401k Plan data: SOUTHERN REGIONAL HEALTH SYSTEM, INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN plan

SOUTHERN REGIONAL HEALTH SYSTEM, INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 401k Plan overview

Plan Name	SOUTHERN REGIONAL HEALTH SYSTEM, INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN
Plan identification number	002

SOUTHERN REGIONAL HEALTH SYSTEM, INC. SUPPLEMENTAL 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.
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.

401k Sponsoring company profile

SOUTHERN REGIONAL HEALTH SYSTEM INC. has sponsored the creation of one or more 401k plans.

Company Name: SOUTHERN REGIONAL HEALTH SYSTEM INC.

Employer identification number (EIN): 581955423

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SOUTHERN REGIONAL HEALTH SYSTEM, INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2017-01-01 LOIS DEMERICH
002 2017-01-01
002 2016-01-01 LOIS DEMERICH
002 2016-01-01
002 2015-01-01 LOIS DEMERICH
002 2014-01-01 STACEY HANCOCK
002 2013-01-01 STACEY HANCOCK
002 2012-01-01 STACEY J. HANCOCK STACEY J. HANCOCK 2013-10-11
002 2011-01-01 STACEY J. HANCOCK
002 2009-01-01 STACEY J. HANCOCK
002 2009-01-01 STACEY J. HANCOCK

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
002	2017-01-01	LOIS DEMERICH
002	2017-01-01
002	2016-01-01	LOIS DEMERICH
002	2016-01-01
002	2015-01-01	LOIS DEMERICH
002	2014-01-01	STACEY HANCOCK
002	2013-01-01	STACEY HANCOCK
002	2012-01-01	STACEY J. HANCOCK	STACEY J. HANCOCK	2013-10-11
002	2011-01-01	STACEY J. HANCOCK
002	2009-01-01	STACEY J. HANCOCK
002	2009-01-01	STACEY J. HANCOCK

Plan Statistics for SOUTHERN REGIONAL HEALTH SYSTEM, INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN

401k plan membership statisitcs for SOUTHERN REGIONAL HEALTH SYSTEM, INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN

Measure Date Value
2017: SOUTHERN REGIONAL HEALTH SYSTEM, INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 1,520
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 0
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 0
Total of all active and inactive participants 2017-01-01 0
Total participants 2017-01-01 0
2016: SOUTHERN REGIONAL HEALTH SYSTEM, INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 1,997
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 0
Number of retired or separated participants receiving benefits 2016-01-01 2
Number of other retired or separated participants entitled to future benefits 2016-01-01 1,516
Total of all active and inactive participants 2016-01-01 1,518
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 2
Total participants 2016-01-01 1,520
Number of participants with account balances 2016-01-01 1,520
2015: SOUTHERN REGIONAL HEALTH SYSTEM, INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 2,307
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 1,188
Number of retired or separated participants receiving benefits 2015-01-01 8
Number of other retired or separated participants entitled to future benefits 2015-01-01 800
Total of all active and inactive participants 2015-01-01 1,996
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 1
Total participants 2015-01-01 1,997
Number of participants with account balances 2015-01-01 1,976
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: SOUTHERN REGIONAL HEALTH SYSTEM, INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 2,378
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 1,294
Number of retired or separated participants receiving benefits 2014-01-01 9
Number of other retired or separated participants entitled to future benefits 2014-01-01 1,003
Total of all active and inactive participants 2014-01-01 2,306
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 1
Total participants 2014-01-01 2,307
Number of participants with account balances 2014-01-01 2,284
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: SOUTHERN REGIONAL HEALTH SYSTEM, INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 2,393
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 1,609
Number of retired or separated participants receiving benefits 2013-01-01 11
Number of other retired or separated participants entitled to future benefits 2013-01-01 758
Total of all active and inactive participants 2013-01-01 2,378
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 2,378
Number of participants with account balances 2013-01-01 2,368
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 1
2012: SOUTHERN REGIONAL HEALTH SYSTEM, INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 2,558
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 1,598
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 789
Total of all active and inactive participants 2012-01-01 2,387
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 2
Total participants 2012-01-01 2,389
Number of participants with account balances 2012-01-01 2,389
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 5
2011: SOUTHERN REGIONAL HEALTH SYSTEM, INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 2,911
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 1,546
Number of retired or separated participants receiving benefits 2011-01-01 5
Number of other retired or separated participants entitled to future benefits 2011-01-01 1,007
Total of all active and inactive participants 2011-01-01 2,558
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 2,558
Number of participants with account balances 2011-01-01 2,547
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: SOUTHERN REGIONAL HEALTH SYSTEM, INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 3,400
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 3,115
Number of retired or separated participants receiving benefits 2009-01-01 4
Number of other retired or separated participants entitled to future benefits 2009-01-01 260
Total of all active and inactive participants 2009-01-01 3,379
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 3,379
Number of participants with account balances 2009-01-01 3,153
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 48

