401k Plan data: WCARC FLEXIBLE BENEFIT PLAN LIFE INSURANCE, LONG TERM DISABILITY AND LOSS OF TIME plan

WCARC FLEXIBLE BENEFIT PLAN LIFE INSURANCE, LONG TERM DISABILITY AND LOSS OF TIME 401k Plan overview

Plan Name	WCARC FLEXIBLE BENEFIT PLAN LIFE INSURANCE, LONG TERM DISABILITY AND LOSS OF TIME
Plan identification number	508

WCARC FLEXIBLE BENEFIT PLAN LIFE INSURANCE, LONG TERM DISABILITY AND LOSS OF TIME Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance Temporary disability (accident and sickness) Long-term disability cover Death benefits (include travel accident but not life insurance) Other welfare benefit cover

401k Sponsoring company profile

ARC OF WASHINGTON COUNTY, INC. has sponsored the creation of one or more 401k plans.

Company Name: ARC OF WASHINGTON COUNTY, INC.

Employer identification number (EIN): 520696197

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WCARC FLEXIBLE BENEFIT PLAN LIFE INSURANCE, LONG TERM DISABILITY AND LOSS OF TIME

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
508 2014-01-01 TROY VAN SCOYOC
508 2013-01-01 SHIRLEY BOTTOMS
508 2012-01-01 SHIRLEY BOTTOMS
508 2011-01-01 SHIRLEY BOTTOMS
508 2008-07-01 SANDRA MILES

Plan id#	Filing Submission Date	Name of Administrator
508	2014-01-01	TROY VAN SCOYOC
508	2013-01-01	SHIRLEY BOTTOMS
508	2012-01-01	SHIRLEY BOTTOMS
508	2011-01-01	SHIRLEY BOTTOMS
508	2008-07-01	SANDRA MILES

Plan Statistics for WCARC FLEXIBLE BENEFIT PLAN LIFE INSURANCE, LONG TERM DISABILITY AND LOSS OF TIME

401k plan membership statisitcs for WCARC FLEXIBLE BENEFIT PLAN LIFE INSURANCE, LONG TERM DISABILITY AND LOSS OF TIME

Measure Date Value
2014: WCARC FLEXIBLE BENEFIT PLAN LIFE INSURANCE, LONG TERM DISABILITY AND LOSS OF TIME 2014 401k membership
Total participants, beginning-of-year 2014-01-01 517
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 0
Total of all active and inactive participants 2014-01-01 0
2013: WCARC FLEXIBLE BENEFIT PLAN LIFE INSURANCE, LONG TERM DISABILITY AND LOSS OF TIME 2013 401k membership
Total participants, beginning-of-year 2013-01-01 545
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 517
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 0
Total of all active and inactive participants 2013-01-01 517
2012: WCARC FLEXIBLE BENEFIT PLAN LIFE INSURANCE, LONG TERM DISABILITY AND LOSS OF TIME 2012 401k membership
Total participants, beginning-of-year 2012-01-01 521
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 538
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 0
Total of all active and inactive participants 2012-01-01 538
2011: WCARC FLEXIBLE BENEFIT PLAN LIFE INSURANCE, LONG TERM DISABILITY AND LOSS OF TIME 2011 401k membership
Total participants, beginning-of-year 2011-01-01 525
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 491
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 0
Total of all active and inactive participants 2011-01-01 491
2008: WCARC FLEXIBLE BENEFIT PLAN LIFE INSURANCE, LONG TERM DISABILITY AND LOSS OF TIME 2008 401k membership
Total participants, beginning-of-year 2008-07-01 99
Total number of active participants reported on line 7a of the Form 5500 2008-07-01 85
Total of all active and inactive participants 2008-07-01 85
Total participants 2008-07-01 85

Measure	Date	Value
2014: WCARC FLEXIBLE BENEFIT PLAN LIFE INSURANCE, LONG TERM DISABILITY AND LOSS OF TIME 2014 401k membership
Total participants, beginning-of-year	2014-01-01	517
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	0
Total of all active and inactive participants	2014-01-01	0
2013: WCARC FLEXIBLE BENEFIT PLAN LIFE INSURANCE, LONG TERM DISABILITY AND LOSS OF TIME 2013 401k membership
Total participants, beginning-of-year	2013-01-01	545
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	517
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	0
Total of all active and inactive participants	2013-01-01	517
2012: WCARC FLEXIBLE BENEFIT PLAN LIFE INSURANCE, LONG TERM DISABILITY AND LOSS OF TIME 2012 401k membership
Total participants, beginning-of-year	2012-01-01	521
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	538
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	0
Total of all active and inactive participants	2012-01-01	538
2011: WCARC FLEXIBLE BENEFIT PLAN LIFE INSURANCE, LONG TERM DISABILITY AND LOSS OF TIME 2011 401k membership
Total participants, beginning-of-year	2011-01-01	525
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	491
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	0
Total of all active and inactive participants	2011-01-01	491
2008: WCARC FLEXIBLE BENEFIT PLAN LIFE INSURANCE, LONG TERM DISABILITY AND LOSS OF TIME 2008 401k membership
Total participants, beginning-of-year	2008-07-01	99
Total number of active participants reported on line 7a of the Form 5500	2008-07-01	85
Total of all active and inactive participants	2008-07-01	85
Total participants	2008-07-01	85

Form 5500 Responses for WCARC FLEXIBLE BENEFIT PLAN LIFE INSURANCE, LONG TERM DISABILITY AND LOSS OF TIME

2014: WCARC FLEXIBLE BENEFIT PLAN LIFE INSURANCE, LONG TERM DISABILITY AND LOSS OF TIME 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	Yes
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 benefit arrangement – Insurance	Yes
2013: WCARC FLEXIBLE BENEFIT PLAN LIFE INSURANCE, LONG TERM DISABILITY AND LOSS OF TIME 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: WCARC FLEXIBLE BENEFIT PLAN LIFE INSURANCE, LONG TERM DISABILITY AND LOSS OF TIME 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: WCARC FLEXIBLE BENEFIT PLAN LIFE INSURANCE, LONG TERM DISABILITY AND LOSS OF TIME 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2008: WCARC FLEXIBLE BENEFIT PLAN LIFE INSURANCE, LONG TERM DISABILITY AND LOSS OF TIME 2008 form 5500 responses
2008-07-01	Type of plan entity	Single employer plan
2008-07-01	Submission has been amended	No
2008-07-01	This submission is the final filing	No
2008-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2008-07-01	Plan is a collectively bargained plan	No
2008-07-01	Plan funding arrangement – Insurance	Yes
2008-07-01	Plan benefit arrangement – Insurance	Yes

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Company Name:	ARC OF WASHINGTON COUNTY, INC.
Employer identification number (EIN):	520696197
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities