401k Plan data: STEWARD GOOD SAMARITAN MEDICAL CENTER EMPLOYEE RETIREMENT PARTNERSHIP PLAN (DEFINED BENEFIT COMPONENT) plan

STEWARD GOOD SAMARITAN MEDICAL CENTER EMPLOYEE RETIREMENT PARTNERSHIP PLAN (DEFINED BENEFIT COMPONENT) 401k Plan overview

Plan Name	STEWARD GOOD SAMARITAN MEDICAL CENTER EMPLOYEE RETIREMENT PARTNERSHIP PLAN (DEFINED BENEFIT COMPONENT)
Plan identification number	001

STEWARD GOOD SAMARITAN MEDICAL CENTER EMPLOYEE RETIREMENT PARTNERSHIP PLAN (DEFINED BENEFIT COMPONENT) Benefits

401k Plan Type

Defined Benefit Pension

Plan Features/Benefits

Benefits are primarily pay related
Covered by PBGC - Plan is covered under the PBGC insurance program (see ERISA section 4021).
Frozen Plan - As of the last day of the plan year, the plan provides that no participant will get any new benefit accrual (whether because of service or compensation).
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

STEWARD GOOD SAMARITAN MEDICAL CENTER, INC. has sponsored the creation of one or more 401k plans.

Company Name: STEWARD GOOD SAMARITAN MEDICAL CENTER, INC.

Employer identification number (EIN): 272473728

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan STEWARD GOOD SAMARITAN MEDICAL CENTER EMPLOYEE RETIREMENT PARTNERSHIP PLAN (DEFINED BENEFIT COMPONENT)

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2015-01-01
001 2014-01-01 DEBORAH BRADSHAW
001 2013-01-01 DEBORAH BRADSHAW
001 2012-01-01 MELINDA BRAITHWAITE
001 2011-01-01 STUART GRIEF

Plan Statistics for STEWARD GOOD SAMARITAN MEDICAL CENTER EMPLOYEE RETIREMENT PARTNERSHIP PLAN (DEFINED BENEFIT COMPONENT)

401k plan membership statisitcs for STEWARD GOOD SAMARITAN MEDICAL CENTER EMPLOYEE RETIREMENT PARTNERSHIP PLAN (DEFINED BENEFIT COMPONENT)

Measure Date Value
2015: STEWARD GOOD SAMARITAN MEDICAL CENTER EMPLOYEE RETIREMENT PARTNERSHIP PLAN (DEFINED BENEFIT COMPONENT) 2015 401k membership
Total participants, beginning-of-year 2015-01-01 937
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 0
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: STEWARD GOOD SAMARITAN MEDICAL CENTER EMPLOYEE RETIREMENT PARTNERSHIP PLAN (DEFINED BENEFIT COMPONENT) 2014 401k membership
Total participants, beginning-of-year 2014-01-01 958
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 335
Number of retired or separated participants receiving benefits 2014-01-01 240
Number of other retired or separated participants entitled to future benefits 2014-01-01 340
Total of all active and inactive participants 2014-01-01 915
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 22
Total participants 2014-01-01 937
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: STEWARD GOOD SAMARITAN MEDICAL CENTER EMPLOYEE RETIREMENT PARTNERSHIP PLAN (DEFINED BENEFIT COMPONENT) 2013 401k membership
Total participants, beginning-of-year 2013-01-01 993
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 349
Number of retired or separated participants receiving benefits 2013-01-01 226
Number of other retired or separated participants entitled to future benefits 2013-01-01 364
Total of all active and inactive participants 2013-01-01 939
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 19
Total participants 2013-01-01 958
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: STEWARD GOOD SAMARITAN MEDICAL CENTER EMPLOYEE RETIREMENT PARTNERSHIP PLAN (DEFINED BENEFIT COMPONENT) 2012 401k membership
Total participants, beginning-of-year 2012-01-01 1,027
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 407
Number of retired or separated participants receiving benefits 2012-01-01 223
Number of other retired or separated participants entitled to future benefits 2012-01-01 340
Total of all active and inactive participants 2012-01-01 970
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 23
Total participants 2012-01-01 993
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: STEWARD GOOD SAMARITAN MEDICAL CENTER EMPLOYEE RETIREMENT PARTNERSHIP PLAN (DEFINED BENEFIT COMPONENT) 2011 401k membership
Total participants, beginning-of-year 2011-01-01 1,056
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 424
Number of retired or separated participants receiving benefits 2011-01-01 225
Number of other retired or separated participants entitled to future benefits 2011-01-01 358
Total of all active and inactive participants 2011-01-01 1,007
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 20
Total participants 2011-01-01 1,027
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0

