401k Plan data: KITSAP PHYSICIANS SERVICE EMPLOYEES' RETIREMENT PLAN plan

KITSAP PHYSICIANS SERVICE EMPLOYEES' RETIREMENT PLAN 401k Plan overview

Plan Name	KITSAP PHYSICIANS SERVICE EMPLOYEES' RETIREMENT PLAN
Plan identification number	001

KITSAP PHYSICIANS SERVICE EMPLOYEES' RETIREMENT PLAN Benefits

401k Plan Type	Defined Benefit Pension
Plan Features/Benefits	Benefits are primarily pay related Covered by PBGC - Plan is covered under the PBGC insurance program (see ERISA section 4021). Frozen Plan - As of the last day of the plan year, the plan provides that no participant will get any new benefit accrual (whether because of service or compensation). Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

KPS HEALTH PLANS has sponsored the creation of one or more 401k plans.

Company Name: KPS HEALTH PLANS

Employer identification number (EIN): 910540525

NAIC Classification: 524140

Additional information about KPS HEALTH PLANS

Jurisdiction of Incorporation: Washington Secretary of State Corporations Division

Incorporation Date: 1948-06-08

Company Identification Number: 181005557

More information about KPS HEALTH PLANS

Form 5500 Filing Information

Submission information for form 5500 for 401k plan KITSAP PHYSICIANS SERVICE EMPLOYEES' RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2014-01-01 SHEILA BURROUGHS MARTIN DOPPS 2015-10-06
001 2013-01-01 ANDREW HARRISON MARTIN DOPPS 2014-10-09
001 2012-01-01 MARIAN GEDDES MARTIN DOPPS 2013-10-08
001 2011-01-01 MARIAN GEDDES MARTIN DOPPS 2012-10-12
001 2010-01-01 W. JAMES PAGE, JR.
001 2009-01-01 DEBBIE LAUDENSLAGER W. JAMES PAGE 2010-09-28

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2014-01-01	SHEILA BURROUGHS	MARTIN DOPPS	2015-10-06
001	2013-01-01	ANDREW HARRISON	MARTIN DOPPS	2014-10-09
001	2012-01-01	MARIAN GEDDES	MARTIN DOPPS	2013-10-08
001	2011-01-01	MARIAN GEDDES	MARTIN DOPPS	2012-10-12
001	2010-01-01	W. JAMES PAGE, JR.
001	2009-01-01	DEBBIE LAUDENSLAGER	W. JAMES PAGE	2010-09-28

Plan Statistics for KITSAP PHYSICIANS SERVICE EMPLOYEES' RETIREMENT PLAN

401k plan membership statisitcs for KITSAP PHYSICIANS SERVICE EMPLOYEES' RETIREMENT PLAN

Measure Date Value
2014: KITSAP PHYSICIANS SERVICE EMPLOYEES' RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 299
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 53
Number of retired or separated participants receiving benefits 2014-01-01 86
Number of other retired or separated participants entitled to future benefits 2014-01-01 154
Total of all active and inactive participants 2014-01-01 293
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 4
Total participants 2014-01-01 297
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: KITSAP PHYSICIANS SERVICE EMPLOYEES' RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 301
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 57
Number of retired or separated participants receiving benefits 2013-01-01 81
Number of other retired or separated participants entitled to future benefits 2013-01-01 159
Total of all active and inactive participants 2013-01-01 297
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 2
Total participants 2013-01-01 299
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: KITSAP PHYSICIANS SERVICE EMPLOYEES' RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 301
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 69
Number of retired or separated participants receiving benefits 2012-01-01 74
Number of other retired or separated participants entitled to future benefits 2012-01-01 156
Total of all active and inactive participants 2012-01-01 299
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 2
Total participants 2012-01-01 301
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: KITSAP PHYSICIANS SERVICE EMPLOYEES' RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 293
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 87
Number of retired or separated participants receiving benefits 2011-01-01 66
Number of other retired or separated participants entitled to future benefits 2011-01-01 146
Total of all active and inactive participants 2011-01-01 299
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 2
Total participants 2011-01-01 301
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: KITSAP PHYSICIANS SERVICE EMPLOYEES' RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 303
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 92
Number of retired or separated participants receiving benefits 2010-01-01 62
Number of other retired or separated participants entitled to future benefits 2010-01-01 138
Total of all active and inactive participants 2010-01-01 292
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 1
Total participants 2010-01-01 293
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 10
2009: KITSAP PHYSICIANS SERVICE EMPLOYEES' RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 320
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 118
Number of retired or separated participants receiving benefits 2009-01-01 54
Number of other retired or separated participants entitled to future benefits 2009-01-01 130
Total of all active and inactive participants 2009-01-01 302
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 1
Total participants 2009-01-01 303
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 16

Measure	Date	Value
2014: KITSAP PHYSICIANS SERVICE EMPLOYEES' RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	299
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	53
Number of retired or separated participants receiving benefits	2014-01-01	86
Number of other retired or separated participants entitled to future benefits	2014-01-01	154
Total of all active and inactive participants	2014-01-01	293
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	4
Total participants	2014-01-01	297
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: KITSAP PHYSICIANS SERVICE EMPLOYEES' RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	301
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	57
Number of retired or separated participants receiving benefits	2013-01-01	81
Number of other retired or separated participants entitled to future benefits	2013-01-01	159
Total of all active and inactive participants	2013-01-01	297
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	2
Total participants	2013-01-01	299
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: KITSAP PHYSICIANS SERVICE EMPLOYEES' RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	301
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	69
Number of retired or separated participants receiving benefits	2012-01-01	74
Number of other retired or separated participants entitled to future benefits	2012-01-01	156
Total of all active and inactive participants	2012-01-01	299
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	2
Total participants	2012-01-01	301
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: KITSAP PHYSICIANS SERVICE EMPLOYEES' RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	293
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	87
Number of retired or separated participants receiving benefits	2011-01-01	66
Number of other retired or separated participants entitled to future benefits	2011-01-01	146
Total of all active and inactive participants	2011-01-01	299
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	2
Total participants	2011-01-01	301
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: KITSAP PHYSICIANS SERVICE EMPLOYEES' RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	303
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	92
Number of retired or separated participants receiving benefits	2010-01-01	62
Number of other retired or separated participants entitled to future benefits	2010-01-01	138
Total of all active and inactive participants	2010-01-01	292
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	1
Total participants	2010-01-01	293
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	10
2009: KITSAP PHYSICIANS SERVICE EMPLOYEES' RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	320
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	118
Number of retired or separated participants receiving benefits	2009-01-01	54
Number of other retired or separated participants entitled to future benefits	2009-01-01	130
Total of all active and inactive participants	2009-01-01	302
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	1
Total participants	2009-01-01	303
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	16

Financial Data on KITSAP PHYSICIANS SERVICE EMPLOYEES' RETIREMENT PLAN

Measure	Date	Value
2014 : KITSAP PHYSICIANS SERVICE EMPLOYEES' RETIREMENT PLAN 2014 401k financial data
Unrealized appreciation/depreciation of real estate assets	2014-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2014-12-31	$0
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total transfer of assets to this plan	2014-12-31	$0
Total transfer of assets from this plan	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$19,057
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$16,270
Expenses. Interest paid	2014-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$4,818,486
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$929,519
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$756,625
Expenses. Certain deemed distributions of participant loans	2014-12-31	$0
Value of total corrective distributions	2014-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$0
Value of total assets at end of year	2014-12-31	$26,615,392
Value of total assets at beginning of year	2014-12-31	$22,723,638
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$172,894
Total income from rents	2014-12-31	$0
Total interest from all sources	2014-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$1,226,671
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$1,226,671
Administrative expenses professional fees incurred	2014-12-31	$64,267
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$500,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2014-12-31	$0
Other income not declared elsewhere	2014-12-31	$0
Administrative expenses (other) incurred	2014-12-31	$57,463
Liabilities. Value of operating payables at end of year	2014-12-31	$19,057
Liabilities. Value of operating payables at beginning of year	2014-12-31	$16,270
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Income. Non cash contributions	2014-12-31	$0
Value of net income/loss	2014-12-31	$3,888,967
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$26,596,335
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$22,707,368
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Investment advisory and management fees	2014-12-31	$51,164
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$26,615,392
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$22,723,638
Interest on participant loans	2014-12-31	$0
Income. Interest from loans (other than to participants)	2014-12-31	$0
Interest earned on other investments	2014-12-31	$0
Income. Interest from US Government securities	2014-12-31	$0
Income. Interest from corporate debt instruments	2014-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2014-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2014-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$3,591,815
Net investment gain/loss from pooled separate accounts	2014-12-31	$0
Net investment gain or loss from common/collective trusts	2014-12-31	$0
Net gain/loss from 103.12 investment entities	2014-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$0
Income. Dividends from preferred stock	2014-12-31	$0
Income. Dividends from common stock	2014-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$756,625
Contract administrator fees	2014-12-31	$0
Did the plan have assets held for investment	2014-12-31	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	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Aggregate proceeds on sale of assets	2014-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2014-12-31	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	MOSS ADAMS LLP
Accountancy firm EIN	2014-12-31	910189318
2013 : KITSAP PHYSICIANS SERVICE EMPLOYEES' RETIREMENT PLAN 2013 401k financial data
Unrealized appreciation/depreciation of real estate assets	2013-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2013-12-31	$0
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$16,270
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$12,175
Expenses. Interest paid	2013-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$-121,411
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$855,447
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$739,394
Expenses. Certain deemed distributions of participant loans	2013-12-31	$0
Value of total corrective distributions	2013-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$0
Value of total assets at end of year	2013-12-31	$22,723,638
Value of total assets at beginning of year	2013-12-31	$23,696,401
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$116,053
Total interest from all sources	2013-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$1,032,206
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-12-31	$1,032,206
Administrative expenses professional fees incurred	2013-12-31	$35,492
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$20,000,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2013-12-31	$0
Administrative expenses (other) incurred	2013-12-31	$12,642
Liabilities. Value of operating payables at end of year	2013-12-31	$16,270
Liabilities. Value of operating payables at beginning of year	2013-12-31	$12,175
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Income. Non cash contributions	2013-12-31	$0
Value of net income/loss	2013-12-31	$-976,858
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$22,707,368
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$23,684,226
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Investment advisory and management fees	2013-12-31	$67,919
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$22,723,638
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$21,696,401
Interest on participant loans	2013-12-31	$0
Income. Interest from loans (other than to participants)	2013-12-31	$0
Interest earned on other investments	2013-12-31	$0
Income. Interest from US Government securities	2013-12-31	$0
Income. Interest from corporate debt instruments	2013-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2013-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2013-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2013-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2013-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2013-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$-1,153,617
Net investment gain/loss from pooled separate accounts	2013-12-31	$0
Net investment gain or loss from common/collective trusts	2013-12-31	$0
Net gain/loss from 103.12 investment entities	2013-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$0
Employer contributions (assets) at end of year	2013-12-31	$0
Employer contributions (assets) at beginning of year	2013-12-31	$2,000,000
Income. Dividends from preferred stock	2013-12-31	$0
Income. Dividends from common stock	2013-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$739,394
Contract administrator fees	2013-12-31	$0
Did the plan have assets held for investment	2013-12-31	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	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Aggregate proceeds on sale of assets	2013-12-31	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	MOSS ADAMS LLP
Accountancy firm EIN	2013-12-31	910189318
2012 : KITSAP PHYSICIANS SERVICE EMPLOYEES' RETIREMENT PLAN 2012 401k financial data
Unrealized appreciation/depreciation of real estate assets	2012-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2012-12-31	$0
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$12,175
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$11,215
Expenses. Interest paid	2012-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$4,533,028
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$687,251
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$578,763
Expenses. Certain deemed distributions of participant loans	2012-12-31	$0
Value of total corrective distributions	2012-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$2,000,000
Value of total assets at end of year	2012-12-31	$23,696,401
Value of total assets at beginning of year	2012-12-31	$19,849,664
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$108,488
Total income from rents	2012-12-31	$0
Total interest from all sources	2012-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$933,571
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-12-31	$933,571
Administrative expenses professional fees incurred	2012-12-31	$46,711
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$20,000,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2012-12-31	$0
Other income not declared elsewhere	2012-12-31	$0
Administrative expenses (other) incurred	2012-12-31	$18,830
Liabilities. Value of operating payables at end of year	2012-12-31	$12,175
Liabilities. Value of operating payables at beginning of year	2012-12-31	$11,215
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Income. Non cash contributions	2012-12-31	$0
Value of net income/loss	2012-12-31	$3,845,777
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$23,684,226
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$19,838,449
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Investment advisory and management fees	2012-12-31	$42,947
