401k Plan data: NORTH HILLS MEDICAL CENTER RETIREMENT PLAN plan

NORTH HILLS MEDICAL CENTER RETIREMENT PLAN 401k Plan overview

Plan Name	NORTH HILLS MEDICAL CENTER RETIREMENT PLAN
Plan identification number	001

NORTH HILLS MEDICAL CENTER RETIREMENT PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Participant-directed brokerage accounts provided as an investment option under the plan.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Plan covering Self-Employed individuals.
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.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

NORTH HILLS MEDICAL CENTER has sponsored the creation of one or more 401k plans.

Company Name: NORTH HILLS MEDICAL CENTER

Employer identification number (EIN): 570902920

NAIC Classification: 621111
NAIC Description: Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NORTH HILLS MEDICAL CENTER RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2017-01-01 RITU CHADHA 2017-10-31
001 2016-01-01 RITU CHADHA
001 2015-01-01 RITU CHADHA
001 2014-01-01 RITU CHADHA
001 2013-01-01 RITU CHADHA
001 2012-01-01 RITU CHADHA
001 2011-01-01 TONY MARABLE
001 2010-01-01 TONY MARABLE

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2017-01-01	RITU CHADHA	2017-10-31
001	2016-01-01	RITU CHADHA
001	2015-01-01	RITU CHADHA
001	2014-01-01	RITU CHADHA
001	2013-01-01	RITU CHADHA
001	2012-01-01	RITU CHADHA
001	2011-01-01	TONY MARABLE
001	2010-01-01	TONY MARABLE

Plan Statistics for NORTH HILLS MEDICAL CENTER RETIREMENT PLAN

401k plan membership statisitcs for NORTH HILLS MEDICAL CENTER RETIREMENT PLAN

Measure Date Value
2016: NORTH HILLS MEDICAL CENTER RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 177
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 0
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 15
Total of all active and inactive participants 2016-01-01 15
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 15
Number of participants with account balances 2016-01-01 15
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: NORTH HILLS MEDICAL CENTER RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 169
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 160
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 16
Total of all active and inactive participants 2015-01-01 176
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 176
Number of participants with account balances 2015-01-01 52
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: NORTH HILLS MEDICAL CENTER RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 173
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 149
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 12
Total of all active and inactive participants 2014-01-01 161
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 161
Number of participants with account balances 2014-01-01 57
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 1
2013: NORTH HILLS MEDICAL CENTER RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 157
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 145
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 14
Total of all active and inactive participants 2013-01-01 159
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 159
Number of participants with account balances 2013-01-01 62
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 3
2012: NORTH HILLS MEDICAL CENTER RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 199
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 139
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 13
Total of all active and inactive participants 2012-01-01 152
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 152
Number of participants with account balances 2012-01-01 71
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: NORTH HILLS MEDICAL CENTER RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 188
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 180
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 12
Total of all active and inactive participants 2011-01-01 192
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 192
Number of participants with account balances 2011-01-01 67
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 1
2010: NORTH HILLS MEDICAL CENTER RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 134
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 169
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 13
Total of all active and inactive participants 2010-01-01 182
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 182
Number of participants with account balances 2010-01-01 61
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0

Measure	Date	Value
2016: NORTH HILLS MEDICAL CENTER RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	177
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	0
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	15
Total of all active and inactive participants	2016-01-01	15
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	15
Number of participants with account balances	2016-01-01	15
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: NORTH HILLS MEDICAL CENTER RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	169
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	160
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	16
Total of all active and inactive participants	2015-01-01	176
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	176
Number of participants with account balances	2015-01-01	52
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: NORTH HILLS MEDICAL CENTER RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	173
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	149
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	12
Total of all active and inactive participants	2014-01-01	161
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	161
Number of participants with account balances	2014-01-01	57
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	1
2013: NORTH HILLS MEDICAL CENTER RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	157
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	145
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	14
Total of all active and inactive participants	2013-01-01	159
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	159
Number of participants with account balances	2013-01-01	62
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	3
2012: NORTH HILLS MEDICAL CENTER RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	199
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	139
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	13
Total of all active and inactive participants	2012-01-01	152
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	152
Number of participants with account balances	2012-01-01	71
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: NORTH HILLS MEDICAL CENTER RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	188
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	180
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	12
Total of all active and inactive participants	2011-01-01	192
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	192
Number of participants with account balances	2011-01-01	67
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	1
2010: NORTH HILLS MEDICAL CENTER RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	134
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	169
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	13
Total of all active and inactive participants	2010-01-01	182
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	182
Number of participants with account balances	2010-01-01	61
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0

Financial Data on NORTH HILLS MEDICAL CENTER RETIREMENT PLAN

Measure	Date	Value
2016 : NORTH HILLS MEDICAL CENTER RETIREMENT PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$11
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$49,682
Total income from all sources (including contributions)	2016-12-31	$251,475
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$2,986,929
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$2,960,379
Value of total corrective distributions	2016-12-31	$1,283
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$85,175
Value of total assets at end of year	2016-12-31	$1,692
Value of total assets at beginning of year	2016-12-31	$2,786,817
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$25,267
Total interest from all sources	2016-12-31	$1,520
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$10,363
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$10,363
Administrative expenses professional fees incurred	2016-12-31	$8,750
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$85,175
Participant contributions at beginning of year	2016-12-31	$67,177
Participant contributions at beginning of year	2016-12-31	$11,349
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2016-12-31	$110
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2016-12-31	$11
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2016-12-31	$49,682
Other income not declared elsewhere	2016-12-31	$221
Administrative expenses (other) incurred	2016-12-31	$16,517
Total non interest bearing cash at end of year	2016-12-31	$11
Total non interest bearing cash at beginning of year	2016-12-31	$43,282
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$-2,735,454
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$1,681
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$2,737,135
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$1,671
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$2,364,460
Interest on participant loans	2016-12-31	$1,520
Value of interest in common/collective trusts at end of year	2016-12-31	$10
Value of interest in common/collective trusts at beginning of year	2016-12-31	$300,439
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$152,099
Net investment gain or loss from common/collective trusts	2016-12-31	$2,097
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$2,960,379
Did the plan have assets held for investment	2016-12-31	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	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	GREENE, FINNEY & HORTON, LLP
Accountancy firm EIN	2016-12-31	522212837
2015 : NORTH HILLS MEDICAL CENTER RETIREMENT PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$49,682
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$43,000
Total income from all sources (including contributions)	2015-12-31	$84,965
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$136,600
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$108,151
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$177,187
Value of total assets at end of year	2015-12-31	$2,786,817
Value of total assets at beginning of year	2015-12-31	$2,831,770
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$28,449
Total interest from all sources	2015-12-31	$3,064
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$80,073
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$80,073
Administrative expenses professional fees incurred	2015-12-31	$8,650
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$177,187
Participant contributions at end of year	2015-12-31	$67,177
Participant contributions at beginning of year	2015-12-31	$23,837
Participant contributions at end of year	2015-12-31	$11,349
Participant contributions at beginning of year	2015-12-31	$8,814
Value of other receiveables (less allowance for doubtful accounts) at end of year	2015-12-31	$110
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2015-12-31	$49,682
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2015-12-31	$0
Other income not declared elsewhere	2015-12-31	$5,966
Administrative expenses (other) incurred	2015-12-31	$19,799
Total non interest bearing cash at end of year	2015-12-31	$43,282
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$-51,635
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$2,737,135
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$2,788,770
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$2,364,460
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$2,418,821
Interest on participant loans	2015-12-31	$3,064
Value of interest in common/collective trusts at end of year	2015-12-31	$300,439
Value of interest in common/collective trusts at beginning of year	2015-12-31	$380,298
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-184,364
Net investment gain or loss from common/collective trusts	2015-12-31	$3,039
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$108,151
Liabilities. Value of benefit claims payable at beginning of year	2015-12-31	$43,000
Did the plan have assets held for investment	2015-12-31	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	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	GREENE, FINNEY & HORTON, LLP
Accountancy firm EIN	2015-12-31	522212837
2014 : NORTH HILLS MEDICAL CENTER RETIREMENT PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total transfer of assets to this plan	2014-12-31	$0
Total transfer of assets from this plan	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$43,000
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$9,809
Total income from all sources (including contributions)	2014-12-31	$-2,867
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$332,038
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$307,462
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$172,134
Value of total assets at end of year	2014-12-31	$2,831,770
Value of total assets at beginning of year	2014-12-31	$3,133,484
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$24,576
Total interest from all sources	2014-12-31	$558
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$70,058
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$70,058
Administrative expenses professional fees incurred	2014-12-31	$8,500
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
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
Contributions received from participants	2014-12-31	$172,134
Participant contributions at end of year	2014-12-31	$23,837
Participant contributions at beginning of year	2014-12-31	$10,118
Participant contributions at end of year	2014-12-31	$8,814
Participant contributions at beginning of year	2014-12-31	$5,705
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2014-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2014-12-31	$9,809
Administrative expenses (other) incurred	2014-12-31	$16,076
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	$-334,905
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$2,788,770
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$3,123,675
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 registered invesment companies (eg mutual funds) at end of year	2014-12-31	$2,418,821
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$2,700,100
Interest on participant loans	2014-12-31	$558
Value of interest in common/collective trusts at end of year	2014-12-31	$380,298
Value of interest in common/collective trusts at beginning of year	2014-12-31	$417,561
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$-249,103
Net investment gain or loss from common/collective trusts	2014-12-31	$3,486
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$307,462
Liabilities. Value of benefit claims payable at end of year	2014-12-31	$43,000
Liabilities. Value of benefit claims payable at beginning of year	2014-12-31	$0
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	GREENE, FINNEY & HORTON, LLP
Accountancy firm EIN	2014-12-31	522212837
2013 : NORTH HILLS MEDICAL CENTER RETIREMENT PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$9,809
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	$588,024
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$490,754
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$467,279
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$196,370
Value of total assets at end of year	2013-12-31	$3,133,484
Value of total assets at beginning of year	2013-12-31	$3,026,405
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$23,475
Total interest from all sources	2013-12-31	$1,253
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$54,978
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	$54,978
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	Yes
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	$196,370
Participant contributions at end of year	2013-12-31	$10,118
Participant contributions at beginning of year	2013-12-31	$35,148
Participant contributions at end of year	2013-12-31	$5,705
Participant contributions at beginning of year	2013-12-31	$15,796
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2013-12-31	$9,809
Other income not declared elsewhere	2013-12-31	$118,133
Administrative expenses (other) incurred	2013-12-31	$23,475
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	$97,270
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$3,123,675
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$3,026,405
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$2,700,100
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$2,530,163
Interest on participant loans	2013-12-31	$1,253
Value of interest in common/collective trusts at end of year	2013-12-31	$417,561
Value of interest in common/collective trusts at beginning of year	2013-12-31	$440,452
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$212,278
Net investment gain or loss from common/collective trusts	2013-12-31	$5,012
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
Employer contributions (assets) at beginning of year	2013-12-31	$4,846
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$467,279
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2013-12-31	Yes
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	GREENE, FINNEY & HORTON, LLP
Accountancy firm EIN	2013-12-31	522212837
2012 : NORTH HILLS MEDICAL CENTER RETIREMENT PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$828,156
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$95,501
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$77,800
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$464,234
Value of total assets at end of year	2012-12-31	$3,026,405
Value of total assets at beginning of year	2012-12-31	$2,293,750
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$17,701
Total interest from all sources	2012-12-31	$4,143
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$49,369
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	$49,369
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2012-12-31	Yes
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	$413,910
Participant contributions at end of year	2012-12-31	$35,148
Participant contributions at beginning of year	2012-12-31	$70,734
Participant contributions at end of year	2012-12-31	$15,796
Participant contributions at beginning of year	2012-12-31	$20,403
Other income not declared elsewhere	2012-12-31	$136,740
Administrative expenses (other) incurred	2012-12-31	$17,701
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	$732,655
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$3,026,405
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$2,293,750
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	$2,530,163
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$1,887,081
Interest on participant loans	2012-12-31	$4,143
Value of interest in common/collective trusts at end of year	2012-12-31	$440,452
Value of interest in common/collective trusts at beginning of year	2012-12-31	$313,605
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$167,344
Net investment gain or loss from common/collective trusts	2012-12-31	$6,326
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	$50,324
Employer contributions (assets) at end of year	2012-12-31	$4,846
Employer contributions (assets) at beginning of year	2012-12-31	$1,927
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$77,800
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2012-12-31	Yes
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	REBECCA L COGGINS CPA LLC
Accountancy firm EIN	2012-12-31	550789330
2011 : NORTH HILLS MEDICAL CENTER RETIREMENT PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$4,248
Total income from all sources (including contributions)	2011-12-31	$454,516
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$124,732
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$110,864
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$439,846
Value of total assets at end of year	2011-12-31	$2,293,750
Value of total assets at beginning of year	2011-12-31	$1,968,214
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$13,868
Total interest from all sources	2011-12-31	$6,854
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$43,854
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2011-12-31	$43,854
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2011-12-31	Yes
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
Contributions received from participants	2011-12-31	$393,130
Participant contributions at end of year	2011-12-31	$70,734
Participant contributions at beginning of year	2011-12-31	$107,035
Participant contributions at end of year	2011-12-31	$20,403
Participant contributions at beginning of year	2011-12-31	$14,150
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-12-31	$1,614
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2011-12-31	$4,248
Other income not declared elsewhere	2011-12-31	$-21,814
Administrative expenses (other) incurred	2011-12-31	$13,868
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	$329,784
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$2,293,750
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$1,963,966
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$1,887,081
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$1,529,835
Interest on participant loans	2011-12-31	$6,854
Value of interest in common/collective trusts at end of year	2011-12-31	$313,605
Value of interest in common/collective trusts at beginning of year	2011-12-31	$313,633
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-19,773
Net investment gain or loss from common/collective trusts	2011-12-31	$5,549
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$46,716
Employer contributions (assets) at end of year	2011-12-31	$1,927
Employer contributions (assets) at beginning of year	2011-12-31	$1,947
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$110,864
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2011-12-31	Yes
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	REBECCA L COGGINS CPA LLC
Accountancy firm EIN	2011-12-31	550789330
2010 : NORTH HILLS MEDICAL CENTER RETIREMENT PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$4,248
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$931
Total income from all sources (including contributions)	2010-12-31	$600,287
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$71,465
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$61,677
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$422,034
Value of total assets at end of year	2010-12-31	$1,968,214
Value of total assets at beginning of year	2010-12-31	$1,436,075
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$9,788
Total interest from all sources	2010-12-31	$20
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$18,167
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2010-12-31	$18,167
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2010-12-31	Yes
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$378,218
Participant contributions at end of year	2010-12-31	$107,035
Participant contributions at beginning of year	2010-12-31	$829
Participant contributions at end of year	2010-12-31	$14,150
Value of other receiveables (less allowance for doubtful accounts) at end of year	2010-12-31	$1,614
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2010-12-31	$4,248
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2010-12-31	$931
Administrative expenses (other) incurred	2010-12-31	$9,788
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	$528,822
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$1,963,966
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$1,435,144
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$1,529,835
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$1,021,581
Interest on participant loans	2010-12-31	$20
Value of interest in common/collective trusts at end of year	2010-12-31	$313,633
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$413,665
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$158,713
Net investment gain or loss from common/collective trusts	2010-12-31	$1,353
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	$43,816
Employer contributions (assets) at end of year	2010-12-31	$1,947
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$61,677
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2010-12-31	Yes
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	REBECCA L COGGINS CPA LLC
Accountancy firm EIN	2010-12-31	550789330

Form 5500 Responses for NORTH HILLS MEDICAL CENTER RETIREMENT PLAN

2016: NORTH HILLS MEDICAL CENTER RETIREMENT PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: NORTH HILLS MEDICAL CENTER RETIREMENT PLAN 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	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: NORTH HILLS MEDICAL CENTER RETIREMENT PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	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	No
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: NORTH HILLS MEDICAL CENTER RETIREMENT PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: NORTH HILLS MEDICAL CENTER RETIREMENT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: NORTH HILLS MEDICAL CENTER RETIREMENT PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: NORTH HILLS MEDICAL CENTER RETIREMENT PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	Yes
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

800847-000

Policy instance

Insurance contract or identification number	800847-000
Number of Individuals Covered	0
Insurance policy start date	2010-01-01
Insurance policy end date	2010-10-27
Total amount of commissions paid to insurance broker	USD $9,546
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:	NORTH HILLS MEDICAL CENTER
Employer identification number (EIN):	570902920
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)