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

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

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

INDIANA UNIVERSITY HEALTH NORTH MEDICAL CENTER 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 L.L.C. has sponsored the creation of one or more 401k plans.

Company Name: INDIANA UNIVERSITY HEALTH NORTH L.L.C.

Employer identification number (EIN): 562343791

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

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

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2011-01-01 ANGELA THOMPSON JONATHAN GOBLE 2012-07-31
001 2009-01-01 ANGELA S. THOMPSON JONATHAN R. GOBLE 2010-10-11

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2011-01-01	ANGELA THOMPSON		JONATHAN GOBLE	2012-07-31
001	2009-01-01	ANGELA S. THOMPSON		JONATHAN R. GOBLE	2010-10-11

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

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

Measure Date Value
2011: INDIANA UNIVERSITY HEALTH NORTH MEDICAL CENTER 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 1,573
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 1,455
Number of retired or separated participants receiving benefits 2011-01-01 31
Number of other retired or separated participants entitled to future benefits 2011-01-01 206
Total of all active and inactive participants 2011-01-01 1,692
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 1,692
Number of participants with account balances 2011-01-01 1,382
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: INDIANA UNIVERSITY HEALTH NORTH MEDICAL CENTER 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 1,442
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 1,590
Number of retired or separated participants receiving benefits 2009-01-01 2
Number of other retired or separated participants entitled to future benefits 2009-01-01 124
Total of all active and inactive participants 2009-01-01 1,716
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 1,716
Number of participants with account balances 2009-01-01 1,089
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2011: INDIANA UNIVERSITY HEALTH NORTH MEDICAL CENTER 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	1,573
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	1,455
Number of retired or separated participants receiving benefits	2011-01-01	31
Number of other retired or separated participants entitled to future benefits	2011-01-01	206
Total of all active and inactive participants	2011-01-01	1,692
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	1,692
Number of participants with account balances	2011-01-01	1,382
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: INDIANA UNIVERSITY HEALTH NORTH MEDICAL CENTER 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	1,442
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	1,590
Number of retired or separated participants receiving benefits	2009-01-01	2
Number of other retired or separated participants entitled to future benefits	2009-01-01	124
Total of all active and inactive participants	2009-01-01	1,716
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	1,716
Number of participants with account balances	2009-01-01	1,089
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

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

Measure	Date	Value
2011 : INDIANA UNIVERSITY HEALTH NORTH MEDICAL CENTER 401(K) 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	$4,757,324
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$1,320,757
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$1,261,878
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$5,180,898
Value of total assets at end of year	2011-12-31	$21,733,926
Value of total assets at beginning of year	2011-12-31	$18,297,359
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$58,879
Total interest from all sources	2011-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$491,259
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	$491,259
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$20,000,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$3,125,607
Participant contributions at end of year	2011-12-31	$0
Participant contributions at beginning of year	2011-12-31	$104,106
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$92,722
Administrative expenses (other) incurred	2011-12-31	$45,701
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	$3,436,567
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$21,733,926
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$18,297,359
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
Investment advisory and management fees	2011-12-31	$13,178
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$17,897,356
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$15,229,458
Value of interest in master investment trust accounts at end of year	2011-12-31	$1,359,776
Value of interest in master investment trust accounts at beginning of year	2011-12-31	$1,086,197
Value of interest in common/collective trusts at end of year	2011-12-31	$2,476,794
Value of interest in common/collective trusts at beginning of year	2011-12-31	$1,808,204
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-1,008,886
Net investment gain or loss from common/collective trusts	2011-12-31	$45,607
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
Contributions received in cash from employer	2011-12-31	$1,962,569
Employer contributions (assets) at end of year	2011-12-31	$0
Employer contributions (assets) at beginning of year	2011-12-31	$69,394
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$1,261,878
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	ERNST & YOUNG LLP
Accountancy firm EIN	2011-12-31	346565596
2010 : INDIANA UNIVERSITY HEALTH NORTH MEDICAL CENTER 401(K) 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	$6,946,439
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$952,394
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$898,713
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$4,836,591
Value of total assets at end of year	2010-12-31	$18,297,359
Value of total assets at beginning of year	2010-12-31	$12,303,314
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$53,681
Total interest from all sources	2010-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$345,837
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2010-12-31	$345,837
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$20,000,000
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	$2,895,710
Participant contributions at end of year	2010-12-31	$104,106
Participant contributions at beginning of year	2010-12-31	$103,022
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$85,673
Administrative expenses (other) incurred	2010-12-31	$46,146
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	$5,994,045
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$18,297,359
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$12,303,314
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Investment advisory and management fees	2010-12-31	$7,535
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$15,229,458
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$10,243,022
Value of interest in master investment trust accounts at end of year	2010-12-31	$1,086,197
Value of interest in master investment trust accounts at beginning of year	2010-12-31	$690,886
Value of interest in common/collective trusts at end of year	2010-12-31	$1,808,204
Value of interest in common/collective trusts at beginning of year	2010-12-31	$1,201,598
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$1,497,309
Net investment gain or loss from common/collective trusts	2010-12-31	$229,370
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$1,855,208
Employer contributions (assets) at end of year	2010-12-31	$69,394
Employer contributions (assets) at beginning of year	2010-12-31	$64,786
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$898,713
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	No
Opinion of an independent qualified public accountant for this plan	2010-12-31	Unqualified
Accountancy firm name	2010-12-31	ERNST & YOUNG LLP
Accountancy firm EIN	2010-12-31	346565596
2009 : INDIANA UNIVERSITY HEALTH NORTH MEDICAL CENTER 401(K) PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for INDIANA UNIVERSITY HEALTH NORTH MEDICAL CENTER 401(K) PLAN

2011: INDIANA UNIVERSITY HEALTH NORTH MEDICAL CENTER 401(K) PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	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 – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: INDIANA UNIVERSITY HEALTH NORTH MEDICAL CENTER 401(K) PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	INDIANA UNIVERSITY HEALTH NORTH L.L.C.
Employer identification number (EIN):	562343791
NAIC Classification:	622000
NAIC Description:	Hospitals