401k Plan data: SOUTH BEND ORTHOPAEDIC ASSOCIATES, INC. INSURANCE PLAN plan

SOUTH BEND ORTHOPAEDIC ASSOCIATES, INC. INSURANCE PLAN 401k Plan overview

Plan Name	SOUTH BEND ORTHOPAEDIC ASSOCIATES, INC. INSURANCE PLAN
Plan identification number	501

SOUTH BEND ORTHOPAEDIC ASSOCIATES, INC. INSURANCE PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Long-term disability cover

401k Sponsoring company profile

SOUTH BEND ORTHOPAEDIC ASSOCIATES, INC. has sponsored the creation of one or more 401k plans.

Company Name: SOUTH BEND ORTHOPAEDIC ASSOCIATES, INC.

Employer identification number (EIN): 351263039

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SOUTH BEND ORTHOPAEDIC ASSOCIATES, INC. INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2015-01-01 TRENT MILLER
501 2014-01-01 TRENT MILLER
501 2013-01-01 TRENT MILLER
501 2012-01-01 TRENT MILLER
501 2011-01-01 TRENT MILLER
501 2010-01-01 TRENT MILLER
501 2009-01-01 TRENT MILLER
501 2009-01-01 TRENT MILLER

Plan id#	Filing Submission Date	Name of Administrator
501	2015-01-01	TRENT MILLER
501	2014-01-01	TRENT MILLER
501	2013-01-01	TRENT MILLER
501	2012-01-01	TRENT MILLER
501	2011-01-01	TRENT MILLER
501	2010-01-01	TRENT MILLER
501	2009-01-01	TRENT MILLER
501	2009-01-01	TRENT MILLER

Plan Statistics for SOUTH BEND ORTHOPAEDIC ASSOCIATES, INC. INSURANCE PLAN

401k plan membership statisitcs for SOUTH BEND ORTHOPAEDIC ASSOCIATES, INC. INSURANCE PLAN

Measure Date Value
2015: SOUTH BEND ORTHOPAEDIC ASSOCIATES, INC. INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 126
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 307
Total of all active and inactive participants 2015-01-01 307
Total participants 2015-01-01 307
2014: SOUTH BEND ORTHOPAEDIC ASSOCIATES, INC. INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 122
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 126
Total of all active and inactive participants 2014-01-01 126
Total participants 2014-01-01 126
2013: SOUTH BEND ORTHOPAEDIC ASSOCIATES, INC. INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 144
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 119
Number of retired or separated participants receiving benefits 2013-01-01 3
Total of all active and inactive participants 2013-01-01 122
Total participants 2013-01-01 122
Number of participants with account balances 2013-01-01 122
2012: SOUTH BEND ORTHOPAEDIC ASSOCIATES, INC. INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 144
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 123
Number of retired or separated participants receiving benefits 2012-01-01 2
Total of all active and inactive participants 2012-01-01 125
Total participants 2012-01-01 125
2011: SOUTH BEND ORTHOPAEDIC ASSOCIATES, INC. INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 137
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 144
Total of all active and inactive participants 2011-01-01 144
Total participants 2011-01-01 144
2010: SOUTH BEND ORTHOPAEDIC ASSOCIATES, INC. INSURANCE PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 139
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 137
Total of all active and inactive participants 2010-01-01 137
Total participants 2010-01-01 137
2009: SOUTH BEND ORTHOPAEDIC ASSOCIATES, INC. INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 132
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 139
Total of all active and inactive participants 2009-01-01 139
Total participants 2009-01-01 139

Measure	Date	Value
2015: SOUTH BEND ORTHOPAEDIC ASSOCIATES, INC. INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	126
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	307
Total of all active and inactive participants	2015-01-01	307
Total participants	2015-01-01	307
2014: SOUTH BEND ORTHOPAEDIC ASSOCIATES, INC. INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	122
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	126
Total of all active and inactive participants	2014-01-01	126
Total participants	2014-01-01	126
2013: SOUTH BEND ORTHOPAEDIC ASSOCIATES, INC. INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	144
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	119
Number of retired or separated participants receiving benefits	2013-01-01	3
Total of all active and inactive participants	2013-01-01	122
Total participants	2013-01-01	122
Number of participants with account balances	2013-01-01	122
2012: SOUTH BEND ORTHOPAEDIC ASSOCIATES, INC. INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	144
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	123
Number of retired or separated participants receiving benefits	2012-01-01	2
Total of all active and inactive participants	2012-01-01	125
Total participants	2012-01-01	125
2011: SOUTH BEND ORTHOPAEDIC ASSOCIATES, INC. INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	137
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	144
Total of all active and inactive participants	2011-01-01	144
Total participants	2011-01-01	144
2010: SOUTH BEND ORTHOPAEDIC ASSOCIATES, INC. INSURANCE PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	139
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	137
Total of all active and inactive participants	2010-01-01	137
Total participants	2010-01-01	137
2009: SOUTH BEND ORTHOPAEDIC ASSOCIATES, INC. INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	132
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	139
Total of all active and inactive participants	2009-01-01	139
Total participants	2009-01-01	139

Form 5500 Responses for SOUTH BEND ORTHOPAEDIC ASSOCIATES, INC. INSURANCE PLAN

2015: SOUTH BEND ORTHOPAEDIC ASSOCIATES, INC. INSURANCE PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: SOUTH BEND ORTHOPAEDIC ASSOCIATES, INC. INSURANCE PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: SOUTH BEND ORTHOPAEDIC ASSOCIATES, INC. INSURANCE PLAN 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	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: SOUTH BEND ORTHOPAEDIC ASSOCIATES, INC. INSURANCE PLAN 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 benefit arrangement – Insurance	Yes
2011: SOUTH BEND ORTHOPAEDIC ASSOCIATES, INC. INSURANCE PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	First time form 5500 has been submitted	Yes
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 benefit arrangement – Insurance	Yes
2010: SOUTH BEND ORTHOPAEDIC ASSOCIATES, INC. INSURANCE PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	First time form 5500 has been submitted	Yes
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2009: SOUTH BEND ORTHOPAEDIC ASSOCIATES, INC. INSURANCE PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	First time form 5500 has been submitted	Yes
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 benefit arrangement – Insurance	Yes

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Company Name:	SOUTH BEND ORTHOPAEDIC ASSOCIATES, INC.
Employer identification number (EIN):	351263039
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)