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ROSWELL REGIONAL HOSPITAL 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan NameROSWELL REGIONAL HOSPITAL 401(K) PROFIT SHARING PLAN
Plan identification number 001

ROSWELL REGIONAL HOSPITAL 401(K) PROFIT SHARING PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
  • 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.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

NM MEDICAL SURGICAL HOSPITAL LLC DBA ROSWELL has sponsored the creation of one or more 401k plans.

Company Name:NM MEDICAL SURGICAL HOSPITAL LLC DBA ROSWELL
Employer identification number (EIN):810657021
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ROSWELL REGIONAL HOSPITAL 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012012-01-01ROBERT TYK ROBERT TYK2013-05-23
0012011-01-01ROBERT TYK ROBERT TYK2012-10-15

Plan Statistics for ROSWELL REGIONAL HOSPITAL 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for ROSWELL REGIONAL HOSPITAL 401(K) PROFIT SHARING PLAN

Measure Date Value
2012: ROSWELL REGIONAL HOSPITAL 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01111
Total number of active participants reported on line 7a of the Form 55002012-01-010
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-010
Number of participants with account balances2012-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: ROSWELL REGIONAL HOSPITAL 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01294
Total number of active participants reported on line 7a of the Form 55002011-01-01276
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-012
Total of all active and inactive participants2011-01-01278
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-01278
Number of participants with account balances2011-01-01108
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-0143

