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SERVICESOURCE, INC. HEALTH & WELFARE PLAN 401k Plan overview

Plan NameSERVICESOURCE, INC. HEALTH & WELFARE PLAN
Plan identification number 501

SERVICESOURCE, INC. HEALTH & WELFARE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Supplemental unemployment
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

SERVICESOURCE, INC. has sponsored the creation of one or more 401k plans.

Company Name:SERVICESOURCE, INC.
Employer identification number (EIN):562226062
NAIC Classification:238900

Additional information about SERVICESOURCE, INC.

Jurisdiction of Incorporation: Virginia Secretary of State
Incorporation Date: 1971-12-03
Company Identification Number: 0135311
Legal Registered Office Address: 10467 WHITE GRANITE DRIVE

OAKTON
United States of America (USA)
22124-2763

More information about SERVICESOURCE, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SERVICESOURCE, INC. HEALTH & WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012011-01-01TOM CHANG TOM CHANG2012-10-08
5012010-01-01TOM CHANG TOM CHANG2011-10-06
5012009-01-01THOMAS CHANG

Plan Statistics for SERVICESOURCE, INC. HEALTH & WELFARE PLAN

401k plan membership statisitcs for SERVICESOURCE, INC. HEALTH & WELFARE PLAN

Measure Date Value
2011: SERVICESOURCE, INC. HEALTH & WELFARE PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01446
Total number of active participants reported on line 7a of the Form 55002011-01-010
Total of all active and inactive participants2011-01-010
2010: SERVICESOURCE, INC. HEALTH & WELFARE PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01407
Total number of active participants reported on line 7a of the Form 55002010-01-01446
Total of all active and inactive participants2010-01-01446
2009: SERVICESOURCE, INC. HEALTH & WELFARE PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01360
Total number of active participants reported on line 7a of the Form 55002009-01-01407
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-01407
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Number of participants with account balances2009-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on SERVICESOURCE, INC. HEALTH & WELFARE PLAN

Measure Date Value
2011 : SERVICESOURCE, INC. HEALTH & WELFARE PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-12-31$0
Total transfer of assets from this plan2011-12-31$118,486
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$252,170
Total income from all sources (including contributions)2011-12-31$20,260
Total loss/gain on sale of assets2011-12-31$0
Total of all expenses incurred2011-12-31$38,772
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$2,229
Value of total assets at end of year2011-12-31$0
Value of total assets at beginning of year2011-12-31$389,168
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$38,772
Total interest from all sources2011-12-31$1,140
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 year2011-12-31Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan2011-12-31$0
Administrative expenses professional fees incurred2011-12-31$13,000
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$200,000
If this is an individual account plan, was there a blackout period2011-12-31No
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$2,229
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-12-31$0
Other income not declared elsewhere2011-12-31$16,891
Administrative expenses (other) incurred2011-12-31$25,772
Liabilities. Value of operating payables at beginning of year2011-12-31$78,802
Total non interest bearing cash at beginning of year2011-12-31$3,233
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-18,512
Value of net assets at end of year (total assets less liabilities)2011-12-31$0
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$136,998
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-12-31$385,789
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-12-31$385,789
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$1,140
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Employer contributions (assets) at beginning of year2011-12-31$146
Liabilities. Value of benefit claims payable at beginning of year2011-12-31$173,368
Did the plan have assets held for investment2011-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31No
Opinion of an independent qualified public accountant for this plan2011-12-31Unqualified
Accountancy firm name2011-12-31INEICH & COMPANY, LLP
Accountancy firm EIN2011-12-31562552172
2010 : SERVICESOURCE, INC. HEALTH & WELFARE PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets2010-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$252,170
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$721,987
Total income from all sources (including contributions)2010-12-31$2,043,363
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$2,365,714
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$1,813,099
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$2,026,871
Value of total assets at end of year2010-12-31$389,168
Value of total assets at beginning of year2010-12-31$1,181,336
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$552,615
Total interest from all sources2010-12-31$5,103
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 year2010-12-31No
Administrative expenses professional fees incurred2010-12-31$9,864
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$200,000
If this is an individual account plan, was there a blackout period2010-12-31No
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$11,979
Value of other receiveables (less allowance for doubtful accounts) at end of year2010-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2010-12-31$517,121
Other income not declared elsewhere2010-12-31$11,389
Administrative expenses (other) incurred2010-12-31$263,643
Liabilities. Value of operating payables at end of year2010-12-31$78,802
Liabilities. Value of operating payables at beginning of year2010-12-31$68,317
Total non interest bearing cash at end of year2010-12-31$3,233
Total non interest bearing cash at beginning of year2010-12-31$19,574
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$-322,351
Value of net assets at end of year (total assets less liabilities)2010-12-31$136,998
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$459,349
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2010-12-31$385,789
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2010-12-31$504,054
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2010-12-31$504,054
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$5,103
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$391,570
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$2,014,892
Employer contributions (assets) at end of year2010-12-31$146
Employer contributions (assets) at beginning of year2010-12-31$140,587
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$1,421,529
Contract administrator fees2010-12-31$279,108
Liabilities. Value of benefit claims payable at end of year2010-12-31$173,368
Liabilities. Value of benefit claims payable at beginning of year2010-12-31$653,670
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31No
Opinion of an independent qualified public accountant for this plan2010-12-31Unqualified
Accountancy firm name2010-12-31INEICH & COMPANY, LLP
Accountancy firm EIN2010-12-31562552172

Form 5500 Responses for SERVICESOURCE, INC. HEALTH & WELFARE PLAN

2011: SERVICESOURCE, INC. HEALTH & WELFARE PLAN 2011 form 5500 responses
2011-01-01Type of plan entityMulti-employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingYes
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2010: SERVICESOURCE, INC. HEALTH & WELFARE PLAN 2010 form 5500 responses
2010-01-01Type of plan entityMulti-employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes
2009: SERVICESOURCE, INC. HEALTH & WELFARE PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

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