401k Plan data: DIVERSIFIED OPHTHALMICS, INC. RETIREMENT AND SAVINGS PLAN plan

DIVERSIFIED OPHTHALMICS, INC. RETIREMENT AND SAVINGS PLAN 401k Plan overview

Plan Name	DIVERSIFIED OPHTHALMICS, INC. RETIREMENT AND SAVINGS PLAN
Plan identification number	001

DIVERSIFIED OPHTHALMICS, INC. RETIREMENT AND SAVINGS 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.

401k Sponsoring company profile

DIVERSIFIED OPHTHAMLICS, INC has sponsored the creation of one or more 401k plans.

Company Name: DIVERSIFIED OPHTHAMLICS, INC

Employer identification number (EIN): 310927558

NAIC Classification: 424210
NAIC Description: Drugs and Druggists' Sundries Merchant Wholesalers

Additional information about DIVERSIFIED OPHTHAMLICS, INC

Jurisdiction of Incorporation: Ohio Secretary of State Business Services Division

Incorporation Date: 1977-11-30

Company Identification Number: 507918

Legal Registered Office Address: 8970 WINTON ROAD
-
CINCINNATI
United States of America (USA)
45231

More information about DIVERSIFIED OPHTHAMLICS, INC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DIVERSIFIED OPHTHALMICS, INC. RETIREMENT AND SAVINGS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2015-11-30 DEBORAH MUNZ
001 2014-11-30 DEBORAH MUNZ
001 2013-11-30 DEBORAH MUNZ
001 2012-11-30 DEBORAH MUNZ
001 2011-11-30 DEBORAH MUNZ DEBORAH MUNZ 2013-09-16
001 2010-11-30 DEBORAH MUNZ DEBORAH MUNZ 2012-09-14
001 2009-11-30 DEBORAH MUNZ
001 2008-11-30

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2015-11-30	DEBORAH MUNZ
001	2014-11-30	DEBORAH MUNZ
001	2013-11-30	DEBORAH MUNZ
001	2012-11-30	DEBORAH MUNZ
001	2011-11-30	DEBORAH MUNZ	DEBORAH MUNZ	2013-09-16
001	2010-11-30	DEBORAH MUNZ	DEBORAH MUNZ	2012-09-14
001	2009-11-30	DEBORAH MUNZ
001	2008-11-30

Plan Statistics for DIVERSIFIED OPHTHALMICS, INC. RETIREMENT AND SAVINGS PLAN

401k plan membership statisitcs for DIVERSIFIED OPHTHALMICS, INC. RETIREMENT AND SAVINGS PLAN