Measure	Date	Value
2015: STEWARD GOOD SAMARITAN MEDICAL CENTER EMPLOYEE RETIREMENT PARTNERSHIP PLAN (DEFINED BENEFIT COMPONENT) 2015 401k membership
Total participants, beginning-of-year	2015-01-01	937
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	0
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: STEWARD GOOD SAMARITAN MEDICAL CENTER EMPLOYEE RETIREMENT PARTNERSHIP PLAN (DEFINED BENEFIT COMPONENT) 2014 401k membership
Total participants, beginning-of-year	2014-01-01	958
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	335
Number of retired or separated participants receiving benefits	2014-01-01	240
Number of other retired or separated participants entitled to future benefits	2014-01-01	340
Total of all active and inactive participants	2014-01-01	915
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	22
Total participants	2014-01-01	937
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: STEWARD GOOD SAMARITAN MEDICAL CENTER EMPLOYEE RETIREMENT PARTNERSHIP PLAN (DEFINED BENEFIT COMPONENT) 2013 401k membership
Total participants, beginning-of-year	2013-01-01	993
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	349
Number of retired or separated participants receiving benefits	2013-01-01	226
Number of other retired or separated participants entitled to future benefits	2013-01-01	364
Total of all active and inactive participants	2013-01-01	939
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	19
Total participants	2013-01-01	958
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: STEWARD GOOD SAMARITAN MEDICAL CENTER EMPLOYEE RETIREMENT PARTNERSHIP PLAN (DEFINED BENEFIT COMPONENT) 2012 401k membership
Total participants, beginning-of-year	2012-01-01	1,027
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	407
Number of retired or separated participants receiving benefits	2012-01-01	223
Number of other retired or separated participants entitled to future benefits	2012-01-01	340
Total of all active and inactive participants	2012-01-01	970
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	23
Total participants	2012-01-01	993
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: STEWARD GOOD SAMARITAN MEDICAL CENTER EMPLOYEE RETIREMENT PARTNERSHIP PLAN (DEFINED BENEFIT COMPONENT) 2011 401k membership
Total participants, beginning-of-year	2011-01-01	1,056
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	424
Number of retired or separated participants receiving benefits	2011-01-01	225
Number of other retired or separated participants entitled to future benefits	2011-01-01	358
Total of all active and inactive participants	2011-01-01	1,007
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	20
Total participants	2011-01-01	1,027
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0

Financial Data on STEWARD GOOD SAMARITAN MEDICAL CENTER EMPLOYEE RETIREMENT PARTNERSHIP PLAN (DEFINED BENEFIT COMPONENT)