Financial Data on ROSWELL REGIONAL HOSPITAL 401(K) PROFIT SHARING PLAN

Measure Date Value
2012 : ROSWELL REGIONAL HOSPITAL 401(K) PROFIT SHARING PLAN 2012 401k financial data
Unrealized appreciation/depreciation of real estate assets2012-07-06$0
Unrealized appreciation/depreciation of other (non real estate) assets2012-07-06$0
Total unrealized appreciation/depreciation of assets2012-07-06$0
Total transfer of assets to this plan2012-07-06$0
Total transfer of assets from this plan2012-07-06$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-07-06$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-07-06$0
Expenses. Interest paid2012-07-06$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022012-07-06$0
Total income from all sources (including contributions)2012-07-06$49,361
Total loss/gain on sale of assets2012-07-06$0
Total of all expenses incurred2012-07-06$585,746
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-07-06$582,454
Value of total corrective distributions2012-07-06$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-07-06$13,976
Value of total assets at end of year2012-07-06$0
Value of total assets at beginning of year2012-07-06$536,385
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-07-06$3,292
Total income from rents2012-07-06$0
Total interest from all sources2012-07-06$0
Total dividends received (eg from common stock, registered investment company shares)2012-07-06$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-07-06No
Total dividends received from registered investment company shares (eg mutual funds)2012-07-06$0
Administrative expenses professional fees incurred2012-07-06$0
Was this plan covered by a fidelity bond2012-07-06Yes
Value of fidelity bond cover2012-07-06$30,000
If this is an individual account plan, was there a blackout period2012-07-06No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-07-06$0
Were there any nonexempt tranactions with any party-in-interest2012-07-06No
Amount of non-exempt transactions with any party-in-interest2012-07-06$0
Contributions received from participants2012-07-06$13,976
Participant contributions at end of year2012-07-06$0
Participant contributions at beginning of year2012-07-06$0
Income. Received or receivable in cash from other sources (including rollovers)2012-07-06$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2012-07-06$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-07-06$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-07-06$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-07-06$0
Other income not declared elsewhere2012-07-06$0
Administrative expenses (other) incurred2012-07-06$0
Liabilities. Value of operating payables at beginning of year2012-07-06$0
Total non interest bearing cash at end of year2012-07-06$0
Total non interest bearing cash at beginning of year2012-07-06$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-07-06No
Income. Non cash contributions2012-07-06$0
Value of net income/loss2012-07-06$-536,385
Value of net assets at end of year (total assets less liabilities)2012-07-06$0
Value of net assets at beginning of year (total assets less liabilities)2012-07-06$536,385
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-07-06No
Were any loans by the plan or fixed income obligations due to the plan in default2012-07-06No
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year2012-07-06$0
Were any leases to which the plan was party in default or uncollectible2012-07-06No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year2012-07-06$0
Investment advisory and management fees2012-07-06$0
Value of interest in pooled separate accounts at end of year2012-07-06$0
Value of interest in pooled separate accounts at beginning of year2012-07-06$536,385
Income. Interest from loans (other than to participants)2012-07-06$0
Interest earned on other investments2012-07-06$0
Income. Interest from US Government securities2012-07-06$0
Income. Interest from corporate debt instruments2012-07-06$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-07-06$0
Expenses. Payments to insurance carriers foe the provision of benefits2012-07-06$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-07-06$0
Net investment gain/loss from pooled separate accounts2012-07-06$35,385
Net investment gain or loss from common/collective trusts2012-07-06$0
Net gain/loss from 103.12 investment entities2012-07-06$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-07-06No
Was there a failure to transmit to the plan any participant contributions2012-07-06No
Has the plan failed to provide any benefit when due under the plan2012-07-06No
Contributions received in cash from employer2012-07-06$0
Employer contributions (assets) at end of year2012-07-06$0
Employer contributions (assets) at beginning of year2012-07-06$0
Income. Dividends from preferred stock2012-07-06$0
Income. Dividends from common stock2012-07-06$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-07-06$582,454
Contract administrator fees2012-07-06$3,292
Liabilities. Value of benefit claims payable at beginning of year2012-07-06$0
Did the plan have assets held for investment2012-07-06No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-07-06No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-07-06Yes
Aggregate proceeds on sale of assets2012-07-06$0
Aggregate carrying amount (costs) on sale of assets2012-07-06$0
Liabilities. Value of acquisition indebtedness at beginning of year2012-07-06$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-07-06Yes
Opinion of an independent qualified public accountant for this plan2012-07-06Disclaimer
Accountancy firm name2012-07-06RITTER & COMPANY LLC
Accountancy firm EIN2012-07-06272067951
2011 : ROSWELL REGIONAL HOSPITAL 401(K) PROFIT SHARING PLAN 2011 401k financial data
Unrealized appreciation/depreciation of real estate assets2011-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2011-12-31$0
Total unrealized appreciation/depreciation of assets2011-12-31$0
Total transfer of assets to this plan2011-12-31$0
Total transfer of assets from this plan2011-12-31$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$1,244
Expenses. Interest paid2011-12-31$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-1022011-12-31$0
Total income from all sources (including contributions)2011-12-31$334,815
Total loss/gain on sale of assets2011-12-31$0
Total of all expenses incurred2011-12-31$97,803
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$89,733
Value of total corrective distributions2011-12-31$920
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$356,852
Value of total assets at end of year2011-12-31$536,385
Value of total assets at beginning of year2011-12-31$300,617
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$7,150
Total income from rents2011-12-31$0
Total interest from all sources2011-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2011-12-31$0
Administrative expenses professional fees incurred2011-12-31$0
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$30,000
If this is an individual account plan, was there a blackout period2011-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Amount of non-exempt transactions with any party-in-interest2011-12-31$0
Contributions received from participants2011-12-31$226,925
Participant contributions at end of year2011-12-31$0
Participant contributions at beginning of year2011-12-31$6,974
Income. Received or receivable in cash from other sources (including rollovers)2011-12-31$129,927
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2011-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2011-12-31$0
Other income not declared elsewhere2011-12-31$0
Administrative expenses (other) incurred2011-12-31$0
Liabilities. Value of operating payables at beginning of year2011-12-31$0
Total non interest bearing cash at end of year2011-12-31$0
Total non interest bearing cash at beginning of year2011-12-31$239,958
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Income. Non cash contributions2011-12-31$0
Value of net income/loss2011-12-31$237,012
Value of net assets at end of year (total assets less liabilities)2011-12-31$536,385
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$299,373
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year2011-12-31$0
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year2011-12-31$0
Investment advisory and management fees2011-12-31$0
Value of interest in pooled separate accounts at end of year2011-12-31$536,385
Value of interest in pooled separate accounts at beginning of year2011-12-31$0
Income. Interest from loans (other than to participants)2011-12-31$0
Interest earned on other investments2011-12-31$0
Income. Interest from US Government securities2011-12-31$0
Income. Interest from corporate debt instruments2011-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-12-31$0
Net investment gain/loss from pooled separate accounts2011-12-31$-22,037
Net investment gain or loss from common/collective trusts2011-12-31$0
Net gain/loss from 103.12 investment entities2011-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$0
Employer contributions (assets) at end of year2011-12-31$0
Employer contributions (assets) at beginning of year2011-12-31$53,685
Income. Dividends from preferred stock2011-12-31$0
Income. Dividends from common stock2011-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$89,733
Contract administrator fees2011-12-31$7,150
Liabilities. Value of benefit claims payable at beginning of year2011-12-31$1,244
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Aggregate proceeds on sale of assets2011-12-31$0
Aggregate carrying amount (costs) on sale of assets2011-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2011-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31RITTER & COMPANY, LLC
Accountancy firm EIN2011-12-31272067951
2010 : ROSWELL REGIONAL HOSPITAL 401(K) PROFIT SHARING PLAN 2010 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$1,244
Total income from all sources (including contributions)2010-12-31$319,828
Total of all expenses incurred2010-12-31$20,455
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$12,076
Value of total corrective distributions2010-12-31$8,379
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$298,297
Value of total assets at end of year2010-12-31$300,617
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$4,067
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2010-12-31$4,067
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$30,000
If this is an individual account plan, was there a blackout period2010-12-31Yes
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$226,417
Participant contributions at end of year2010-12-31$6,974
Income. Received or receivable in cash from other sources (including rollovers)2010-12-31$18,195
Total non interest bearing cash at end of year2010-12-31$239,958
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$299,373
Value of net assets at end of year (total assets less liabilities)2010-12-31$299,373
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Net investment gain/loss from registered investment companies (e.g. mutual funds)2010-12-31$17,464
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31Yes
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$53,685
Employer contributions (assets) at end of year2010-12-31$53,685
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$12,076
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32010-12-31Yes
Liabilities. Value of benefit claims payable at end of year2010-12-31$1,244
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31No
Opinion of an independent qualified public accountant for this plan2010-12-31Unqualified
Accountancy firm name2010-12-31RITTER & CO., LLC
Accountancy firm EIN2010-12-31272067951

Form 5500 Responses for ROSWELL REGIONAL HOSPITAL 401(K) PROFIT SHARING PLAN

2012: ROSWELL REGIONAL HOSPITAL 401(K) PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01This submission is the final filingYes
2012-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: ROSWELL REGIONAL HOSPITAL 401(K) PROFIT SHARING PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes

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