401k Plan data: GPCH, LLC 401 RETIREMENT PLAN plan

GPCH, LLC 401 RETIREMENT PLAN 401k Plan overview

Plan Name	GPCH, LLC 401 RETIREMENT PLAN
Plan identification number	001

GPCH, LLC 401 RETIREMENT PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
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

GPCH,LLC DBA GOLDEN PLAINS COMMUNITY HOSPITAL has sponsored the creation of one or more 401k plans.

Company Name: GPCH,LLC DBA GOLDEN PLAINS COMMUNITY HOSPITAL

Employer identification number (EIN): 260328929

NAIC Classification: 622000
NAIC Description: Hospitals

Additional information about GPCH,LLC DBA GOLDEN PLAINS COMMUNITY HOSPITAL

Jurisdiction of Incorporation: Texas Secretary of State

Incorporation Date: 2007-06-05

Company Identification Number: 0800825212

Legal Registered Office Address: 100 HOSPITAL DR

BORGER
United States of America (USA)
79007

More information about GPCH,LLC DBA GOLDEN PLAINS COMMUNITY HOSPITAL

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GPCH, LLC 401 RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2014-01-01 SALLY MASON
001 2013-01-01 SALLY MASON SALLY MASON 2014-10-13
001 2012-01-01 SALLY MASON
001 2011-01-01 SALLY MASON
001 2010-01-01 SALLY MASON
001 2009-01-01 SALLY MASON

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2014-01-01	SALLY MASON
001	2013-01-01	SALLY MASON	SALLY MASON	2014-10-13
001	2012-01-01	SALLY MASON
001	2011-01-01	SALLY MASON
001	2010-01-01	SALLY MASON
001	2009-01-01	SALLY MASON

Plan Statistics for GPCH, LLC 401 RETIREMENT PLAN

401k plan membership statisitcs for GPCH, LLC 401 RETIREMENT PLAN

Measure Date Value
2014: GPCH, LLC 401 RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 108
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 0
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 0
Number of participants with account balances 2014-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: GPCH, LLC 401 RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 115
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 71
Number of retired or separated participants receiving benefits 2013-01-01 1
Number of other retired or separated participants entitled to future benefits 2013-01-01 36
Total of all active and inactive participants 2013-01-01 108
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 108
Number of participants with account balances 2013-01-01 108
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 2
2012: GPCH, LLC 401 RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 119
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 70
Number of retired or separated participants receiving benefits 2012-01-01 1
Number of other retired or separated participants entitled to future benefits 2012-01-01 44
Total of all active and inactive participants 2012-01-01 115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 115
Number of participants with account balances 2012-01-01 115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 8
2011: GPCH, LLC 401 RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 116
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 84
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 36
Total of all active and inactive participants 2011-01-01 120
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 120
Number of participants with account balances 2011-01-01 115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 4
2010: GPCH, LLC 401 RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 121
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 83
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 31
Total of all active and inactive participants 2010-01-01 114
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 114
Number of participants with account balances 2010-01-01 105
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 8
2009: GPCH, LLC 401 RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 116
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 83
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 35
Total of all active and inactive participants 2009-01-01 118
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 118
Number of participants with account balances 2009-01-01 117
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 7

Measure	Date	Value
2014: GPCH, LLC 401 RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	108
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	0
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	0
Number of participants with account balances	2014-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: GPCH, LLC 401 RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	115
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	71
Number of retired or separated participants receiving benefits	2013-01-01	1
Number of other retired or separated participants entitled to future benefits	2013-01-01	36
Total of all active and inactive participants	2013-01-01	108
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	108
Number of participants with account balances	2013-01-01	108
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	2
2012: GPCH, LLC 401 RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	119
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	70
Number of retired or separated participants receiving benefits	2012-01-01	1
Number of other retired or separated participants entitled to future benefits	2012-01-01	44
Total of all active and inactive participants	2012-01-01	115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	115
Number of participants with account balances	2012-01-01	115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	8
2011: GPCH, LLC 401 RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	116
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	84
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	36
Total of all active and inactive participants	2011-01-01	120
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	120
Number of participants with account balances	2011-01-01	115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	4
2010: GPCH, LLC 401 RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	121
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	83
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	31
Total of all active and inactive participants	2010-01-01	114
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	114
Number of participants with account balances	2010-01-01	105
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	8
2009: GPCH, LLC 401 RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	116
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	83
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	35
Total of all active and inactive participants	2009-01-01	118
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	118
Number of participants with account balances	2009-01-01	117
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	7

