401k Plan data: COMMUNITY MEMORIAL HEALTHCENTER RETIREMENT SAVINGS PLAN plan

COMMUNITY MEMORIAL HEALTHCENTER RETIREMENT SAVINGS PLAN 401k Plan overview

Plan Name	COMMUNITY MEMORIAL HEALTHCENTER RETIREMENT SAVINGS PLAN
Plan identification number	001

COMMUNITY MEMORIAL HEALTHCENTER RETIREMENT SAVINGS PLAN 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.
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

COMMUNITY MEMORIAL HEALTHCENTER has sponsored the creation of one or more 401k plans.

Company Name: COMMUNITY MEMORIAL HEALTHCENTER

Employer identification number (EIN): 540551711

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COMMUNITY MEMORIAL HEALTHCENTER RETIREMENT SAVINGS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2015-07-01 W. SCOTT BURNETTE 2016-05-23
001 2014-07-01 SCOTT BURNETTE SCOTT BURNETTE 2015-07-06
001 2014-07-01 W. SCOTT BURNETTE
001 2013-07-01 W. SCOTT BURNETTE
001 2012-07-01 W. SCOTT BURNETTE
001 2012-01-01 W. SCOTT BURNETTE
001 2011-01-01 W. SCOTT BURNETTE
001 2010-01-01 W. SCOTT BURNETTE
001 2009-01-01 W. SCOTT BURNETTE
001 2009-01-01 BARRY NATEMAN BARRY NATEMAN 2010-10-22
001 2009-01-01 BARRY NATEMAN 2010-10-19

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2015-07-01	W. SCOTT BURNETTE	2016-05-23
001	2014-07-01	SCOTT BURNETTE		SCOTT BURNETTE	2015-07-06
001	2014-07-01	W. SCOTT BURNETTE
001	2013-07-01	W. SCOTT BURNETTE
001	2012-07-01	W. SCOTT BURNETTE
001	2012-01-01	W. SCOTT BURNETTE
001	2011-01-01	W. SCOTT BURNETTE
001	2010-01-01	W. SCOTT BURNETTE
001	2009-01-01	W. SCOTT BURNETTE
001	2009-01-01	BARRY NATEMAN		BARRY NATEMAN	2010-10-22
001	2009-01-01			BARRY NATEMAN	2010-10-19

Plan Statistics for COMMUNITY MEMORIAL HEALTHCENTER RETIREMENT SAVINGS PLAN

401k plan membership statisitcs for COMMUNITY MEMORIAL HEALTHCENTER RETIREMENT SAVINGS PLAN

