Touro Infirmary. Summary Plan Description of the. Touro Infirmary Retirement Plan (Cash Balance Plan) and

Touro Infirmary Summary Plan Description of the Touro Infirmary Retirement Plan (Cash Balance Plan) and Section 403(b) Retirement Plan for Touro Infirmary (TSA Plan) As Revised Through January 1, 2010

Touro Retirement Programs Touro Infirmary ("Touro") provides retirement benefits to its employees through two plans: Touro Infirmary Retirement Plan: This plan is a defined benefit plan and was amended effective January 1, 2002 to provide benefits under a cash balance plan approach (the "Cash Balance Plan"). Your benefit under this plan is referred to as your "Cash Balance Account." Section 403(b) Retirement Plan for Touro Infirmary: This plan is a defined contribution plan and is also known as a tax-sheltered annuity plan ("TSA Plan"). This plan allows you to contribute on a pre-tax basis and receive a matching contribution from Touro. Your benefit under this plan is referred to as your "TSA Account." These two plans work together to help you establish a source of income for your retirement years. Through these plans, you and Touro set aside money during the time you are working to provide income for you on your retirement. The basic intent of the plans is to help you provide for your future financial security. The Touro retirement programs are an important source of dependable retirement income. When benefits from these plans are combined with other retirement benefits you may receive and your personal savings, you should have a solid financial base to help you enjoy your retirement years. Plan Documents The information in this SPD describes the plans in everyday language and tries to avoid the technical language of the plans legal documents. If, in our efforts to make the plans easier to understand, we have omitted or misstated any of the plans provisions, the plans official legal documents must remain the final authority. If you wish, you may examine the legal documents in Touro s Human Resources Department. i

TABLE OF CONTENTS PAGE Touro Retirement Programs... i INDEX OF DEFINED TERMS... iii TOURO INFIRMARY RETIREMENT PLAN... 1 Cash Balance Plan Participation... 1 Cash Balance Plan Annual Credits... 1 Cash Balance Plan Vesting and Service... 3 Cash Balance Plan When Payments Begin... 3 Cash Balance Plan Benefit Payment Options... 5 Cash Balance Plan - Plan Maximum Benefits... 7 Cash Balance Plan - Plan Amendment and Termination... 7 SECTION 403(b) RETIREMENT PLAN FOR TOURO INFIRMARY... 9 TSA Plan Participation... 9 TSA Plan Compensation... 9 TSA Plan Contributions and Rollovers... 9 TSA Plan Vesting... 10 TSA Plan Tax Advantages... 10 TSA Plan Investments... 10 TSA Plan When Payments Begin... 11 TSA Plan Loans... 12 TSA Plan Benefit Payment Options... 13 TSA Plan - Plan Amendment and Termination... 14 GENERAL INFORMATION ABOUT BOTH PLANS... 15 Assignment of Benefits... 15 Claims Review Procedure... 15 Your ERISA Benefit Rights... 16 General Plan Information... 18 ii

INDEX OF DEFINED TERMS PAGE Affiliated Employers... 2 Basic Pay Credit... 1 Benefit Service... 2 Cash Balance Account... i Cash Balance Plan... i Compensation... 2 Covered Employment... 1 ERISA... 11 Flex Pool Professional... 1 Hour of Service... 1 Interest Credit... 2 Participation Service... 1 PBGC... 7 Plan Administrator... 6 Total Account Balance... 3 Touro... i Transition Credit... 2 TSA Account... i TSA Plan... i Vesting Service... 3 iii

TOURO INFIRMARY RETIREMENT PLAN Cash Balance Plan Participation You are eligible to participate in the Cash Balance Plan on the day you complete a year of Participation Service if you are in Covered Employment. You will have completed a year of "Participation Service" if, at the end of your first twelve consecutive months of employment with Touro, you have been credited with 1,000 Hours of Service. If you have not been credited with 1,000 Hours of Service by the end of your first twelve consecutive months of employment, you will have completed a year of Participation Service at the end of any calendar year beginning after your hire date during which you have 1,000 Hours of Service. If you are a salaried employee, you will be credited with 90 Hours of Service for each bi-weekly pay period you work. You are credited with an "Hour of Service" for each hour Touro directly or indirectly compensates you either for performing work or for certain reasons other than performing work (such as vacation, holidays, sickness, disability, lay-off, military duty, jury duty, or leave of absence) and for each hour of back pay Touro pays you. "Covered Employment" means employment with Touro. Covered Employment does not include employment as a "Flex Pool Professional" (i.e., a professional employee who is eligible to provide services to Touro from time to time as Touro requests, but who is not required to provide such services when Touro requests) or as a leased employee. Cash Balance Plan Annual Credits Each year, there are annual additions to your Cash Balance Account in the form of Basic Pay Credits, Interest Credits, and Transition Credits. You do not make any contributions to the Cash Balance Plan. Touro pays the entire cost. You will be eligible to receive Basic Pay Credits for a calendar year if you are employed on the last day of the year and if you are credited with a year of Participation Service in Covered Employment during the calendar year. Basic Pay Credit Your annual "Basic Pay Credit" is a percentage of your Compensation based on your years of service with Touro as of December 31 of the year for which the credit is made. The chart below shows the Basic Pay Credit schedule: Cash Balance Plan Page 1

Percentage of Your Pay Credited Your Years of Benefit Service to your Cash Balance Account 0-6 3% 7-13 4% 14-20 5% 21+ 6% Your "Compensation" generally is the amount reported on your Form W-2, except it is not reduced by your contributions to the TSA Plan or by amounts deducted from your pay on a pretax basis for other benefits. It does not include compensation above the maximum allowed under the Internal Revenue Code ($245,000 for 2010). The level of your Basic Pay Credits is determined by your "Benefit Service," which is your total period or periods of employment with Touro in Covered Employment or (effective January 1, 2008) with "Affiliated Employers" (currently, Crescent City Physicians, Inc., MetroLab, Touro At Home, and Woldenberg Village), irrespective of the hours you work. You are credited with periods of less than 12 months during which you were a Touro employee but during which you were not at work (such as because of vacation, holiday, sick leave, or leave of absence). For example, Jennifer worked in Covered Employment throughout 2010 and received $60,000 in Compensation from Touro. She has 12 years of Benefit Service. If Jennifer was credited with at least 1,000 Hours of Service in Covered Employment during 2010 and was employed on December 31, 2010, Jennifer's Basic Pay Credit for 2010 will be $2,400 ($60,000 times 4%, the rate that applies to employees with 7 to 13 years of Benefit Service). New Participants Basic Pay Credits are based only on your Compensation while you are a Cash Balance Plan participant. However, if you become a participant in the middle of a pay period, your Basic Pay Credits are based on your Compensation for the entire pay period in which you become a participant. Interest Credit Touro provides an Interest Credit to your Cash Balance Account each year as of December 31. The amount of your annual Interest Credit is based on the five-year U.S. Treasury constant maturity yield as of November of the prior year, but not less than 2.85%. Transition Credit A special Transition Credit is applicable to individuals who were participants in the Cash Balance Plan before 2002 and is designed to protect those individuals who may be adversely affected by the change in the plan formula to a cash balance arrangement. Cash Balance Plan Page 2

Trust Fund All money the employer contributes to the Cash Balance Plan is held in a trust fund. The Trustee is responsible for the safekeeping of the trust fund. The trust fund is the funding medium used for the accumulation of assets from which benefits will be distributed. Cash Balance Plan Vesting and Service Vesting means full ownership of your benefits under the Cash Balance Plan. You are vested in your account when you have at least 3 years of Vesting Service with Touro. Before 2008, you needed 5 years of Vesting Service to be vested. You become vested earlier than 3 years if either of the following occurs: You reach age 65 (normal retirement age) while participating in the Plan, or The Cash Balance Plan is terminated. Vesting Service Definition Your "Vesting Service" is the same as your Benefit Service, except it also includes work for Touro that is not in Covered Employment and it includes service with Affiliated Employers. In addition, you are given credit for the time you were not a Touro employee if you terminate employment and Touro rehires you within 12 months from your termination date. If your employment terminated when you were not working (such as if you were on a leave of absence), you will also receive credit for the time between your termination date and the first anniversary of the date you were first absent from Touro if you return to work for Touro within 12 months of your termination date. Credit for Military Service You may receive Vesting Service and Benefit Service credit under the Cash Balance Plan while serving in the military according to the Uniformed Services Employment and Reemployment Rights Act of 1994 (USERRA). Information about USERRA rights is available from Touro s Human Resources Department. Cash Balance Plan When Payments Begin You, or your beneficiary, are eligible to receive your total vested Cash Balance Account balance if you retire, leave employment with Touro, or if you are married and die while employed by Touro. Your benefit payments will begin on the date you select (subject to the rules below), provided you have completed a valid payment election form. You may also choose to delay payments until you reach age 65. In the case of a lump sum distribution, payment will be made as soon as administratively possible. Total Account Balance means all of Touro s credits to your Cash Balance Account based on Basic Pay Credits, Interest Credits, TSA Matching Credits (which were made before 2010), and Transition Credits. Touro recommends you consider your benefit payment options well in advance of your planned retirement date to allow yourself plenty of time to talk to a tax advisor, if you so desire. You may be required to furnish certain information about yourself and/or your family members Cash Balance Plan Page 3

