401k Plan data: INDIANA UNIVERSITY HEALTH NORTH HOSPITAL 401(K) PLAN plan

INDIANA UNIVERSITY HEALTH NORTH HOSPITAL 401(K) PLAN 401k Plan overview

Plan Name	INDIANA UNIVERSITY HEALTH NORTH HOSPITAL 401(K) PLAN
Plan identification number	001

INDIANA UNIVERSITY HEALTH NORTH HOSPITAL 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
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 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.
Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
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.
Plan sponsor(s) received services of leased employees, as defined in Code section 414(n), during the plan year.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

INDIANA UNIVERSITY HEALTH NORTH HOSPITAL, INC. has sponsored the creation of one or more 401k plans.

Company Name: INDIANA UNIVERSITY HEALTH NORTH HOSPITAL, INC.

Employer identification number (EIN): 351932442

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan INDIANA UNIVERSITY HEALTH NORTH HOSPITAL 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2013-01-01 ANGELA THOMPSON
001 2012-01-01 RANDALL YUST

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2013-01-01	ANGELA THOMPSON
001	2012-01-01	RANDALL YUST

Plan Statistics for INDIANA UNIVERSITY HEALTH NORTH HOSPITAL 401(K) PLAN

401k plan membership statisitcs for INDIANA UNIVERSITY HEALTH NORTH HOSPITAL 401(K) PLAN

Measure Date Value
2013: INDIANA UNIVERSITY HEALTH NORTH HOSPITAL 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 1,820
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 2,878
Number of retired or separated participants receiving benefits 2013-01-01 71
Number of other retired or separated participants entitled to future benefits 2013-01-01 485
Total of all active and inactive participants 2013-01-01 3,434
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 3,434
Number of participants with account balances 2013-01-01 2,709
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 32
2012: INDIANA UNIVERSITY HEALTH NORTH HOSPITAL 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 1,692
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 1,523
Number of retired or separated participants receiving benefits 2012-01-01 48
Number of other retired or separated participants entitled to future benefits 2012-01-01 249
Total of all active and inactive participants 2012-01-01 1,820
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 1,820
Number of participants with account balances 2012-01-01 1,545
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0

Measure	Date	Value
2013: INDIANA UNIVERSITY HEALTH NORTH HOSPITAL 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	1,820
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	2,878
Number of retired or separated participants receiving benefits	2013-01-01	71
Number of other retired or separated participants entitled to future benefits	2013-01-01	485
Total of all active and inactive participants	2013-01-01	3,434
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	3,434
Number of participants with account balances	2013-01-01	2,709
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	32
2012: INDIANA UNIVERSITY HEALTH NORTH HOSPITAL 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	1,692
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	1,523
Number of retired or separated participants receiving benefits	2012-01-01	48
Number of other retired or separated participants entitled to future benefits	2012-01-01	249
Total of all active and inactive participants	2012-01-01	1,820
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	1,820
Number of participants with account balances	2012-01-01	1,545
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0

Financial Data on INDIANA UNIVERSITY HEALTH NORTH HOSPITAL 401(K) PLAN

Measure	Date	Value
2013 : INDIANA UNIVERSITY HEALTH NORTH HOSPITAL 401(K) PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total transfer of assets to this plan	2013-12-31	$26,330,946
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	$0
Total income from all sources (including contributions)	2013-12-31	$10,903,769
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$3,058,809
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$2,968,388
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$5,250,362
Value of total assets at end of year	2013-12-31	$63,072,702
Value of total assets at beginning of year	2013-12-31	$28,896,796
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$90,421
Total interest from all sources	2013-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$1,355,101
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-12-31	$1,355,101
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$20,000,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$3,220,654
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$119,821
Value of other receiveables (less allowance for doubtful accounts) at end of year	2013-12-31	$433,760
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2013-12-31	$0
Administrative expenses (other) incurred	2013-12-31	$62,423
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	$7,844,960
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$63,072,702
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$28,896,796
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
Investment advisory and management fees	2013-12-31	$27,998
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$51,546,335
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$23,826,524
Value of interest in master investment trust accounts at end of year	2013-12-31	$2,818,834
Value of interest in master investment trust accounts at beginning of year	2013-12-31	$1,651,655
Value of interest in common/collective trusts at end of year	2013-12-31	$8,273,773
Value of interest in common/collective trusts at beginning of year	2013-12-31	$3,418,617
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$3,202,238
Net investment gain or loss from common/collective trusts	2013-12-31	$1,101,814
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
Contributions received in cash from employer	2013-12-31	$1,909,887
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$2,968,388
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	Yes
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 : INDIANA UNIVERSITY HEALTH NORTH HOSPITAL 401(K) 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	$0
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	$8,781,949
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$1,619,079
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$1,546,766
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$5,323,466
Value of total assets at end of year	2012-12-31	$28,896,796
Value of total assets at beginning of year	2012-12-31	$21,733,926
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$72,313
Total interest from all sources	2012-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$727,957
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	$727,957
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$20,000,000
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	$3,272,898
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$29,719
Administrative expenses (other) incurred	2012-12-31	$50,836
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	$7,162,870
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$28,896,796
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$21,733,926
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
Investment advisory and management fees	2012-12-31	$21,477
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$23,826,524
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$17,897,356
Value of interest in master investment trust accounts at end of year	2012-12-31	$1,651,655
Value of interest in master investment trust accounts at beginning of year	2012-12-31	$1,359,776
Value of interest in common/collective trusts at end of year	2012-12-31	$3,418,617
Value of interest in common/collective trusts at beginning of year	2012-12-31	$2,476,794
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$2,260,597
Net investment gain or loss from common/collective trusts	2012-12-31	$418,115
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
Contributions received in cash from employer	2012-12-31	$2,020,849
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$1,546,766
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	Yes
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 INDIANA UNIVERSITY HEALTH NORTH HOSPITAL 401(K) PLAN

2013: INDIANA UNIVERSITY HEALTH NORTH HOSPITAL 401(K) 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	No
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: INDIANA UNIVERSITY HEALTH NORTH HOSPITAL 401(K) PLAN 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 – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	INDIANA UNIVERSITY HEALTH NORTH HOSPITAL, INC.
Employer identification number (EIN):	351932442
NAIC Classification:	622000
NAIC Description:	Hospitals