Measure Date Value
2015: DIVERSIFIED OPHTHALMICS, INC. RETIREMENT AND SAVINGS PLAN 2015 401k membership
Total participants, beginning-of-year 2015-11-30 222
Total number of active participants reported on line 7a of the Form 5500 2015-11-30 155
Number of retired or separated participants receiving benefits 2015-11-30 0
Number of other retired or separated participants entitled to future benefits 2015-11-30 31
Total of all active and inactive participants 2015-11-30 186
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-11-30 0
Total participants 2015-11-30 186
Number of participants with account balances 2015-11-30 173
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-11-30 16
2014: DIVERSIFIED OPHTHALMICS, INC. RETIREMENT AND SAVINGS PLAN 2014 401k membership
Total participants, beginning-of-year 2014-11-30 216
Total number of active participants reported on line 7a of the Form 5500 2014-11-30 155
Number of retired or separated participants receiving benefits 2014-11-30 0
Number of other retired or separated participants entitled to future benefits 2014-11-30 48
Total of all active and inactive participants 2014-11-30 203
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-11-30 0
Total participants 2014-11-30 203
Number of participants with account balances 2014-11-30 189
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-11-30 14
2013: DIVERSIFIED OPHTHALMICS, INC. RETIREMENT AND SAVINGS PLAN 2013 401k membership
Total participants, beginning-of-year 2013-11-30 186
Total number of active participants reported on line 7a of the Form 5500 2013-11-30 175
Number of retired or separated participants receiving benefits 2013-11-30 0
Number of other retired or separated participants entitled to future benefits 2013-11-30 34
Total of all active and inactive participants 2013-11-30 209
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-11-30 0
Total participants 2013-11-30 209
Number of participants with account balances 2013-11-30 194
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-11-30 13
2012: DIVERSIFIED OPHTHALMICS, INC. RETIREMENT AND SAVINGS PLAN 2012 401k membership
Total participants, beginning-of-year 2012-11-30 172
Total number of active participants reported on line 7a of the Form 5500 2012-11-30 135
Number of retired or separated participants receiving benefits 2012-11-30 0
Number of other retired or separated participants entitled to future benefits 2012-11-30 30
Total of all active and inactive participants 2012-11-30 165
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-11-30 0
Total participants 2012-11-30 165
Number of participants with account balances 2012-11-30 165
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-11-30 10
2011: DIVERSIFIED OPHTHALMICS, INC. RETIREMENT AND SAVINGS PLAN 2011 401k membership
Total participants, beginning-of-year 2011-11-30 166
Total number of active participants reported on line 7a of the Form 5500 2011-11-30 144
Number of retired or separated participants receiving benefits 2011-11-30 0
Number of other retired or separated participants entitled to future benefits 2011-11-30 20
Total of all active and inactive participants 2011-11-30 164
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-11-30 0
Total participants 2011-11-30 164
Number of participants with account balances 2011-11-30 164
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-11-30 7
2010: DIVERSIFIED OPHTHALMICS, INC. RETIREMENT AND SAVINGS PLAN 2010 401k membership
Total participants, beginning-of-year 2010-11-30 158
Total number of active participants reported on line 7a of the Form 5500 2010-11-30 135
Number of retired or separated participants receiving benefits 2010-11-30 0
Number of other retired or separated participants entitled to future benefits 2010-11-30 23
Total of all active and inactive participants 2010-11-30 158
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-11-30 2
Total participants 2010-11-30 160
Number of participants with account balances 2010-11-30 160
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-11-30 4
2009: DIVERSIFIED OPHTHALMICS, INC. RETIREMENT AND SAVINGS PLAN 2009 401k membership
Total participants, beginning-of-year 2009-11-30 206
Total number of active participants reported on line 7a of the Form 5500 2009-11-30 133
Number of retired or separated participants receiving benefits 2009-11-30 0
Number of other retired or separated participants entitled to future benefits 2009-11-30 18
Total of all active and inactive participants 2009-11-30 151
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-11-30 2
Total participants 2009-11-30 153
Number of participants with account balances 2009-11-30 145
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-11-30 0

Measure	Date	Value
2015: DIVERSIFIED OPHTHALMICS, INC. RETIREMENT AND SAVINGS PLAN 2015 401k membership
Total participants, beginning-of-year	2015-11-30	222
Total number of active participants reported on line 7a of the Form 5500	2015-11-30	155
Number of retired or separated participants receiving benefits	2015-11-30	0
Number of other retired or separated participants entitled to future benefits	2015-11-30	31
Total of all active and inactive participants	2015-11-30	186
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-11-30	0
Total participants	2015-11-30	186
Number of participants with account balances	2015-11-30	173
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-11-30	16
2014: DIVERSIFIED OPHTHALMICS, INC. RETIREMENT AND SAVINGS PLAN 2014 401k membership
Total participants, beginning-of-year	2014-11-30	216
Total number of active participants reported on line 7a of the Form 5500	2014-11-30	155
Number of retired or separated participants receiving benefits	2014-11-30	0
Number of other retired or separated participants entitled to future benefits	2014-11-30	48
Total of all active and inactive participants	2014-11-30	203
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-11-30	0
Total participants	2014-11-30	203
Number of participants with account balances	2014-11-30	189
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-11-30	14
2013: DIVERSIFIED OPHTHALMICS, INC. RETIREMENT AND SAVINGS PLAN 2013 401k membership
Total participants, beginning-of-year	2013-11-30	186
Total number of active participants reported on line 7a of the Form 5500	2013-11-30	175
Number of retired or separated participants receiving benefits	2013-11-30	0
Number of other retired or separated participants entitled to future benefits	2013-11-30	34
Total of all active and inactive participants	2013-11-30	209
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-11-30	0
Total participants	2013-11-30	209
Number of participants with account balances	2013-11-30	194
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-11-30	13
2012: DIVERSIFIED OPHTHALMICS, INC. RETIREMENT AND SAVINGS PLAN 2012 401k membership
Total participants, beginning-of-year	2012-11-30	172
Total number of active participants reported on line 7a of the Form 5500	2012-11-30	135
Number of retired or separated participants receiving benefits	2012-11-30	0
Number of other retired or separated participants entitled to future benefits	2012-11-30	30
Total of all active and inactive participants	2012-11-30	165
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-11-30	0
Total participants	2012-11-30	165
Number of participants with account balances	2012-11-30	165
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-11-30	10
2011: DIVERSIFIED OPHTHALMICS, INC. RETIREMENT AND SAVINGS PLAN 2011 401k membership
Total participants, beginning-of-year	2011-11-30	166
Total number of active participants reported on line 7a of the Form 5500	2011-11-30	144
Number of retired or separated participants receiving benefits	2011-11-30	0
Number of other retired or separated participants entitled to future benefits	2011-11-30	20
Total of all active and inactive participants	2011-11-30	164
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-11-30	0
Total participants	2011-11-30	164
Number of participants with account balances	2011-11-30	164
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-11-30	7
2010: DIVERSIFIED OPHTHALMICS, INC. RETIREMENT AND SAVINGS PLAN 2010 401k membership
Total participants, beginning-of-year	2010-11-30	158
Total number of active participants reported on line 7a of the Form 5500	2010-11-30	135
Number of retired or separated participants receiving benefits	2010-11-30	0
Number of other retired or separated participants entitled to future benefits	2010-11-30	23
Total of all active and inactive participants	2010-11-30	158
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-11-30	2
Total participants	2010-11-30	160
Number of participants with account balances	2010-11-30	160
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-11-30	4
2009: DIVERSIFIED OPHTHALMICS, INC. RETIREMENT AND SAVINGS PLAN 2009 401k membership
Total participants, beginning-of-year	2009-11-30	206
Total number of active participants reported on line 7a of the Form 5500	2009-11-30	133
Number of retired or separated participants receiving benefits	2009-11-30	0
Number of other retired or separated participants entitled to future benefits	2009-11-30	18
Total of all active and inactive participants	2009-11-30	151
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-11-30	2
Total participants	2009-11-30	153
Number of participants with account balances	2009-11-30	145
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-11-30	0

