401k Plan data: CHAMPLAIN VALLEY URGENT CARE 401K PROFIT SHARING PLAN plan

CHAMPLAIN VALLEY URGENT CARE 401K PROFIT SHARING PLAN 401k Plan overview

Plan Name	CHAMPLAIN VALLEY URGENT CARE 401K PROFIT SHARING PLAN
Plan identification number	001

CHAMPLAIN VALLEY URGENT CARE 401K PROFIT SHARING PLAN Benefits

401k Plan Type

Defined 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
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.
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

CHAMPLAIN VALLEY URGENT CARE, P.C. has sponsored the creation of one or more 401k plans.

Company Name: CHAMPLAIN VALLEY URGENT CARE, P.C.

Employer identification number (EIN): 043595303

NAIC Classification: 621498
NAIC Description: All Other Outpatient Care Centers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CHAMPLAIN VALLEY URGENT CARE 401K PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2008-01-01 TIMOTHY FITZGERALD

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2008-01-01	TIMOTHY FITZGERALD

Plan Statistics for CHAMPLAIN VALLEY URGENT CARE 401K PROFIT SHARING PLAN

401k plan membership statisitcs for CHAMPLAIN VALLEY URGENT CARE 401K PROFIT SHARING PLAN

Measure Date Value
2008: CHAMPLAIN VALLEY URGENT CARE 401K PROFIT SHARING PLAN 2008 401k membership
Total participants, beginning-of-year 2008-01-01 12
Total number of active participants reported on line 7a of the Form 5500 2008-01-01 0
Number of retired or separated participants receiving benefits 2008-01-01 0
Number of other retired or separated participants entitled to future benefits 2008-01-01 0
Total of all active and inactive participants 2008-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2008-01-01 0
Total participants 2008-01-01 0
Number of participants with account balances 2008-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2008-01-01 0

Measure	Date	Value
2008: CHAMPLAIN VALLEY URGENT CARE 401K PROFIT SHARING PLAN 2008 401k membership
Total participants, beginning-of-year	2008-01-01	12
Total number of active participants reported on line 7a of the Form 5500	2008-01-01	0
Number of retired or separated participants receiving benefits	2008-01-01	0
Number of other retired or separated participants entitled to future benefits	2008-01-01	0
Total of all active and inactive participants	2008-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2008-01-01	0
Total participants	2008-01-01	0
Number of participants with account balances	2008-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2008-01-01	0

Financial Data on CHAMPLAIN VALLEY URGENT CARE 401K PROFIT SHARING PLAN

Measure	Date	Value
2008 : CHAMPLAIN VALLEY URGENT CARE 401K PROFIT SHARING PLAN 2008 401k financial data
Total income from all sources	2008-12-31	$3,070
Expenses. Total of all expenses incurred	2008-12-31	$91,666
Benefits paid (including direct rollovers)	2008-12-31	$91,666
Total plan assets at end of year	2008-12-31	$0
Total plan assets at beginning of year	2008-12-31	$88,596
Value of fidelity bond covering the plan	2008-12-31	$265,000
Total contributions received or receivable from participants	2008-12-31	$19,526
Other income received	2008-12-31	$-20,560
Net income (gross income less expenses)	2008-12-31	$-88,596
Net plan assets at end of year (total assets less liabilities)	2008-12-31	$0
Net plan assets at beginning of year (total assets less liabilities)	2008-12-31	$88,596
Total contributions received or receivable from employer(s)	2008-12-31	$4,104

Form 5500 Responses for CHAMPLAIN VALLEY URGENT CARE 401K PROFIT SHARING PLAN

2008: CHAMPLAIN VALLEY URGENT CARE 401K PROFIT SHARING PLAN 2008 form 5500 responses
2008-01-01	Type of plan entity	Single employer plan
2008-01-01	Submission has been amended	No
2008-01-01	This submission is the final filing	Yes
2008-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2008-01-01	Plan is a collectively bargained plan	No
2008-01-01	Plan funding arrangement – Insurance	Yes
2008-01-01	Plan funding arrangement – Trust	Yes
2008-01-01	Plan benefit arrangement – Insurance	Yes
2008-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	CHAMPLAIN VALLEY URGENT CARE, P.C.
Employer identification number (EIN):	043595303
NAIC Classification:	621498
NAIC Description:	All Other Outpatient Care Centers