before you can receive your benefits under the Cash Balance Plan. Please contact Touro Human Resources, at least three months before your planned retirement date, to discuss the options available and the procedures for requesting payment. Once you have selected a benefit payment option, you must choose the option in writing on a form provided by Touro. Your choice is not valid unless you complete it at least 30 days but not more than 180 days before the date benefits are to begin. If your spouse s consent is required for the type of benefit payment you request, a notary public or plan representative must witness your spouse s signature. Normal Retirement: Your normal retirement date is the first of the month on or after your 65th birthday. At that time, you are eligible to receive your Total Account Balance under the Cash Balance Plan. Early Retirement: You may retire early any time after you reach age 55 and have at least 5 years of vesting service with Touro. If you choose early retirement, you will receive your Total Account Balance under the Cash Balance Plan. Late Retirement: If you continue to work for Touro beyond age 65, you continue to earn benefits under the Cash Balance Plan and can choose to delay receipt of your Total Account Balance until your final retirement date. However, by law, you must begin receiving payments by April 1 of the calendar year following the later of: The calendar year in which you reach age 70½, or The calendar year in which you retire. If you work past age 70½, your benefit may be actuarially increased to comply with IRS regulations. Employment Termination: If you are vested and leave employment with Touro before you reach normal or early retirement age, you may choose to receive your Total Account Balance in a lump sum (with spousal consent, if you are married) or as a monthly annuity. If you choose to receive your benefit in a lump sum, you may choose a direct rollover to a personal IRA or another qualified retirement plan. You may leave your Total Account Balance in the Cash Balance Plan until you reach age 65, at which time you must begin receiving your benefits. At that time, you may choose to receive your benefit as a lump sum or monthly annuity payments. In all events, you must begin receiving your benefits April 1 following the year you retire or the year in which you reach age 70½, whichever is later. If you leave employment with Touro as a vested employee, but you do not choose to begin receiving your benefit, you will continue to earn an annual Interest Credit on your Cash Balance Account. However, if leave employment with Touro as a vested employee and you die before you begin your payments, a death benefit will be paid only if you have a surviving spouse. Cash Balance Plan Page 4

If you are not vested and you leave employment with Touro before you reach normal or early retirement age, you are not entitled to a benefit from the Cash Balance Plan. You may be able to reclaim your right to a vested benefit if you are reemployed before five consecutive years have elapsed since your last date of termination. If You Received Benefits and are Rehired: If you begin receiving benefits in the form of an annuity payment under the Cash Balance Plan and Touro rehires you, your benefit payments (if applicable) will stop, but only if the following three conditions are met: (1) you return to Covered Employment, (2) Touro classifies you as being regularly scheduled to work more than 16 hours per week, and (3) during the month you complete 40 or more Hours of Service for Touro or an Affiliate. To account for the payments you already received during your period of non-employment, your account balance will be recalculated by adjusting for the present value of the benefits you already received. Touro will once again make annual Basic Pay and Interest Credits to your account. You will continue to be vested in your benefit. If you received a lump-sum distribution when you ended your employment and Touro rehires you after been separated from Touro for longer than 5 years (or if it is greater the number of years you were a Touro employee), you will be considered a new participant in the Cash Balance Plan without a previous benefit earned under the Cash Balance Plan. If You Die While Employed: If you die while you are employed with Touro and you are vested, your surviving spouse (if you are married) receives a death benefit from your Total Account Balance. The monthly payment will be made in the form of a single life annuity equal to 50% of the total benefit you would have been entitled to. Your spouse may choose to begin receiving payments at any time before your Normal Retirement Date (payments will begin on the first day of the month your spouse chooses). If your spouse fails to choose a payment beginning date, or if your death occurs after your Normal Retirement Date, the payments will begin on the first day of the month coincident with or following your death. If you are vested and you die before you begin your payments, a death benefit will be paid only if you have a surviving spouse. Designating a Beneficiary: When you choose to begin your benefit payments, you will be required to designate a beneficiary if you choose a form of payment other than a single life annuity, a lump sum distribution, or if you choose a direct rollover. Your beneficiary designation must be made on the forms provided by Touro Human Resources. Cash Balance Plan Benefit Payment Options The Cash Balance Plan allows you maximum portability: you can take your earned benefit with you whenever you leave Touro as a vested employee. Instead of receiving an annuity, you can choose to receive your benefit in a single payment. If you choose to receive your benefit as a lump sum, the full value of your account balance is paid in a single lump-sum payment. If a lump-sum payment is made, you and your spouse will not be entitled to any additional benefits from the Cash Balance Plan. In addition, if your balance is $1,000 or less, you will automatically receive your Total Account Balance as a lump-sum payment. Cash Balance Plan Page 5