Financial Data on GPCH, LLC 401 RETIREMENT PLAN

Measure	Date	Value
2014 : GPCH, LLC 401 RETIREMENT PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-06-30	$0
Total transfer of assets from this plan	2014-06-30	$2,522,626
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-06-30	$0
Total income from all sources (including contributions)	2014-06-30	$-65,322
Total loss/gain on sale of assets	2014-06-30	$0
Total of all expenses incurred	2014-06-30	$20,707
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-06-30	$20,707
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-06-30	$0
Value of total assets at end of year	2014-06-30	$0
Value of total assets at beginning of year	2014-06-30	$2,608,655
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-06-30	$0
Total interest from all sources	2014-06-30	$644
Total dividends received (eg from common stock, registered investment company shares)	2014-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-06-30	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2014-06-30	$0
Was this plan covered by a fidelity bond	2014-06-30	Yes
Value of fidelity bond cover	2014-06-30	$500,000
If this is an individual account plan, was there a blackout period	2014-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2014-06-30	No
Contributions received from participants	2014-06-30	$0
Income. Received or receivable in cash from other sources (including rollovers)	2014-06-30	$0
Administrative expenses (other) incurred	2014-06-30	$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	2014-06-30	No
Value of net income/loss	2014-06-30	$-86,029
Value of net assets at end of year (total assets less liabilities)	2014-06-30	$0
Value of net assets at beginning of year (total assets less liabilities)	2014-06-30	$2,608,655
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-06-30	No
Were any leases to which the plan was party in default or uncollectible	2014-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-06-30	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-06-30	$2,315,676
Interest on participant loans	2014-06-30	$0
Interest earned on other investments	2014-06-30	$644
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-06-30	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-06-30	$292,979
Net investment gain/loss from pooled separate accounts	2014-06-30	$-65,966
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-06-30	No
Was there a failure to transmit to the plan any participant contributions	2014-06-30	No
Has the plan failed to provide any benefit when due under the plan	2014-06-30	No
Contributions received in cash from employer	2014-06-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-06-30	$20,707
Did the plan have assets held for investment	2014-06-30	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-06-30	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2014-06-30	Disclaimer
Accountancy firm name	2014-06-30	DURBIN AND COMPANY, LLP
Accountancy firm EIN	2014-06-30	752570395
2013 : GPCH, LLC 401 RETIREMENT 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	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$1,031,223
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$410,094
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$409,944
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$557,775
Value of total assets at end of year	2013-12-31	$2,608,655
Value of total assets at beginning of year	2013-12-31	$1,987,526
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$150
Total interest from all sources	2013-12-31	$9,497
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$500,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Funding deficiency by the employer to the plan for this plan year	2013-12-31	$0
Minimum employer required contribution for this plan year	2013-12-31	$0
Amount contributed by the employer to the plan for this plan year	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	$204,992
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$252,698
Administrative expenses (other) incurred	2013-12-31	$150
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$621,129
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$2,608,655
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$1,987,526
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$2,315,676
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$1,675,535
Interest on participant loans	2013-12-31	$0
Interest earned on other investments	2013-12-31	$9,497
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$292,979
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$311,991
Net investment gain/loss from pooled separate accounts	2013-12-31	$463,951
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	$100,085
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$409,944
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	DURBIN AND COMPANY, LLP
Accountancy firm EIN	2013-12-31	752570395
2012 : GPCH, LLC 401 RETIREMENT PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$492,145
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$112,376
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$112,376
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$282,731
Value of total assets at end of year	2012-12-31	$1,987,526
Value of total assets at beginning of year	2012-12-31	$1,607,757
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$0
Total interest from all sources	2012-12-31	$8,803
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$500,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Funding deficiency by the employer to the plan for this plan year	2012-12-31	$0
Minimum employer required contribution for this plan year	2012-12-31	$0
Amount contributed by the employer to the plan for this plan year	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	$191,709
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$0
Administrative expenses (other) incurred	2012-12-31	$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	2012-12-31	No