Measure Date Value
2014: COMMUNITY MEMORIAL HEALTHCENTER RETIREMENT SAVINGS PLAN 2014 401k membership
Total participants, beginning-of-year 2014-07-01 922
Total number of active participants reported on line 7a of the Form 5500 2014-07-01 0
Number of retired or separated participants receiving benefits 2014-07-01 0
Number of other retired or separated participants entitled to future benefits 2014-07-01 0
Total of all active and inactive participants 2014-07-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-07-01 0
Total participants 2014-07-01 0
Number of participants with account balances 2014-07-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-07-01 0
2013: COMMUNITY MEMORIAL HEALTHCENTER RETIREMENT SAVINGS PLAN 2013 401k membership
Total participants, beginning-of-year 2013-07-01 996
Total number of active participants reported on line 7a of the Form 5500 2013-07-01 833
Number of retired or separated participants receiving benefits 2013-07-01 10
Number of other retired or separated participants entitled to future benefits 2013-07-01 115
Total of all active and inactive participants 2013-07-01 958
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-07-01 0
Total participants 2013-07-01 958
Number of participants with account balances 2013-07-01 922
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-07-01 617
2012: COMMUNITY MEMORIAL HEALTHCENTER RETIREMENT SAVINGS PLAN 2012 401k membership
Total participants, beginning-of-year 2012-07-01 1,014
Total number of active participants reported on line 7a of the Form 5500 2012-07-01 678
Number of retired or separated participants receiving benefits 2012-07-01 12
Number of other retired or separated participants entitled to future benefits 2012-07-01 300
Total of all active and inactive participants 2012-07-01 990
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-07-01 6
Total participants 2012-07-01 996
Number of participants with account balances 2012-07-01 754
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-07-01 5
Total participants, beginning-of-year 2012-01-01 1,104
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 741
Number of retired or separated participants receiving benefits 2012-01-01 10
Number of other retired or separated participants entitled to future benefits 2012-01-01 257
Total of all active and inactive participants 2012-01-01 1,008
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 6
Total participants 2012-01-01 1,014
Number of participants with account balances 2012-01-01 775
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 6
2011: COMMUNITY MEMORIAL HEALTHCENTER RETIREMENT SAVINGS PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 1,029
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 768
Number of retired or separated participants receiving benefits 2011-01-01 8
Number of other retired or separated participants entitled to future benefits 2011-01-01 234
Total of all active and inactive participants 2011-01-01 1,010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 5
Total participants 2011-01-01 1,015
Number of participants with account balances 2011-01-01 767
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 15
2010: COMMUNITY MEMORIAL HEALTHCENTER RETIREMENT SAVINGS PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 798
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 839
Number of retired or separated participants receiving benefits 2010-01-01 5
Number of other retired or separated participants entitled to future benefits 2010-01-01 190
Total of all active and inactive participants 2010-01-01 1,034
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 1
Total participants 2010-01-01 1,035
Number of participants with account balances 2010-01-01 782
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 471
2009: COMMUNITY MEMORIAL HEALTHCENTER RETIREMENT SAVINGS PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 1,238
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 1,069
Number of retired or separated participants receiving benefits 2009-01-01 6
Number of other retired or separated participants entitled to future benefits 2009-01-01 144
Total of all active and inactive participants 2009-01-01 1,219
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 2
Total participants 2009-01-01 1,221
Number of participants with account balances 2009-01-01 847
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 31

Measure	Date	Value
2014: COMMUNITY MEMORIAL HEALTHCENTER RETIREMENT SAVINGS PLAN 2014 401k membership
Total participants, beginning-of-year	2014-07-01	922
Total number of active participants reported on line 7a of the Form 5500	2014-07-01	0
Number of retired or separated participants receiving benefits	2014-07-01	0
Number of other retired or separated participants entitled to future benefits	2014-07-01	0
Total of all active and inactive participants	2014-07-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-07-01	0
Total participants	2014-07-01	0
Number of participants with account balances	2014-07-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-07-01	0
2013: COMMUNITY MEMORIAL HEALTHCENTER RETIREMENT SAVINGS PLAN 2013 401k membership
Total participants, beginning-of-year	2013-07-01	996
Total number of active participants reported on line 7a of the Form 5500	2013-07-01	833
Number of retired or separated participants receiving benefits	2013-07-01	10
Number of other retired or separated participants entitled to future benefits	2013-07-01	115
Total of all active and inactive participants	2013-07-01	958
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-07-01	0
Total participants	2013-07-01	958
Number of participants with account balances	2013-07-01	922
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-07-01	617
2012: COMMUNITY MEMORIAL HEALTHCENTER RETIREMENT SAVINGS PLAN 2012 401k membership
Total participants, beginning-of-year	2012-07-01	1,014
Total number of active participants reported on line 7a of the Form 5500	2012-07-01	678
Number of retired or separated participants receiving benefits	2012-07-01	12
Number of other retired or separated participants entitled to future benefits	2012-07-01	300
Total of all active and inactive participants	2012-07-01	990
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-07-01	6
Total participants	2012-07-01	996
Number of participants with account balances	2012-07-01	754
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-07-01	5
Total participants, beginning-of-year	2012-01-01	1,104
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	741
Number of retired or separated participants receiving benefits	2012-01-01	10
Number of other retired or separated participants entitled to future benefits	2012-01-01	257
Total of all active and inactive participants	2012-01-01	1,008
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	6
Total participants	2012-01-01	1,014
Number of participants with account balances	2012-01-01	775
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	6
2011: COMMUNITY MEMORIAL HEALTHCENTER RETIREMENT SAVINGS PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	1,029
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	768
Number of retired or separated participants receiving benefits	2011-01-01	8
Number of other retired or separated participants entitled to future benefits	2011-01-01	234
Total of all active and inactive participants	2011-01-01	1,010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	5
Total participants	2011-01-01	1,015
Number of participants with account balances	2011-01-01	767
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	15
2010: COMMUNITY MEMORIAL HEALTHCENTER RETIREMENT SAVINGS PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	798
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	839
Number of retired or separated participants receiving benefits	2010-01-01	5
Number of other retired or separated participants entitled to future benefits	2010-01-01	190
Total of all active and inactive participants	2010-01-01	1,034
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	1
Total participants	2010-01-01	1,035
Number of participants with account balances	2010-01-01	782
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	471
2009: COMMUNITY MEMORIAL HEALTHCENTER RETIREMENT SAVINGS PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	1,238
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	1,069
Number of retired or separated participants receiving benefits	2009-01-01	6
Number of other retired or separated participants entitled to future benefits	2009-01-01	144
Total of all active and inactive participants	2009-01-01	1,219
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	2
Total participants	2009-01-01	1,221
Number of participants with account balances	2009-01-01	847
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	31

