401k Plan data: BELL MEMORIAL HOSPITAL NON-UNION PENSION PLAN plan

BELL MEMORIAL HOSPITAL NON-UNION PENSION PLAN 401k Plan overview

Plan Name	BELL MEMORIAL HOSPITAL NON-UNION PENSION PLAN
Plan identification number	001

BELL MEMORIAL HOSPITAL NON-UNION PENSION PLAN 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).

401k Sponsoring company profile

BELL MEMORIAL HOSPITAL has sponsored the creation of one or more 401k plans.

Company Name: BELL MEMORIAL HOSPITAL

Employer identification number (EIN): 381394903

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BELL MEMORIAL HOSPITAL NON-UNION PENSION PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2011-11-01 KAREN LASSILA
001 2010-11-01 KAREN LASSILA
001 2009-11-01 RUTH SOLINSKI
001 2009-11-01 RUTH A SOLINSKI
001 2008-11-01

Plan Statistics for BELL MEMORIAL HOSPITAL NON-UNION PENSION PLAN

401k plan membership statisitcs for BELL MEMORIAL HOSPITAL NON-UNION PENSION PLAN

Measure Date Value
2011: BELL MEMORIAL HOSPITAL NON-UNION PENSION PLAN 2011 401k membership
Total participants, beginning-of-year 2011-11-01 238
Total number of active participants reported on line 7a of the Form 5500 2011-11-01 65
Number of retired or separated participants receiving benefits 2011-11-01 63
Number of other retired or separated participants entitled to future benefits 2011-11-01 105
Total of all active and inactive participants 2011-11-01 233
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-11-01 4
Total participants 2011-11-01 237
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-11-01 0
2010: BELL MEMORIAL HOSPITAL NON-UNION PENSION PLAN 2010 401k membership
Total participants, beginning-of-year 2010-11-01 246
Total number of active participants reported on line 7a of the Form 5500 2010-11-01 69
Number of retired or separated participants receiving benefits 2010-11-01 61
Number of other retired or separated participants entitled to future benefits 2010-11-01 105
Total of all active and inactive participants 2010-11-01 235
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-11-01 3
Total participants 2010-11-01 238
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-11-01 0
2009: BELL MEMORIAL HOSPITAL NON-UNION PENSION PLAN 2009 401k membership
Total participants, beginning-of-year 2009-11-01 249
Total number of active participants reported on line 7a of the Form 5500 2009-11-01 75
Number of retired or separated participants receiving benefits 2009-11-01 64
Number of other retired or separated participants entitled to future benefits 2009-11-01 104
Total of all active and inactive participants 2009-11-01 243
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-11-01 3
Total participants 2009-11-01 246
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-11-01 0

Measure	Date	Value
2011: BELL MEMORIAL HOSPITAL NON-UNION PENSION PLAN 2011 401k membership
Total participants, beginning-of-year	2011-11-01	238
Total number of active participants reported on line 7a of the Form 5500	2011-11-01	65
Number of retired or separated participants receiving benefits	2011-11-01	63
Number of other retired or separated participants entitled to future benefits	2011-11-01	105
Total of all active and inactive participants	2011-11-01	233
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-11-01	4
Total participants	2011-11-01	237
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-11-01	0
2010: BELL MEMORIAL HOSPITAL NON-UNION PENSION PLAN 2010 401k membership
Total participants, beginning-of-year	2010-11-01	246
Total number of active participants reported on line 7a of the Form 5500	2010-11-01	69
Number of retired or separated participants receiving benefits	2010-11-01	61
Number of other retired or separated participants entitled to future benefits	2010-11-01	105
Total of all active and inactive participants	2010-11-01	235
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-11-01	3
Total participants	2010-11-01	238
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-11-01	0
2009: BELL MEMORIAL HOSPITAL NON-UNION PENSION PLAN 2009 401k membership
Total participants, beginning-of-year	2009-11-01	249
Total number of active participants reported on line 7a of the Form 5500	2009-11-01	75
Number of retired or separated participants receiving benefits	2009-11-01	64
Number of other retired or separated participants entitled to future benefits	2009-11-01	104
Total of all active and inactive participants	2009-11-01	243
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-11-01	3
Total participants	2009-11-01	246
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-11-01	0

