401k Plan data: WOMEN'S CARE FOR THE COMMONWEALTH 401(K) PLAN plan

WOMEN'S CARE FOR THE COMMONWEALTH 401(K) PLAN 401k Plan overview

Plan Name	WOMEN'S CARE FOR THE COMMONWEALTH 401(K) PLAN
Plan identification number	002

WOMEN'S CARE FOR THE COMMONWEALTH 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.

401k Sponsoring company profile

WOMEN'S CARE FOR THE COMMONWEALTH has sponsored the creation of one or more 401k plans.

Company Name: WOMEN'S CARE FOR THE COMMONWEALTH

Employer identification number (EIN): 610932632

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WOMEN'S CARE FOR THE COMMONWEALTH 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2017-01-01 BRIAN REYNOLDS 2018-06-13
002 2016-01-01 BRIAN REYNOLDS 2017-07-19
002 2015-01-01 DR. GARY AHNQUIST 2016-06-10
002 2014-01-01 DR. GARY AHNQUIST 2015-06-18
002 2013-01-01 DR. GARY AHNQUIST 2014-05-15
002 2012-01-01 DR. GARY AHNQUIST 2013-06-11
002 2011-01-01 DR. GARY AHNQUIST

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
002	2017-01-01	BRIAN REYNOLDS	2018-06-13
002	2016-01-01	BRIAN REYNOLDS	2017-07-19
002	2015-01-01	DR. GARY AHNQUIST	2016-06-10
002	2014-01-01	DR. GARY AHNQUIST	2015-06-18
002	2013-01-01	DR. GARY AHNQUIST	2014-05-15
002	2012-01-01	DR. GARY AHNQUIST	2013-06-11
002	2011-01-01	DR. GARY AHNQUIST

Plan Statistics for WOMEN'S CARE FOR THE COMMONWEALTH 401(K) PLAN

401k plan membership statisitcs for WOMEN'S CARE FOR THE COMMONWEALTH 401(K) PLAN

Measure Date Value
2011: WOMEN'S CARE FOR THE COMMONWEALTH 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 25
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 21
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 2
Total of all active and inactive participants 2011-01-01 23
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 23
Number of participants with account balances 2011-01-01 23
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0

Measure	Date	Value
2011: WOMEN'S CARE FOR THE COMMONWEALTH 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	25
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	21
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	2
Total of all active and inactive participants	2011-01-01	23
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	23
Number of participants with account balances	2011-01-01	23
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0

Financial Data on WOMEN'S CARE FOR THE COMMONWEALTH 401(K) PLAN

Measure	Date	Value
2011 : WOMEN'S CARE FOR THE COMMONWEALTH 401(K) PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$269,128
Expenses. Total of all expenses incurred	2011-12-31	$99,219
Benefits paid (including direct rollovers)	2011-12-31	$64,780
Total plan assets at end of year	2011-12-31	$4,071,691
Total plan assets at beginning of year	2011-12-31	$3,901,782
Value of fidelity bond covering the plan	2011-12-31	$500,000
Total contributions received or receivable from participants	2011-12-31	$63,203
Other income received	2011-12-31	$152,867
Net income (gross income less expenses)	2011-12-31	$169,909
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$4,071,691
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$3,901,782
Assets. Value of participant loans	2011-12-31	$55,958
Total contributions received or receivable from employer(s)	2011-12-31	$53,058
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$34,439
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
2010 : WOMEN'S CARE FOR THE COMMONWEALTH 401(K) PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$638,784
Expenses. Total of all expenses incurred	2010-12-31	$3,917,543
Benefits paid (including direct rollovers)	2010-12-31	$3,899,824
Total plan assets at end of year	2010-12-31	$3,901,782
Total plan assets at beginning of year	2010-12-31	$7,180,541
Total contributions received or receivable from participants	2010-12-31	$78,001
Contributions received from other sources (not participants or employers)	2010-12-31	$258,506
Other income received	2010-12-31	$255,775
Net income (gross income less expenses)	2010-12-31	$-3,278,759
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$3,901,782
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$7,180,541
Assets. Value of participant loans	2010-12-31	$68,407
Total contributions received or receivable from employer(s)	2010-12-31	$46,502
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$17,719
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0

Form 5500 Responses for WOMEN'S CARE FOR THE COMMONWEALTH 401(K) PLAN

2011: WOMEN'S CARE FOR THE COMMONWEALTH 401(K) 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	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

Insurance Providers Used on plan

NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )

Policy contract number

13707

Policy instance

Insurance contract or identification number	13707
Number of Individuals Covered	7
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $52
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	Yes
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

NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )

Policy contract number

13707

Policy instance

Insurance contract or identification number	13707
Number of Individuals Covered	1
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $568
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
Commission paid to Insurance Broker	USD $537
Insurance broker organization code?	3
Insurance broker name	HUGH GATES HINES JR

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Company Name:	WOMEN'S CARE FOR THE COMMONWEALTH
Employer identification number (EIN):	610932632
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)