Financial Data on COMMUNITY MEMORIAL HEALTHCENTER RETIREMENT SAVINGS PLAN

Measure	Date	Value
2015 : COMMUNITY MEMORIAL HEALTHCENTER RETIREMENT SAVINGS PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-06-30	$0
Total income from all sources (including contributions)	2015-06-30	$-19,641
Total loss/gain on sale of assets	2015-06-30	$0
Total of all expenses incurred	2015-06-30	$18,267,107
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-06-30	$18,251,614
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-06-30	$27,356
Value of total assets at end of year	2015-06-30	$42,545
Value of total assets at beginning of year	2015-06-30	$18,329,293
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-06-30	$15,493
Total interest from all sources	2015-06-30	$-4,940
Total dividends received (eg from common stock, registered investment company shares)	2015-06-30	$3,121
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-06-30	$3,121
Administrative expenses professional fees incurred	2015-06-30	$14,868
Was this plan covered by a fidelity bond	2015-06-30	Yes
Value of fidelity bond cover	2015-06-30	$1,000,000
If this is an individual account plan, was there a blackout period	2015-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2015-06-30	No
Contributions received from participants	2015-06-30	$27,356
Participant contributions at end of year	2015-06-30	$7,446
Participant contributions at beginning of year	2015-06-30	$252,221
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2015-06-30	$17,636,896
Administrative expenses (other) incurred	2015-06-30	$300
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-06-30	No
Value of net income/loss	2015-06-30	$-18,286,748
Value of net assets at end of year (total assets less liabilities)	2015-06-30	$42,545
Value of net assets at beginning of year (total assets less liabilities)	2015-06-30	$18,329,293
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-06-30	No
Were any leases to which the plan was party in default or uncollectible	2015-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-06-30	$9,438,577
Interest on participant loans	2015-06-30	$33
Interest earned on other investments	2015-06-30	$-4,973
Value of interest in common/collective trusts at beginning of year	2015-06-30	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-06-30	$35,099
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-06-30	$8,638,495
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-06-30	$-45,178
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-06-30	No
Was there a failure to transmit to the plan any participant contributions	2015-06-30	No
Has the plan failed to provide any benefit when due under the plan	2015-06-30	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-06-30	$614,718
Contract administrator fees	2015-06-30	$325
Did the plan have assets held for investment	2015-06-30	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	2015-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2015-06-30	Disclaimer
Accountancy firm name	2015-06-30	BROWN, EDWARDS & COMPANY, LLP
Accountancy firm EIN	2015-06-30	540504608
2014 : COMMUNITY MEMORIAL HEALTHCENTER RETIREMENT SAVINGS PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-12	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-12	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-12	$0
Total income from all sources (including contributions)	2014-12-12	$-21,823
Total loss/gain on sale of assets	2014-12-12	$0
Total of all expenses incurred	2014-12-12	$18,201,577
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-12	$18,186,084
Expenses. Certain deemed distributions of participant loans	2014-12-12	$0
Value of total corrective distributions	2014-12-12	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-12	$27,356
Value of total assets at end of year	2014-12-12	$0
Value of total assets at beginning of year	2014-12-12	$18,223,400
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-12	$15,493
Total interest from all sources	2014-12-12	$-7,122
Total dividends received (eg from common stock, registered investment company shares)	2014-12-12	$3,121
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-12	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2014-12-12	$0
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-12	$3,121
Administrative expenses professional fees incurred	2014-12-12	$14,868
Was this plan covered by a fidelity bond	2014-12-12	Yes
Value of fidelity bond cover	2014-12-12	$10,000,000
If this is an individual account plan, was there a blackout period	2014-12-12	Yes
Were there any nonexempt tranactions with any party-in-interest	2014-12-12	No
Contributions received from participants	2014-12-12	$27,356
Participant contributions at end of year	2014-12-12	$0
Participant contributions at beginning of year	2014-12-12	$241,064
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2014-12-12	$17,636,896
Administrative expenses (other) incurred	2014-12-12	$300
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-12	No
Value of net income/loss	2014-12-12	$-18,223,400
Value of net assets at end of year (total assets less liabilities)	2014-12-12	$0
Value of net assets at beginning of year (total assets less liabilities)	2014-12-12	$18,223,400
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-12	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-12	No
Were any leases to which the plan was party in default or uncollectible	2014-12-12	No
Investment advisory and management fees	2014-12-12	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-12	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-12	$9,438,577
Interest on participant loans	2014-12-12	$33
Interest earned on other investments	2014-12-12	$-7,155
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-12	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-12	$8,543,759
Expenses. Payments to insurance carriers foe the provision of benefits	2014-12-12	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-12	$-45,178
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-12	No
Was there a failure to transmit to the plan any participant contributions	2014-12-12	No
