401k Plan data: TBI RESIDIENTIAL & COMMUNITY SERVICES, INC. GROUP DENTAL, LTD, AD&D AND LIFE PLAN plan

TBI RESIDIENTIAL & COMMUNITY SERVICES, INC. GROUP DENTAL, LTD, AD&D AND LIFE PLAN 401k Plan overview

Plan Name	TBI RESIDIENTIAL & COMMUNITY SERVICES, INC. GROUP DENTAL, LTD, AD&D AND LIFE PLAN
Plan identification number	501

TBI RESIDIENTIAL & COMMUNITY SERVICES, INC. GROUP DENTAL, LTD, AD&D AND LIFE PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance Dental Long-term disability cover Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

TBI RESIDENTIAL & COMMUNITY SERVICES has sponsored the creation of one or more 401k plans.

Company Name: TBI RESIDENTIAL & COMMUNITY SERVICES

Employer identification number (EIN): 411836739

NAIC Classification: 623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TBI RESIDIENTIAL & COMMUNITY SERVICES, INC. GROUP DENTAL, LTD, AD&D AND LIFE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2013-03-01 SHAWN M. NEUMANN
501 2012-03-01 SHAWN M. NEUMANN
501 2011-03-01 SHAWN M NEUMANN
501 2010-03-01 SHAWN NEUMANN SHAWN NEUMANN 2014-02-10
501 2009-03-01 SHAWN NEUMANN SHAWN NEUMANN 2014-02-10

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
501	2013-03-01	SHAWN M. NEUMANN
501	2012-03-01	SHAWN M. NEUMANN
501	2011-03-01	SHAWN M NEUMANN
501	2010-03-01	SHAWN NEUMANN	SHAWN NEUMANN	2014-02-10
501	2009-03-01	SHAWN NEUMANN	SHAWN NEUMANN	2014-02-10

Plan Statistics for TBI RESIDIENTIAL & COMMUNITY SERVICES, INC. GROUP DENTAL, LTD, AD&D AND LIFE PLAN

401k plan membership statisitcs for TBI RESIDIENTIAL & COMMUNITY SERVICES, INC. GROUP DENTAL, LTD, AD&D AND LIFE PLAN

Measure Date Value
2013: TBI RESIDIENTIAL & COMMUNITY SERVICES, INC. GROUP DENTAL, LTD, AD&D AND LIFE PLAN 2013 401k membership
Total participants, beginning-of-year 2013-03-01 215
Total number of active participants reported on line 7a of the Form 5500 2013-03-01 0
Number of retired or separated participants receiving benefits 2013-03-01 0
Number of other retired or separated participants entitled to future benefits 2013-03-01 0
Total of all active and inactive participants 2013-03-01 0
2012: TBI RESIDIENTIAL & COMMUNITY SERVICES, INC. GROUP DENTAL, LTD, AD&D AND LIFE PLAN 2012 401k membership
Total participants, beginning-of-year 2012-03-01 220
Total number of active participants reported on line 7a of the Form 5500 2012-03-01 215
Total of all active and inactive participants 2012-03-01 215
Total participants 2012-03-01 0
2011: TBI RESIDIENTIAL & COMMUNITY SERVICES, INC. GROUP DENTAL, LTD, AD&D AND LIFE PLAN 2011 401k membership
Total participants, beginning-of-year 2011-03-01 232
Total number of active participants reported on line 7a of the Form 5500 2011-03-01 215
Total of all active and inactive participants 2011-03-01 215
Total participants 2011-03-01 215
2010: TBI RESIDIENTIAL & COMMUNITY SERVICES, INC. GROUP DENTAL, LTD, AD&D AND LIFE PLAN 2010 401k membership
Total participants, beginning-of-year 2010-03-01 231
Total number of active participants reported on line 7a of the Form 5500 2010-03-01 232
Total of all active and inactive participants 2010-03-01 232
Total participants 2010-03-01 232
2009: TBI RESIDIENTIAL & COMMUNITY SERVICES, INC. GROUP DENTAL, LTD, AD&D AND LIFE PLAN 2009 401k membership
Total participants, beginning-of-year 2009-03-01 235
Total number of active participants reported on line 7a of the Form 5500 2009-03-01 231
Total of all active and inactive participants 2009-03-01 231
Total participants 2009-03-01 231