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$21,696,401
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$19,849,664
Interest on participant loans	2012-12-31	$0
Income. Interest from loans (other than to participants)	2012-12-31	$0
Interest earned on other investments	2012-12-31	$0
Income. Interest from US Government securities	2012-12-31	$0
Income. Interest from corporate debt instruments	2012-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2012-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$1,599,457
Net investment gain/loss from pooled separate accounts	2012-12-31	$0
Net investment gain or loss from common/collective trusts	2012-12-31	$0
Net gain/loss from 103.12 investment entities	2012-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$2,000,000
Employer contributions (assets) at end of year	2012-12-31	$2,000,000
Employer contributions (assets) at beginning of year	2012-12-31	$0
Income. Dividends from preferred stock	2012-12-31	$0
Income. Dividends from common stock	2012-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$578,763
Contract administrator fees	2012-12-31	$0
Did the plan have assets held for investment	2012-12-31	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	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Aggregate proceeds on sale of assets	2012-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2012-12-31	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	No
Opinion of an independent qualified public accountant for this plan	2012-12-31	Unqualified
Accountancy firm name	2012-12-31	MOSS ADAMS LLP
Accountancy firm EIN	2012-12-31	910189318
2011 : KITSAP PHYSICIANS SERVICE EMPLOYEES' RETIREMENT PLAN 2011 401k financial data
Unrealized appreciation/depreciation of real estate assets	2011-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2011-12-31	$0
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total transfer of assets to this plan	2011-12-31	$0
Total transfer of assets from this plan	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$11,215
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$12,465
Expenses. Interest paid	2011-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$1,525,020
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$699,118
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$600,762
Expenses. Certain deemed distributions of participant loans	2011-12-31	$0
Value of total corrective distributions	2011-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$0
Value of total assets at end of year	2011-12-31	$19,849,664
Value of total assets at beginning of year	2011-12-31	$19,025,012
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$98,356
Total interest from all sources	2011-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$633,677
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2011-12-31	$633,677
Administrative expenses professional fees incurred	2011-12-31	$47,872
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$20,000,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2011-12-31	$0
Administrative expenses (other) incurred	2011-12-31	$11,255
Liabilities. Value of operating payables at end of year	2011-12-31	$11,215
Liabilities. Value of operating payables at beginning of year	2011-12-31	$12,465
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Income. Non cash contributions	2011-12-31	$0
Value of net income/loss	2011-12-31	$825,902
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$19,838,449
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$19,012,547
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Investment advisory and management fees	2011-12-31	$39,229
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$19,849,664
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$19,025,012
Interest on participant loans	2011-12-31	$0
Income. Interest from loans (other than to participants)	2011-12-31	$0
Interest earned on other investments	2011-12-31	$0
Income. Interest from US Government securities	2011-12-31	$0
Income. Interest from corporate debt instruments	2011-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2011-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$891,343
Net investment gain/loss from pooled separate accounts	2011-12-31	$0
Net investment gain or loss from common/collective trusts	2011-12-31	$0
Net gain/loss from 103.12 investment entities	2011-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$0
Employer contributions (assets) at end of year	2011-12-31	$0
Employer contributions (assets) at beginning of year	2011-12-31	$0
Income. Dividends from preferred stock	2011-12-31	$0
Income. Dividends from common stock	2011-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$600,762
Contract administrator fees	2011-12-31	$0
Did the plan have assets held for investment	2011-12-31	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	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Aggregate proceeds on sale of assets	2011-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2011-12-31	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	No
Opinion of an independent qualified public accountant for this plan	2011-12-31	Unqualified
Accountancy firm name	2011-12-31	MOSS ADAMS LLP
Accountancy firm EIN	2011-12-31	910189318
2010 : KITSAP PHYSICIANS SERVICE EMPLOYEES' 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	$12,465
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$3,591
Total income from all sources (including contributions)	2010-12-31	$2,156,363
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$571,610
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$478,830
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$0
Value of total assets at end of year	2010-12-31	$19,025,012
Value of total assets at beginning of year	2010-12-31	$17,431,385
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$92,780
Total interest from all sources	2010-12-31	$1
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$532,755
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2010-12-31	$532,755
Administrative expenses professional fees incurred	2010-12-31	$46,184
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$500,000
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
Liabilities. Value of operating payables at end of year	2010-12-31	$12,465
Liabilities. Value of operating payables at beginning of year	2010-12-31	$3,591
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	$1,584,753
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$19,012,547
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$17,427,794
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
Investment advisory and management fees	2010-12-31	$46,596
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$19,025,012
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$17,049,355
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2010-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2010-12-31	$7,030
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2010-12-31	$7,030
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2010-12-31	$1
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$1,623,607
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
Employer contributions (assets) at end of year	2010-12-31	$0
Employer contributions (assets) at beginning of year	2010-12-31	$375,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$478,830
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	MOSS ADAMS LLP
Accountancy firm EIN	2010-12-31	910189318
2009 : KITSAP PHYSICIANS SERVICE EMPLOYEES' 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 KITSAP PHYSICIANS SERVICE EMPLOYEES' RETIREMENT PLAN

2014: KITSAP PHYSICIANS SERVICE EMPLOYEES' RETIREMENT PLAN 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	No
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 – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: KITSAP PHYSICIANS SERVICE EMPLOYEES' RETIREMENT PLAN 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 – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: KITSAP PHYSICIANS SERVICE EMPLOYEES' RETIREMENT PLAN 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 – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: KITSAP PHYSICIANS SERVICE EMPLOYEES' 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	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 – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: KITSAP PHYSICIANS SERVICE EMPLOYEES' RETIREMENT PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: KITSAP PHYSICIANS SERVICE EMPLOYEES' RETIREMENT PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

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KITSAP PHYSICIANS SERVICE EMPLOYEES' RETIREMENT PLAN [EIN = 911467158]

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Company Name:	KPS HEALTH PLANS
Employer identification number (EIN):	910540525
NAIC Classification:	524140

Jurisdiction of Incorporation:	Washington Secretary of State Corporations Division
Incorporation Date:	1948-06-08
Company Identification Number:	181005557