Has the plan failed to provide any benefit when due under the plan	2014-12-12	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-12	$549,188
Contract administrator fees	2014-12-12	$325
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	2014-12-12	Yes
Did the plan have assets held for investment	2014-12-12	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	2014-12-12	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-12	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-12	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-12	Disclaimer
Accountancy firm name	2014-12-12	BROWN, EDWARDS & COMPANY, L.L.P.
Accountancy firm EIN	2014-12-12	540504608
Total unrealized appreciation/depreciation of assets	2014-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-06-30	$0
Total income from all sources (including contributions)	2014-06-30	$2,524,364
Total loss/gain on sale of assets	2014-06-30	$0
Total of all expenses incurred	2014-06-30	$1,020,287
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-06-30	$1,001,537
Expenses. Certain deemed distributions of participant loans	2014-06-30	$5,100
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-06-30	$855,857
Value of total assets at end of year	2014-06-30	$18,223,400
Value of total assets at beginning of year	2014-06-30	$16,719,323
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-06-30	$13,650
Total interest from all sources	2014-06-30	$260,674
Total dividends received (eg from common stock, registered investment company shares)	2014-06-30	$572,407
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-06-30	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2014-06-30	$0
Total dividends received from registered investment company shares (eg mutual funds)	2014-06-30	$572,407
Administrative expenses professional fees incurred	2014-06-30	$8,750
Was this plan covered by a fidelity bond	2014-06-30	Yes
Value of fidelity bond cover	2014-06-30	$1,000,000
If this is an individual account plan, was there a blackout period	2014-06-30	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2014-06-30	No
Contributions received from participants	2014-06-30	$734,223
Participant contributions at end of year	2014-06-30	$241,064
Participant contributions at beginning of year	2014-06-30	$203,756
Income. Received or receivable in cash from other sources (including rollovers)	2014-06-30	$121,634
Other income not declared elsewhere	2014-06-30	$-22,401
Administrative expenses (other) incurred	2014-06-30	$150
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-06-30	No
Value of net income/loss	2014-06-30	$1,504,077
Value of net assets at end of year (total assets less liabilities)	2014-06-30	$18,223,400
Value of net assets at beginning of year (total assets less liabilities)	2014-06-30	$16,719,323
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-06-30	No
Were any leases to which the plan was party in default or uncollectible	2014-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-06-30	$9,438,577
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-06-30	$7,518,861
Interest on participant loans	2014-06-30	$11,334
Interest earned on other investments	2014-06-30	$249,340
Value of interest in common/collective trusts at end of year	2014-06-30	$0
Value of interest in common/collective trusts at beginning of year	2014-06-30	$618,917
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-06-30	$8,543,759
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-06-30	$8,377,789
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-06-30	$826,456
Net investment gain or loss from common/collective trusts	2014-06-30	$31,371
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-06-30	No
Was there a failure to transmit to the plan any participant contributions	2014-06-30	No
Has the plan failed to provide any benefit when due under the plan	2014-06-30	No
Contributions received in cash from employer	2014-06-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-06-30	$1,001,537
Contract administrator fees	2014-06-30	$4,750
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	2014-06-30	Yes
Did the plan have assets held for investment	2014-06-30	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	2014-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2014-06-30	Disclaimer
Accountancy firm name	2014-06-30	BROWN, EDWARDS & COMPANY, L.L.P.
Accountancy firm EIN	2014-06-30	540504608
2013 : COMMUNITY MEMORIAL HEALTHCENTER RETIREMENT SAVINGS PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-06-30	$0
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	$2,061,707
Total loss/gain on sale of assets	2013-06-30	$0
Total of all expenses incurred	2013-06-30	$1,084,797
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-06-30	$1,063,851
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-06-30	$741,884
Value of total assets at end of year	2013-06-30	$16,719,323
Value of total assets at beginning of year	2013-06-30	$15,742,413
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-06-30	$20,946
Total interest from all sources	2013-06-30	$253,959
Total dividends received (eg from common stock, registered investment company shares)	2013-06-30	$216,733
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-06-30	$216,733
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	$727,530
Participant contributions at end of year	2013-06-30	$203,756
Participant contributions at beginning of year	2013-06-30	$235,923
Income. Received or receivable in cash from other sources (including rollovers)	2013-06-30	$14,354
Administrative expenses (other) incurred	2013-06-30	$20,946
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	$976,910
Value of net assets at end of year (total assets less liabilities)	2013-06-30	$16,719,323
Value of net assets at beginning of year (total assets less liabilities)	2013-06-30	$15,742,413
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	$7,518,861
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-06-30	$6,816,360
Interest on participant loans	2013-06-30	$10,327
Interest earned on other investments	2013-06-30	$243,632
