401k Plan data: RETIREMENT PLAN FOR EMPLOYEES OF TRI-COUNTY MENTAL HEALTH & CONSELING SERVICES, INC. plan

RETIREMENT PLAN FOR EMPLOYEES OF TRI-COUNTY MENTAL HEALTH & CONSELING SERVICES, INC. 401k Plan overview

Plan Name	RETIREMENT PLAN FOR EMPLOYEES OF TRI-COUNTY MENTAL HEALTH & CONSELING SERVICES, INC.
Plan identification number	001

RETIREMENT PLAN FOR EMPLOYEES OF TRI-COUNTY MENTAL HEALTH & CONSELING SERVICES, INC. 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

TRI-COUNTY MENTAL HEALTH & COUNSELING SERVICES, INC. has sponsored the creation of one or more 401k plans.

Company Name: TRI-COUNTY MENTAL HEALTH & COUNSELING SERVICES, INC.

Employer identification number (EIN): 310860366

NAIC Classification: 621112
NAIC Description: Offices of Physicians, Mental Health Specialists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan RETIREMENT PLAN FOR EMPLOYEES OF TRI-COUNTY MENTAL HEALTH & CONSELING SERVICES, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2012-01-01 GEORGE P. WEIGLY
001 2011-01-01 GEORGE P. WEIGLY
001 2009-01-01 GEORGE P. WEIGLY
001 2009-01-01 GEORGE P. WEIGLY

Plan id#	Filing Submission Date	Name of Administrator
001	2012-01-01	GEORGE P. WEIGLY
001	2011-01-01	GEORGE P. WEIGLY
001	2009-01-01	GEORGE P. WEIGLY
001	2009-01-01	GEORGE P. WEIGLY

Plan Statistics for RETIREMENT PLAN FOR EMPLOYEES OF TRI-COUNTY MENTAL HEALTH & CONSELING SERVICES, INC.

401k plan membership statisitcs for RETIREMENT PLAN FOR EMPLOYEES OF TRI-COUNTY MENTAL HEALTH & CONSELING SERVICES, INC.

Measure Date Value
2012: RETIREMENT PLAN FOR EMPLOYEES OF TRI-COUNTY MENTAL HEALTH & CONSELING SERVICES, INC. 2012 401k membership
Total participants, beginning-of-year 2012-01-01 231
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 205
Number of retired or separated participants receiving benefits 2012-01-01 8
Number of other retired or separated participants entitled to future benefits 2012-01-01 25
Total of all active and inactive participants 2012-01-01 238
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 238
Number of participants with account balances 2012-01-01 169
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: RETIREMENT PLAN FOR EMPLOYEES OF TRI-COUNTY MENTAL HEALTH & CONSELING SERVICES, INC. 2011 401k membership
Total participants, beginning-of-year 2011-01-01 220
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 193
Number of retired or separated participants receiving benefits 2011-01-01 9
Number of other retired or separated participants entitled to future benefits 2011-01-01 29
Total of all active and inactive participants 2011-01-01 231
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 231
Number of participants with account balances 2011-01-01 163
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 2
2009: RETIREMENT PLAN FOR EMPLOYEES OF TRI-COUNTY MENTAL HEALTH & CONSELING SERVICES, INC. 2009 401k membership
Total participants, beginning-of-year 2009-01-01 205
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 167
Number of retired or separated participants receiving benefits 2009-01-01 5
Number of other retired or separated participants entitled to future benefits 2009-01-01 35
Total of all active and inactive participants 2009-01-01 207
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 207
Number of participants with account balances 2009-01-01 154
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 4

Measure	Date	Value
2012: RETIREMENT PLAN FOR EMPLOYEES OF TRI-COUNTY MENTAL HEALTH & CONSELING SERVICES, INC. 2012 401k membership
Total participants, beginning-of-year	2012-01-01	231
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	205
Number of retired or separated participants receiving benefits	2012-01-01	8
Number of other retired or separated participants entitled to future benefits	2012-01-01	25
Total of all active and inactive participants	2012-01-01	238
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	238
Number of participants with account balances	2012-01-01	169
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: RETIREMENT PLAN FOR EMPLOYEES OF TRI-COUNTY MENTAL HEALTH & CONSELING SERVICES, INC. 2011 401k membership
Total participants, beginning-of-year	2011-01-01	220
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	193
Number of retired or separated participants receiving benefits	2011-01-01	9
Number of other retired or separated participants entitled to future benefits	2011-01-01	29
Total of all active and inactive participants	2011-01-01	231
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	231
Number of participants with account balances	2011-01-01	163
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	2
2009: RETIREMENT PLAN FOR EMPLOYEES OF TRI-COUNTY MENTAL HEALTH & CONSELING SERVICES, INC. 2009 401k membership
Total participants, beginning-of-year	2009-01-01	205
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	167
Number of retired or separated participants receiving benefits	2009-01-01	5
Number of other retired or separated participants entitled to future benefits	2009-01-01	35
Total of all active and inactive participants	2009-01-01	207
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	207
Number of participants with account balances	2009-01-01	154
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	4

Financial Data on RETIREMENT PLAN FOR EMPLOYEES OF TRI-COUNTY MENTAL HEALTH & CONSELING SERVICES, INC.

