401k Plan data: FORT WORTH PEDIATRICS RETIREMENT SAVINGS PLAN plan

FORT WORTH PEDIATRICS RETIREMENT SAVINGS PLAN 401k Plan overview

Plan Name	FORT WORTH PEDIATRICS RETIREMENT SAVINGS PLAN
Plan identification number	001

FORT WORTH PEDIATRICS RETIREMENT SAVINGS PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
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.
Participant-directed brokerage accounts provided as an investment option under the plan.
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

FORT WORTH PEDIATRICS, PA has sponsored the creation of one or more 401k plans.

Company Name: FORT WORTH PEDIATRICS, PA

Employer identification number (EIN): 752509430

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FORT WORTH PEDIATRICS RETIREMENT SAVINGS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2016-01-01 JERRI HAYDON 2016-10-16 JERRI HAYDON 2016-10-16
001 2015-01-01 JERRI HAYDON JERRI HAYDON 2016-10-14
001 2014-01-01 JERRI HAYDON JERRI HAYDON 2015-10-14
001 2013-01-01 JERRI HAYDON
001 2012-01-01 CATHERINE STORM
001 2011-01-01 DIANE RICHEY
001 2009-01-01 CATHERINE STORM CATHERINE STORM 2010-10-18

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2016-01-01	JERRI HAYDON	2016-10-16	JERRI HAYDON	2016-10-16
001	2015-01-01	JERRI HAYDON		JERRI HAYDON	2016-10-14
001	2014-01-01	JERRI HAYDON		JERRI HAYDON	2015-10-14
001	2013-01-01	JERRI HAYDON
001	2012-01-01	CATHERINE STORM
001	2011-01-01	DIANE RICHEY
001	2009-01-01	CATHERINE STORM		CATHERINE STORM	2010-10-18

Plan Statistics for FORT WORTH PEDIATRICS RETIREMENT SAVINGS PLAN

401k plan membership statisitcs for FORT WORTH PEDIATRICS RETIREMENT SAVINGS PLAN

Measure Date Value
2015: FORT WORTH PEDIATRICS RETIREMENT SAVINGS PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 147
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 0
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 11
Total of all active and inactive participants 2015-01-01 11
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 11
Number of participants with account balances 2015-01-01 11
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: FORT WORTH PEDIATRICS RETIREMENT SAVINGS PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 140
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 95
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 45
Total of all active and inactive participants 2014-01-01 140
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 140
Number of participants with account balances 2014-01-01 139
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 4
2013: FORT WORTH PEDIATRICS RETIREMENT SAVINGS PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 139
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 88
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 47
Total of all active and inactive participants 2013-01-01 135
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 135
Number of participants with account balances 2013-01-01 133
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 2
2012: FORT WORTH PEDIATRICS RETIREMENT SAVINGS PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 129
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 87
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 44
Total of all active and inactive participants 2012-01-01 131
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 131
Number of participants with account balances 2012-01-01 131
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 5
2011: FORT WORTH PEDIATRICS RETIREMENT SAVINGS PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 118
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 90
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 30
Total of all active and inactive participants 2011-01-01 120
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 120
Number of participants with account balances 2011-01-01 120
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 9
2009: FORT WORTH PEDIATRICS RETIREMENT SAVINGS PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 156
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 82
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 68
Total of all active and inactive participants 2009-01-01 150
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 150
Number of participants with account balances 2009-01-01 150
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 5