Normal Forms of Payment: If you choose to retire with Touro, there are a number of different ways to receive your benefits, as described below. The normal form of payment will depend on whether you are married or single. Your benefit payments will be made in the normal form unless you choose an optional payment method in writing, which may be changed at any time within 180 days of the date your payments begin. All monthly payment amounts are the actuarial equivalent of your Cash Balance Account. If you are married and you and your spouse do not choose an optional form of payment, you will receive the joint and 50% survivor annuity with a 5-year certain guarantee. This option provides a monthly benefit for your life, with 50% of this amount continued to your surviving spouse after your death. These payments continue until your spouse dies as well. However, full payments are guaranteed for 60 months. If you die before you receive all of the guaranteed payments, the remaining payments will be made to your spouse or, if your spouse predeceased you, to your beneficiary. If you are living after you received all of the guaranteed payments, you will continue to receive payments for your life. When you die, your spouse will receive monthly payments that are 50% of your original benefit amount for his or her life. If you are single and you do not choose an optional form of payment, your benefit will be paid in the form of a 5-year certain and life annuity. This option provides a monthly benefit for your life, with payments guaranteed for 60 months. If you die before you receive all of the guaranteed payments, the remaining payments will be made to your beneficiary. If your beneficiary is not living when you die, the remaining payments will be paid to your secondary beneficiary, if you designated one. Otherwise the remaining payments will be paid in a lump sum to your beneficiary's estate. Touro's Retirement Plan Committee (the "Plan Administrator") may choose to continue making monthly payments in the same amount or to pay an actuarially equivalent lump sum. If you are living after you have received all of the guaranteed payments, you will continue to receive payments for your life; however, no payments will be made to your beneficiary after your death. Optional Forms of Payment: If you are married, you must have your spouse s consent to choose one of these options. Single Life Annuity: A monthly benefit is paid for your life. When you die, benefits under this option will end. Joint and 50%, 75%, or 100% Survivor Annuity: A monthly benefit is paid for your life. After you die, 50%, 75%, or 100% (depending on your choice) of your monthly benefit will be paid to your beneficiary for his or her life. If your beneficiary is not living when you die, benefit payments will stop. Your beneficiary may be your spouse or someone other than your spouse. 5- or 10-Year Certain and Life Annuity: A monthly benefit is paid for at least your life, with payments guaranteed for 60 to 120 months (depending on your choice, but not longer than your and your beneficiary's life expectancy). If you die before you receive all of the guaranteed payments, the remaining payments will be made to your beneficiary. If your beneficiary is not living when you die, the remaining payments will be paid to your secondary beneficiary, if you designated one. Otherwise the remaining payments will be Cash Balance Plan Page 6

paid in a lump sum to your beneficiary's estate. The Plan Administrator may choose to continue making monthly payments in the same amount or to pay an actuarially equivalent a lump sum. If you are living after you have received all of the guaranteed payments, you will continue to receive payments for your life; however, no payments will be made to your beneficiary after your death. Lump-Sum Payment: A single payment equal to your vested account balance. After receiving the lump sum you will not be entitled to any additional benefits from the plan. If your Total Account Balance is $5,000 or less the only form of benefit available to you is a lump sum. You may not receive an annuity form of payout, but you may delay the time when you take a distribution until no later than when you reach age 65 or terminate employment. If your Total Account Balance is $1,000 or less, you will automatically receive your Total Account Balance as a lump-sum payment. You may not delay the time of your distribution. Participants who terminated employment before January 1, 2002 may not receive a lump sum distribution over $5,000. Cash Balance Plan - Plan Maximum Benefits In accordance with federal regulations, the Touro Infirmary Retirement Plan has provisions detailing the maximum amount that can be contributed to your account or received by you each year. While most employees will never reach this maximum, the limit is stated in the Plan s legal document. You will be notified if you are affected by this provision. Cash Balance Plan - Plan Amendment and Termination Plan Amendment Touro intends to continue the Cash Balance Plan indefinitely, but reserves the right to change or discontinue the Cash Balance Plan at any time. Plan Termination Procedures On termination of the Plan, the assets of the trust will be divided among participants and beneficiaries in accordance with the following priorities: (1) that portion of each Employee s accrued pension attributable to his required Employee contributions to this Cash Balance Plan, if any; (2) benefits to Employees or beneficiaries who began receiving benefits at least three years before the Cash Balance Plan termination date (including those benefits that would have been received for at least three years if the Employee had retired) based on Plan provisions in effect during the five years before termination that produce the least benefits; (3) all other benefits insured by the Pension Benefit Guaranty Corporation ("PBGC") (including benefits that would be guaranteed except for the special limitation on coverage of a substantial owner ); Cash Balance Plan Page 7

