401k Plan data: CAROLINA CARE PLAN RETIREMENT PLAN plan

CAROLINA CARE PLAN RETIREMENT PLAN 401k Plan overview

Plan Name	CAROLINA CARE PLAN RETIREMENT PLAN
Plan identification number	001

CAROLINA CARE PLAN RETIREMENT 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.

401k Sponsoring company profile

CAROLINA CARE PLAN RETIREMENT PLAN has sponsored the creation of one or more 401k plans.

Company Name: CAROLINA CARE PLAN RETIREMENT PLAN

Employer identification number (EIN): 571048554

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CAROLINA CARE PLAN RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2011-01-01 THOMAS GREENE
001 2009-01-01 CARSON MEEHAN

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2011-01-01	THOMAS GREENE
001	2009-01-01	CARSON MEEHAN

Plan Statistics for CAROLINA CARE PLAN RETIREMENT PLAN

401k plan membership statisitcs for CAROLINA CARE PLAN RETIREMENT PLAN

Measure Date Value
2011: CAROLINA CARE PLAN RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 123
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 0
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 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 0
Number of participants with account balances 2011-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: CAROLINA CARE PLAN RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 166
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 56
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 65
Total of all active and inactive participants 2009-01-01 121
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 121
Number of participants with account balances 2009-01-01 121
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2011: CAROLINA CARE PLAN RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	123
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	0
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	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	0
Number of participants with account balances	2011-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: CAROLINA CARE PLAN RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	166
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	56
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	65
Total of all active and inactive participants	2009-01-01	121
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	121
Number of participants with account balances	2009-01-01	121
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on CAROLINA CARE PLAN RETIREMENT PLAN

Measure	Date	Value
2011 : CAROLINA CARE PLAN RETIREMENT PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-09-01	$0
Total transfer of assets from this plan	2011-09-01	$1,618,328
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-09-01	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-09-01	$0
Total income from all sources (including contributions)	2011-09-01	$-48,434
Total loss/gain on sale of assets	2011-09-01	$0
Total of all expenses incurred	2011-09-01	$406,379
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-09-01	$393,936
Expenses. Certain deemed distributions of participant loans	2011-09-01	$12,200
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-09-01	$0
Value of total assets at end of year	2011-09-01	$0
Value of total assets at beginning of year	2011-09-01	$2,073,141
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-09-01	$243
Total interest from all sources	2011-09-01	$1,076
Total dividends received (eg from common stock, registered investment company shares)	2011-09-01	$6,627
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-09-01	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2011-09-01	$0
Was this plan covered by a fidelity bond	2011-09-01	Yes
Value of fidelity bond cover	2011-09-01	$500,000
If this is an individual account plan, was there a blackout period	2011-09-01	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-09-01	$0
Were there any nonexempt tranactions with any party-in-interest	2011-09-01	No
Participant contributions at end of year	2011-09-01	$0
Participant contributions at beginning of year	2011-09-01	$45,606
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-09-01	No
Value of net income/loss	2011-09-01	$-454,813
Value of net assets at end of year (total assets less liabilities)	2011-09-01	$0
Value of net assets at beginning of year (total assets less liabilities)	2011-09-01	$2,073,141
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-09-01	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-09-01	No
Were any leases to which the plan was party in default or uncollectible	2011-09-01	No
Investment advisory and management fees	2011-09-01	$243
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-09-01	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-09-01	$1,779,447
Interest on participant loans	2011-09-01	$1,057
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-09-01	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-09-01	$248,088
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-09-01	$248,088
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-09-01	$19
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-09-01	$-56,137
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-09-01	Yes
Was there a failure to transmit to the plan any participant contributions	2011-09-01	No
Has the plan failed to provide any benefit when due under the plan	2011-09-01	No
Employer contributions (assets) at end of year	2011-09-01	$0
Employer contributions (assets) at beginning of year	2011-09-01	$0
Income. Dividends from common stock	2011-09-01	$6,627
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-09-01	$393,936
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2011-09-01	Yes
Did the plan have assets held for investment	2011-09-01	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	2011-09-01	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-09-01	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-09-01	No
Opinion of an independent qualified public accountant for this plan	2011-09-01	Unqualified
Accountancy firm name	2011-09-01	ELLIOTT DAVIS, LLC
Accountancy firm EIN	2011-09-01	570381582
2010 : CAROLINA CARE PLAN RETIREMENT 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	$173,585
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$113,343
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$112,726
Expenses. Certain deemed distributions of participant loans	2010-12-31	$617
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$1,875
Value of total assets at end of year	2010-12-31	$2,073,141
Value of total assets at beginning of year	2010-12-31	$2,012,899
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$0
Total interest from all sources	2010-12-31	$2,820
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$20,862
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
Participant contributions at end of year	2010-12-31	$45,606
Participant contributions at beginning of year	2010-12-31	$68,850
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	$60,242
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$2,073,141
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$2,012,899
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 registered invesment companies (eg mutual funds) at end of year	2010-12-31	$1,779,447
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$1,678,866
Interest on participant loans	2010-12-31	$2,794
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2010-12-31	$248,088
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2010-12-31	$260,074
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2010-12-31	$260,074
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2010-12-31	$26
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$148,028
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$1,875
Employer contributions (assets) at end of year	2010-12-31	$0
Employer contributions (assets) at beginning of year	2010-12-31	$5,109
Income. Dividends from common stock	2010-12-31	$20,862
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$112,726
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	No
Opinion of an independent qualified public accountant for this plan	2010-12-31	Unqualified
Accountancy firm name	2010-12-31	ELLIOTT DAVIS, LLC
Accountancy firm EIN	2010-12-31	570381582
2009 : CAROLINA CARE PLAN RETIREMENT 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 CAROLINA CARE PLAN RETIREMENT PLAN

2011: CAROLINA CARE PLAN RETIREMENT PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	Yes
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: CAROLINA CARE PLAN RETIREMENT PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	CAROLINA CARE PLAN RETIREMENT PLAN
Employer identification number (EIN):	571048554
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)