Financial Data on DIVERSIFIED OPHTHALMICS, INC. RETIREMENT AND SAVINGS PLAN

Measure	Date	Value
2016 : DIVERSIFIED OPHTHALMICS, INC. RETIREMENT AND SAVINGS PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-11-29	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-11-29	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-11-29	$0
Total income from all sources (including contributions)	2016-11-29	$1,406,530
Total loss/gain on sale of assets	2016-11-29	$0
Total of all expenses incurred	2016-11-29	$1,470,376
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-11-29	$1,371,746
Value of total corrective distributions	2016-11-29	$92,429
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-11-29	$747,742
Value of total assets at end of year	2016-11-29	$12,911,155
Value of total assets at beginning of year	2016-11-29	$12,975,001
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-11-29	$6,201
Total interest from all sources	2016-11-29	$49,757
Total dividends received (eg from common stock, registered investment company shares)	2016-11-29	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-11-29	No
Was this plan covered by a fidelity bond	2016-11-29	Yes
Value of fidelity bond cover	2016-11-29	$500,000
If this is an individual account plan, was there a blackout period	2016-11-29	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-11-29	$0
Were there any nonexempt tranactions with any party-in-interest	2016-11-29	No
Contributions received from participants	2016-11-29	$481,628
Participant contributions at end of year	2016-11-29	$273,957
Participant contributions at beginning of year	2016-11-29	$417,043
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-11-29	No
Value of net income/loss	2016-11-29	$-63,846
Value of net assets at end of year (total assets less liabilities)	2016-11-29	$12,911,155
Value of net assets at beginning of year (total assets less liabilities)	2016-11-29	$12,975,001
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-11-29	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-11-29	No
Were any leases to which the plan was party in default or uncollectible	2016-11-29	No
Investment advisory and management fees	2016-11-29	$6,201
Value of interest in pooled separate accounts at end of year	2016-11-29	$11,655,890
Value of interest in pooled separate accounts at beginning of year	2016-11-29	$11,549,158
Interest on participant loans	2016-11-29	$19,066
Interest earned on other investments	2016-11-29	$30,691
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-11-29	$881,622
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-11-29	$902,359
Net investment gain/loss from pooled separate accounts	2016-11-29	$609,031
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-11-29	No
Was there a failure to transmit to the plan any participant contributions	2016-11-29	No
Has the plan failed to provide any benefit when due under the plan	2016-11-29	No
Contributions received in cash from employer	2016-11-29	$266,114
Employer contributions (assets) at end of year	2016-11-29	$99,686
Employer contributions (assets) at beginning of year	2016-11-29	$106,441
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-11-29	$1,371,746
Did the plan have assets held for investment	2016-11-29	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	2016-11-29	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-11-29	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-11-29	Yes
Opinion of an independent qualified public accountant for this plan	2016-11-29	Disclaimer
Accountancy firm name	2016-11-29	BARNES & DENNIG CO. LTD
Accountancy firm EIN	2016-11-29	311119890
2015 : DIVERSIFIED OPHTHALMICS, INC. RETIREMENT AND SAVINGS PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-11-29	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-11-29	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-11-29	$0
Total income from all sources (including contributions)	2015-11-29	$779,455
Total loss/gain on sale of assets	2015-11-29	$0
Total of all expenses incurred	2015-11-29	$1,088,667
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-11-29	$1,012,375
Value of total corrective distributions	2015-11-29	$70,348
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-11-29	$679,103
Value of total assets at end of year	2015-11-29	$12,975,001
Value of total assets at beginning of year	2015-11-29	$13,284,213
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-11-29	$5,944
Total interest from all sources	2015-11-29	$52,778
Total dividends received (eg from common stock, registered investment company shares)	2015-11-29	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-11-29	No
Was this plan covered by a fidelity bond	2015-11-29	Yes
Value of fidelity bond cover	2015-11-29	$500,000
If this is an individual account plan, was there a blackout period	2015-11-29	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-11-29	$0
Were there any nonexempt tranactions with any party-in-interest	2015-11-29	No
Contributions received from participants	2015-11-29	$432,222
Participant contributions at end of year	2015-11-29	$417,043
Participant contributions at beginning of year	2015-11-29	$443,522
Participant contributions at beginning of year	2015-11-29	$13,308
Income. Received or receivable in cash from other sources (including rollovers)	2015-11-29	$3,578
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-11-29	No
Value of net income/loss	2015-11-29	$-309,212