Measure	Date	Value
2013: TBI RESIDIENTIAL & COMMUNITY SERVICES, INC. GROUP DENTAL, LTD, AD&D AND LIFE PLAN 2013 401k membership
Total participants, beginning-of-year	2013-03-01	215
Total number of active participants reported on line 7a of the Form 5500	2013-03-01	0
Number of retired or separated participants receiving benefits	2013-03-01	0
Number of other retired or separated participants entitled to future benefits	2013-03-01	0
Total of all active and inactive participants	2013-03-01	0
2012: TBI RESIDIENTIAL & COMMUNITY SERVICES, INC. GROUP DENTAL, LTD, AD&D AND LIFE PLAN 2012 401k membership
Total participants, beginning-of-year	2012-03-01	220
Total number of active participants reported on line 7a of the Form 5500	2012-03-01	215
Total of all active and inactive participants	2012-03-01	215
Total participants	2012-03-01	0
2011: TBI RESIDIENTIAL & COMMUNITY SERVICES, INC. GROUP DENTAL, LTD, AD&D AND LIFE PLAN 2011 401k membership
Total participants, beginning-of-year	2011-03-01	232
Total number of active participants reported on line 7a of the Form 5500	2011-03-01	215
Total of all active and inactive participants	2011-03-01	215
Total participants	2011-03-01	215
2010: TBI RESIDIENTIAL & COMMUNITY SERVICES, INC. GROUP DENTAL, LTD, AD&D AND LIFE PLAN 2010 401k membership
Total participants, beginning-of-year	2010-03-01	231
Total number of active participants reported on line 7a of the Form 5500	2010-03-01	232
Total of all active and inactive participants	2010-03-01	232
Total participants	2010-03-01	232
2009: TBI RESIDIENTIAL & COMMUNITY SERVICES, INC. GROUP DENTAL, LTD, AD&D AND LIFE PLAN 2009 401k membership
Total participants, beginning-of-year	2009-03-01	235
Total number of active participants reported on line 7a of the Form 5500	2009-03-01	231
Total of all active and inactive participants	2009-03-01	231
Total participants	2009-03-01	231

Form 5500 Responses for TBI RESIDIENTIAL & COMMUNITY SERVICES, INC. GROUP DENTAL, LTD, AD&D AND LIFE PLAN

2013: TBI RESIDIENTIAL & COMMUNITY SERVICES, INC. GROUP DENTAL, LTD, AD&D AND LIFE PLAN 2013 form 5500 responses
2013-03-01	Type of plan entity	Single employer plan
2013-03-01	Submission has been amended	No
2013-03-01	This submission is the final filing	Yes
2013-03-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2013-03-01	Plan is a collectively bargained plan	No
2013-03-01	Plan funding arrangement – Insurance	Yes
2013-03-01	Plan benefit arrangement – Insurance	Yes
2012: TBI RESIDIENTIAL & COMMUNITY SERVICES, INC. GROUP DENTAL, LTD, AD&D AND LIFE PLAN 2012 form 5500 responses
2012-03-01	Type of plan entity	Single employer plan
2012-03-01	Plan funding arrangement – Insurance	Yes
2012-03-01	Plan benefit arrangement – Insurance	Yes
2011: TBI RESIDIENTIAL & COMMUNITY SERVICES, INC. GROUP DENTAL, LTD, AD&D AND LIFE PLAN 2011 form 5500 responses
2011-03-01	Type of plan entity	Single employer plan
2011-03-01	Plan funding arrangement – Insurance	Yes
2011-03-01	Plan benefit arrangement – Insurance	Yes
2010: TBI RESIDIENTIAL & COMMUNITY SERVICES, INC. GROUP DENTAL, LTD, AD&D AND LIFE PLAN 2010 form 5500 responses
2010-03-01	Type of plan entity	Single employer plan
2010-03-01	Submission has been amended	No
2010-03-01	This submission is the final filing	No
2010-03-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-03-01	Plan is a collectively bargained plan	No
2010-03-01	Plan funding arrangement – Insurance	Yes
2010-03-01	Plan benefit arrangement – Insurance	Yes
2009: TBI RESIDIENTIAL & COMMUNITY SERVICES, INC. GROUP DENTAL, LTD, AD&D AND LIFE PLAN 2009 form 5500 responses
2009-03-01	Type of plan entity	Single employer plan
2009-03-01	Submission has been amended	No
2009-03-01	This submission is the final filing	No
2009-03-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-03-01	Plan is a collectively bargained plan	No
2009-03-01	Plan funding arrangement – Insurance	Yes
2009-03-01	Plan benefit arrangement – Insurance	Yes

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Company Name:	TBI RESIDENTIAL & COMMUNITY SERVICES
Employer identification number (EIN):	411836739
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities