-12-31	$0
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total transfer of assets to this plan	2011-12-31	$0
Total transfer of assets from this plan	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
Expenses. Interest paid	2011-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$621,965
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$681,161
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$665,882
Expenses. Certain deemed distributions of participant loans	2011-12-31	$4,736
Value of total corrective distributions	2011-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$657,898
Value of total assets at end of year	2011-12-31	$4,215,886
Value of total assets at beginning of year	2011-12-31	$4,275,082
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$10,543
Total income from rents	2011-12-31	$0
Total interest from all sources	2011-12-31	$26,022
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$66,678
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	$66,678
Assets. Real estate other than employer real property at end of year	2011-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2011-12-31	$0
Administrative expenses professional fees incurred	2011-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2011-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2011-12-31	$0
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
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
Contributions received from participants	2011-12-31	$561,628
Participant contributions at end of year	2011-12-31	$168,204
Participant contributions at beginning of year	2011-12-31	$80,080
Participant contributions at end of year	2011-12-31	$0
Participant contributions at beginning of year	2011-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2011-12-31	$976,034
Assets. Other investments not covered elsewhere at beginning of year	2011-12-31	$961,472
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$96,270
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2011-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-12-31	$0
Assets. Loans (other than to participants) at end of year	2011-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2011-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2011-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2011-12-31	$0
Other income not declared elsewhere	2011-12-31	$0
Administrative expenses (other) incurred	2011-12-31	$0
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
Income. Non cash contributions	2011-12-31	$0
Value of net income/loss	2011-12-31	$-59,196
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$4,215,886
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$4,275,082
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	$0
Assets. partnership/joint venture interests at beginning of year	2011-12-31	$0
Investment advisory and management fees	2011-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$2,519,319
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$2,622,848
Interest on participant loans	2011-12-31	$7,615
Income. Interest from loans (other than to participants)	2011-12-31	$0
Interest earned on other investments	2011-12-31	$18,407
Income. Interest from US Government securities	2011-12-31	$0
Income. Interest from corporate debt instruments	2011-12-31	$0
Value of interest in master investment trust accounts at end of year	2011-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2011-12-31	$0
Value of interest in common/collective trusts at end of year	2011-12-31	$0
Value of interest in common/collective trusts at beginning of year	2011-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2011-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2011-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$552,329
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$610,682
Expenses. Payments to insurance carriers foe the provision of benefits	2011-12-31	$0
Asset value of US Government securities at end of year	2011-12-31	$0
Asset value of US Government securities at beginning of year	2011-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-128,633
Net investment gain/loss from pooled separate accounts	2011-12-31	$0
Net investment gain or loss from common/collective trusts	2011-12-31	$0
Net gain/loss from 103.12 investment entities	2011-12-31	$0
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
Employer contributions (assets) at end of year	2011-12-31	$0
Employer contributions (assets) at beginning of year	2011-12-31	$0
Income. Dividends from preferred stock	2011-12-31	$0
Income. Dividends from common stock	2011-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$665,882
Asset. Corporate debt instrument preferred debt at end of year	2011-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2011-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2011-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2011-12-31	$0
Contract administrator fees	2011-12-31	$10,543
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	2011-12-31	No
Assets. Corporate common stocks other than exployer securities at end of year	2011-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2011-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2011-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	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	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
Aggregate proceeds on sale of assets	2011-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2011-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2011-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2011-12-31	$0
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	PLANTE & MORAN, PLLC
Accountancy firm EIN	2011-12-31	381357951

Form 5500 Responses for EMPLOYEE RETIREMENT SAVINGS PLAN - FIDELITY HEALTH CARE

2013: EMPLOYEE RETIREMENT SAVINGS PLAN - FIDELITY HEALTH CARE 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	Yes
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2013-01-01	Plan is a collectively bargained plan	No
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: EMPLOYEE RETIREMENT SAVINGS PLAN - FIDELITY HEALTH CARE 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 – 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
2011: EMPLOYEE RETIREMENT SAVINGS PLAN - FIDELITY HEALTH CARE 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	First time form 5500 has been submitted	Yes
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 funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	FIDELITY HEALTH CARE
Employer identification number (EIN):	311075381
NAIC Classification:	622000
NAIC Description:	Hospitals

Jurisdiction of Incorporation:	Ohio Secretary of State Business Services Division
Incorporation Date:	1983-09-12
Company Identification Number:	620335
Legal Registered Office Address:	110 N. MAIN ST. STE 900 DAYTON United States of America (USA) 45402