Value of net assets at end of year (total assets less liabilities)	2015-11-29	$12,975,001
Value of net assets at beginning of year (total assets less liabilities)	2015-11-29	$13,284,213
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-11-29	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-11-29	No
Were any leases to which the plan was party in default or uncollectible	2015-11-29	No
Investment advisory and management fees	2015-11-29	$5,944
Value of interest in pooled separate accounts at end of year	2015-11-29	$11,549,158
Value of interest in pooled separate accounts at beginning of year	2015-11-29	$11,783,679
Interest on participant loans	2015-11-29	$22,433
Interest earned on other investments	2015-11-29	$30,345
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-11-29	$902,359
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-11-29	$943,355
Net investment gain/loss from pooled separate accounts	2015-11-29	$47,574
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-11-29	No
Was there a failure to transmit to the plan any participant contributions	2015-11-29	No
Has the plan failed to provide any benefit when due under the plan	2015-11-29	No
Contributions received in cash from employer	2015-11-29	$243,303
Employer contributions (assets) at end of year	2015-11-29	$106,441
Employer contributions (assets) at beginning of year	2015-11-29	$100,349
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-11-29	$1,012,375
Did the plan have assets held for investment	2015-11-29	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-11-29	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-11-29	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-11-29	Yes
Opinion of an independent qualified public accountant for this plan	2015-11-29	Disclaimer
Accountancy firm name	2015-11-29	BARNES & DENNIG CO. LTD.
Accountancy firm EIN	2015-11-29	311119890
2014 : DIVERSIFIED OPHTHALMICS, INC. RETIREMENT AND SAVINGS PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-11-29	$0
Total transfer of assets to this plan	2014-11-29	$1,099,772
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-11-29	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-11-29	$0
Total income from all sources (including contributions)	2014-11-29	$1,499,352
Total loss/gain on sale of assets	2014-11-29	$0
Total of all expenses incurred	2014-11-29	$1,106,677
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-11-29	$1,035,076
Value of total corrective distributions	2014-11-29	$66,779
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-11-29	$639,018
Value of total assets at end of year	2014-11-29	$13,284,213
Value of total assets at beginning of year	2014-11-29	$11,791,766
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-11-29	$4,822
Total interest from all sources	2014-11-29	$40,148
Total dividends received (eg from common stock, registered investment company shares)	2014-11-29	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-11-29	No
Was this plan covered by a fidelity bond	2014-11-29	Yes
Value of fidelity bond cover	2014-11-29	$500,000
If this is an individual account plan, was there a blackout period	2014-11-29	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-11-29	$0
Were there any nonexempt tranactions with any party-in-interest	2014-11-29	No
Contributions received from participants	2014-11-29	$399,326
Participant contributions at end of year	2014-11-29	$443,522
Participant contributions at beginning of year	2014-11-29	$364,367
Participant contributions at end of year	2014-11-29	$13,308
Income. Received or receivable in cash from other sources (including rollovers)	2014-11-29	$23,952
Other income not declared elsewhere	2014-11-29	$6,020
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-11-29	No
Value of net income/loss	2014-11-29	$392,675
Value of net assets at end of year (total assets less liabilities)	2014-11-29	$13,284,213
Value of net assets at beginning of year (total assets less liabilities)	2014-11-29	$11,791,766
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-11-29	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-11-29	No
Were any leases to which the plan was party in default or uncollectible	2014-11-29	No
Investment advisory and management fees	2014-11-29	$4,822
Value of interest in pooled separate accounts at end of year	2014-11-29	$11,783,679
Value of interest in pooled separate accounts at beginning of year	2014-11-29	$10,340,236
Interest on participant loans	2014-11-29	$12,959
Interest earned on other investments	2014-11-29	$27,189
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-11-29	$943,355
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-11-29	$810,425
Net investment gain/loss from pooled separate accounts	2014-11-29	$814,166
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-11-29	No
Was there a failure to transmit to the plan any participant contributions	2014-11-29	Yes
Has the plan failed to provide any benefit when due under the plan	2014-11-29	No
Contributions received in cash from employer	2014-11-29	$215,740
Employer contributions (assets) at end of year	2014-11-29	$100,349
Employer contributions (assets) at beginning of year	2014-11-29	$276,738
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-11-29	$1,035,076
Did the plan have assets held for investment	2014-11-29	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	2014-11-29	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-11-29	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-11-29	Yes
Opinion of an independent qualified public accountant for this plan	2014-11-29	Disclaimer
Accountancy firm name	2014-11-29	BARNES & DENNIG CO.LTD.
Accountancy firm EIN	2014-11-29	311119890
2013 : DIVERSIFIED OPHTHALMICS, INC. RETIREMENT AND SAVINGS PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-11-29	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-11-29	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-11-29	$0
Total income from all sources (including contributions)	2013-11-29	$2,556,073
Total loss/gain on sale of assets	2013-11-29	$0
Total of all expenses incurred	2013-11-29	$236,016
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-11-29	$231,778
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-11-29	$705,372
Value of total assets at end of year	2013-11-29	$11,791,766
Value of total assets at beginning of year	2013-11-29	$9,471,709
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-11-29	$4,238
Total interest from all sources	2013-11-29	$23,741
Total dividends received (eg from common stock, registered investment company shares)	2013-11-29	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-11-29	No
Was this plan covered by a fidelity bond	2013-11-29	Yes
Value of fidelity bond cover	2013-11-29	$500,000
If this is an individual account plan, was there a blackout period	2013-11-29	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-11-29	$0
Were there any nonexempt tranactions with any party-in-interest	2013-11-29	No
Contributions received from participants	2013-11-29	$324,225
Participant contributions at end of year	2013-11-29	$364,367
Participant contributions at beginning of year	2013-11-29	$324,328
Income. Received or receivable in cash from other sources (including rollovers)	2013-11-29	$210
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-11-29	No
Value of net income/loss	2013-11-29	$2,320,057
Value of net assets at end of year (total assets less liabilities)	2013-11-29	$11,791,766
Value of net assets at beginning of year (total assets less liabilities)	2013-11-29	$9,471,709
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-11-29	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-11-29	No
Were any leases to which the plan was party in default or uncollectible	2013-11-29	No
Value of interest in pooled separate accounts at end of year	2013-11-29	$10,340,236
Value of interest in pooled separate accounts at beginning of year	2013-11-29	$8,517,214
Interest on participant loans	2013-11-29	$12,406
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2013-11-29	$11,335
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-11-29	$810,425
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-11-29	$359,258
Net investment gain/loss from pooled separate accounts	2013-11-29	$1,826,960
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-11-29	No
Was there a failure to transmit to the plan any participant contributions	2013-11-29	No
Has the plan failed to provide any benefit when due under the plan	2013-11-29	No
Contributions received in cash from employer	2013-11-29	$380,937
Employer contributions (assets) at end of year	2013-11-29	$276,738
Employer contributions (assets) at beginning of year	2013-11-29	$270,909
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-11-29	$231,778
Contract administrator fees	2013-11-29	$4,238
Did the plan have assets held for investment	2013-11-29	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	2013-11-29	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-11-29	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-11-29	Yes
Opinion of an independent qualified public accountant for this plan	2013-11-29	Disclaimer
Accountancy firm name	2013-11-29	BARNES & DENNIG CO. LTD.
Accountancy firm EIN	2013-11-29	311119890
2012 : DIVERSIFIED OPHTHALMICS, INC. RETIREMENT AND SAVINGS PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-11-29	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-11-29	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-11-29	$0
Total income from all sources (including contributions)	2012-11-29	$1,841,393
Total loss/gain on sale of assets	2012-11-29	$0
Total of all expenses incurred	2012-11-29	$592,645
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-11-29	$588,995
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-11-29	$678,763
Value of total assets at end of year	2012-11-29	$9,471,709
Value of total assets at beginning of year	2012-11-29	$8,222,961
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-11-29	$3,650
Total interest from all sources	2012-11-29	$14,189
Total dividends received (eg from common stock, registered investment company shares)	2012-11-29	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-11-29	No
Was this plan covered by a fidelity bond	2012-11-29	Yes
Value of fidelity bond cover	2012-11-29	$500,000
If this is an individual account plan, was there a blackout period	2012-11-29	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-11-29	$0
Were there any nonexempt tranactions with any party-in-interest	2012-11-29	No
Contributions received from participants	2012-11-29	$306,312
Participant contributions at end of year	2012-11-29	$324,328
Participant contributions at beginning of year	2012-11-29	$344,135
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-11-29	No
Value of net income/loss	2012-11-29	$1,248,748
Value of net assets at end of year (total assets less liabilities)	2012-11-29	$9,471,709
Value of net assets at beginning of year (total assets less liabilities)	2012-11-29	$8,222,961
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-11-29	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-11-29	No
Were any leases to which the plan was party in default or uncollectible	2012-11-29	No
Investment advisory and management fees	2012-11-29	$3,650
Value of interest in pooled separate accounts at end of year	2012-11-29	$8,517,214
Value of interest in pooled separate accounts at beginning of year	2012-11-29	$7,631,472
Interest on participant loans	2012-11-29	$12,625
Interest earned on other investments	2012-11-29	$1,564
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-11-29	$359,258
Net investment gain/loss from pooled separate accounts	2012-11-29	$1,148,441
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-11-29	No
Was there a failure to transmit to the plan any participant contributions	2012-11-29	No
Has the plan failed to provide any benefit when due under the plan	2012-11-29	No
Contributions received in cash from employer	2012-11-29	$372,451
Employer contributions (assets) at end of year	2012-11-29	$270,909
Employer contributions (assets) at beginning of year	2012-11-29	$247,354
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-11-29	$588,995
Did the plan have assets held for investment	2012-11-29	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	2012-11-29	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-11-29	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-11-29	Yes
Opinion of an independent qualified public accountant for this plan	2012-11-29	Disclaimer
Accountancy firm name	2012-11-29	BARNES & DENNIG CO. LTD.
Accountancy firm EIN	2012-11-29	311119890
2011 : DIVERSIFIED OPHTHALMICS, INC. RETIREMENT AND SAVINGS PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-11-29	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-11-29	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-11-29	$0
Total income from all sources (including contributions)	2011-11-29	$501,767
Total loss/gain on sale of assets	2011-11-29	$0
Total of all expenses incurred	2011-11-29	$191,900
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-11-29	$147,216
Value of total corrective distributions	2011-11-29	$40,904
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-11-29	$653,202
Value of total assets at end of year	2011-11-29	$8,222,961
Value of total assets at beginning of year	2011-11-29	$7,913,094
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-11-29	$3,780
Total interest from all sources	2011-11-29	$13,311
Total dividends received (eg from common stock, registered investment company shares)	2011-11-29	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-11-29	No
Was this plan covered by a fidelity bond	2011-11-29	Yes
Value of fidelity bond cover	2011-11-29	$500,000
If this is an individual account plan, was there a blackout period	2011-11-29	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-11-29	$0
Were there any nonexempt tranactions with any party-in-interest	2011-11-29	No
Contributions received from participants	2011-11-29	$296,177
Participant contributions at end of year	2011-11-29	$344,135
Participant contributions at beginning of year	2011-11-29	$227,513
Income. Received or receivable in cash from other sources (including rollovers)	2011-11-29	$10,481
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2011-11-29	$0
Administrative expenses (other) incurred	2011-11-29	$3,780
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-11-29	No
Value of net income/loss	2011-11-29	$309,867
Value of net assets at end of year (total assets less liabilities)	2011-11-29	$8,222,961
Value of net assets at beginning of year (total assets less liabilities)	2011-11-29	$7,913,094
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-11-29	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-11-29	No
Were any leases to which the plan was party in default or uncollectible	2011-11-29	No
Value of interest in pooled separate accounts at end of year	2011-11-29	$7,631,472
Value of interest in pooled separate accounts at beginning of year	2011-11-29	$7,477,066
Interest on participant loans	2011-11-29	$13,311
Net investment gain/loss from pooled separate accounts	2011-11-29	$-164,746
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-11-29	No
Was there a failure to transmit to the plan any participant contributions	2011-11-29	Yes
Has the plan failed to provide any benefit when due under the plan	2011-11-29	No
Contributions received in cash from employer	2011-11-29	$346,544
Employer contributions (assets) at end of year	2011-11-29	$247,354
Employer contributions (assets) at beginning of year	2011-11-29	$208,515
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-11-29	$147,216
Did the plan have assets held for investment	2011-11-29	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	2011-11-29	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-11-29	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-11-29	Yes
Opinion of an independent qualified public accountant for this plan	2011-11-29	Disclaimer
Accountancy firm name	2011-11-29	BARNES & DENNIG CO. LTD.
Accountancy firm EIN	2011-11-29	311119890
2010 : DIVERSIFIED OPHTHALMICS, INC. RETIREMENT AND SAVINGS PLAN 2010 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-11-29	$0