Measure	Date	Value
2015: FORT WORTH PEDIATRICS RETIREMENT SAVINGS PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	147
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	0
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	11
Total of all active and inactive participants	2015-01-01	11
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	11
Number of participants with account balances	2015-01-01	11
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: FORT WORTH PEDIATRICS RETIREMENT SAVINGS PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	140
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	95
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	45
Total of all active and inactive participants	2014-01-01	140
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	140
Number of participants with account balances	2014-01-01	139
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	4
2013: FORT WORTH PEDIATRICS RETIREMENT SAVINGS PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	139
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	88
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	47
Total of all active and inactive participants	2013-01-01	135
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	135
Number of participants with account balances	2013-01-01	133
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	2
2012: FORT WORTH PEDIATRICS RETIREMENT SAVINGS PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	129
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	87
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	44
Total of all active and inactive participants	2012-01-01	131
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	131
Number of participants with account balances	2012-01-01	131
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	5
2011: FORT WORTH PEDIATRICS RETIREMENT SAVINGS PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	118
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	90
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	30
Total of all active and inactive participants	2011-01-01	120
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	120
Number of participants with account balances	2011-01-01	120
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	9
2009: FORT WORTH PEDIATRICS RETIREMENT SAVINGS PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	156
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	82
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	68
Total of all active and inactive participants	2009-01-01	150
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	150
Number of participants with account balances	2009-01-01	150
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	5

Financial Data on FORT WORTH PEDIATRICS RETIREMENT SAVINGS PLAN

Measure	Date	Value
2015 : FORT WORTH PEDIATRICS RETIREMENT SAVINGS PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$42,145
Total income from all sources (including contributions)	2015-12-31	$737,803
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$12,599,535
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$12,548,865
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$588,644
Value of total assets at end of year	2015-12-31	$249
Value of total assets at beginning of year	2015-12-31	$11,904,126
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$50,670
Total interest from all sources	2015-12-31	$1,430
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$82,492
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2015-12-31	$0
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$82,492
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$500,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$287,144
Participant contributions at end of year	2015-12-31	$0
Participant contributions at beginning of year	2015-12-31	$46,389
Participant contributions at end of year	2015-12-31	$0
Participant contributions at beginning of year	2015-12-31	$12,330
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2015-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2015-12-31	$41,905
Other income not declared elsewhere	2015-12-31	$427
Administrative expenses (other) incurred	2015-12-31	$50,670
Total non interest bearing cash at end of year	2015-12-31	$13
Total non interest bearing cash at beginning of year	2015-12-31	$29,897
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$-11,861,732
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$249
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$11,861,981
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$24
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$9,943,115
Interest on participant loans	2015-12-31	$1,430
Value of interest in common/collective trusts at end of year	2015-12-31	$212
Value of interest in common/collective trusts at beginning of year	2015-12-31	$1,872,395
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$31,836
Net investment gain or loss from common/collective trusts	2015-12-31	$32,974
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$301,500
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$12,548,865
Liabilities. Value of benefit claims payable at end of year	2015-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2015-12-31	$240
Did the plan have assets held for investment	2015-12-31	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	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	CATHERINE STORM
Accountancy firm EIN	2015-12-31	752401981
2014 : FORT WORTH PEDIATRICS RETIREMENT SAVINGS PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$42,145
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$57,595
Total income from all sources (including contributions)	2014-12-31	$1,526,248
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$187,097
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$153,219
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$785,726
Value of total assets at end of year	2014-12-31	$11,904,126
Value of total assets at beginning of year	2014-12-31	$10,580,425
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$33,878
Total interest from all sources	2014-12-31	$1,835
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$447,105
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$447,105
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$500,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$383,726
Participant contributions at end of year	2014-12-31	$46,389
Participant contributions at beginning of year	2014-12-31	$37,584
Participant contributions at end of year	2014-12-31	$12,330
Participant contributions at beginning of year	2014-12-31	$15,739
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2014-12-31	$41,905
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2014-12-31	$56,595
Other income not declared elsewhere	2014-12-31	$498
Administrative expenses (other) incurred	2014-12-31	$33,878
Total non interest bearing cash at end of year	2014-12-31	$29,897
Total non interest bearing cash at beginning of year	2014-12-31	$45,390
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$1,339,151
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$11,861,981
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$10,522,830
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$9,943,115
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$9,433,219
Interest on participant loans	2014-12-31	$1,835
Value of interest in common/collective trusts at end of year	2014-12-31	$1,872,395
Value of interest in common/collective trusts at beginning of year	2014-12-31	$1,048,493
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$266,058
Net investment gain or loss from common/collective trusts	2014-12-31	$25,026
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$402,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$153,219
Liabilities. Value of benefit claims payable at end of year	2014-12-31	$240
Liabilities. Value of benefit claims payable at beginning of year	2014-12-31	$1,000
Did the plan have assets held for investment	2014-12-31	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	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	CATHERINE STORM
Accountancy firm EIN	2014-12-31	752401981
2013 : FORT WORTH PEDIATRICS RETIREMENT SAVINGS PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$57,595
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$60,181
Total income from all sources (including contributions)	2013-12-31	$2,438,500
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$692,277
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$664,909
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$789,666
Value of total assets at end of year	2013-12-31	$10,580,425
Value of total assets at beginning of year	2013-12-31	$8,836,788
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$27,368
Total interest from all sources	2013-12-31	$1,335
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$343,646
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-12-31	$343,646
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$500,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$360,254
Participant contributions at end of year	2013-12-31	$37,584
Participant contributions at beginning of year	2013-12-31	$44,895
Participant contributions at end of year	2013-12-31	$15,739
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$3,205
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2013-12-31	$159
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2013-12-31	$56,595
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2013-12-31	$60,181
Administrative expenses (other) incurred	2013-12-31	$27,368
Total non interest bearing cash at end of year	2013-12-31	$45,390
Total non interest bearing cash at beginning of year	2013-12-31	$60,181
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$1,746,223
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$10,522,830
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$8,776,607
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$9,433,219
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$7,895,065
Interest on participant loans	2013-12-31	$1,335
Value of interest in common/collective trusts at end of year	2013-12-31	$1,048,493
Value of interest in common/collective trusts at beginning of year	2013-12-31	$836,488
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$1,288,237
Net investment gain or loss from common/collective trusts	2013-12-31	$15,616
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$426,207
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$664,909
Liabilities. Value of benefit claims payable at end of year	2013-12-31	$1,000
Did the plan have assets held for investment	2013-12-31	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	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	CATHERINE STORM
Accountancy firm EIN	2013-12-31	752401981
2012 : FORT WORTH PEDIATRICS RETIREMENT SAVINGS PLAN 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	$60,181
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$58,972
Total income from all sources (including contributions)	2012-12-31	$1,762,713
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$560,729
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$534,075
Expenses. Certain deemed distributions of participant loans	2012-12-31	$1,136
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$779,377
Value of total assets at end of year	2012-12-31	$8,836,788
Value of total assets at beginning of year	2012-12-31	$7,633,595
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$25,518
Total interest from all sources	2012-12-31	$2,302
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$240,919
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-12-31	$240,919
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
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$377,377
Participant contributions at end of year	2012-12-31	$44,895
Participant contributions at beginning of year	2012-12-31	$63,065
Participant contributions at beginning of year	2012-12-31	$12,721
Value of other receiveables (less allowance for doubtful accounts) at end of year	2012-12-31	$159
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2012-12-31	$4,537
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2012-12-31	$60,181
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2012-12-31	$58,972
Administrative expenses (other) incurred	2012-12-31	$25,518
Total non interest bearing cash at end of year	2012-12-31	$60,181
Total non interest bearing cash at beginning of year	2012-12-31	$46,970
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	$1,201,984
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$8,776,607
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$7,574,623
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 registered invesment companies (eg mutual funds) at end of year	2012-12-31	$7,895,065
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$6,810,671
Interest on participant loans	2012-12-31	$2,302
Value of interest in common/collective trusts at end of year	2012-12-31	$836,488
Value of interest in common/collective trusts at beginning of year	2012-12-31	$695,631
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$721,581
Net investment gain or loss from common/collective trusts	2012-12-31	$18,534
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	Yes
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	$402,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$534,075
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	CATHERINE STORM
Accountancy firm EIN	2012-12-31	752401981
2011 : FORT WORTH PEDIATRICS RETIREMENT SAVINGS PLAN 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	$58,972
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$24,669
Total income from all sources (including contributions)	2011-12-31	$753,546
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$124,697
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$92,656
Expenses. Certain deemed distributions of participant loans	2011-12-31	$8,105
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$800,058
Value of total assets at end of year	2011-12-31	$7,633,595
Value of total assets at beginning of year	2011-12-31	$6,970,443
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$23,936
Total interest from all sources	2011-12-31	$2,974
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$192,336
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2011-12-31	$192,336
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	$398,058
Participant contributions at end of year	2011-12-31	$63,065
Participant contributions at beginning of year	2011-12-31	$72,826
Participant contributions at end of year	2011-12-31	$12,721
Participant contributions at beginning of year	2011-12-31	$86
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-12-31	$4,537
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-12-31	$2,741
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2011-12-31	$58,972
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2011-12-31	$24,669
Administrative expenses (other) incurred	2011-12-31	$23,936
Total non interest bearing cash at end of year	2011-12-31	$46,970
Total non interest bearing cash at beginning of year	2011-12-31	$24,669
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	$628,849
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$7,574,623
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$6,945,774
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 registered invesment companies (eg mutual funds) at end of year	2011-12-31	$6,810,671
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$6,238,667
Interest on participant loans	2011-12-31	$2,974
Value of interest in common/collective trusts at end of year	2011-12-31	$695,631
Value of interest in common/collective trusts at beginning of year	2011-12-31	$631,454
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-262,870
Net investment gain or loss from common/collective trusts	2011-12-31	$21,048
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	Yes
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	$402,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$92,656
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	CATHERINE STORM
Accountancy firm EIN	2011-12-31	752401981
2010 : FORT WORTH PEDIATRICS RETIREMENT SAVINGS PLAN 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	$24,669
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$25,853
Total income from all sources (including contributions)	2010-12-31	$1,519,871
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$135,845
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$111,485
Expenses. Certain deemed distributions of participant loans	2010-12-31	$1,136
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$760,989
Value of total assets at end of year	2010-12-31	$6,970,443
Value of total assets at beginning of year	2010-12-31	$5,587,601
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$23,224
Total interest from all sources	2010-12-31	$2,499
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	$402,489
Participant contributions at end of year	2010-12-31	$72,826
Participant contributions at beginning of year	2010-12-31	$42,958
Participant contributions at end of year	2010-12-31	$86
Value of other receiveables (less allowance for doubtful accounts) at end of year	2010-12-31	$2,741
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2010-12-31	$24,669
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2010-12-31	$25,853
Other income not declared elsewhere	2010-12-31	$3,442
Administrative expenses (other) incurred	2010-12-31	$23,224
Total non interest bearing cash at end of year	2010-12-31	$24,669
Total non interest bearing cash at beginning of year	2010-12-31	$25,853
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	$1,384,026
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$6,945,774
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$5,561,748
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 registered invesment companies (eg mutual funds) at end of year	2010-12-31	$6,238,667
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$4,666,479
Interest on participant loans	2010-12-31	$2,499
Value of interest in common/collective trusts at end of year	2010-12-31	$631,454
Value of interest in common/collective trusts at beginning of year	2010-12-31	$852,311
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$732,856
Net investment gain or loss from common/collective trusts	2010-12-31	$20,085
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	Yes
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	$358,500
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$111,485
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	CATHERINE STORM
Accountancy firm EIN	2010-12-31	752401981

Form 5500 Responses for FORT WORTH PEDIATRICS RETIREMENT SAVINGS PLAN

2015: FORT WORTH PEDIATRICS RETIREMENT SAVINGS 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 – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: FORT WORTH PEDIATRICS RETIREMENT SAVINGS 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 – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: FORT WORTH PEDIATRICS RETIREMENT SAVINGS 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 – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: FORT WORTH PEDIATRICS RETIREMENT SAVINGS 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
2011: FORT WORTH PEDIATRICS RETIREMENT SAVINGS PLAN 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: FORT WORTH PEDIATRICS RETIREMENT SAVINGS PLAN 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:	FORT WORTH PEDIATRICS, PA
Employer identification number (EIN):	752509430
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)