(4) all other benefits that were nonforfeitable under the Cash Balance Plan immediately before Plan termination; (5) all other benefits under the Plan. Any excess funds will revert to Touro. Plan Termination Benefit Guarantee Your pension benefits under this plan are insured by the PBGC, a federal insurance agency. If the Cash Balance Plan terminates (ends) without enough money to pay all benefits, the PBGC will step in to pay pension benefits. Most people receive all of the pension benefits they would have received under their plan, but some people may lose certain benefits. The PBGC guarantee generally covers: (1) normal and early retirement benefits; (2) disability benefits if you become disabled before the Cash Balance Plan terminates; and (3) certain benefits for your survivors. The PBGC guarantee generally does not cover: (1) benefits greater than the maximum guaranteed amount set by law for the year in which the Cash Balance Plan terminates; (2) some or all of benefit increases and new benefits based on plan provisions that have been in place for fewer than five years at the time the Cash Balance Plan terminates; (3) benefits that are not vested because you have not worked long enough for the employer; (4) benefits for which you have not met all of the requirements at the time the Cash Balance Plan terminates; (5) certain early retirement payments (such as supplemental benefits that stop when you become eligible for Social Security) that result in an early retirement monthly benefit greater than your monthly benefit at the plan s normal retirement age; and (6) non-pension benefits, such as health insurance, life insurance, certain death benefits, vacation pay, and severance pay. Even if certain of your benefits are not guaranteed, you still may receive some of those benefits from the PBGC depending on how much money your plan has and on how much the PBGC collects from the employers. For more information about the PBGC and the benefits it guarantees, ask the Plan Administrator or contact the PBGC s Technical Assistance Division, 1200 K Street N.W., Suite 930, Washington, D.C., 20005-4026 or call 202-326-4000 (not a toll-free number). TTY/TDD users may call the federal relay service toll-free at 1-800-877-8339 and ask to be connected to 202-326-4000. Additional information about the PBGC s pension insurance program is available through the PBGC s website on the Internet at http://www.pbgc.gov. Cash Balance Plan Page 8

SECTION 403(b) RETIREMENT PLAN FOR TOURO INFIRMARY Your TSA Plan gives you an opportunity for additional savings and allows you to maximize Touro s contribution toward your retirement income. This section contains a summary of the features of the TSA Plan. TSA Plan Participation You are eligible to participate in the TSA Plan on your hire date. You will continue to be a participant as long as you remain an employee. You are eligible to receive Touro's matching contributions on the first day of the month after you have reached age 21. If you are either (1) a Flex Pool Professional or (2) if you are included in a unit of employees covered by a collective bargaining agreement (unless that agreement by specific reference to this TSA Plan provides for coverage for such unit of employees under this TSA Plan), you may make contributions to the TSA Plan, but you are not eligible to receive matching contributions. TSA Plan Compensation Your compensation is defined as your total cash remuneration while in Covered Employment, but does not include compensation in excess of the maximum allowed under the Internal Revenue Code limits ($245,000 for 2010). The compensation amount is determined before any contributions to Section 403(b), 401(k) or 125 benefit plans. TSA Plan Contributions and Rollovers Each year, as a participant in the TSA Plan, you may contribute up to the IRS limits ($16,500 in 2010) on a pre-tax basis to the TSA Plan. The limit on your annual contributions is indexed each year for inflation. You may change the amount you contribute to the TSA Plan at the beginning of each payroll cycle throughout the year. If you choose to change your contribution amount, the change will take effect as soon as administratively feasible. There is no penalty for reducing or stopping contributions. However, if you do not contribute to the TSA Plan in a plan year you will not receive a matching contribution for that year. If you are age 50 or older, the TSA Plan permits you to make additional employee contributions up to $5,500 (for 2010). The limit on these additional (catch-up) contributions is indexed each year for inflation. Touro has the discretion to make matching contributions to the TSA Plan on your behalf at the end of a calendar year, provided you (1) are credited with a 1,000 Hours of Service during the calendar year and (2) are employed on the last day of the calendar year. For 2010, Touro intends TSA Plan Page 9

to make a matching contribution of 50% of the first 4% of Compensation you defer to the TSA Plan. This is double the matching contribution Touro has made in the past and it is not subject to the $1,000 maximum matching contribution that had applied in the past. For example, in 2010 Donna received $60,000 in Compensation from Touro. She was credited with at least 1,000 Hours of Service during 2010 and was employed on December 31, 2010. Donna deferred 5% of her Compensation or $3,000 to the TSA Plan. Touro intends to make a discretionary matching contribution that will apply to the first 4% of the Compensation Donna deferred ($2,400 = 4% of $60,000). Touro's matching contribution for Donna would be $1,200 (50% of $2,400). If you receive an eligible rollover distribution from another employer s 403(b), governmental 457(b), 401(k), qualified retirement, pension, profit sharing plan or your individual IRA rollover account, you may deposit all or part of it into the TSA Plan. By taking advantage of this opportunity, you can defer paying taxes on the amount you roll over into the TSA Plan and continue to accumulate tax-deferred investment earnings. A rollover may be made either by your trustee or custodian through a direct rollover or you may make a rollover yourself by transferring the amount to be rolled over within 60 days after you receive the payment from the other plan. You should contact Touro s Human Resources Department for additional details. TSA Plan Vesting You are always 100% vested in your contributions to the TSA Plan. You are also 100% vested in Touro s matching contributions to your TSA Plan, and the investment earnings on those contributions. If you leave employment with Touro, you are entitled to receive your total vested TSA Account balance. TSA Plan Tax Advantages Since your contributions are deducted from your pay before federal and Louisiana state taxes are taken out, your taxable income is reduced. The earnings on your savings also accumulate taxdeferred. You pay taxes on your savings and investment earnings only when you take your money out of your TSA Account. TSA Plan Investments You will be able to direct the investment of your Total Account Balance. The Plan Administrator has designated a menu of investment choices that are available to you and Touro has established participant investment fund direction procedures, which state the frequency with which you can change your investment choices and instructions on how you can obtain other important information on directed investments available under the TSA Plan. You need to TSA Plan Page 10

