401k Plan data: NORTHERN MICHIGAN REGIONAL HEALTH SYSTEM TAX DEFERRED ANNUITY SAVINGS PLAN plan

NORTHERN MICHIGAN REGIONAL HEALTH SYSTEM TAX DEFERRED ANNUITY SAVINGS PLAN 401k Plan overview

Plan Name	NORTHERN MICHIGAN REGIONAL HEALTH SYSTEM TAX DEFERRED ANNUITY SAVINGS PLAN
Plan identification number	002

NORTHERN MICHIGAN REGIONAL HEALTH SYSTEM TAX DEFERRED ANNUITY SAVINGS PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

MCLAREN NORTHERN MICHIGAN has sponsored the creation of one or more 401k plans.

Company Name: MCLAREN NORTHERN MICHIGAN

Employer identification number (EIN): 382146751

NAIC Classification: 622000
NAIC Description: Hospitals

Additional information about MCLAREN NORTHERN MICHIGAN

Jurisdiction of Incorporation: Michigan Secretary of State

Incorporation Date: 0000-00-00

Company Identification Number: 828000

Legal Registered Office Address: 416 CONNABLE AVE PETOSKEY

United States of America (USA)
49770

More information about MCLAREN NORTHERN MICHIGAN

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NORTHERN MICHIGAN REGIONAL HEALTH SYSTEM TAX DEFERRED ANNUITY SAVINGS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2013-01-01 DONNA AHO
002 2012-01-01 CHRISTINE VANSLEMBROUCK EUGENE KAMINSKI 2014-07-21

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2013-01-01	DONNA AHO
002	2012-01-01	CHRISTINE VANSLEMBROUCK		EUGENE KAMINSKI	2014-07-21

Plan Statistics for NORTHERN MICHIGAN REGIONAL HEALTH SYSTEM TAX DEFERRED ANNUITY SAVINGS PLAN

401k plan membership statisitcs for NORTHERN MICHIGAN REGIONAL HEALTH SYSTEM TAX DEFERRED ANNUITY SAVINGS PLAN

Measure Date Value
2013: NORTHERN MICHIGAN REGIONAL HEALTH SYSTEM TAX DEFERRED ANNUITY SAVINGS PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 1,830
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 0
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 0
Total of all active and inactive participants 2013-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 0
Number of participants with account balances 2013-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: NORTHERN MICHIGAN REGIONAL HEALTH SYSTEM TAX DEFERRED ANNUITY SAVINGS PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 1,859
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 1,383
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 446
Total of all active and inactive participants 2012-01-01 1,829
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 1
Total participants 2012-01-01 1,830
Number of participants with account balances 2012-01-01 1,770
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0

Measure	Date	Value
2013: NORTHERN MICHIGAN REGIONAL HEALTH SYSTEM TAX DEFERRED ANNUITY SAVINGS PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	1,830
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	0
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	0
Total of all active and inactive participants	2013-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	0
Number of participants with account balances	2013-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: NORTHERN MICHIGAN REGIONAL HEALTH SYSTEM TAX DEFERRED ANNUITY SAVINGS PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	1,859
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	1,383
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	446
Total of all active and inactive participants	2012-01-01	1,829
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	1
Total participants	2012-01-01	1,830
Number of participants with account balances	2012-01-01	1,770
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0

Financial Data on NORTHERN MICHIGAN REGIONAL HEALTH SYSTEM TAX DEFERRED ANNUITY SAVINGS PLAN

Measure	Date	Value
2013 : NORTHERN MICHIGAN REGIONAL HEALTH SYSTEM TAX DEFERRED ANNUITY SAVINGS PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total transfer of assets from this plan	2013-12-31	$40,058,928
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	$15,325,818
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$5,663,666
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$5,600,889
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$9,364,551
Value of total assets at end of year	2013-12-31	$0
Value of total assets at beginning of year	2013-12-31	$30,396,776
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$62,777
Total interest from all sources	2013-12-31	$116,256
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$1,054,857
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-12-31	$1,054,857
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$3,735,425
Participant contributions at end of year	2013-12-31	$0
Participant contributions at beginning of year	2013-12-31	$353,976
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$599,837
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	$9,662,152
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$30,396,776
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	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$26,578,979
Interest on participant loans	2013-12-31	$13,316
Interest earned on other investments	2013-12-31	$102,940
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$3,463,821
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$4,790,154
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	$5,029,289
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$5,600,889
Contract administrator fees	2013-12-31	$62,777
Did the plan have assets held for investment	2013-12-31	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	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	Yes
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	PLANTE & MORAN PLLC
Accountancy firm EIN	2013-12-31	381357951
2012 : NORTHERN MICHIGAN REGIONAL HEALTH SYSTEM TAX DEFERRED ANNUITY SAVINGS PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total transfer of assets to this plan	2012-12-31	$1,164,339
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	$12,120,269
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$1,375,899
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$1,332,978
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$9,217,429
Value of total assets at end of year	2012-12-31	$30,396,776
Value of total assets at beginning of year	2012-12-31	$18,488,067
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$42,921
Total interest from all sources	2012-12-31	$105,397
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$557,292
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-12-31	$557,292
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
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$4,636,035
Participant contributions at end of year	2012-12-31	$353,976
Participant contributions at beginning of year	2012-12-31	$266,478
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$747,893
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	$10,744,370
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$30,396,776
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$18,488,067
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	$26,578,979
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$15,368,580
Interest on participant loans	2012-12-31	$11,904
Interest earned on other investments	2012-12-31	$93,493
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$3,463,821
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$2,853,009
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$2,240,151
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	$3,833,501
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$1,332,978
Contract administrator fees	2012-12-31	$42,921
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	PLANTE & MORAN PLLC
Accountancy firm EIN	2012-12-31	381357951

Form 5500 Responses for NORTHERN MICHIGAN REGIONAL HEALTH SYSTEM TAX DEFERRED ANNUITY SAVINGS PLAN

2013: NORTHERN MICHIGAN REGIONAL HEALTH SYSTEM TAX DEFERRED ANNUITY SAVINGS PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	Yes
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: NORTHERN MICHIGAN REGIONAL HEALTH SYSTEM TAX DEFERRED ANNUITY SAVINGS PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	MCLAREN NORTHERN MICHIGAN
Employer identification number (EIN):	382146751
NAIC Classification:	622000
NAIC Description:	Hospitals

Jurisdiction of Incorporation:	Michigan Secretary of State
Incorporation Date:	0000-00-00
Company Identification Number:	828000
Legal Registered Office Address:	416 CONNABLE AVE PETOSKEY United States of America (USA) 49770