Measure	Date	Value
2015 : STEWARD GOOD SAMARITAN MEDICAL CENTER EMPLOYEE RETIREMENT PARTNERSHIP PLAN (DEFINED BENEFIT COMPONENT) 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-15	$0
Total transfer of assets from this plan	2015-12-15	$21,583,430
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-15	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-15	$0
Total income from all sources (including contributions)	2015-12-15	$939,271
Total loss/gain on sale of assets	2015-12-15	$0
Total of all expenses incurred	2015-12-15	$1,868,638
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-15	$1,645,818
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-15	$1,107,505
Value of total assets at end of year	2015-12-15	$0
Value of total assets at beginning of year	2015-12-15	$22,512,797
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-15	$222,820
Total interest from all sources	2015-12-15	$0
Total dividends received (eg from common stock, registered investment company shares)	2015-12-15	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-15	No
Administrative expenses professional fees incurred	2015-12-15	$18,192
Was this plan covered by a fidelity bond	2015-12-15	Yes
Value of fidelity bond cover	2015-12-15	$500,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-15	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-15	No
Administrative expenses (other) incurred	2015-12-15	$187,362
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-15	No
Value of net income/loss	2015-12-15	$-929,367
Value of net assets at end of year (total assets less liabilities)	2015-12-15	$0
Value of net assets at beginning of year (total assets less liabilities)	2015-12-15	$22,512,797
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-15	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-15	No
Were any leases to which the plan was party in default or uncollectible	2015-12-15	No
Investment advisory and management fees	2015-12-15	$17,266
Value of interest in pooled separate accounts at end of year	2015-12-15	$0
Value of interest in pooled separate accounts at beginning of year	2015-12-15	$22,258,874
Net investment gain/loss from pooled separate accounts	2015-12-15	$-168,234
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-15	Yes
Was there a failure to transmit to the plan any participant contributions	2015-12-15	No
Has the plan failed to provide any benefit when due under the plan	2015-12-15	No
Contributions received in cash from employer	2015-12-15	$1,107,505
Employer contributions (assets) at end of year	2015-12-15	$0
Employer contributions (assets) at beginning of year	2015-12-15	$253,923
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-15	$1,645,818
Did the plan have assets held for investment	2015-12-15	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	2015-12-15	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-15	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-15	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-15	Disclaimer
Accountancy firm name	2015-12-15	BDO USA, LLP
Accountancy firm EIN	2015-12-15	135381590
2014 : STEWARD GOOD SAMARITAN MEDICAL CENTER EMPLOYEE RETIREMENT PARTNERSHIP PLAN (DEFINED BENEFIT COMPONENT) 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	$0
Total income from all sources (including contributions)	2014-12-31	$2,807,880
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$2,682,726
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$2,415,923
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$1,016,293
Value of total assets at end of year	2014-12-31	$22,512,797
Value of total assets at beginning of year	2014-12-31	$22,387,643
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$266,803
Total interest from all sources	2014-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Administrative expenses professional fees incurred	2014-12-31	$96,946
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$500,000
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
Administrative expenses (other) incurred	2014-12-31	$152,334
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	$125,154
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$22,512,797
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$22,387,643
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 pooled separate accounts at end of year	2014-12-31	$22,258,874
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$22,214,013
Net investment gain/loss from pooled separate accounts	2014-12-31	$1,791,587
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	Yes
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	$1,016,293
Employer contributions (assets) at end of year	2014-12-31	$253,923
Employer contributions (assets) at beginning of year	2014-12-31	$173,630
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$2,415,923
Contract administrator fees	2014-12-31	$17,523
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	FEELEY & DRISCOLL, P.C.
Accountancy firm EIN	2014-12-31	042684828
2013 : STEWARD GOOD SAMARITAN MEDICAL CENTER EMPLOYEE RETIREMENT PARTNERSHIP PLAN (DEFINED BENEFIT COMPONENT) 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	$3,807,349
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$2,798,249
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$2,658,280
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$1,083,630
Value of total assets at end of year	2013-12-31	$22,387,643
Value of total assets at beginning of year	2013-12-31	$21,378,543
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$139,969
Total interest from all sources	2013-12-31	$0
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
Administrative expenses professional fees incurred	2013-12-31	$11,898
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$500,000
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
Administrative expenses (other) incurred	2013-12-31	$118,173
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	$1,009,100
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$22,387,643
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$21,378,543
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 pooled separate accounts at end of year	2013-12-31	$22,214,013
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$20,257,457
Net investment gain/loss from pooled separate accounts	2013-12-31	$2,723,719
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$1,083,630
Employer contributions (assets) at end of year	2013-12-31	$173,630
Employer contributions (assets) at beginning of year	2013-12-31	$1,121,086
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$2,658,280
Contract administrator fees	2013-12-31	$9,898
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	FEELEY & DRISCOLL, P.C.
Accountancy firm EIN	2013-12-31	042684828
2012 : STEWARD GOOD SAMARITAN MEDICAL CENTER EMPLOYEE RETIREMENT PARTNERSHIP PLAN (DEFINED BENEFIT COMPONENT) 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	$4,000,460
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$2,260,068
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$2,123,476
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$1,916,086
Value of total assets at end of year	2012-12-31	$21,378,543
Value of total assets at beginning of year	2012-12-31	$19,638,151
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$136,592
Total interest from all sources	2012-12-31	$0
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
Administrative expenses professional fees incurred	2012-12-31	$18,000
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$500,000
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
Other income not declared elsewhere	2012-12-31	$2,244
Administrative expenses (other) incurred	2012-12-31	$118,592
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	$1,740,392
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$21,378,543
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$19,638,151
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 pooled separate accounts at end of year	2012-12-31	$20,257,457
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$19,298,261
Net investment gain/loss from pooled separate accounts	2012-12-31	$2,082,130
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	Yes
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	$1,916,086
Employer contributions (assets) at end of year	2012-12-31	$1,121,086
Employer contributions (assets) at beginning of year	2012-12-31	$339,890
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$2,123,476
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	FEELEY & DRISCOLL, P.C.
Accountancy firm EIN	2012-12-31	042684828
2011 : STEWARD GOOD SAMARITAN MEDICAL CENTER EMPLOYEE RETIREMENT PARTNERSHIP PLAN (DEFINED BENEFIT COMPONENT) 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	$2,035,914
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$1,872,972
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$1,747,688
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$1,089,890
Value of total assets at end of year	2011-12-31	$19,638,151
Value of total assets at beginning of year	2011-12-31	$19,475,209
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$125,284
Total interest from all sources	2011-12-31	$0
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
Administrative expenses professional fees incurred	2011-12-31	$31,676
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$500,000
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
Administrative expenses (other) incurred	2011-12-31	$93,608
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	$162,942
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$19,638,151
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$19,475,209
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 pooled separate accounts at end of year	2011-12-31	$19,298,261
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$18,918,604
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$0
Net investment gain/loss from pooled separate accounts	2011-12-31	$946,024
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$1,089,890
Employer contributions (assets) at end of year	2011-12-31	$339,890
Employer contributions (assets) at beginning of year	2011-12-31	$556,605
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$1,747,688
Liabilities. Value of benefit claims payable at end of year	2011-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2011-12-31	$0
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	FEELEY & DRISCOLL, P.C.
Accountancy firm EIN	2011-12-31	042684828
2010 : STEWARD GOOD SAMARITAN MEDICAL CENTER EMPLOYEE RETIREMENT PARTNERSHIP PLAN (DEFINED BENEFIT COMPONENT) 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	$750,199
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$374,711
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$342,768
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$556,605
Value of total assets at end of year	2010-12-31	$19,475,209
Value of total assets at beginning of year	2010-12-31	$19,099,721
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$31,943
Total interest from all sources	2010-12-31	$0
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
Administrative expenses professional fees incurred	2010-12-31	$31,943
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$500,000
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
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	$375,488
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$19,475,209
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$19,099,721
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 pooled separate accounts at end of year	2010-12-31	$18,918,604
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$19,099,721
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$0
Net investment gain/loss from pooled separate accounts	2010-12-31	$193,594
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	$556,605
Employer contributions (assets) at end of year	2010-12-31	$556,605
Employer contributions (assets) at beginning of year	2010-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$342,768
Liabilities. Value of benefit claims payable at end of year	2010-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2010-12-31	$0
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	FEELEY & DRISCOLL, P.C.
Accountancy firm EIN	2010-12-31	042684828