follow these procedures when you direct investments. You should review the information in these procedures carefully before you give investment directions. The TSA Plan is intended to comply with Section 404(c) of the Employee Retirement Income Security Act ("ERISA"). If the TSA Plan complies with this Section, then the fiduciaries of the TSA Plan, including Touro, the Funding Agent and the Plan Administrator, will be relieved of any legal liability for any losses that are the direct and necessary result of the investment directions that you give. Procedures must be followed in giving investment directions. If you fail to do so, then your investment directions need not be followed. You are not required to direct investments. If you choose not to direct investments, then your contributions will be invested in a default investment fund the Plan Administrator designates. When you direct investments, your accounts are segregated for purposes of determining the earnings or losses on these investments. Your account does not share in the investment performance of other participants who have directed their own investments. You should remember that the amount of your benefits under the TSA Plan will depend in part on your choice of investments. Gains as well as losses can occur. There are no guarantees of performance. Touro, the Plan Administrator, and the Funding Agent will not provide investment advice or guarantee the performance of any investment you choose. All money that is contributed to the TSA Plan is held in investment accounts provided by the Funding Agent. The Funding Agent is responsible for the safekeeping of the investment accounts. These accounts are the funding medium used for the accumulation of assets from which benefits are distributed. TSA Plan When Payments Begin You may receive a distribution from the TSA Plan on the earliest of: termination of employment, attainment of age 59½, disability, death, or on proof of hardship. In addition, you may at any time withdraw any amounts from your rollover account, if any. Required Minimum Distributions: You must begin payment of your benefits on the April 1 following the calendar year in which you terminate employment or reach age 70½, whichever is later. Disability: The Plan Administrator may rule that you are disabled if a qualified physician determines that you have a physical or mental impairment that is expected to result in death or to be of long-continued and indefinite duration. Hardship: A participant is eligible to make a hardship withdrawal if there is an immediate and heavy financial need, and only if the amount of the withdrawal does not exceed the amount necessary to satisfy the financial need. The withdrawal cannot exceed the amount you actually contributed to your TSA Account, not including any investment earnings on your contributions. You must first apply for a loan (unless a loan would increase your hardship) or in-service TSA Plan Page 11

withdrawal (to the extent permitted) before you can apply for a financial hardship withdrawal. Hardship is granted only for the following substantiated reasons: For expenses for medical care previously incurred by you, your spouse, or any dependent or necessary for those persons to obtain medical care, For costs directly related to the purchase of your principal residence (not including mortgage payments), To assist you in paying tuition expenses for you, your spouse, or your dependents, for the next twelve months of post-secondary education, To prevent your eviction from or foreclosure on your principal residence, or To pay burial or funeral expenses of a deceased parent, spouse, child or dependent, or To repair damage to your principal residence that would qualify as a casualty. On receipt of a hardship distribution you are prohibited from making contributions to your TSA Account for 6 months. Death If you die while you are employed with Touro, your spouse or designated beneficiary will receive your TSA Account balance. If you die while you are receiving payment of your TSA Account benefits, the amount payable to your spouse or beneficiary will be determined according to the payment form you selected. Designating a Beneficiary When you begin contributing to the TSA Plan, you must designate a beneficiary on the form provided by Touro Human Resources. If you are married and designate a beneficiary other than your spouse, you must have your spouse s written consent, witnessed by a notary or plan representative. You may change your designation at any time by filling out a new form and sending it to Touro Human Resources. If you do not designate a beneficiary or if your designation is not valid (i.e., no spousal consent), your benefit will be distributed in the following order when you die: 1. Your spouse (if applicable) 2. Your estate. TSA Plan Loans You may make a loan from the TSA Plan, subject to the following rules: The minimum amount of any loan shall be $1,000 and a maximum of $50,000, not to exceed 50% of the value of your TSA Account The loan must be repaid in five years Payments must be made on a level basis at least quarterly Only one loan may be outstanding at any time A reasonable rate of interest must be charged There will be a service charge for initiating a loan If you are married, your spouse must consent to the loan Loans are secured by your entire TSA Account. TSA Plan Page 12

