401k Plan data: CSHM 401(K) PLAN plan

CSHM 401(K) PLAN 401k Plan overview

Plan Name	CSHM 401(K) PLAN
Plan identification number	001

CSHM 401(K) 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.
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.
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.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

CSHM LLC has sponsored the creation of one or more 401k plans.

Company Name: CSHM LLC

Employer identification number (EIN): 204762335

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Additional information about CSHM LLC

Jurisdiction of Incorporation: State of Delaware Division of Corporations

Incorporation Date:

Company Identification Number: 5111599

More information about CSHM LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CSHM 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2014-01-01 BRENDA LYNCH
001 2013-01-01 SHERRY SANDERS
001 2012-01-01 SHERRY SANDERS
001 2011-01-01 KERRY LESTER
001 2009-01-01 JODIE WAIT
001 2009-01-01 JODIE WAIT

Plan id#	Filing Submission Date	Name of Administrator
001	2014-01-01	BRENDA LYNCH
001	2013-01-01	SHERRY SANDERS
001	2012-01-01	SHERRY SANDERS
001	2011-01-01	KERRY LESTER
001	2009-01-01	JODIE WAIT
001	2009-01-01	JODIE WAIT

Plan Statistics for CSHM 401(K) PLAN

401k plan membership statisitcs for CSHM 401(K) PLAN

Measure Date Value
2014: CSHM 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 1,372
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 0
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 20
Total of all active and inactive participants 2014-01-01 20
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 20
Number of participants with account balances 2014-01-01 20
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 36
2013: CSHM 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 1,384
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 1,084
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 263
Total of all active and inactive participants 2013-01-01 1,347
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 1,347
Number of participants with account balances 2013-01-01 684
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 62
2012: CSHM 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 1,586
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 1,063
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 266
Total of all active and inactive participants 2012-01-01 1,329
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 1,329
Number of participants with account balances 2012-01-01 760
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 104
2011: CSHM 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 1,909
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 1,363
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 237
Total of all active and inactive participants 2011-01-01 1,600
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 1,600
Number of participants with account balances 2011-01-01 882
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 109
2009: CSHM 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 1,758
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 1,398
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 447
Total of all active and inactive participants 2009-01-01 1,845
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 1,845
Number of participants with account balances 2009-01-01 1,167
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 178

Measure	Date	Value
2014: CSHM 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	1,372
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	0
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	20
Total of all active and inactive participants	2014-01-01	20
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	20
Number of participants with account balances	2014-01-01	20
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	36
2013: CSHM 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	1,384
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	1,084
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	263
Total of all active and inactive participants	2013-01-01	1,347
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	1,347
Number of participants with account balances	2013-01-01	684
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	62
2012: CSHM 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	1,586
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	1,063
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	266
Total of all active and inactive participants	2012-01-01	1,329
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	1,329
Number of participants with account balances	2012-01-01	760
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	104
2011: CSHM 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	1,909
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	1,363
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	237
Total of all active and inactive participants	2011-01-01	1,600
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	1,600
Number of participants with account balances	2011-01-01	882
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	109
2009: CSHM 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	1,758
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	1,398
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	447
Total of all active and inactive participants	2009-01-01	1,845
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	1,845
Number of participants with account balances	2009-01-01	1,167
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	178

Financial Data on CSHM 401(K) PLAN

Measure	Date	Value
2014 : CSHM 401(K) 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	$2,413,075
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$18,713,778
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$18,621,125
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$1,396,402
Value of total assets at end of year	2014-12-31	$41,462
Value of total assets at beginning of year	2014-12-31	$16,342,165
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$92,653
Total interest from all sources	2014-12-31	$44,442
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2014-12-31	$0
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	$1,196,077
Participant contributions at end of year	2014-12-31	$0
Participant contributions at beginning of year	2014-12-31	$258,834
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$11,453
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	$-16,300,703
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$41,462
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$16,342,165
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 pooled separate accounts at end of year	2014-12-31	$41,462
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$13,463,035
Interest on participant loans	2014-12-31	$6,355
Interest earned on other investments	2014-12-31	$38,087
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$2,620,296
Net investment gain/loss from pooled separate accounts	2014-12-31	$972,231
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	$188,872
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$18,621,125
Contract administrator fees	2014-12-31	$92,653
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	FRAISER, DEAN & HOWARD PLLC
Accountancy firm EIN	2014-12-31	621073578
2013 : CSHM 401(K) 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	$5,485,617
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$2,446,761
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$2,309,743
Value of total corrective distributions	2013-12-31	$100,911
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$2,324,509
Value of total assets at end of year	2013-12-31	$16,342,165
Value of total assets at beginning of year	2013-12-31	$13,303,309
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$36,107
Total interest from all sources	2013-12-31	$53,974
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	No
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	$1,973,292
Participant contributions at end of year	2013-12-31	$258,834
Participant contributions at beginning of year	2013-12-31	$322,404
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$75,807
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	$3,038,856
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$16,342,165
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$13,303,309
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 pooled separate accounts at end of year	2013-12-31	$13,463,035
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$10,796,340
Interest on participant loans	2013-12-31	$12,861
Interest earned on other investments	2013-12-31	$41,113
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$2,620,296
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$2,184,565
Net investment gain/loss from pooled separate accounts	2013-12-31	$3,107,134
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	$275,410
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$2,309,743
Contract administrator fees	2013-12-31	$36,107
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	FRASIER, DEAN & HOWARD, PLLC
Accountancy firm EIN	2013-12-31	621073578
2012 : CSHM 401(K) 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	$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	$3,751,306
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$2,345,398
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$2,236,561
Value of total corrective distributions	2012-12-31	$57,131
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$2,297,007
Value of total assets at end of year	2012-12-31	$13,303,309
Value of total assets at beginning of year	2012-12-31	$11,897,401
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$51,706
Total interest from all sources	2012-12-31	$57,555
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
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	$2,000,769
Participant contributions at end of year	2012-12-31	$322,404
Participant contributions at beginning of year	2012-12-31	$267,485
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$10,817
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	$1,405,908
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$13,303,309
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$11,897,401
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 pooled separate accounts at end of year	2012-12-31	$10,796,340
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$9,498,856
Interest on participant loans	2012-12-31	$11,765
Interest earned on other investments	2012-12-31	$45,790
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$2,184,565
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$2,131,060
Net investment gain/loss from pooled separate accounts	2012-12-31	$1,396,744
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	$285,421
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$2,236,561
Contract administrator fees	2012-12-31	$51,706
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	FRASIER, DEAN & HOWARD, PLLC
Accountancy firm EIN	2012-12-31	621073578
2011 : CSHM 401(K) 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	$2,721,902
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$1,702,048
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$1,572,882
Expenses. Certain deemed distributions of participant loans	2011-12-31	$1,971
Value of total corrective distributions	2011-12-31	$69,818
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$2,903,757
Value of total assets at end of year	2011-12-31	$11,897,401
Value of total assets at beginning of year	2011-12-31	$10,877,547
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$57,377
Total interest from all sources	2011-12-31	$52,249
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	$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	$2,402,759
Participant contributions at end of year	2011-12-31	$267,485
Participant contributions at beginning of year	2011-12-31	$171,506
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$58,974
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	$1,019,854
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$11,897,401
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$10,877,547
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 pooled separate accounts at end of year	2011-12-31	$9,498,856
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$8,816,772
Interest on participant loans	2011-12-31	$8,612
Interest earned on other investments	2011-12-31	$43,637
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$2,131,060
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$1,889,269
Net investment gain/loss from pooled separate accounts	2011-12-31	$-234,104
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	$442,024
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$1,572,882
Contract administrator fees	2011-12-31	$57,377
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	FRASIER, DEAN & HOWARD, PLLC
Accountancy firm EIN	2011-12-31	621073578
2010 : CSHM 401(K) 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	$4,251,174
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$869,739
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$827,764
Value of total corrective distributions	2010-12-31	$2,241
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$2,987,516
Value of total assets at end of year	2010-12-31	$10,877,547
Value of total assets at beginning of year	2010-12-31	$7,496,112
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$39,734
Total interest from all sources	2010-12-31	$40,403
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	$2,441,945
Participant contributions at end of year	2010-12-31	$171,506
Participant contributions at beginning of year	2010-12-31	$74,634
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$80,163
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	$3,381,435
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$10,877,547
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$7,496,112
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 pooled separate accounts at end of year	2010-12-31	$8,816,772
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$5,989,894
Interest on participant loans	2010-12-31	$4,948
Interest earned on other investments	2010-12-31	$35,455
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$1,889,269
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$1,431,584
Net investment gain/loss from pooled separate accounts	2010-12-31	$1,223,255
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	$465,408
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$827,764
Contract administrator fees	2010-12-31	$39,734
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	FRASIER, DEAN & HOWARD, PLLC
Accountancy firm EIN	2010-12-31	621073578
2009 : CSHM 401(K) PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for CSHM 401(K) PLAN

2014: CSHM 401(K) PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Mulitple 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 – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: CSHM 401(K) PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Mulitple 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 – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: CSHM 401(K) PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Mulitple 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 – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: CSHM 401(K) PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Mulitple 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 – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: CSHM 401(K) PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Mulitple 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 – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

806484

Policy instance

Insurance contract or identification number	806484
Number of Individuals Covered	20
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $50,789
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	1
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?	No
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

806484

Policy instance

Insurance contract or identification number	806484
Number of Individuals Covered	1347
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $49,613
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	1
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?	No
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $49,613
Insurance broker organization code?	3
Insurance broker name	CAPFINANCIAL PARTNERS LLC

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

806484

Policy instance

Insurance contract or identification number	806484
Number of Individuals Covered	1329
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $42,305
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	1
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?	No
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $42,305
Insurance broker organization code?	3
Insurance broker name	CAPFINANCIAL PARTNERS LLC

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

806484

Policy instance

Insurance contract or identification number	806484
Number of Individuals Covered	1600
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $38,394
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?	No
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

806484

Policy instance

Insurance contract or identification number	806484
Number of Individuals Covered	1881
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $29,826
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?	No
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $29,826
Insurance broker organization code?	3
Insurance broker name	CAPFINANCIAL PARTNERS LLC

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Company Name:	CSHM LLC
Employer identification number (EIN):	204762335
NAIC Classification:	621210
NAIC Description:	Offices of Dentists

Jurisdiction of Incorporation:	State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number:	5111599