Form 5500 Responses for DIVERSIFIED OPHTHALMICS, INC. RETIREMENT AND SAVINGS PLAN

2015: DIVERSIFIED OPHTHALMICS, INC. RETIREMENT AND SAVINGS PLAN 2015 form 5500 responses
2015-11-30	Type of plan entity	Single employer plan
2015-11-30	Submission has been amended	No
2015-11-30	This submission is the final filing	No
2015-11-30	This return/report is a short plan year return/report (less than 12 months)	No
2015-11-30	Plan is a collectively bargained plan	No
2015-11-30	Plan funding arrangement – Insurance	Yes
2015-11-30	Plan funding arrangement – Trust	Yes
2015-11-30	Plan benefit arrangement – Insurance	Yes
2015-11-30	Plan benefit arrangement - Trust	Yes
2014: DIVERSIFIED OPHTHALMICS, INC. RETIREMENT AND SAVINGS PLAN 2014 form 5500 responses
2014-11-30	Type of plan entity	Single employer plan
2014-11-30	Submission has been amended	No
2014-11-30	This submission is the final filing	No
2014-11-30	This return/report is a short plan year return/report (less than 12 months)	No
2014-11-30	Plan is a collectively bargained plan	No
2014-11-30	Plan funding arrangement – Insurance	Yes
2014-11-30	Plan funding arrangement – Trust	Yes
2014-11-30	Plan benefit arrangement – Insurance	Yes
2014-11-30	Plan benefit arrangement - Trust	Yes
2013: DIVERSIFIED OPHTHALMICS, INC. RETIREMENT AND SAVINGS PLAN 2013 form 5500 responses
2013-11-30	Type of plan entity	Single employer plan
2013-11-30	Submission has been amended	No
2013-11-30	This submission is the final filing	No
2013-11-30	This return/report is a short plan year return/report (less than 12 months)	No
2013-11-30	Plan is a collectively bargained plan	No
2013-11-30	Plan funding arrangement – Insurance	Yes
2013-11-30	Plan funding arrangement – Trust	Yes
2013-11-30	Plan benefit arrangement – Insurance	Yes
2013-11-30	Plan benefit arrangement - Trust	Yes
2012: DIVERSIFIED OPHTHALMICS, INC. RETIREMENT AND SAVINGS PLAN 2012 form 5500 responses
2012-11-30	Type of plan entity	Single employer plan
2012-11-30	Submission has been amended	Yes
2012-11-30	This submission is the final filing	No
2012-11-30	This return/report is a short plan year return/report (less than 12 months)	No
2012-11-30	Plan is a collectively bargained plan	No
2012-11-30	Plan funding arrangement – Insurance	Yes
2012-11-30	Plan funding arrangement – Trust	Yes
2012-11-30	Plan benefit arrangement – Insurance	Yes
2012-11-30	Plan benefit arrangement - Trust	Yes
2011: DIVERSIFIED OPHTHALMICS, INC. RETIREMENT AND SAVINGS PLAN 2011 form 5500 responses
2011-11-30	Type of plan entity	Single employer plan
2011-11-30	Submission has been amended	No
2011-11-30	This submission is the final filing	No
2011-11-30	This return/report is a short plan year return/report (less than 12 months)	No
2011-11-30	Plan is a collectively bargained plan	No
2011-11-30	Plan funding arrangement – Insurance	Yes
2011-11-30	Plan funding arrangement – Trust	Yes
2011-11-30	Plan benefit arrangement – Insurance	Yes
2011-11-30	Plan benefit arrangement - Trust	Yes
2010: DIVERSIFIED OPHTHALMICS, INC. RETIREMENT AND SAVINGS PLAN 2010 form 5500 responses
2010-11-30	Type of plan entity	Single employer plan
2010-11-30	Submission has been amended	No
2010-11-30	This submission is the final filing	No
2010-11-30	This return/report is a short plan year return/report (less than 12 months)	No
2010-11-30	Plan is a collectively bargained plan	No
2010-11-30	Plan funding arrangement – Insurance	Yes
2010-11-30	Plan funding arrangement – Trust	Yes
2010-11-30	Plan benefit arrangement – Insurance	Yes
2010-11-30	Plan benefit arrangement - Trust	Yes
2009: DIVERSIFIED OPHTHALMICS, INC. RETIREMENT AND SAVINGS PLAN 2009 form 5500 responses
2009-11-30	Type of plan entity	Single employer plan
2009-11-30	Submission has been amended	No
2009-11-30	This submission is the final filing	No
2009-11-30	This return/report is a short plan year return/report (less than 12 months)	No
2009-11-30	Plan is a collectively bargained plan	No
2009-11-30	Plan funding arrangement – Insurance	Yes
2009-11-30	Plan funding arrangement – Trust	Yes
2009-11-30	Plan benefit arrangement – Insurance	Yes
2009-11-30	Plan benefit arrangement - Trust	Yes
2008: DIVERSIFIED OPHTHALMICS, INC. RETIREMENT AND SAVINGS PLAN 2008 form 5500 responses
2008-11-30	Type of plan entity	Single employer plan
2008-11-30	Submission has been amended	No
2008-11-30	This submission is the final filing	No
2008-11-30	This return/report is a short plan year return/report (less than 12 months)	No
2008-11-30	Plan is a collectively bargained plan	No

