401k Plan data: EDGERTON HOSPITAL AND HEALTH SERVICES, INC. LIFE INSURANCE plan

EDGERTON HOSPITAL AND HEALTH SERVICES, INC. LIFE INSURANCE 401k Plan overview

Plan Name	EDGERTON HOSPITAL AND HEALTH SERVICES, INC. LIFE INSURANCE
Plan identification number	506

EDGERTON HOSPITAL AND HEALTH SERVICES, INC. LIFE INSURANCE Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance

401k Sponsoring company profile

EDGERTON HOSPITAL AND HEALTH SERVICES, INC. has sponsored the creation of one or more 401k plans.

Company Name: EDGERTON HOSPITAL AND HEALTH SERVICES, INC.

Employer identification number (EIN): 390819992

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EDGERTON HOSPITAL AND HEALTH SERVICES, INC. LIFE INSURANCE

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
506 2012-01-01 MARK KINDSCHI
506 2011-01-01 MARK KINDSCHI
506 2010-01-01 JULIE NORLAND
506 2009-01-01 BARBARA PETERSON

Plan id#	Filing Submission Date	Name of Administrator
506	2012-01-01	MARK KINDSCHI
506	2011-01-01	MARK KINDSCHI
506	2010-01-01	JULIE NORLAND
506	2009-01-01	BARBARA PETERSON

Plan Statistics for EDGERTON HOSPITAL AND HEALTH SERVICES, INC. LIFE INSURANCE

401k plan membership statisitcs for EDGERTON HOSPITAL AND HEALTH SERVICES, INC. LIFE INSURANCE

Measure Date Value
2012: EDGERTON HOSPITAL AND HEALTH SERVICES, INC. LIFE INSURANCE 2012 401k membership
Total participants, beginning-of-year 2012-01-01 126
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 0
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 0
Total of all active and inactive participants 2012-01-01 0
2011: EDGERTON HOSPITAL AND HEALTH SERVICES, INC. LIFE INSURANCE 2011 401k membership
Total participants, beginning-of-year 2011-01-01 120
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 126
Total of all active and inactive participants 2011-01-01 126
Total participants 2011-01-01 126
2010: EDGERTON HOSPITAL AND HEALTH SERVICES, INC. LIFE INSURANCE 2010 401k membership
Total participants, beginning-of-year 2010-01-01 127
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 120
Total of all active and inactive participants 2010-01-01 120
Total participants 2010-01-01 120
2009: EDGERTON HOSPITAL AND HEALTH SERVICES, INC. LIFE INSURANCE 2009 401k membership
Total participants, beginning-of-year 2009-01-01 125
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 126
Number of retired or separated participants receiving benefits 2009-01-01 1
Total of all active and inactive participants 2009-01-01 127
Total participants 2009-01-01 127

Measure	Date	Value
2012: EDGERTON HOSPITAL AND HEALTH SERVICES, INC. LIFE INSURANCE 2012 401k membership
Total participants, beginning-of-year	2012-01-01	126
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	0
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	0
Total of all active and inactive participants	2012-01-01	0
2011: EDGERTON HOSPITAL AND HEALTH SERVICES, INC. LIFE INSURANCE 2011 401k membership
Total participants, beginning-of-year	2011-01-01	120
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	126
Total of all active and inactive participants	2011-01-01	126
Total participants	2011-01-01	126
2010: EDGERTON HOSPITAL AND HEALTH SERVICES, INC. LIFE INSURANCE 2010 401k membership
Total participants, beginning-of-year	2010-01-01	127
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	120
Total of all active and inactive participants	2010-01-01	120
Total participants	2010-01-01	120
2009: EDGERTON HOSPITAL AND HEALTH SERVICES, INC. LIFE INSURANCE 2009 401k membership
Total participants, beginning-of-year	2009-01-01	125
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	126
Number of retired or separated participants receiving benefits	2009-01-01	1
Total of all active and inactive participants	2009-01-01	127
Total participants	2009-01-01	127

Form 5500 Responses for EDGERTON HOSPITAL AND HEALTH SERVICES, INC. LIFE INSURANCE

2012: EDGERTON HOSPITAL AND HEALTH SERVICES, INC. LIFE INSURANCE 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	Yes
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 benefit arrangement – Insurance	Yes
2011: EDGERTON HOSPITAL AND HEALTH SERVICES, INC. LIFE INSURANCE 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 benefit arrangement – Insurance	Yes
2010: EDGERTON HOSPITAL AND HEALTH SERVICES, INC. LIFE INSURANCE 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 benefit arrangement – Insurance	Yes
2009: EDGERTON HOSPITAL AND HEALTH SERVICES, INC. LIFE INSURANCE 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 benefit arrangement – Insurance	Yes

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Company Name:	EDGERTON HOSPITAL AND HEALTH SERVICES, INC.
Employer identification number (EIN):	390819992
NAIC Classification:	622000
NAIC Description:	Hospitals