401k Plan data: TWIN CITY HOSPITAL EMPLOYEES' RETIREMENT PLAN plan

TWIN CITY HOSPITAL EMPLOYEES' RETIREMENT PLAN 401k Plan overview

Plan Name	TWIN CITY HOSPITAL EMPLOYEES' RETIREMENT PLAN
Plan identification number	003

TWIN CITY HOSPITAL EMPLOYEES' RETIREMENT PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
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 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
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.

401k Sponsoring company profile

TWIN CITY HOSPITAL has sponsored the creation of one or more 401k plans.

Company Name: TWIN CITY HOSPITAL

Employer identification number (EIN): 340585740

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TWIN CITY HOSPITAL EMPLOYEES' RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
003 2011-01-01 LAUREN CASTELLO LAUREN CASTELLO 2012-08-15
003 2009-01-01 LAUREN CASTELLO LAUREN CASTELLO 2010-10-14

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
003	2011-01-01	LAUREN CASTELLO		LAUREN CASTELLO	2012-08-15
003	2009-01-01	LAUREN CASTELLO		LAUREN CASTELLO	2010-10-14

Plan Statistics for TWIN CITY HOSPITAL EMPLOYEES' RETIREMENT PLAN

401k plan membership statisitcs for TWIN CITY HOSPITAL EMPLOYEES' RETIREMENT PLAN

Measure Date Value
2011: TWIN CITY HOSPITAL EMPLOYEES' RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 233
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 0
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 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 0
Number of participants with account balances 2011-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: TWIN CITY HOSPITAL EMPLOYEES' RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 254
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 172
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 71
Total of all active and inactive participants 2009-01-01 243
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 243
Number of participants with account balances 2009-01-01 212
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2011: TWIN CITY HOSPITAL EMPLOYEES' RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	233
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	0
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	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	0
Number of participants with account balances	2011-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: TWIN CITY HOSPITAL EMPLOYEES' RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	254
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	172
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	71
Total of all active and inactive participants	2009-01-01	243
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	243
Number of participants with account balances	2009-01-01	212
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on TWIN CITY HOSPITAL EMPLOYEES' RETIREMENT PLAN

Measure	Date	Value
2011 : TWIN CITY HOSPITAL EMPLOYEES' RETIREMENT PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-10-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-10-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-10-31	$0
Total income from all sources (including contributions)	2011-10-31	$-66,285
Total loss/gain on sale of assets	2011-10-31	$0
Total of all expenses incurred	2011-10-31	$3,481,757
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-10-31	$3,442,530
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-10-31	$78,051
Value of total assets at end of year	2011-10-31	$0
Value of total assets at beginning of year	2011-10-31	$3,548,042
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-10-31	$39,227
Total interest from all sources	2011-10-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2011-10-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-10-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2011-10-31	$0
Administrative expenses professional fees incurred	2011-10-31	$29,008
Was this plan covered by a fidelity bond	2011-10-31	Yes
Value of fidelity bond cover	2011-10-31	$250,000
If this is an individual account plan, was there a blackout period	2011-10-31	No
Were there any nonexempt tranactions with any party-in-interest	2011-10-31	No
Contributions received from participants	2011-10-31	$78,051
Participant contributions at end of year	2011-10-31	$0
Participant contributions at beginning of year	2011-10-31	$6,226
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-10-31	No
Value of net income/loss	2011-10-31	$-3,548,042
Value of net assets at end of year (total assets less liabilities)	2011-10-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2011-10-31	$3,548,042
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-10-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-10-31	No
Were any leases to which the plan was party in default or uncollectible	2011-10-31	No
Investment advisory and management fees	2011-10-31	$10,219
Value of interest in pooled separate accounts at end of year	2011-10-31	$0
Value of interest in pooled separate accounts at beginning of year	2011-10-31	$3,541,816
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-10-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-10-31	$0
Net investment gain/loss from pooled separate accounts	2011-10-31	$-144,336
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-10-31	No
Was there a failure to transmit to the plan any participant contributions	2011-10-31	No
Has the plan failed to provide any benefit when due under the plan	2011-10-31	No
Contributions received in cash from employer	2011-10-31	$0
Employer contributions (assets) at end of year	2011-10-31	$0
Employer contributions (assets) at beginning of year	2011-10-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-10-31	$3,442,530
Did the plan have assets held for investment	2011-10-31	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	2011-10-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-10-31	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-10-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-10-31	Disclaimer
Accountancy firm name	2011-10-31	REA & ASSOCIATES
Accountancy firm EIN	2011-10-31	341310124
2010 : TWIN CITY HOSPITAL EMPLOYEES' RETIREMENT PLAN 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	$1,100,738
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$665,081
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$648,935
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$777,685
Value of total assets at end of year	2010-12-31	$3,548,042
Value of total assets at beginning of year	2010-12-31	$3,112,385
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$16,146
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
Administrative expenses professional fees incurred	2010-12-31	$2,173
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$250,000
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
Contributions received from participants	2010-12-31	$304,261
Participant contributions at end of year	2010-12-31	$6,226
Participant contributions at beginning of year	2010-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$342,162
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	$435,657
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$3,548,042
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$3,112,385
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
Investment advisory and management fees	2010-12-31	$13,973
Value of interest in pooled separate accounts at end of year	2010-12-31	$3,541,816
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$3,112,385
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2010-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$0
Net investment gain/loss from pooled separate accounts	2010-12-31	$323,053
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	$131,262
Employer contributions (assets) at end of year	2010-12-31	$0
Employer contributions (assets) at beginning of year	2010-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$648,935
Did the plan have assets held for investment	2010-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	REA & ASSOCIATES
Accountancy firm EIN	2010-12-31	341310124

Form 5500 Responses for TWIN CITY HOSPITAL EMPLOYEES' RETIREMENT PLAN

2011: TWIN CITY HOSPITAL EMPLOYEES' RETIREMENT PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	Yes
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2011-01-01	Plan is a collectively bargained plan	Yes
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
2009: TWIN CITY HOSPITAL EMPLOYEES' RETIREMENT PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	TWIN CITY HOSPITAL
Employer identification number (EIN):	340585740
NAIC Classification:	622000
NAIC Description:	Hospitals