There may be other rules that apply to loans or the failure to comply with the terms of a loan. You should check with Touro s Human Resources Department for complete details. TSA Plan Benefit Payment Options Normal Forms of Payment: If you choose to retire with Touro, there are a number of different ways to receive your benefits, as described below. The normal form of payment will depend on whether you are married or single. If your TSA Account is more than $5,000, your benefit payments will be made in the normal form unless you choose an optional payment method in writing, which may be changed at any time within 180 days of the date your payments begin. If your TSA Account is $5,000 or less, your benefit will be paid in the form of a single lump sum. All monthly payment amounts are the actuarial equivalent of your TSA Account. If you are married and you and your spouse do not choose an optional form of payment, you will receive the joint and 50% survivor annuity. This option provides a fixed monthly benefit for your life. When you die, your spouse will receive monthly payments that are 50% of your original benefit amount for his or her life. If you are single and you do not choose an optional form of payment, your benefit will be paid in the form of a 10-year certain and life annuity. This option provides a monthly benefit for your life, with payments guaranteed for 120 months. If you die before you receive all of the guaranteed payments, the remaining payments will be made to your beneficiary. If your beneficiary is not living when you die, the remaining payments will be paid in a lump sum to your estate. If you are living after you have received all of the guaranteed payments, you will continue to receive payments for your life; however, no payments will be made to your beneficiary after your death. Optional Forms of Payment: If you are married, you must have your spouse s consent to choose one of these options. You should also consult with your tax and financial advisors regarding the tax consequences for each form of distribution. Lump-Sum Payment: A single payment equal to your vested TSA Account balance. After receiving the lump sum you will not be entitled to any additional benefits from the plan. If your lump sum amount is $5,000 or less you are required to receive the lump sum and may not receive an annuity form of payout. You can choose to receive payment as a distribution to you (subject to applicable taxes), or as a direct rollover to an IRA, another Section 403(b) plan, or a qualified retirement plan. Payments Over a Period Certain: Monthly, quarterly or annual installments over a fixed reasonable period of time, not exceeding your life expectancy, or the joint life and last survivor expectancy of you and your designated beneficiary. Annuity Contract: By distribution of an annuity contract that the Funding Agent provides or purchases with your TSA Account balance. TSA Plan Page 13

TSA Plan - Plan Amendment and Termination Plan Amendment Touro intends to continue the TSA Plan indefinitely, but reserves the right to change or discontinue the TSA Plan at any time. Plan Termination Procedures On termination of the Plan, Touro will no longer make contributions to the Plan. At that time you will have full access to your account subject to the contractual rules of the Funding Agent. Plan benefits are not guaranteed or insured by any third-party or governmental agency, such as the Pension Benefit Guaranty Corporation (PBGC). TSA Plan Page 14

GENERAL INFORMATION ABOUT BOTH PLANS Assignment of Benefits The plans are intended to pay benefits only to you or your beneficiaries. Benefits cannot be used as collateral for loans (except for loans provided by the TSA Plan) or be assigned in any other way, except as required under a qualified domestic relations order (QDRO). These generally are court orders related to child support, alimony, or marital property rights. A copy of the QDRO procedures is available from Touro Human Resources. Claims Review Procedure Disagreements about benefits are rare. If you feel you have a disagreement about benefits, you must submit it in writing to Touro s Human Resources Department. If your claim for benefits is denied, Touro has a review procedure to ensure the dispute is settled fairly. Under this procedure, you can get another opinion about a benefit decision. Here are the steps in the review procedure: 1. When an application for benefits is denied, you will normally receive a written verification of the denial within 90 days after filing. The notice will explain all of the following: The reason for the denial, The plan provisions on which it is based, Any additional material or information needed to make the application acceptable and the reason it is necessary, and The procedure for requesting a review. If special circumstances require more than 90 days for processing your application, you will be notified in writing within the initial 90 days of filing. The extension may be for up to another 90 days. If you are not notified, consider the claim denied. 2. Within 60 days after receiving a denial notice, you may: Submit a written request to the Plan Administrator for a review of the denial Look at relevant documents Submit issues and comments in writing A decision regarding the denial normally will be made within 60 days after the request for a review has been received. If special circumstances require a review period longer than 60 days, you will be notified that the time for making a final decision may be extended for an additional 60 days. You will be notified of the decision in writing, including specific reasons for the decision and reference to the plan provisions on which the decision is based. Any claim not decided in these time periods will be deemed denied. All interpretations and decisions by the Funding Agent or the Plan Administrator will be final and binding. General Information About Both Plans Page 15