Insurance Providers Used on plan

AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )

Policy contract number

321281

Policy instance

Insurance contract or identification number	321281
Number of Individuals Covered	189
Insurance policy start date	2014-11-30
Insurance policy end date	2015-11-29
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?	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

AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )

Policy contract number

321281

Policy instance

Insurance contract or identification number	321281
Number of Individuals Covered	194
Insurance policy start date	2013-11-30
Insurance policy end date	2014-11-29
Total amount of commissions paid to insurance broker	USD $17,788
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 $17,369
Insurance broker organization code?	3
Insurance broker name	LM KOHN & CO.

UNION CENTRAL LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 80837 )

Policy contract number

E710611

Policy instance

Insurance contract or identification number	E710611
Number of Individuals Covered	165
Insurance policy start date	2012-11-30
Insurance policy end date	2013-11-29
Total amount of commissions paid to insurance broker	USD $17,788
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 $17,369
Insurance broker organization code?	3
Insurance broker name	GUSTAFSON, PAUL D

UNION CENTRAL LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 80837 )

Policy contract number

ESPB061

Policy instance

Insurance contract or identification number	ESPB061
Number of Individuals Covered	164
Insurance policy start date	2011-11-30
Insurance policy end date	2012-11-29
Total amount of commissions paid to insurance broker	USD $16,875
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

UNION CENTRAL LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 80837 )

Policy contract number

ESPB061

Policy instance

Insurance contract or identification number	ESPB061
Insurance policy start date	2010-11-30
Insurance policy end date	2011-11-29
Total amount of commissions paid to insurance broker	USD $16,046
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

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Company Name:	DIVERSIFIED OPHTHAMLICS, INC
Employer identification number (EIN):	310927558
NAIC Classification:	424210
NAIC Description:	Drugs and Druggists' Sundries Merchant Wholesalers

Jurisdiction of Incorporation:	Ohio Secretary of State Business Services Division
Incorporation Date:	1977-11-30
Company Identification Number:	507918
Legal Registered Office Address:	8970 WINTON ROAD - CINCINNATI United States of America (USA) 45231