401k Plan data: WESTERN CAROLINA PULMONARY & CRITICAL CARE PLLC RETIREMENT PLAN AND TRUST plan

WESTERN CAROLINA PULMONARY & CRITICAL CARE PLLC RETIREMENT PLAN AND TRUST 401k Plan overview

Plan Name	WESTERN CAROLINA PULMONARY & CRITICAL CARE PLLC RETIREMENT PLAN AND TRUST
Plan identification number	001

WESTERN CAROLINA PULMONARY & CRITICAL CARE PLLC RETIREMENT PLAN AND TRUST 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.
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

WESTERN CAROLINA PULMONARY & CRITICAL CARE PLLC has sponsored the creation of one or more 401k plans.

Company Name: WESTERN CAROLINA PULMONARY & CRITICAL CARE PLLC

Employer identification number (EIN): 061692872

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WESTERN CAROLINA PULMONARY & CRITICAL CARE PLLC RETIREMENT PLAN AND TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2013-01-01 WAVERLY GREEN WAVERLY GREEN 2013-11-08
001 2012-01-01 WAVERLY GREEN WAVERLY GREEN 2013-06-07
001 2011-01-01 WAVERLY GREEN WAVERLY GREEN 2012-09-23
001 2009-01-01 WAVERLY SYDNOR GREEN III WAVERLY SYDNOR GREEN III 2010-07-01

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2013-01-01	WAVERLY GREEN	WAVERLY GREEN	2013-11-08
001	2012-01-01	WAVERLY GREEN	WAVERLY GREEN	2013-06-07
001	2011-01-01	WAVERLY GREEN	WAVERLY GREEN	2012-09-23
001	2009-01-01	WAVERLY SYDNOR GREEN III	WAVERLY SYDNOR GREEN III	2010-07-01

Plan Statistics for WESTERN CAROLINA PULMONARY & CRITICAL CARE PLLC RETIREMENT PLAN AND TRUST

401k plan membership statisitcs for WESTERN CAROLINA PULMONARY & CRITICAL CARE PLLC RETIREMENT PLAN AND TRUST

Measure Date Value
2013: WESTERN CAROLINA PULMONARY & CRITICAL CARE PLLC RETIREMENT PLAN AND TRUST 2013 401k membership
Total participants, beginning-of-year 2013-01-01 1
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 0
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 0
Total of all active and inactive participants 2013-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 0
Number of participants with account balances 2013-01-01 0
2012: WESTERN CAROLINA PULMONARY & CRITICAL CARE PLLC RETIREMENT PLAN AND TRUST 2012 401k membership
Total participants, beginning-of-year 2012-01-01 1
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 1
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 0
Total of all active and inactive participants 2012-01-01 1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 1
Number of participants with account balances 2012-01-01 1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: WESTERN CAROLINA PULMONARY & CRITICAL CARE PLLC RETIREMENT PLAN AND TRUST 2011 401k membership
Total participants, beginning-of-year 2011-01-01 1
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 1
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 0
Total of all active and inactive participants 2011-01-01 1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 1
Number of participants with account balances 2011-01-01 1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: WESTERN CAROLINA PULMONARY & CRITICAL CARE PLLC RETIREMENT PLAN AND TRUST 2009 401k membership
Total participants, beginning-of-year 2009-01-01 3
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 1
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 2
Total of all active and inactive participants 2009-01-01 3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 3
Number of participants with account balances 2009-01-01 3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2013: WESTERN CAROLINA PULMONARY & CRITICAL CARE PLLC RETIREMENT PLAN AND TRUST 2013 401k membership
Total participants, beginning-of-year	2013-01-01	1
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	0
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	0
Total of all active and inactive participants	2013-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	0
Number of participants with account balances	2013-01-01	0
2012: WESTERN CAROLINA PULMONARY & CRITICAL CARE PLLC RETIREMENT PLAN AND TRUST 2012 401k membership
Total participants, beginning-of-year	2012-01-01	1
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	1
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	0
Total of all active and inactive participants	2012-01-01	1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	1
Number of participants with account balances	2012-01-01	1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: WESTERN CAROLINA PULMONARY & CRITICAL CARE PLLC RETIREMENT PLAN AND TRUST 2011 401k membership
Total participants, beginning-of-year	2011-01-01	1
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	1
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	0
Total of all active and inactive participants	2011-01-01	1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	1
Number of participants with account balances	2011-01-01	1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: WESTERN CAROLINA PULMONARY & CRITICAL CARE PLLC RETIREMENT PLAN AND TRUST 2009 401k membership
Total participants, beginning-of-year	2009-01-01	3
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	1
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	2
Total of all active and inactive participants	2009-01-01	3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	3
Number of participants with account balances	2009-01-01	3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on WESTERN CAROLINA PULMONARY & CRITICAL CARE PLLC RETIREMENT PLAN AND TRUST

Measure	Date	Value
2013 : WESTERN CAROLINA PULMONARY & CRITICAL CARE PLLC RETIREMENT PLAN AND TRUST 2013 401k financial data
Total plan liabilities at end of year	2013-10-31	$0
Total plan liabilities at beginning of year	2013-10-31	$0
Total income from all sources	2013-10-31	$91,907
Expenses. Total of all expenses incurred	2013-10-31	$781,861
Benefits paid (including direct rollovers)	2013-10-31	$778,212
Total plan assets at end of year	2013-10-31	$0
Total plan assets at beginning of year	2013-10-31	$689,954
Value of fidelity bond covering the plan	2013-10-31	$40,000
Total contributions received or receivable from participants	2013-10-31	$0
Other income received	2013-10-31	$91,907
Net income (gross income less expenses)	2013-10-31	$-689,954
Net plan assets at end of year (total assets less liabilities)	2013-10-31	$0
Net plan assets at beginning of year (total assets less liabilities)	2013-10-31	$689,954
Total contributions received or receivable from employer(s)	2013-10-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2013-10-31	$3,649
2012 : WESTERN CAROLINA PULMONARY & CRITICAL CARE PLLC RETIREMENT PLAN AND TRUST 2012 401k financial data
Total income from all sources	2012-12-31	$111,053
Expenses. Total of all expenses incurred	2012-12-31	$4,599
Total plan assets at end of year	2012-12-31	$689,954
Total plan assets at beginning of year	2012-12-31	$583,500
Value of fidelity bond covering the plan	2012-12-31	$40,000
Other income received	2012-12-31	$111,053
Net income (gross income less expenses)	2012-12-31	$106,454
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$689,954
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$583,500
Expenses. Administrative service providers (salaries,fees and commissions)	2012-12-31	$4,599
2011 : WESTERN CAROLINA PULMONARY & CRITICAL CARE PLLC RETIREMENT PLAN AND TRUST 2011 401k financial data
Total income from all sources	2011-12-31	$-7,342
Expenses. Total of all expenses incurred	2011-12-31	$3,908
Total plan assets at end of year	2011-12-31	$583,500
Total plan assets at beginning of year	2011-12-31	$594,750
Value of fidelity bond covering the plan	2011-12-31	$40,000
Other income received	2011-12-31	$-7,342
Net income (gross income less expenses)	2011-12-31	$-11,250
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$583,500
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$594,750
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$3,908
2010 : WESTERN CAROLINA PULMONARY & CRITICAL CARE PLLC RETIREMENT PLAN AND TRUST 2010 401k financial data
Total income from all sources	2010-12-31	$64,174
Expenses. Total of all expenses incurred	2010-12-31	$131,239
Benefits paid (including direct rollovers)	2010-12-31	$127,486
Total plan assets at end of year	2010-12-31	$594,750
Total plan assets at beginning of year	2010-12-31	$661,815
Value of fidelity bond covering the plan	2010-12-31	$40,000
Total contributions received or receivable from participants	2010-12-31	$0
Other income received	2010-12-31	$64,174
Net income (gross income less expenses)	2010-12-31	$-67,065
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$594,750
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$661,815
Total contributions received or receivable from employer(s)	2010-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$3,753

Form 5500 Responses for WESTERN CAROLINA PULMONARY & CRITICAL CARE PLLC RETIREMENT PLAN AND TRUST

2013: WESTERN CAROLINA PULMONARY & CRITICAL CARE PLLC RETIREMENT PLAN AND TRUST 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	Yes
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
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: WESTERN CAROLINA PULMONARY & CRITICAL CARE PLLC RETIREMENT PLAN AND TRUST 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: WESTERN CAROLINA PULMONARY & CRITICAL CARE PLLC RETIREMENT PLAN AND TRUST 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
2009: WESTERN CAROLINA PULMONARY & CRITICAL CARE PLLC RETIREMENT PLAN AND TRUST 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	WESTERN CAROLINA PULMONARY & CRITICAL CARE PLLC
Employer identification number (EIN):	061692872
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)