Financial Data on BELL MEMORIAL HOSPITAL NON-UNION PENSION PLAN

Measure	Date	Value
2012 : BELL MEMORIAL HOSPITAL NON-UNION PENSION PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-10-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-10-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-10-31	$0
Total income from all sources (including contributions)	2012-10-31	$1,125,962
Total loss/gain on sale of assets	2012-10-31	$0
Total of all expenses incurred	2012-10-31	$339,649
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-10-31	$321,651
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-10-31	$408,437
Value of total assets at end of year	2012-10-31	$8,242,040
Value of total assets at beginning of year	2012-10-31	$7,455,727
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-10-31	$17,998
Total interest from all sources	2012-10-31	$163
Total dividends received (eg from common stock, registered investment company shares)	2012-10-31	$88,542
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-10-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-10-31	$88,542
Was this plan covered by a fidelity bond	2012-10-31	Yes
Value of fidelity bond cover	2012-10-31	$1,000,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-10-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-10-31	No
Value of other receiveables (less allowance for doubtful accounts) at end of year	2012-10-31	$48
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2012-10-31	$1,541
Other income not declared elsewhere	2012-10-31	$17,998
Administrative expenses (other) incurred	2012-10-31	$17,998
Total non interest bearing cash at end of year	2012-10-31	$0
Total non interest bearing cash at beginning of year	2012-10-31	$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	2012-10-31	No
Value of net income/loss	2012-10-31	$786,313
Value of net assets at end of year (total assets less liabilities)	2012-10-31	$8,242,040
Value of net assets at beginning of year (total assets less liabilities)	2012-10-31	$7,455,727
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-10-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-10-31	No
Were any leases to which the plan was party in default or uncollectible	2012-10-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-10-31	$1,842,021
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-10-31	$7,011,643
Value of interest in common/collective trusts at end of year	2012-10-31	$6,056,833
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-10-31	$198,788
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-10-31	$197,813
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-10-31	$197,813
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-10-31	$163
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-10-31	$710,369
Net investment gain or loss from common/collective trusts	2012-10-31	$-99,547
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-10-31	Yes
Was there a failure to transmit to the plan any participant contributions	2012-10-31	No
Has the plan failed to provide any benefit when due under the plan	2012-10-31	No
Contributions received in cash from employer	2012-10-31	$408,437
Employer contributions (assets) at end of year	2012-10-31	$144,350
Employer contributions (assets) at beginning of year	2012-10-31	$244,730
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-10-31	$321,651
Did the plan have assets held for investment	2012-10-31	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	2012-10-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-10-31	No
Aggregate proceeds on sale of assets	2012-10-31	$788,235
Aggregate carrying amount (costs) on sale of assets	2012-10-31	$788,235
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-10-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-10-31	Disclaimer
Accountancy firm name	2012-10-31	WIPFLI LLP
Accountancy firm EIN	2012-10-31	390758449
2011 : BELL MEMORIAL HOSPITAL NON-UNION PENSION PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-10-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-10-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-10-31	$0
Total income from all sources (including contributions)	2011-10-31	$712,080
Total loss/gain on sale of assets	2011-10-31	$0
Total of all expenses incurred	2011-10-31	$330,784
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-10-31	$315,639
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-10-31	$299,904
Value of total assets at end of year	2011-10-31	$7,455,727
Value of total assets at beginning of year	2011-10-31	$7,074,431
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-10-31	$15,145
Total interest from all sources	2011-10-31	$101
Total dividends received (eg from common stock, registered investment company shares)	2011-10-31	$96,826
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-10-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2011-10-31	$96,826
Was this plan covered by a fidelity bond	2011-10-31	Yes
Value of fidelity bond cover	2011-10-31	$500,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-10-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-10-31	No
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-10-31	$1,541
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-10-31	$2,114
Other income not declared elsewhere	2011-10-31	$15,267
Administrative expenses (other) incurred	2011-10-31	$15,145
Total non interest bearing cash at end of year	2011-10-31	$0
Total non interest bearing cash at beginning of year	2011-10-31	$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	2011-10-31	No
Value of net income/loss	2011-10-31	$381,296
Value of net assets at end of year (total assets less liabilities)	2011-10-31	$7,455,727
Value of net assets at beginning of year (total assets less liabilities)	2011-10-31	$7,074,431
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-10-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-10-31	No
Were any leases to which the plan was party in default or uncollectible	2011-10-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-10-31	$7,011,643
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-10-31	$6,991,637
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-10-31	$197,813
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-10-31	$80,680
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-10-31	$80,680
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-10-31	$101
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-10-31	$299,982
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-10-31	Yes
Was there a failure to transmit to the plan any participant contributions	2011-10-31	No
Has the plan failed to provide any benefit when due under the plan	2011-10-31	No
Contributions received in cash from employer	2011-10-31	$299,904
Employer contributions (assets) at end of year	2011-10-31	$244,730
Employer contributions (assets) at beginning of year	2011-10-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-10-31	$315,639
Did the plan have assets held for investment	2011-10-31	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	2011-10-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-10-31	No
Aggregate proceeds on sale of assets	2011-10-31	$319,674
Aggregate carrying amount (costs) on sale of assets	2011-10-31	$319,674
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-10-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-10-31	Disclaimer
Accountancy firm name	2011-10-31	WIPFLI LLP
Accountancy firm EIN	2011-10-31	390758449
2010 : BELL MEMORIAL HOSPITAL NON-UNION PENSION PLAN 2010 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-10-31	$0