Measure	Date	Value
2017: SOUTHERN REGIONAL HEALTH SYSTEM, INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	1,520
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	0
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	0
Total of all active and inactive participants	2017-01-01	0
Total participants	2017-01-01	0
2016: SOUTHERN REGIONAL HEALTH SYSTEM, INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	1,997
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	0
Number of retired or separated participants receiving benefits	2016-01-01	2
Number of other retired or separated participants entitled to future benefits	2016-01-01	1,516
Total of all active and inactive participants	2016-01-01	1,518
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	2
Total participants	2016-01-01	1,520
Number of participants with account balances	2016-01-01	1,520
2015: SOUTHERN REGIONAL HEALTH SYSTEM, INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	2,307
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	1,188
Number of retired or separated participants receiving benefits	2015-01-01	8
Number of other retired or separated participants entitled to future benefits	2015-01-01	800
Total of all active and inactive participants	2015-01-01	1,996
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	1
Total participants	2015-01-01	1,997
Number of participants with account balances	2015-01-01	1,976
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: SOUTHERN REGIONAL HEALTH SYSTEM, INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	2,378
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	1,294
Number of retired or separated participants receiving benefits	2014-01-01	9
Number of other retired or separated participants entitled to future benefits	2014-01-01	1,003
Total of all active and inactive participants	2014-01-01	2,306
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	1
Total participants	2014-01-01	2,307
Number of participants with account balances	2014-01-01	2,284
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: SOUTHERN REGIONAL HEALTH SYSTEM, INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	2,393
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	1,609
Number of retired or separated participants receiving benefits	2013-01-01	11
Number of other retired or separated participants entitled to future benefits	2013-01-01	758
Total of all active and inactive participants	2013-01-01	2,378
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	2,378
Number of participants with account balances	2013-01-01	2,368
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	1
2012: SOUTHERN REGIONAL HEALTH SYSTEM, INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	2,558
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	1,598
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	789
Total of all active and inactive participants	2012-01-01	2,387
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	2
Total participants	2012-01-01	2,389
Number of participants with account balances	2012-01-01	2,389
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	5
2011: SOUTHERN REGIONAL HEALTH SYSTEM, INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	2,911
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	1,546
Number of retired or separated participants receiving benefits	2011-01-01	5
Number of other retired or separated participants entitled to future benefits	2011-01-01	1,007
Total of all active and inactive participants	2011-01-01	2,558
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	2,558
Number of participants with account balances	2011-01-01	2,547
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: SOUTHERN REGIONAL HEALTH SYSTEM, INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	3,400
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	3,115
Number of retired or separated participants receiving benefits	2009-01-01	4
Number of other retired or separated participants entitled to future benefits	2009-01-01	260
Total of all active and inactive participants	2009-01-01	3,379
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	3,379
Number of participants with account balances	2009-01-01	3,153
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	48

Financial Data on SOUTHERN REGIONAL HEALTH SYSTEM, INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN

Measure	Date	Value
2017 : SOUTHERN REGIONAL HEALTH SYSTEM, INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-01-18	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-01-18	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-01-18	$0
Total income from all sources (including contributions)	2017-01-18	$325
Total loss/gain on sale of assets	2017-01-18	$0
Total of all expenses incurred	2017-01-18	$24,735
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-01-18	$24,735
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-01-18	$0
Value of total assets at end of year	2017-01-18	$0
Value of total assets at beginning of year	2017-01-18	$24,410
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-01-18	$0
Total interest from all sources	2017-01-18	$0
Total dividends received (eg from common stock, registered investment company shares)	2017-01-18	$1
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-01-18	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2017-01-18	$0
Total dividends received from registered investment company shares (eg mutual funds)	2017-01-18	$1
Was this plan covered by a fidelity bond	2017-01-18	Yes
Value of fidelity bond cover	2017-01-18	$10,000,000
If this is an individual account plan, was there a blackout period	2017-01-18	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-01-18	$0
Were there any nonexempt tranactions with any party-in-interest	2017-01-18	No
Assets. Other investments not covered elsewhere at end of year	2017-01-18	$0
Assets. Other investments not covered elsewhere at beginning of year	2017-01-18	$7,856
Other income not declared elsewhere	2017-01-18	$6
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-01-18	No
Value of net income/loss	2017-01-18	$-24,410
Value of net assets at end of year (total assets less liabilities)	2017-01-18	$0
Value of net assets at beginning of year (total assets less liabilities)	2017-01-18	$24,410
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-01-18	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-01-18	No
Were any leases to which the plan was party in default or uncollectible	2017-01-18	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-01-18	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-01-18	$16,554
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-01-18	$318
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-01-18	No
Was there a failure to transmit to the plan any participant contributions	2017-01-18	No
Has the plan failed to provide any benefit when due under the plan	2017-01-18	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-01-18	$24,735
Did the plan have assets held for investment	2017-01-18	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	2017-01-18	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-01-18	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-01-18	Yes
Opinion of an independent qualified public accountant for this plan	2017-01-18	Disclaimer
Accountancy firm name	2017-01-18	WINDHAM BRANNON, P.C.
Accountancy firm EIN	2017-01-18	581763439
2016 : SOUTHERN REGIONAL HEALTH SYSTEM, INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$-1,260,387
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$67,261,288
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$66,873,656
Expenses. Certain deemed distributions of participant loans	2016-12-31	$263,749
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$-219,324
Value of total assets at end of year	2016-12-31	$24,410
Value of total assets at beginning of year	2016-12-31	$68,546,085
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$123,883
Total interest from all sources	2016-12-31	$5,119
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$119,021
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2016-12-31	$0
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$119,021
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$10,000,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$-10,438
Participant contributions at end of year	2016-12-31	$0
Participant contributions at beginning of year	2016-12-31	$1,062,939
Assets. Other investments not covered elsewhere at end of year	2016-12-31	$7,856
Assets. Other investments not covered elsewhere at beginning of year	2016-12-31	$19,733,958
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$26,535
Other income not declared elsewhere	2016-12-31	$113,247
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$-68,521,675
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$24,410
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$68,546,085
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Investment advisory and management fees	2016-12-31	$72,821
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$16,554
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$45,531,034
Interest on participant loans	2016-12-31	$44,231
Interest earned on other investments	2016-12-31	$-39,112
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$2,218,154
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$-1,278,450
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$-235,421
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$66,873,656
Contract administrator fees	2016-12-31	$51,062
Did the plan have assets held for investment	2016-12-31	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	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	WINDHAM BRANNON, P.C.
Accountancy firm EIN	2016-12-31	581763439
2015 : SOUTHERN REGIONAL HEALTH SYSTEM, INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$6,160,353
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$13,676,698
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$13,096,682
Expenses. Certain deemed distributions of participant loans	2015-12-31	$396,274
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$5,305,451
Value of total assets at end of year	2015-12-31	$68,546,085
Value of total assets at beginning of year	2015-12-31	$76,062,430
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$183,742
Total interest from all sources	2015-12-31	$130,453
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$2,381,770
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2015-12-31	$0
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$2,381,770
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$10,000,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$3,372,802
Participant contributions at end of year	2015-12-31	$1,062,939
Participant contributions at beginning of year	2015-12-31	$1,401,868
Assets. Other investments not covered elsewhere at end of year	2015-12-31	$19,733,958
Assets. Other investments not covered elsewhere at beginning of year	2015-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$220,532
Other income not declared elsewhere	2015-12-31	$407,543
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$-7,516,345
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$68,546,085
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$76,062,430
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$45,531,034
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$51,713,115
Interest on participant loans	2015-12-31	$49,711
Interest earned on other investments	2015-12-31	$80,742
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$2,218,154
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$22,947,447
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-2,064,864
