401k Plan data: URGENT CARE SERVICES GROUP, LLC 401(K) PROFIT SHARING PLAN plan

URGENT CARE SERVICES GROUP, LLC 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan Name	URGENT CARE SERVICES GROUP, LLC 401(K) PROFIT SHARING PLAN
Plan identification number	001

URGENT CARE SERVICES GROUP, LLC 401(K) PROFIT SHARING 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.
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.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

URGENT CARE SERVICES GROUP, LLC has sponsored the creation of one or more 401k plans.

Company Name: URGENT CARE SERVICES GROUP, LLC

Employer identification number (EIN): 043730316

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan URGENT CARE SERVICES GROUP, LLC 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2015-01-01 MICHAEL NABIELEC
001 2014-01-01 MATTHEW MIDDENDORF
001 2013-01-01 MATTHEW MIDDENDORF
001 2012-01-01 MATTHEW MIDDENDORF
001 2011-01-01 MATTHEW MIDDENDORF
001 2010-01-01 JAMES BEHRENSMEYER
001 2009-01-01 JAMES BEHRENSMEYER

Plan id#	Filing Submission Date	Name of Administrator
001	2015-01-01	MICHAEL NABIELEC
001	2014-01-01	MATTHEW MIDDENDORF
001	2013-01-01	MATTHEW MIDDENDORF
001	2012-01-01	MATTHEW MIDDENDORF
001	2011-01-01	MATTHEW MIDDENDORF
001	2010-01-01	JAMES BEHRENSMEYER
001	2009-01-01	JAMES BEHRENSMEYER

Plan Statistics for URGENT CARE SERVICES GROUP, LLC 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for URGENT CARE SERVICES GROUP, LLC 401(K) PROFIT SHARING PLAN

Measure Date Value
2015: URGENT CARE SERVICES GROUP, LLC 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 114
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 0
Total of all active and inactive participants 2015-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 0
Number of participants with account balances 2015-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: URGENT CARE SERVICES GROUP, LLC 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 100
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 73
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 25
Total of all active and inactive participants 2014-01-01 98
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 98
Number of participants with account balances 2014-01-01 91
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 8
2013: URGENT CARE SERVICES GROUP, LLC 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 105
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 71
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 23
Total of all active and inactive participants 2013-01-01 94
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 94
Number of participants with account balances 2013-01-01 70
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 4
2012: URGENT CARE SERVICES GROUP, LLC 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 403
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 291
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 38
Total of all active and inactive participants 2012-01-01 329
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 329
Number of participants with account balances 2012-01-01 76
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 10
2011: URGENT CARE SERVICES GROUP, LLC 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 426
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 309
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 89
Total of all active and inactive participants 2011-01-01 398
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 398
Number of participants with account balances 2011-01-01 397
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 36
2010: URGENT CARE SERVICES GROUP, LLC 401(K) PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 365
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 270
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 126
Total of all active and inactive participants 2010-01-01 396
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 396
Number of participants with account balances 2010-01-01 325
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 30
2009: URGENT CARE SERVICES GROUP, LLC 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 291
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 262
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 77
Total of all active and inactive participants 2009-01-01 339
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 339
Number of participants with account balances 2009-01-01 339
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 11

Measure	Date	Value
2015: URGENT CARE SERVICES GROUP, LLC 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	114
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	0
Total of all active and inactive participants	2015-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	0
Number of participants with account balances	2015-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: URGENT CARE SERVICES GROUP, LLC 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	100
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	73
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	25
Total of all active and inactive participants	2014-01-01	98
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	98
Number of participants with account balances	2014-01-01	91
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	8
2013: URGENT CARE SERVICES GROUP, LLC 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	105
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	71
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	23
Total of all active and inactive participants	2013-01-01	94
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	94
Number of participants with account balances	2013-01-01	70
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	4
2012: URGENT CARE SERVICES GROUP, LLC 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	403
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	291
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	38
Total of all active and inactive participants	2012-01-01	329
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	329
Number of participants with account balances	2012-01-01	76
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	10
2011: URGENT CARE SERVICES GROUP, LLC 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	426
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	309
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	89
Total of all active and inactive participants	2011-01-01	398
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	398
Number of participants with account balances	2011-01-01	397
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	36
2010: URGENT CARE SERVICES GROUP, LLC 401(K) PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	365
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	270
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	126
Total of all active and inactive participants	2010-01-01	396
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	396
Number of participants with account balances	2010-01-01	325
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	30
2009: URGENT CARE SERVICES GROUP, LLC 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	291
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	262
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	77
Total of all active and inactive participants	2009-01-01	339
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	339
Number of participants with account balances	2009-01-01	339
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	11

