401k Plan data: BENEFITGUARD RETIREMENT INCOME SECURITY PLAN plan

BENEFITGUARD RETIREMENT INCOME SECURITY PLAN 401k Plan overview

Plan Name	BENEFITGUARD RETIREMENT INCOME SECURITY PLAN
Plan identification number	003

BENEFITGUARD RETIREMENT INCOME SECURITY PLAN 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.
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

FORT DEFIANCE INDIAN HOSPITAL BOARD, INC. has sponsored the creation of one or more 401k plans.

Company Name: FORT DEFIANCE INDIAN HOSPITAL BOARD, INC.

Employer identification number (EIN): 860817397

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BENEFITGUARD RETIREMENT INCOME SECURITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
003 2013-01-01 SPENCER BARCLAY
003 2012-01-01 JEFF EHLERS
003 2011-01-01 D. TAYLOR WELCH

Plan id#	Filing Submission Date	Name of Administrator
003	2013-01-01	SPENCER BARCLAY
003	2012-01-01	JEFF EHLERS
003	2011-01-01	D. TAYLOR WELCH

Plan Statistics for BENEFITGUARD RETIREMENT INCOME SECURITY PLAN

401k plan membership statisitcs for BENEFITGUARD RETIREMENT INCOME SECURITY PLAN

Measure Date Value
2013: BENEFITGUARD RETIREMENT INCOME SECURITY PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 836
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
Number of participants with account balances 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: BENEFITGUARD RETIREMENT INCOME SECURITY PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 710
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 852
Number of retired or separated participants receiving benefits 2012-01-01 6
Number of other retired or separated participants entitled to future benefits 2012-01-01 20
Total of all active and inactive participants 2012-01-01 878
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 878
Number of participants with account balances 2012-01-01 515
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: BENEFITGUARD RETIREMENT INCOME SECURITY PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 377
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 721
Number of retired or separated participants receiving benefits 2011-01-01 6
Number of other retired or separated participants entitled to future benefits 2011-01-01 8
Total of all active and inactive participants 2011-01-01 735
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 735
Number of participants with account balances 2011-01-01 381
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0

Measure	Date	Value
2013: BENEFITGUARD RETIREMENT INCOME SECURITY PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	836
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
Number of participants with account balances	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: BENEFITGUARD RETIREMENT INCOME SECURITY PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	710
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	852
Number of retired or separated participants receiving benefits	2012-01-01	6
Number of other retired or separated participants entitled to future benefits	2012-01-01	20
Total of all active and inactive participants	2012-01-01	878
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	878
Number of participants with account balances	2012-01-01	515
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: BENEFITGUARD RETIREMENT INCOME SECURITY PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	377
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	721
Number of retired or separated participants receiving benefits	2011-01-01	6
Number of other retired or separated participants entitled to future benefits	2011-01-01	8
Total of all active and inactive participants	2011-01-01	735
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	735
Number of participants with account balances	2011-01-01	381
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0

Financial Data on BENEFITGUARD RETIREMENT INCOME SECURITY PLAN

Measure	Date	Value
2013 : BENEFITGUARD RETIREMENT INCOME SECURITY PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total transfer of assets to this plan	2013-12-31	$0
Total transfer of assets from this plan	2013-12-31	$9,707,632
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$300
Total income from all sources (including contributions)	2013-12-31	$4,637,842
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$1,279,889
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$1,135,139
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$3,590,843
Value of total assets at end of year	2013-12-31	$0
Value of total assets at beginning of year	2013-12-31	$6,349,979
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$144,750
Total interest from all sources	2013-12-31	$25,665
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2013-12-31	$0
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	$1,819,950
Participant contributions at end of year	2013-12-31	$0
Participant contributions at beginning of year	2013-12-31	$502,407
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$327,840
Value of other receiveables (less allowance for doubtful accounts) at end of year	2013-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2013-12-31	$593
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2013-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2013-12-31	$300
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	$3,357,953
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$6,349,679
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
Investment advisory and management fees	2013-12-31	$45,874
Interest on participant loans	2013-12-31	$25,665
Assets. Value of investments in 103.12 investment entities at end of year	2013-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2013-12-31	$5,846,979
Net gain/loss from 103.12 investment entities	2013-12-31	$1,021,334
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	No
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	$1,443,053
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$1,135,139
Contract administrator fees	2013-12-31	$98,876
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	Yes
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	SCOTT SKIBBIE, INC.
Accountancy firm EIN	2013-12-31	270851321
2012 : BENEFITGUARD RETIREMENT INCOME SECURITY 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	$300
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	$4,069,371
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$709,975
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$631,067
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$3,563,280
Value of total assets at end of year	2012-12-31	$6,349,979
Value of total assets at beginning of year	2012-12-31	$2,990,283
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$78,908
Total interest from all sources	2012-12-31	$13,141
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
Administrative expenses professional fees incurred	2012-12-31	$42,101
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	$1,645,252
Participant contributions at end of year	2012-12-31	$502,407
Participant contributions at beginning of year	2012-12-31	$233,999
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$588,081
Value of other receiveables (less allowance for doubtful accounts) at end of year	2012-12-31	$593
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2012-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2012-12-31	$300
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2012-12-31	$0
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	$3,359,396
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$6,349,679
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$2,990,283
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
Interest on participant loans	2012-12-31	$13,141
Assets. Value of investments in 103.12 investment entities at end of year	2012-12-31	$5,846,979
Assets. Value of investments in 103.12 investment entities at beginning of year	2012-12-31	$2,756,284
Net gain/loss from 103.12 investment entities	2012-12-31	$492,950
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	$1,329,947
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$631,067
Contract administrator fees	2012-12-31	$36,807
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	SCOTT SKIBBY, INC.
Accountancy firm EIN	2012-12-31	270851321
2011 : BENEFITGUARD RETIREMENT INCOME SECURITY PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total transfer of assets to this plan	2011-12-31	$745,211
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	$2,372,271
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$127,199
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$91,373
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$2,413,300
Value of total assets at end of year	2011-12-31	$2,990,283
Value of total assets at beginning of year	2011-12-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$35,826
Total interest from all sources	2011-12-31	$2,897
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	$1,700,000
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	$1,076,676
Participant contributions at end of year	2011-12-31	$233,999
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$453,369
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	$2,245,072
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$2,990,283
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$0
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
Interest on participant loans	2011-12-31	$2,897
Assets. Value of investments in 103.12 investment entities at end of year	2011-12-31	$2,756,284
Net gain/loss from 103.12 investment entities	2011-12-31	$-43,926
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	$883,255
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$91,373
Contract administrator fees	2011-12-31	$35,826
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	SCOTT SKIBBY, INC.
Accountancy firm EIN	2011-12-31	270851321

Form 5500 Responses for BENEFITGUARD RETIREMENT INCOME SECURITY PLAN

2013: BENEFITGUARD RETIREMENT INCOME SECURITY 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: BENEFITGUARD RETIREMENT INCOME SECURITY 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: BENEFITGUARD RETIREMENT INCOME SECURITY 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 – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	FORT DEFIANCE INDIAN HOSPITAL BOARD, INC.
Employer identification number (EIN):	860817397
NAIC Classification:	622000
NAIC Description:	Hospitals