Measure	Date	Value
2012 : RETIREMENT PLAN FOR EMPLOYEES OF TRI-COUNTY MENTAL HEALTH & CONSELING SERVICES, INC. 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$1,370,915
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$686,796
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$662,202
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$636,056
Value of total assets at end of year	2012-12-31	$6,388,846
Value of total assets at beginning of year	2012-12-31	$5,704,727
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$24,594
Total interest from all sources	2012-12-31	$17,133
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$500,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$353,725
Participant contributions at end of year	2012-12-31	$322,950
Participant contributions at beginning of year	2012-12-31	$268,018
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$100,108
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2012-12-31	$5,130
Total non interest bearing cash at end of year	2012-12-31	$5,131
Total non interest bearing cash at beginning of year	2012-12-31	$1,478
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$684,119
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$6,388,846
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$5,704,727
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in pooled separate accounts at end of year	2012-12-31	$5,644,943
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$5,143,471
Interest on participant loans	2012-12-31	$13,643
Interest earned on other investments	2012-12-31	$3,490
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$415,822
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$291,760
Net investment gain/loss from pooled separate accounts	2012-12-31	$717,726
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$182,223
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$657,072
Contract administrator fees	2012-12-31	$24,594
Did the plan have assets held for investment	2012-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	CLARK, SCHAEFER, HACKETT & CO.
Accountancy firm EIN	2012-12-31	310800053
2011 : RETIREMENT PLAN FOR EMPLOYEES OF TRI-COUNTY MENTAL HEALTH & CONSELING SERVICES, INC. 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$433,561
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$391,418
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$368,473
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$512,320
Value of total assets at end of year	2011-12-31	$5,704,727
Value of total assets at beginning of year	2011-12-31	$5,662,584
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$22,945
Total interest from all sources	2011-12-31	$16,798
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 year	2011-12-31	No
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$500,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$342,344
Participant contributions at end of year	2011-12-31	$268,018
Participant contributions at beginning of year	2011-12-31	$258,680
Total non interest bearing cash at end of year	2011-12-31	$1,478
Total non interest bearing cash at beginning of year	2011-12-31	$5,711
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$42,143
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$5,704,727
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$5,662,584
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in pooled separate accounts at end of year	2011-12-31	$5,143,471
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$5,092,374
Interest on participant loans	2011-12-31	$12,810
Interest earned on other investments	2011-12-31	$3,988
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$291,760
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$305,819
Net investment gain/loss from pooled separate accounts	2011-12-31	$-95,557
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$169,976
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$368,473
Contract administrator fees	2011-12-31	$22,945
Did the plan have assets held for investment	2011-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	CLARK, SCHAEFER, HACKETT & CO.
Accountancy firm EIN	2011-12-31	310800053
2010 : RETIREMENT PLAN FOR EMPLOYEES OF TRI-COUNTY MENTAL HEALTH & CONSELING SERVICES, INC. 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total income from all sources (including contributions)	2010-12-31	$1,131,433
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$1,033,576
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$1,009,584
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$474,760
Value of total assets at end of year	2010-12-31	$5,662,584
Value of total assets at beginning of year	2010-12-31	$5,564,727
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$23,992
Total interest from all sources	2010-12-31	$19,390
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$500,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$309,392
Participant contributions at end of year	2010-12-31	$258,680
Participant contributions at beginning of year	2010-12-31	$223,515
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$12,498
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2010-12-31	$0
Other income not declared elsewhere	2010-12-31	$180
Administrative expenses (other) incurred	2010-12-31	$7,015
Total non interest bearing cash at end of year	2010-12-31	$5,711
Total non interest bearing cash at beginning of year	2010-12-31	$408
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$97,857
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$5,662,584
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$5,564,727
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in pooled separate accounts at end of year	2010-12-31	$5,092,374
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$5,110,866
Interest on participant loans	2010-12-31	$13,415
Interest earned on other investments	2010-12-31	$5,975
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$305,819
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$229,938
Net investment gain/loss from pooled separate accounts	2010-12-31	$637,103
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$152,870
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$1,009,584
Contract administrator fees	2010-12-31	$16,977
Did the plan have assets held for investment	2010-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	CLARK, SCHAEFER, HACKETT & CO.
Accountancy firm EIN	2010-12-31	310800053
2009 : RETIREMENT PLAN FOR EMPLOYEES OF TRI-COUNTY MENTAL HEALTH & CONSELING SERVICES, INC. 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for RETIREMENT PLAN FOR EMPLOYEES OF TRI-COUNTY MENTAL HEALTH & CONSELING SERVICES, INC.

2012: RETIREMENT PLAN FOR EMPLOYEES OF TRI-COUNTY MENTAL HEALTH & CONSELING SERVICES, INC. 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 – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: RETIREMENT PLAN FOR EMPLOYEES OF TRI-COUNTY MENTAL HEALTH & CONSELING SERVICES, INC. 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 – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: RETIREMENT PLAN FOR EMPLOYEES OF TRI-COUNTY MENTAL HEALTH & CONSELING SERVICES, INC. 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	Yes
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 – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	TRI-COUNTY MENTAL HEALTH & COUNSELING SERVICES, INC.
Employer identification number (EIN):	310860366
NAIC Classification:	621112
NAIC Description:	Offices of Physicians, Mental Health Specialists