No legal action related to the plans to recover benefits or with respect to any other matter related to the plans may be commenced before the claimant has timely exhausted the claim and claim review procedures described above. In no event may any such action be brought more than six months after the Plan Administrator sends the claimant a decision on the claimant s request for review. The Plan Administrator has the complete discretionary authority to interpret the plans and decide all questions of eligibility for participation and for benefits. The Plan Administrator also has the power, in its sole discretion, to determine all questions arising in connection with the administration and application of the plans (and any related documents and underlying policies). Any such determination by the Plan Administrator is conclusive and binding on all persons. Any questions about the process for requesting a review should be addressed to Touro Human Resources. Your ERISA Benefit Rights As a participant in the plans, you are entitled to certain rights and protections under the Employee Retirement Income Security Act of 1974 (ERISA). ERISA provides that all plan participants are entitled to: Examine, without charge, at the Plan Administrator s office, all documents governing the plans, including insurance contracts and copies of all documents filed by the plans with the U.S. Department of Labor, such as detailed annual reports (Form 5500) and the summary plan description. Obtain copies of all plan documents, the latest annual report and summary plan description, and other plan information on written request to the Plan Administrator; a charge for duplicating may be made for these copies. Obtain a statement telling you whether you have a right to receive a benefit at normal retirement age (age 65) and, if so, what your benefits would be at normal retirement age if you stop working under the plans now. If you do not have a right to a benefit, the statement will tell you how many more years you have to work to earn a right to a benefit. This statement must be requested in writing and is not required to be given more than once a year. The plans must provide the statement free of charge. In addition to creating rights for plan participants, ERISA imposes duties on the people who are responsible for the operation of the plans. The people who operate the plans, called fiduciaries, have a duty to do so prudently and in the interest of you and other plan participants and beneficiaries. No one, including your employer or any other person, may fire you or otherwise discriminate against you in any way to prevent you from obtaining a benefit or exercising your rights under ERISA. If your claim for a benefit is denied or ignored, in whole or in part, you must receive a written explanation of the reason for the denial, and you have a right to obtain copies of documents relating to the decision without charge. You have the right to have the Plan Administrator review and reconsider your claim. General Information About Both Plans Page 16

Under ERISA, you can take steps to enforce these rights. For instance: If you request materials from the plans and do not receive them within 30 days, you may file suit in a federal court. In such a case, the court may require the Plan Administrator to provide the materials and pay you up to $110 a day until you receive the materials, unless the materials were not sent because of reasons beyond the control of the administrator. If you have a claim for benefits which is denied or ignored, in whole or in part, you may file suit in a state or federal court. In addition, if you disagreed with the plan s decision or lack thereof concerning the qualified status of a domestic relations order, you may file suit in federal court. If the plan fiduciaries misuse the plan s money or if you are discriminated against for asserting your rights, you may seek assistance from the U.S. Department of Labor, or you may file suit in a federal court. If you file suit against the plan, the court will decide who should pay court costs and legal fees. If you are successful, the court may order the person you have sued to pay these costs and fees. If you lose, the court may order you to pay these costs and fees for example, if the court finds your claim is frivolous. If you have any questions about your plan, you should contact the Plan Administrator. If you have any questions about this statement or about your rights under ERISA, you should contact the nearest Regional Office of the Employee Benefits Security Administration, listed in your telephone directory. You also may contact the Division of Technical Assistance and Inquiries, Employee Benefits Security Administration, U.S. Department of Labor, 200 Constitution Avenue N.W., Washington, D.C., 20210. General Information About Both Plans Page 17

General Plan Information Cash Balance Plan TSA Plan Plan Name Touro Infirmary Retirement Plan Section 403(b) Retirement Plan for Touro Infirmary Employer and Plan Sponsor Touro Infirmary 1401 Foucher St. New Orleans, LA 70115 (504) 897-8340 Plan Number 001 003 Plan Administrator Retirement Plan Committee Touro Infirmary 1401 Foucher Street New Orleans, LA 70115 (504) 897-8340 Employer Identification Number (EIN) 72-0423659 72-0423659 Touro Infirmary 1401 Foucher St. New Orleans, LA 70115 (504) 897-8340 Retirement Plan Committee Touro Infirmary 1401 Foucher Street New Orleans, LA 70115 (504) 897-8340 Original Effective May 1, 1960 January 1, 1992 Date Plan Year End December 31 December 31 Funding Agent N/A Metropolitan Life Insurance Company (Metlife) P. O. Box 46516 Denver, CO 80201-6516 (800) 560-5001 Trustee Agent for Service of Legal Process (Service of process may also be made on the Plan Administrator) Capital One Institutional Trust 313 Carondelet Street, Room 301 New Orleans, LA 70130 (504) 533-2559 Touro Infirmary Attention: Vice President of Human Resources 1401 Foucher Street New Orleans, LA 70115 N/A Touro Infirmary Attention: Vice President of Human Resources 1401 Foucher Street New Orleans, LA 70115 General Information About Both Plans Page 18