401k Plan data: OCCUPATIONAL HEALTH SERVICES DEFINED BENEFIT PENSION PLAN plan

OCCUPATIONAL HEALTH SERVICES DEFINED BENEFIT PENSION PLAN 401k Plan overview

Plan Name	OCCUPATIONAL HEALTH SERVICES DEFINED BENEFIT PENSION PLAN
Plan identification number	002

OCCUPATIONAL HEALTH SERVICES DEFINED BENEFIT PENSION PLAN Benefits

401k Plan Type	Defined Benefit Pension
Plan Features/Benefits	Benefits are primarily pay related Plan covering Self-Employed individuals. 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

OCCUPATIONAL HEALTH SERVICES has sponsored the creation of one or more 401k plans.

Company Name: OCCUPATIONAL HEALTH SERVICES

Employer identification number (EIN): 680299334

NAIC Classification: 624310
NAIC Description: Vocational Rehabilitation Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan OCCUPATIONAL HEALTH SERVICES DEFINED BENEFIT PENSION PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2013-01-01 MARTHA TALAMANTES
002 2012-01-01 MARTHA TALAMANTES
002 2011-01-01 LINDA WATSON 2012-10-11 LINDA WATSON 2012-10-11
002 2010-01-01 BEN WATSON 2011-10-14 BEN WATSON 2011-10-14

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2013-01-01	MARTHA TALAMANTES
002	2012-01-01	MARTHA TALAMANTES
002	2011-01-01	LINDA WATSON	2012-10-11	LINDA WATSON	2012-10-11
002	2010-01-01	BEN WATSON	2011-10-14	BEN WATSON	2011-10-14

Plan Statistics for OCCUPATIONAL HEALTH SERVICES DEFINED BENEFIT PENSION PLAN

401k plan membership statisitcs for OCCUPATIONAL HEALTH SERVICES DEFINED BENEFIT PENSION PLAN

Measure Date Value
2013: OCCUPATIONAL HEALTH SERVICES DEFINED BENEFIT PENSION PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 5
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
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: OCCUPATIONAL HEALTH SERVICES DEFINED BENEFIT PENSION PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 5
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 5
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 5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0

Measure	Date	Value
2013: OCCUPATIONAL HEALTH SERVICES DEFINED BENEFIT PENSION PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	5
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
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: OCCUPATIONAL HEALTH SERVICES DEFINED BENEFIT PENSION PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	5
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	5
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	5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0

Financial Data on OCCUPATIONAL HEALTH SERVICES DEFINED BENEFIT PENSION PLAN

Measure	Date	Value
2013 : OCCUPATIONAL HEALTH SERVICES DEFINED BENEFIT PENSION PLAN 2013 401k financial data
Total plan liabilities at end of year	2013-12-31	$0
Total plan liabilities at beginning of year	2013-12-31	$0
Total income from all sources	2013-12-31	$31,908
Expenses. Total of all expenses incurred	2013-12-31	$364,237
Benefits paid (including direct rollovers)	2013-12-31	$359,227
Total plan assets at end of year	2013-12-31	$0
Total plan assets at beginning of year	2013-12-31	$332,329
Total contributions received or receivable from participants	2013-12-31	$0
Expenses. Other expenses not covered elsewhere	2013-12-31	$0
Contributions received from other sources (not participants or employers)	2013-12-31	$0
Other income received	2013-12-31	$31,908
Noncash contributions received	2013-12-31	$0
Net income (gross income less expenses)	2013-12-31	$-332,329
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$0
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$332,329
Total contributions received or receivable from employer(s)	2013-12-31	$0
Value of certain deemed distributions of participant loans	2013-12-31	$0
Value of corrective distributions	2013-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2013-12-31	$5,010
2012 : OCCUPATIONAL HEALTH SERVICES DEFINED BENEFIT PENSION PLAN 2012 401k financial data
Total plan liabilities at end of year	2012-12-31	$0
Total plan liabilities at beginning of year	2012-12-31	$0
Total income from all sources	2012-12-31	$170,659
Expenses. Total of all expenses incurred	2012-12-31	$0
Benefits paid (including direct rollovers)	2012-12-31	$0
Total plan assets at end of year	2012-12-31	$332,329
Total plan assets at beginning of year	2012-12-31	$161,670
Total contributions received or receivable from participants	2012-12-31	$0
Expenses. Other expenses not covered elsewhere	2012-12-31	$0
Contributions received from other sources (not participants or employers)	2012-12-31	$0
Other income received	2012-12-31	$29,032
Noncash contributions received	2012-12-31	$0
Net income (gross income less expenses)	2012-12-31	$170,659
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$332,329
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$161,670
Total contributions received or receivable from employer(s)	2012-12-31	$141,627
Value of certain deemed distributions of participant loans	2012-12-31	$0
Value of corrective distributions	2012-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2012-12-31	$0

Form 5500 Responses for OCCUPATIONAL HEALTH SERVICES DEFINED BENEFIT PENSION PLAN

2013: OCCUPATIONAL HEALTH SERVICES DEFINED BENEFIT PENSION 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	Yes
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 – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: OCCUPATIONAL HEALTH SERVICES DEFINED BENEFIT PENSION 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 – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	OCCUPATIONAL HEALTH SERVICES
Employer identification number (EIN):	680299334
NAIC Classification:	624310
NAIC Description:	Vocational Rehabilitation Services