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$1,712,117
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$13,096,682
Contract administrator fees	2015-12-31	$183,742
Did the plan have assets held for investment	2015-12-31	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	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	WINDHAM BRANNON, P.C.
Accountancy firm EIN	2015-12-31	581763439
2014 : SOUTHERN REGIONAL HEALTH SYSTEM, INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$1,026,103
Total income from all sources (including contributions)	2014-12-31	$11,803,258
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$11,562,346
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$11,178,418
Expenses. Certain deemed distributions of participant loans	2014-12-31	$178,513
Value of total corrective distributions	2014-12-31	$2,290
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$7,054,692
Value of total assets at end of year	2014-12-31	$76,062,430
Value of total assets at beginning of year	2014-12-31	$76,847,621
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$203,125
Total interest from all sources	2014-12-31	$551,349
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$2,651,368
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$2,651,368
Administrative expenses professional fees incurred	2014-12-31	$33,906
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$10,000,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$3,675,509
Participant contributions at end of year	2014-12-31	$1,401,868
Participant contributions at beginning of year	2014-12-31	$1,459,107
Participant contributions at end of year	2014-12-31	$0
Participant contributions at beginning of year	2014-12-31	$146,379
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$1,282,282
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2014-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2014-12-31	$1,026,103
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$240,912
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$76,062,430
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$75,821,518
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$51,713,115
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$50,232,628
Interest on participant loans	2014-12-31	$55,822
Interest earned on other investments	2014-12-31	$495,527
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$22,947,447
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$24,918,246
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$1,545,849
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$2,096,901
Employer contributions (assets) at end of year	2014-12-31	$0
Employer contributions (assets) at beginning of year	2014-12-31	$91,261
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$11,178,418
Contract administrator fees	2014-12-31	$169,219
Did the plan have assets held for investment	2014-12-31	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	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	WINDHAM BRANNON, P.C.
Accountancy firm EIN	2014-12-31	581763439
2013 : SOUTHERN REGIONAL HEALTH SYSTEM, INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$1,026,103
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$18,005,960
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$7,636,856
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$7,414,533
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$6,858,487
Value of total assets at end of year	2013-12-31	$76,847,621
Value of total assets at beginning of year	2013-12-31	$65,452,414
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$222,323
Total interest from all sources	2013-12-31	$574,613
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$1,016,413
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-12-31	$1,016,413
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$10,000,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$3,851,273
Participant contributions at end of year	2013-12-31	$1,459,107
Participant contributions at beginning of year	2013-12-31	$1,264,044
Participant contributions at end of year	2013-12-31	$146,379
Participant contributions at beginning of year	2013-12-31	$165,562
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$556,599
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2013-12-31	$1,026,103
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2013-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$10,369,104
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$75,821,518
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$65,452,414
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Investment advisory and management fees	2013-12-31	$30,830
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$50,232,628
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$39,772,596
Interest on participant loans	2013-12-31	$45,897
Interest earned on other investments	2013-12-31	$528,716
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2013-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2013-12-31	$115,709
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2013-12-31	$115,709
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$24,918,246
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$24,030,452
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$9,556,447
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$2,450,615
Employer contributions (assets) at end of year	2013-12-31	$91,261
Employer contributions (assets) at beginning of year	2013-12-31	$104,051
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$7,414,533
Contract administrator fees	2013-12-31	$191,493
Did the plan have assets held for investment	2013-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	WINDHAM BRANNON, P.C.
Accountancy firm EIN	2013-12-31	581763439
2012 : SOUTHERN REGIONAL HEALTH SYSTEM, INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$123,827
Total income from all sources (including contributions)	2012-12-31	$12,924,615
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$8,401,518
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$8,098,521
Expenses. Certain deemed distributions of participant loans	2012-12-31	$77,413
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$6,678,043
Value of total assets at end of year	2012-12-31	$65,452,414
Value of total assets at beginning of year	2012-12-31	$61,053,144
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$225,584
Total interest from all sources	2012-12-31	$556,753
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$904,185
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-12-31	$904,185
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$10,000,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$3,841,822
Participant contributions at end of year	2012-12-31	$1,264,044
Participant contributions at beginning of year	2012-12-31	$1,355,075
Participant contributions at end of year	2012-12-31	$165,562
Participant contributions at beginning of year	2012-12-31	$142,331
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$391,685
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2012-12-31	$129,122
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2012-12-31	$123,827
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$4,523,097
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$65,452,414