Value of net income/loss	2012-12-31	$379,769
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$1,987,526
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$1,607,757
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	$1,675,535
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$1,278,413
Interest earned on other investments	2012-12-31	$8,803
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$311,991
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$329,344
Net investment gain/loss from pooled separate accounts	2012-12-31	$200,611
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	$91,022
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$112,376
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	BKD, LLP
Accountancy firm EIN	2012-12-31	440160260
2011 : GPCH, LLC 401 RETIREMENT PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$281,638
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$66,875
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$66,875
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$343,475
Value of total assets at end of year	2011-12-31	$1,607,757
Value of total assets at beginning of year	2011-12-31	$1,392,994
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$0
Total interest from all sources	2011-12-31	$7,887
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	$500,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Funding deficiency by the employer to the plan for this plan year	2011-12-31	$0
Minimum employer required contribution for this plan year	2011-12-31	$0
Amount contributed by the employer to the plan for this plan year	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	$233,666
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$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	2011-12-31	No
Value of net income/loss	2011-12-31	$214,763
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$1,607,757
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$1,392,994
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	$1,278,413
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$1,165,654
Interest earned on other investments	2011-12-31	$7,887
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$329,344
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$227,340
Net investment gain/loss from pooled separate accounts	2011-12-31	$-69,724
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	$109,809
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$66,875
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	BKD, LLP
Accountancy firm EIN	2011-12-31	440160260
2010 : GPCH, LLC 401 RETIREMENT PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total income from all sources (including contributions)	2010-12-31	$431,010
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$179,252
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$179,252
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$279,200
Value of total assets at end of year	2010-12-31	$1,392,994
Value of total assets at beginning of year	2010-12-31	$1,141,236
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$0
Total interest from all sources	2010-12-31	$5,768
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Was this plan covered by a fidelity bond	2010-12-31	No
If this is an individual account plan, was there a blackout period	2010-12-31	No
Funding deficiency by the employer to the plan for this plan year	2010-12-31	$0
Minimum employer required contribution for this plan year	2010-12-31	$0
Amount contributed by the employer to the plan for this plan year	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	$189,335
Administrative expenses (other) incurred	2010-12-31	$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	2010-12-31	No
Value of net income/loss	2010-12-31	$251,758
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$1,392,994
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$1,141,236
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	$1,165,654
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$956,001
Interest earned on other investments	2010-12-31	$5,768
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$227,340
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$185,235
Net investment gain/loss from pooled separate accounts	2010-12-31	$146,042
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	$89,865
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$179,252
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	BKD, LLP
Accountancy firm EIN	2010-12-31	440160260
2009 : GPCH, LLC 401 RETIREMENT PLAN 2009 401k financial data
Funding deficiency by the employer to the plan for this plan year	2009-12-31	$0
Minimum employer required contribution for this plan year	2009-12-31	$0
Amount contributed by the employer to the plan for this plan year	2009-12-31	$0

Form 5500 Responses for GPCH, LLC 401 RETIREMENT PLAN

2014: GPCH, LLC 401 RETIREMENT 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	Yes
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
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
2013: GPCH, LLC 401 RETIREMENT 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
2012: GPCH, LLC 401 RETIREMENT 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
2011: GPCH, LLC 401 RETIREMENT PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	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
2010: GPCH, LLC 401 RETIREMENT PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2009: GPCH, LLC 401 RETIREMENT PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

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Company Name:	GPCH,LLC DBA GOLDEN PLAINS COMMUNITY HOSPITAL
Employer identification number (EIN):	260328929
NAIC Classification:	622000
NAIC Description:	Hospitals

Jurisdiction of Incorporation:	Texas Secretary of State
Incorporation Date:	2007-06-05
Company Identification Number:	0800825212
Legal Registered Office Address:	100 HOSPITAL DR BORGER United States of America (USA) 79007