Form 5500 Responses for STEWARD GOOD SAMARITAN MEDICAL CENTER EMPLOYEE RETIREMENT PARTNERSHIP PLAN (DEFINED BENEFIT COMPONENT)

2015: STEWARD GOOD SAMARITAN MEDICAL CENTER EMPLOYEE RETIREMENT PARTNERSHIP PLAN (DEFINED BENEFIT COMPONENT) 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	Yes
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2015-01-01	Plan is a collectively bargained plan	Yes
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: STEWARD GOOD SAMARITAN MEDICAL CENTER EMPLOYEE RETIREMENT PARTNERSHIP PLAN (DEFINED BENEFIT COMPONENT) 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	Yes
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: STEWARD GOOD SAMARITAN MEDICAL CENTER EMPLOYEE RETIREMENT PARTNERSHIP PLAN (DEFINED BENEFIT COMPONENT) 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	Yes
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: STEWARD GOOD SAMARITAN MEDICAL CENTER EMPLOYEE RETIREMENT PARTNERSHIP PLAN (DEFINED BENEFIT COMPONENT) 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	Yes
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: STEWARD GOOD SAMARITAN MEDICAL CENTER EMPLOYEE RETIREMENT PARTNERSHIP PLAN (DEFINED BENEFIT COMPONENT) 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	Yes
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

Insurance Providers Used on plan

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

Policy contract number

SA 13028

Policy instance

Insurance contract or identification number	SA 13028
Number of Individuals Covered	0
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-15
Total amount of commissions paid to insurance broker	USD $32,969
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $32,969
Insurance broker organization code?	3
Insurance broker name	FIRST REPUBLIC SECURITIES CO.

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

Policy contract number

SA 13028

Policy instance

Insurance contract or identification number	SA 13028
Number of Individuals Covered	937
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $32,762
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $26,268
Insurance broker organization code?	3
Insurance broker name	MORGAN STANLEY INS SERV INC

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

Policy contract number

SA 13028

Policy instance

Insurance contract or identification number	SA 13028
Number of Individuals Covered	958
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $260,208
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 $260,208
Insurance broker organization code?	3
Insurance broker name	MORGAN STANLEY INS SERV INC

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

Policy contract number

SA 13028

Policy instance

Insurance contract or identification number	SA 13028
Number of Individuals Covered	993
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $38,901
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 $38,901
Insurance broker organization code?	3
Insurance broker name	MORGAN STANLEY INS SERV INC

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

Policy contract number

SA 13028

Policy instance

Insurance contract or identification number	SA 13028
Number of Individuals Covered	1027
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $27,902
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

SA 13028

Policy instance

Insurance contract or identification number	SA 13028
Number of Individuals Covered	1056
Insurance policy start date	2010-11-06
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $2,296
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No

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Company Name:	STEWARD GOOD SAMARITAN MEDICAL CENTER, INC.
Employer identification number (EIN):	272473728
NAIC Classification:	622000
NAIC Description:	Hospitals

Plan id#	Filing Submission Date	Name of Administrator
001	2015-01-01
001	2014-01-01	DEBORAH BRADSHAW
001	2013-01-01	DEBORAH BRADSHAW
001	2012-01-01	MELINDA BRAITHWAITE
001	2011-01-01	STUART GRIEF