Financial Data on URGENT CARE SERVICES GROUP, LLC 401(K) PROFIT SHARING PLAN

Measure	Date	Value
2015 : URGENT CARE SERVICES GROUP, LLC 401(K) PROFIT SHARING PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-03-31	$0
Total transfer of assets from this plan	2015-03-31	$5,135,577
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-03-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-03-31	$0
Total income from all sources (including contributions)	2015-03-31	$-122,886
Total loss/gain on sale of assets	2015-03-31	$0
Total of all expenses incurred	2015-03-31	$15,992
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-03-31	$15,902
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-03-31	$15,699
Value of total assets at end of year	2015-03-31	$0
Value of total assets at beginning of year	2015-03-31	$5,274,455
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-03-31	$90
Total interest from all sources	2015-03-31	$313
Total dividends received (eg from common stock, registered investment company shares)	2015-03-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-03-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2015-03-31	$0
Administrative expenses professional fees incurred	2015-03-31	$90
Was this plan covered by a fidelity bond	2015-03-31	Yes
Value of fidelity bond cover	2015-03-31	$1,000,000
If this is an individual account plan, was there a blackout period	2015-03-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-03-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-03-31	No
Contributions received from participants	2015-03-31	$5,320
Participant contributions at end of year	2015-03-31	$0
Participant contributions at beginning of year	2015-03-31	$2,395
Participant contributions at end of year	2015-03-31	$0
Participant contributions at beginning of year	2015-03-31	$0
Assets. Other investments not covered elsewhere at end of year	2015-03-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2015-03-31	$51,906
Other income not declared elsewhere	2015-03-31	$-17,338
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-03-31	No
Value of net income/loss	2015-03-31	$-138,878
Value of net assets at end of year (total assets less liabilities)	2015-03-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2015-03-31	$5,274,455
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-03-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-03-31	No
Were any leases to which the plan was party in default or uncollectible	2015-03-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-03-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-03-31	$4,311,827
Value of interest in common/collective trusts at end of year	2015-03-31	$0
Value of interest in common/collective trusts at beginning of year	2015-03-31	$841,175
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2015-03-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2015-03-31	$40,891
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2015-03-31	$40,891
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2015-03-31	$313
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-03-31	$-67,100
Net investment gain or loss from common/collective trusts	2015-03-31	$-54,460
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-03-31	No
Was there a failure to transmit to the plan any participant contributions	2015-03-31	No
Has the plan failed to provide any benefit when due under the plan	2015-03-31	No
Contributions received in cash from employer	2015-03-31	$10,379
Employer contributions (assets) at end of year	2015-03-31	$0
Employer contributions (assets) at beginning of year	2015-03-31	$26,261
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-03-31	$15,902
Did the plan have assets held for investment	2015-03-31	No
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	2015-03-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-03-31	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-03-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-03-31	Disclaimer
Accountancy firm name	2015-03-31	BKD
Accountancy firm EIN	2015-03-31	440160260
2014 : URGENT CARE SERVICES GROUP, LLC 401(K) PROFIT SHARING 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	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$1,327,484
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$528,738
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$502,596
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$1,078,290
Value of total assets at end of year	2014-12-31	$5,274,455
Value of total assets at beginning of year	2014-12-31	$4,475,709
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$26,142
Total interest from all sources	2014-12-31	$624
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$48,662
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	$48,662
Administrative expenses professional fees incurred	2014-12-31	$9,508
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$644,081
Participant contributions at end of year	2014-12-31	$2,395
Participant contributions at beginning of year	2014-12-31	$7,304
Participant contributions at end of year	2014-12-31	$0
Participant contributions at beginning of year	2014-12-31	$846
Assets. Other investments not covered elsewhere at end of year	2014-12-31	$51,906
Assets. Other investments not covered elsewhere at beginning of year	2014-12-31	$94,643
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$197,939
Other income not declared elsewhere	2014-12-31	$-72,897
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$798,746
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$5,274,455
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$4,475,709
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
Investment advisory and management fees	2014-12-31	$16,634
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$4,311,827
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$3,554,784
Interest on participant loans	2014-12-31	$92
Value of interest in common/collective trusts at end of year	2014-12-31	$841,175
Value of interest in common/collective trusts at beginning of year	2014-12-31	$817,289
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2014-12-31	$40,891
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2014-12-31	$279
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2014-12-31	$279
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2014-12-31	$532
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$247,476
Net investment gain or loss from common/collective trusts	2014-12-31	$25,329
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
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	$236,270
Employer contributions (assets) at end of year	2014-12-31	$26,261
Employer contributions (assets) at beginning of year	2014-12-31	$564
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$502,596
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	BKD
Accountancy firm EIN	2014-12-31	440160260
2013 : URGENT CARE SERVICES GROUP, LLC 401(K) PROFIT SHARING 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	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$972,933
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$709,800
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$694,881
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$545,604
Value of total assets at end of year	2013-12-31	$4,475,709
Value of total assets at beginning of year	2013-12-31	$4,212,576
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$14,919
Total interest from all sources	2013-12-31	$1,082
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$40,706
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	$40,706
Administrative expenses professional fees incurred	2013-12-31	$14,919
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$1,000,000
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	$354,580
Participant contributions at end of year	2013-12-31	$7,304
Participant contributions at beginning of year	2013-12-31	$51,502
Participant contributions at end of year	2013-12-31	$846
Participant contributions at beginning of year	2013-12-31	$13,814
Assets. Other investments not covered elsewhere at end of year	2013-12-31	$94,643
Assets. Other investments not covered elsewhere at beginning of year	2013-12-31	$334,069
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$41,934
Other income not declared elsewhere	2013-12-31	$-277,916
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	$263,133
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$4,475,709
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$4,212,576
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	$3,554,784
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$2,833,035
Interest on participant loans	2013-12-31	$1,067
Value of interest in common/collective trusts at end of year	2013-12-31	$817,289
Value of interest in common/collective trusts at beginning of year	2013-12-31	$738,230
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2013-12-31	$279
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2013-12-31	$46,080
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2013-12-31	$46,080
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2013-12-31	$15
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$677,274
Net investment gain or loss from common/collective trusts	2013-12-31	$-13,817
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	$149,090
Employer contributions (assets) at end of year	2013-12-31	$564
Employer contributions (assets) at beginning of year	2013-12-31	$195,846
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$694,881
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	KPMG LLP
Accountancy firm EIN	2013-12-31	135565207
2012 : URGENT CARE SERVICES GROUP, LLC 401(K) PROFIT SHARING PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total transfer of assets from this plan	2012-12-31	$4,855,448
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
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	$1,241,065
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$774,426
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$744,491
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$664,340
Value of total assets at end of year	2012-12-31	$4,212,576
Value of total assets at beginning of year	2012-12-31	$8,601,385
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$29,935
Total interest from all sources	2012-12-31	$7,097
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$45,773
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	$45,773
Administrative expenses professional fees incurred	2012-12-31	$5,815
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$1,000,000
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	$468,286
Participant contributions at end of year	2012-12-31	$51,502
Participant contributions at beginning of year	2012-12-31	$248,454
Participant contributions at end of year	2012-12-31	$13,814
Participant contributions at beginning of year	2012-12-31	$42,321
Assets. Other investments not covered elsewhere at end of year	2012-12-31	$334,069
Assets. Other investments not covered elsewhere at beginning of year	2012-12-31	$453,279
Other income not declared elsewhere	2012-12-31	$39,331
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	$466,639
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$4,212,576
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$8,601,385
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
Investment advisory and management fees	2012-12-31	$24,120
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$2,833,035
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$5,493,029
Interest on participant loans	2012-12-31	$7,070
Value of interest in common/collective trusts at end of year	2012-12-31	$738,230
Value of interest in common/collective trusts at beginning of year	2012-12-31	$1,417,634
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-12-31	$46,080
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-12-31	$35,351
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-12-31	$35,351
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-12-31	$27
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$469,353
Net investment gain or loss from common/collective trusts	2012-12-31	$15,171
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	Yes
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	$196,054
Employer contributions (assets) at end of year	2012-12-31	$195,846
Employer contributions (assets) at beginning of year	2012-12-31	$911,317
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$744,491
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	KPMG LLP
Accountancy firm EIN	2012-12-31	135565207
2011 : URGENT CARE SERVICES GROUP, LLC 401(K) PROFIT SHARING 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	$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	$1,420,943
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$792,052
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$756,077
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$1,495,593
Value of total assets at end of year	2011-12-31	$8,601,385
Value of total assets at beginning of year	2011-12-31	$7,972,494
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$35,975
Total interest from all sources	2011-12-31	$11,842
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$65,461