Value of interest in common/collective trusts at end of year	2013-06-30	$618,917
Value of interest in common/collective trusts at beginning of year	2013-06-30	$509,903
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-06-30	$8,377,789
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-06-30	$8,180,227
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-06-30	$762,060
Net investment gain or loss from common/collective trusts	2013-06-30	$87,071
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	$1,063,851
Did the plan have assets held for investment	2013-06-30	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	2013-06-30	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	No
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	BROWN, EDWARDS & COMPANY, L.L.P.
Accountancy firm EIN	2013-06-30	540504608
2012 : COMMUNITY MEMORIAL HEALTHCENTER RETIREMENT SAVINGS PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-06-30	$0
Total income from all sources (including contributions)	2012-06-30	$1,030,830
Total loss/gain on sale of assets	2012-06-30	$0
Total of all expenses incurred	2012-06-30	$1,129,485
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-06-30	$1,126,935
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-06-30	$398,075
Value of total assets at end of year	2012-06-30	$15,742,413
Value of total assets at beginning of year	2012-06-30	$15,841,068
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-06-30	$2,550
Total interest from all sources	2012-06-30	$126,681
Total dividends received (eg from common stock, registered investment company shares)	2012-06-30	$56,478
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-06-30	$56,478
Was this plan covered by a fidelity bond	2012-06-30	Yes
Value of fidelity bond cover	2012-06-30	$1,000,000
If this is an individual account plan, was there a blackout period	2012-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2012-06-30	No
Contributions received from participants	2012-06-30	$398,075
Participant contributions at end of year	2012-06-30	$235,923
Participant contributions at beginning of year	2012-06-30	$241,427
Income. Received or receivable in cash from other sources (including rollovers)	2012-06-30	$0
Administrative expenses (other) incurred	2012-06-30	$2,550
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-06-30	No
Value of net income/loss	2012-06-30	$-98,655
Value of net assets at end of year (total assets less liabilities)	2012-06-30	$15,742,413
Value of net assets at beginning of year (total assets less liabilities)	2012-06-30	$15,841,068
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-06-30	No
Were any leases to which the plan was party in default or uncollectible	2012-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-06-30	$6,816,360
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-06-30	$6,795,154
Interest on participant loans	2012-06-30	$6,369
Interest earned on other investments	2012-06-30	$120,312
Value of interest in common/collective trusts at end of year	2012-06-30	$509,903
Value of interest in common/collective trusts at beginning of year	2012-06-30	$432,925
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-06-30	$8,180,227
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-06-30	$8,371,562
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-06-30	$411,205
Net investment gain/loss from pooled separate accounts	2012-06-30	$38,391
Net investment gain or loss from common/collective trusts	2012-06-30	$38,391
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-06-30	No
Was there a failure to transmit to the plan any participant contributions	2012-06-30	No
Has the plan failed to provide any benefit when due under the plan	2012-06-30	No
Contributions received in cash from employer	2012-06-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-06-30	$1,126,935
Did the plan have assets held for investment	2012-06-30	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	2012-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2012-06-30	Disclaimer
Accountancy firm name	2012-06-30	BROWN, EDWARDS & COMPANY, L.L.P.
Accountancy firm EIN	2012-06-30	540504608
2011 : COMMUNITY MEMORIAL HEALTHCENTER RETIREMENT SAVINGS PLAN 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	$1,230,833
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$633,602
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$627,859
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$1,179,521
Value of total assets at end of year	2011-12-31	$15,966,083
Value of total assets at beginning of year	2011-12-31	$15,368,852
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$5,743
Total interest from all sources	2011-12-31	$255,942
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$206,849
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	$206,849
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$500,000
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	$904,513
Participant contributions at end of year	2011-12-31	$263,235
Participant contributions at beginning of year	2011-12-31	$297,517
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$275,008
Administrative expenses (other) incurred	2011-12-31	$5,659
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	$597,231
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$15,966,083
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$15,368,852
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$6,795,154
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$6,677,068
Interest on participant loans	2011-12-31	$13,442
Interest earned on other investments	2011-12-31	$242,500
Value of interest in common/collective trusts at end of year	2011-12-31	$432,925
Value of interest in common/collective trusts at beginning of year	2011-12-31	$444,229
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$8,474,769
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$7,950,038
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-410,594
Net investment gain or loss from common/collective trusts	2011-12-31	$-885
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$627,859