Form 5500 Responses for BELL MEMORIAL HOSPITAL NON-UNION PENSION PLAN

2011: BELL MEMORIAL HOSPITAL NON-UNION PENSION PLAN 2011 form 5500 responses
2011-11-01	Type of plan entity	Single employer plan
2011-11-01	Submission has been amended	No
2011-11-01	This submission is the final filing	No
2011-11-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-11-01	Plan is a collectively bargained plan	No
2011-11-01	Plan funding arrangement – Trust	Yes
2011-11-01	Plan benefit arrangement - Trust	Yes
2010: BELL MEMORIAL HOSPITAL NON-UNION PENSION PLAN 2010 form 5500 responses
2010-11-01	Type of plan entity	Single employer plan
2010-11-01	Submission has been amended	No
2010-11-01	This submission is the final filing	No
2010-11-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-11-01	Plan is a collectively bargained plan	No
2010-11-01	Plan funding arrangement – Trust	Yes
2010-11-01	Plan benefit arrangement - Trust	Yes
2009: BELL MEMORIAL HOSPITAL NON-UNION PENSION PLAN 2009 form 5500 responses
2009-11-01	Type of plan entity	Single employer plan
2009-11-01	Submission has been amended	No
2009-11-01	This submission is the final filing	No
2009-11-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-11-01	Plan is a collectively bargained plan	No
2009-11-01	Plan funding arrangement – Trust	Yes
2009-11-01	Plan benefit arrangement - Trust	Yes
2008: BELL MEMORIAL HOSPITAL NON-UNION PENSION PLAN 2008 form 5500 responses
2008-11-01	Type of plan entity	Single employer plan
2008-11-01	Submission has been amended	No
2008-11-01	This submission is the final filing	No
2008-11-01	This return/report is a short plan year return/report (less than 12 months)	No
2008-11-01	Plan is a collectively bargained plan	No

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Company Name:	BELL MEMORIAL HOSPITAL
Employer identification number (EIN):	381394903
NAIC Classification:	622000
NAIC Description:	Hospitals

Plan id#	Filing Submission Date	Name of Administrator
001	2011-11-01	KAREN LASSILA
001	2010-11-01	KAREN LASSILA
001	2009-11-01	RUTH SOLINSKI
001	2009-11-01	RUTH A SOLINSKI
001	2008-11-01