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$60,929,317
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$39,772,596
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$36,393,396
Interest on participant loans	2012-12-31	$32,142
Interest earned on other investments	2012-12-31	$524,573
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-12-31	$115,709
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-12-31	$115,709
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-12-31	$115,709
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-12-31	$38
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$24,030,452
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$22,781,194
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$4,785,634
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$2,444,536
Employer contributions (assets) at end of year	2012-12-31	$104,051
Employer contributions (assets) at beginning of year	2012-12-31	$136,317
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$8,098,521
Contract administrator fees	2012-12-31	$225,584
Did the plan have assets held for investment	2012-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	WINDHAM BRANNON, P.C.
Accountancy firm EIN	2012-12-31	581763439
2011 : SOUTHERN REGIONAL HEALTH SYSTEM, INC. SUPPLEMENTAL 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	$123,827
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$978,866
Total income from all sources (including contributions)	2011-12-31	$7,231,551
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$5,904,619
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$5,671,273
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$7,755,161
Value of total assets at end of year	2011-12-31	$61,053,144
Value of total assets at beginning of year	2011-12-31	$60,581,251
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$233,346
Total interest from all sources	2011-12-31	$692,497
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$10,000,000
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	$3,323,718
Participant contributions at end of year	2011-12-31	$1,355,075
Participant contributions at beginning of year	2011-12-31	$1,029,685
Participant contributions at end of year	2011-12-31	$142,331
Participant contributions at beginning of year	2011-12-31	$125,950
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$1,047,946
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-12-31	$129,122
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-12-31	$63,918
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2011-12-31	$123,827
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2011-12-31	$978,866
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	$1,326,932
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$60,929,317
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$59,602,385
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	$36,393,396
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$36,800,145
Interest on participant loans	2011-12-31	$36,951
Interest earned on other investments	2011-12-31	$655,546
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-12-31	$115,709
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-12-31	$100,307
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-12-31	$100,307
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$22,781,194
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$22,324,856
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-1,216,107
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	$3,383,497
Employer contributions (assets) at end of year	2011-12-31	$136,317
Employer contributions (assets) at beginning of year	2011-12-31	$136,390
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$5,671,273
Contract administrator fees	2011-12-31	$233,346
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	WINDHAM BRANNON, P.C.
Accountancy firm EIN	2011-12-31	581763439
2010 : SOUTHERN REGIONAL HEALTH SYSTEM, INC. SUPPLEMENTAL 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	$978,866
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$149,214
Total income from all sources (including contributions)	2010-12-31	$12,572,711
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$4,246,664
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$3,986,776
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$7,530,169
Value of total assets at end of year	2010-12-31	$60,581,251
Value of total assets at beginning of year	2010-12-31	$51,425,552
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$259,888
Total interest from all sources	2010-12-31	$902,044
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$699,111
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	$699,111
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$10,000,000
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	$3,454,170
Participant contributions at end of year	2010-12-31	$1,029,685
Participant contributions at beginning of year	2010-12-31	$1,071,146
Participant contributions at end of year	2010-12-31	$125,950
Participant contributions at beginning of year	2010-12-31	$130,123
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$469,187
Value of other receiveables (less allowance for doubtful accounts) at end of year	2010-12-31	$63,918
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2010-12-31	$72,206
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2010-12-31	$978,866
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2010-12-31	$149,214
Total non interest bearing cash at beginning of year	2010-12-31	$6,727
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	$8,326,047
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$59,602,385
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$51,276,338
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	$32,914,502
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$26,679,283
Value of interest in pooled separate accounts at end of year	2010-12-31	$3,885,643
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$3,742,453
Interest on participant loans	2010-12-31	$46,906
Interest earned on other investments	2010-12-31	$855,126
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2010-12-31	$100,307
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2010-12-31	$86,971
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2010-12-31	$86,971
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2010-12-31	$12
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$22,324,856
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$19,550,021
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$2,944,591
Net investment gain/loss from pooled separate accounts	2010-12-31	$496,796
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	$3,606,812
Employer contributions (assets) at end of year	2010-12-31	$136,390
Employer contributions (assets) at beginning of year	2010-12-31	$86,622
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$3,986,776
Contract administrator fees	2010-12-31	$259,888
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	WINDHAM BRANNON, P.C.
Accountancy firm EIN	2010-12-31	581763439
2009 : SOUTHERN REGIONAL HEALTH SYSTEM, INC. SUPPLEMENTAL RETIREMENT SAVINGS 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 SOUTHERN REGIONAL HEALTH SYSTEM, INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN

2017: SOUTHERN REGIONAL HEALTH SYSTEM, INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	Yes
2017-01-01	This submission is the final filing	Yes
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: SOUTHERN REGIONAL HEALTH SYSTEM, INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	Yes
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: SOUTHERN REGIONAL HEALTH SYSTEM, INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: SOUTHERN REGIONAL HEALTH SYSTEM, INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: SOUTHERN REGIONAL HEALTH SYSTEM, INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: SOUTHERN REGIONAL HEALTH SYSTEM, INC. SUPPLEMENTAL RETIREMENT SAVINGS PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – 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: SOUTHERN REGIONAL HEALTH SYSTEM, INC. SUPPLEMENTAL RETIREMENT SAVINGS 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 – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: SOUTHERN REGIONAL HEALTH SYSTEM, INC. SUPPLEMENTAL 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

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )

Policy contract number

892981-007

Policy instance

Insurance contract or identification number	892981-007
Number of Individuals Covered	883
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
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

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )

Policy contract number

67159

Policy instance

Insurance contract or identification number	67159
Number of Individuals Covered	493
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $911
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 $310
Insurance broker organization code?	3
Insurance broker name	GREGORY S DANIEL

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )

Policy contract number

CR29610

Policy instance

Insurance contract or identification number	CR29610
Number of Individuals Covered	81
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
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

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )

Policy contract number

892981-007

Policy instance

Insurance contract or identification number	892981-007
Number of Individuals Covered	1031
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
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

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )

Policy contract number

CR29610

Policy instance

Insurance contract or identification number	CR29610
Number of Individuals Covered	87
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
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

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )

Policy contract number

67159

Policy instance

Insurance contract or identification number	67159
Number of Individuals Covered	539
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $1,886
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 $1,408
Insurance broker organization code?	3
Insurance broker name	STEVEN J ROSENSTOCK

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )

Policy contract number

892981-007

Policy instance

Insurance contract or identification number	892981-007
Number of Individuals Covered	1167
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
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

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )

Policy contract number

CR29610

Policy instance

Insurance contract or identification number	CR29610
Number of Individuals Covered	89
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
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

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )

Policy contract number

67159

Policy instance

Insurance contract or identification number	67159
Number of Individuals Covered	569
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $1,638
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 $910
Insurance broker organization code?	3
Insurance broker name	CHRISTOPHER J COWART

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )

Policy contract number

892981-007

Policy instance

Insurance contract or identification number	892981-007
Number of Individuals Covered	508
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
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

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )

Policy contract number

67159

Policy instance

Insurance contract or identification number	67159
Number of Individuals Covered	592
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $1,657
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 $1,333
Insurance broker organization code?	3
Insurance broker name	MICHAEL SZYMKEIWICZ

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )

Policy contract number

CR29610

Policy instance

Insurance contract or identification number	CR29610
Number of Individuals Covered	94
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
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

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )

Policy contract number

892981-007

Policy instance

Insurance contract or identification number	892981-007
Number of Individuals Covered	1492
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

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )

Policy contract number

CR29610

Policy instance

Insurance contract or identification number	CR29610
Number of Individuals Covered	108
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

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )

Policy contract number

67159

Policy instance

Insurance contract or identification number	67159
Number of Individuals Covered	646
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $1,964
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

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )

Policy contract number

892981-007

Policy instance

Insurance contract or identification number	892981-007
Number of Individuals Covered	2183
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

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )

Policy contract number

CR29610

Policy instance

Insurance contract or identification number	CR29610
Number of Individuals Covered	117
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

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )

Policy contract number

67159

Policy instance

Insurance contract or identification number	67159
Number of Individuals Covered	698
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $2,116
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:	SOUTHERN REGIONAL HEALTH SYSTEM INC.
Employer identification number (EIN):	581955423
NAIC Classification:	622000
NAIC Description:	Hospitals