Contract administrator fees	2011-12-31	$5,743
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
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	BROWN EDWARDS AND COMPANY, L.L.P.
Accountancy firm EIN	2011-12-31	540504608
2010 : COMMUNITY MEMORIAL HEALTHCENTER RETIREMENT SAVINGS 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	$2,026,555
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$871,889
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$866,523
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$987,990
Value of total assets at end of year	2010-12-31	$15,368,852
Value of total assets at beginning of year	2010-12-31	$14,214,186
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$5,366
Total interest from all sources	2010-12-31	$288,483
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	Yes
Value of fidelity bond cover	2010-12-31	$500,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$969,280
Participant contributions at end of year	2010-12-31	$297,517
Participant contributions at beginning of year	2010-12-31	$264,885
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$18,710
Other income not declared elsewhere	2010-12-31	$269,782
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	$1,154,666
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$15,368,852
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$14,214,186
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$6,677,068
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$5,654,346
Value of interest in pooled separate accounts at end of year	2010-12-31	$444,229
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$330,313
Interest on participant loans	2010-12-31	$13,335
Interest earned on other investments	2010-12-31	$275,148
Value of interest in common/collective trusts at end of year	2010-12-31	$444,229
Value of interest in common/collective trusts at beginning of year	2010-12-31	$330,313
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$7,950,038
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$7,964,642
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$693,771
Net investment gain/loss from pooled separate accounts	2010-12-31	$56,311
Net investment gain or loss from common/collective trusts	2010-12-31	$56,311
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$866,523
Contract administrator fees	2010-12-31	$5,366
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	MITCHELL, WIGGENS AND COMPANY, LLP
Accountancy firm EIN	2010-12-31	540565834
2009 : COMMUNITY MEMORIAL HEALTHCENTER RETIREMENT SAVINGS PLAN 2009 401k financial data
Total unrealized appreciation/depreciation of assets	2009-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2009-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2009-12-31	$0
Total income from all sources (including contributions)	2009-12-31	$3,012,747
Total loss/gain on sale of assets	2009-12-31	$0
Total of all expenses incurred	2009-12-31	$1,287,306
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2009-12-31	$1,283,302
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2009-12-31	$1,344,667
Value of total assets at end of year	2009-12-31	$14,214,186
Value of total assets at beginning of year	2009-12-31	$12,488,745
Total of administrative expenses incurred including professional, contract, advisory and management fees	2009-12-31	$4,004
Total interest from all sources	2009-12-31	$331,068
Total dividends received (eg from common stock, registered investment company shares)	2009-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2009-12-31	No
Was this plan covered by a fidelity bond	2009-12-31	No
If this is an individual account plan, was there a blackout period	2009-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2009-12-31	No
Contributions received from participants	2009-12-31	$918,521
Participant contributions at end of year	2009-12-31	$264,885
Participant contributions at beginning of year	2009-12-31	$257,265
Income. Received or receivable in cash from other sources (including rollovers)	2009-12-31	$9,571
Administrative expenses (other) incurred	2009-12-31	$4,004
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2009-12-31	No
Value of net income/loss	2009-12-31	$1,725,441
Value of net assets at end of year (total assets less liabilities)	2009-12-31	$14,214,186
Value of net assets at beginning of year (total assets less liabilities)	2009-12-31	$12,488,745
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2009-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2009-12-31	No
Were any leases to which the plan was party in default or uncollectible	2009-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2009-12-31	$5,654,346
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2009-12-31	$4,305,144
Interest on participant loans	2009-12-31	$12,350
Interest earned on other investments	2009-12-31	$318,718
Value of interest in common/collective trusts at end of year	2009-12-31	$330,313
Value of interest in common/collective trusts at beginning of year	2009-12-31	$228,365
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2009-12-31	$7,964,642
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2009-12-31	$7,697,971
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2009-12-31	$1,267,305
Net investment gain/loss from pooled separate accounts	2009-12-31	$69,707
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2009-12-31	No
Was there a failure to transmit to the plan any participant contributions	2009-12-31	No
Has the plan failed to provide any benefit when due under the plan	2009-12-31	No
Contributions received in cash from employer	2009-12-31	$416,575
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2009-12-31	$1,283,302
Did the plan have assets held for investment	2009-12-31	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	2009-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2009-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2009-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2009-12-31	Disclaimer
Accountancy firm name	2009-12-31	MITCHELL, WIGGINS AND COMPANY, LLP
Accountancy firm EIN	2009-12-31	540565834