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Administrative expenses professional fees incurred	2011-12-31	$11,548
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	Yes
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	$584,307
Participant contributions at end of year	2011-12-31	$248,454
Participant contributions at beginning of year	2011-12-31	$247,567
Participant contributions at end of year	2011-12-31	$42,321
Participant contributions at beginning of year	2011-12-31	$18,547
Assets. Other investments not covered elsewhere at end of year	2011-12-31	$453,279
Assets. Other investments not covered elsewhere at beginning of year	2011-12-31	$484,336
Other income not declared elsewhere	2011-12-31	$-99,168
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	$628,891
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$8,601,385
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$7,972,494
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
Investment advisory and management fees	2011-12-31	$24,427
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$5,493,029
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$5,183,123
Income. Interest from loans (other than to participants)	2011-12-31	$11,074
Value of interest in common/collective trusts at end of year	2011-12-31	$1,417,634
Value of interest in common/collective trusts at beginning of year	2011-12-31	$1,185,439
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-12-31	$35,351
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-12-31	$11,930
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-12-31	$11,930
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-12-31	$768
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-138,588
Net investment gain or loss from common/collective trusts	2011-12-31	$85,803
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	$911,286
Employer contributions (assets) at end of year	2011-12-31	$911,317
Employer contributions (assets) at beginning of year	2011-12-31	$841,552
Income. Dividends from common stock	2011-12-31	$65,461
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$756,077
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2011-12-31	Yes
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	CLIFTONLARSONALLEN LLP
Accountancy firm EIN	2011-12-31	410746749
2010 : URGENT CARE SERVICES GROUP, LLC 401(K) PROFIT SHARING 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	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total income from all sources (including contributions)	2010-12-31	$2,129,752
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$983,620
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$962,222
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$1,409,719
Value of total assets at end of year	2010-12-31	$7,972,494
Value of total assets at beginning of year	2010-12-31	$6,826,362
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$21,398
Total interest from all sources	2010-12-31	$12,833
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$45,892
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2010-12-31	$45,892
Administrative expenses professional fees incurred	2010-12-31	$15,762
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	Yes
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	$567,217
Participant contributions at end of year	2010-12-31	$247,567
Participant contributions at beginning of year	2010-12-31	$259,596
Participant contributions at end of year	2010-12-31	$18,547
Participant contributions at beginning of year	2010-12-31	$23,462
Assets. Other investments not covered elsewhere at end of year	2010-12-31	$484,336
Assets. Other investments not covered elsewhere at beginning of year	2010-12-31	$418,897
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$949
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2010-12-31	$3,340
Other income not declared elsewhere	2010-12-31	$3,983
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	$1,146,132
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$7,972,494
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$6,826,362
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
Investment advisory and management fees	2010-12-31	$5,636
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$5,183,123
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$5,126,055
Interest on participant loans	2010-12-31	$12,833
Value of interest in common/collective trusts at end of year	2010-12-31	$1,185,439
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2010-12-31	$11,930
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$279,643
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$631,476
Net investment gain or loss from common/collective trusts	2010-12-31	$25,849
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	No
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	$841,553
Employer contributions (assets) at end of year	2010-12-31	$841,552
Employer contributions (assets) at beginning of year	2010-12-31	$715,369
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$962,222
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2010-12-31	Yes
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	CLIFTON GUNDERSON, LLP
Accountancy firm EIN	2010-12-31	370802863

Form 5500 Responses for URGENT CARE SERVICES GROUP, LLC 401(K) PROFIT SHARING PLAN

2015: URGENT CARE SERVICES GROUP, LLC 401(K) PROFIT SHARING 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	Yes
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
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: URGENT CARE SERVICES GROUP, LLC 401(K) PROFIT SHARING 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: URGENT CARE SERVICES GROUP, LLC 401(K) PROFIT SHARING 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: URGENT CARE SERVICES GROUP, LLC 401(K) PROFIT SHARING 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: URGENT CARE SERVICES GROUP, LLC 401(K) PROFIT SHARING 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
2010: URGENT CARE SERVICES GROUP, LLC 401(K) PROFIT SHARING PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: URGENT CARE SERVICES GROUP, LLC 401(K) PROFIT SHARING 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 – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

131-80067

Policy instance

Insurance contract or identification number	131-80067
Number of Individuals Covered	0
Insurance policy start date	2010-01-01
Insurance policy end date	2010-10-14
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No

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Company Name:	URGENT CARE SERVICES GROUP, LLC
Employer identification number (EIN):	043730316
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)