Form 5500 Responses for COMMUNITY MEMORIAL HEALTHCENTER RETIREMENT SAVINGS PLAN

2014: COMMUNITY MEMORIAL HEALTHCENTER RETIREMENT SAVINGS PLAN 2014 form 5500 responses
2014-07-01	Type of plan entity	Single employer plan
2014-07-01	Submission has been amended	Yes
2014-07-01	This submission is the final filing	No
2014-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-07-01	Plan is a collectively bargained plan	No
2014-07-01	Plan funding arrangement – Insurance	Yes
2014-07-01	Plan funding arrangement – Trust	Yes
2014-07-01	Plan benefit arrangement – Insurance	Yes
2014-07-01	Plan benefit arrangement - Trust	Yes
2013: COMMUNITY MEMORIAL HEALTHCENTER RETIREMENT SAVINGS PLAN 2013 form 5500 responses
2013-07-01	Type of plan entity	Single employer plan
2013-07-01	Submission has been amended	Yes
2013-07-01	This submission is the final filing	No
2013-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-07-01	Plan is a collectively bargained plan	No
2013-07-01	Plan funding arrangement – Insurance	Yes
2013-07-01	Plan funding arrangement – Trust	Yes
2013-07-01	Plan benefit arrangement – Insurance	Yes
2013-07-01	Plan benefit arrangement - Trust	Yes
2012: COMMUNITY MEMORIAL HEALTHCENTER RETIREMENT SAVINGS PLAN 2012 form 5500 responses
2012-07-01	Type of plan entity	Single employer plan
2012-07-01	Submission has been amended	Yes
2012-07-01	This submission is the final filing	No
2012-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-07-01	Plan is a collectively bargained plan	No
2012-07-01	Plan funding arrangement – Insurance	Yes
2012-07-01	Plan funding arrangement – Trust	Yes
2012-07-01	Plan benefit arrangement – Insurance	Yes
2012-07-01	Plan benefit arrangement - Trust	Yes
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)	Yes
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: COMMUNITY MEMORIAL HEALTHCENTER RETIREMENT SAVINGS PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	Yes
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
2010: COMMUNITY MEMORIAL HEALTHCENTER RETIREMENT SAVINGS PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	Yes
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 funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: COMMUNITY MEMORIAL HEALTHCENTER RETIREMENT SAVINGS PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	Yes
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

Insurance Providers Used on plan

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

MR 61124

Policy instance

Insurance contract or identification number	MR 61124
Number of Individuals Covered	0
Insurance policy start date	2014-07-01
Insurance policy end date	2014-12-12
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

MR 61124

Policy instance

Insurance contract or identification number	MR 61124
Number of Individuals Covered	0
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

1011005

Policy instance

Insurance contract or identification number	1011005
Number of Individuals Covered	26
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-750440

Policy instance

Insurance contract or identification number	GA-750440
Number of Individuals Covered	0
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

MR61124

Policy instance

Insurance contract or identification number	MR61124
Number of Individuals Covered	922
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
Total amount of commissions paid to insurance broker	USD $13,928
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $13,928
Insurance broker organization code?	1
Insurance broker name	FIRST CITIZENS INVESTOR SERVICE INC

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-750440

Policy instance

Insurance contract or identification number	GA-750440
Number of Individuals Covered	0
Insurance policy start date	2013-07-01
Insurance policy end date	2013-07-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

MR 61124

Policy instance

Insurance contract or identification number	MR 61124
Number of Individuals Covered	922
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
Total amount of commissions paid to insurance broker	USD $13,928
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

1011005

Policy instance

Insurance contract or identification number	1011005
Number of Individuals Covered	30
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-750440

Policy instance

Insurance contract or identification number	GA-750440
Number of Individuals Covered	722
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
Total amount of commissions paid to insurance broker	USD $31,975
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $31,975
Insurance broker organization code?	3
Insurance broker name	FIRST CITIZENS INVESTOR SVCS INC

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

1011005

Policy instance

Insurance contract or identification number	1011005
Number of Individuals Covered	31
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-750471

Policy instance

Insurance contract or identification number	GA-750471
Number of Individuals Covered	722
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
Total amount of commissions paid to insurance broker	USD $31,975
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-750440

Policy instance

Insurance contract or identification number	GA-750440
Number of Individuals Covered	740
Insurance policy start date	2012-01-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $15,658
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Commission paid to Insurance Broker	USD $15,658
Insurance broker organization code?	3
Insurance broker name	FIRST CITIZENS INVESTOR SVCS INC

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

1011005

Policy instance

Insurance contract or identification number	1011005
Number of Individuals Covered	34
Insurance policy start date	2012-01-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA 750471

Policy instance

Insurance contract or identification number	GA 750471
Number of Individuals Covered	1015
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $32,530
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $32,530
Insurance broker organization code?	3
Insurance broker name	FIRST CITIZENS INVESTOR SVCS INC

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

1011005

Policy instance

Insurance contract or identification number	1011005
Number of Individuals Covered	35
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA 750471

Policy instance

Insurance contract or identification number	GA 750471
Number of Individuals Covered	1035
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $29,621
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $29,621
Insurance broker organization code?	3
Insurance broker name	FIRST CITIZENS INVESTOR SVCS INC

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

1011005

Policy instance

Insurance contract or identification number	1011005
Number of Individuals Covered	38
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA 750471

Policy instance

Insurance contract or identification number	GA 750471
Number of Individuals Covered	1221
Insurance policy start date	2009-01-01
Insurance policy end date	2009-12-31
Total amount of commissions paid to insurance broker	USD $26,125
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $26,125
Insurance broker organization code?	3
Insurance broker name	FIRST CITIZENS INVESTOR SVCS INC

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

1011005

Policy instance

Insurance contract or identification number	1011005
Number of Individuals Covered	38
Insurance policy start date	2009-01-01
Insurance policy end date	2009-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	COMMUNITY MEMORIAL HEALTHCENTER
Employer identification number (EIN):	540551711
NAIC Classification:	622000
NAIC Description:	Hospitals