401k Plan data: PARTNERS IN HEALTH, A NONPROFIT CORPORATION DEFINED CONTRIBUTION PLAN AND TAX DEFERRED ANNUITY plan

PARTNERS IN HEALTH, A NONPROFIT CORPORATION DEFINED CONTRIBUTION PLAN AND TAX DEFERRED ANNUITY 401k Plan overview

Plan Name	PARTNERS IN HEALTH, A NONPROFIT CORPORATION DEFINED CONTRIBUTION PLAN AND TAX DEFERRED ANNUITY
Plan identification number	002

PARTNERS IN HEALTH, A NONPROFIT CORPORATION DEFINED CONTRIBUTION PLAN AND TAX DEFERRED ANNUITY Benefits

401k Plan Type	Defined Contribution Pension
Plan Features/Benefits	Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.

401k Sponsoring company profile

PARTNERS IN HEALTH, A NONPROFIT CORPORATION has sponsored the creation of one or more 401k plans.

Company Name: PARTNERS IN HEALTH, A NONPROFIT CORPORATION

Employer identification number (EIN): 043567502

NAIC Classification: 624100
NAIC Description: Individual and Family Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PARTNERS IN HEALTH, A NONPROFIT CORPORATION DEFINED CONTRIBUTION PLAN AND TAX DEFERRED ANNUITY

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2012-01-01 ANN QUANDT ANN QUANDT 2013-09-24
002 2011-01-01 ANN QUANDT ANN QUANDT 2016-02-11
002 2010-01-01 ANN QUANDT 2012-10-25 ANN QUANDT 2012-10-25
002 2008-01-01 DONELLA RAPIER

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2012-01-01	ANN QUANDT		ANN QUANDT	2013-09-24
002	2011-01-01	ANN QUANDT		ANN QUANDT	2016-02-11
002	2010-01-01	ANN QUANDT	2012-10-25	ANN QUANDT	2012-10-25
002	2008-01-01	DONELLA RAPIER

Plan Statistics for PARTNERS IN HEALTH, A NONPROFIT CORPORATION DEFINED CONTRIBUTION PLAN AND TAX DEFERRED ANNUITY

401k plan membership statisitcs for PARTNERS IN HEALTH, A NONPROFIT CORPORATION DEFINED CONTRIBUTION PLAN AND TAX DEFERRED ANNUITY

Measure Date Value
2012: PARTNERS IN HEALTH, A NONPROFIT CORPORATION DEFINED CONTRIBUTION PLAN AND TAX DEFERRED ANNUITY 2012 401k membership
Total participants, beginning-of-year 2012-01-01 179
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 93
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 33
Total of all active and inactive participants 2012-01-01 126
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 126
Number of participants with account balances 2012-01-01 112
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: PARTNERS IN HEALTH, A NONPROFIT CORPORATION DEFINED CONTRIBUTION PLAN AND TAX DEFERRED ANNUITY 2011 401k membership
Total participants, beginning-of-year 2011-01-01 144
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

Measure	Date	Value
2012: PARTNERS IN HEALTH, A NONPROFIT CORPORATION DEFINED CONTRIBUTION PLAN AND TAX DEFERRED ANNUITY 2012 401k membership
Total participants, beginning-of-year	2012-01-01	179
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	93
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	33
Total of all active and inactive participants	2012-01-01	126
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	126
Number of participants with account balances	2012-01-01	112
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: PARTNERS IN HEALTH, A NONPROFIT CORPORATION DEFINED CONTRIBUTION PLAN AND TAX DEFERRED ANNUITY 2011 401k membership
Total participants, beginning-of-year	2011-01-01	144
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

Financial Data on PARTNERS IN HEALTH, A NONPROFIT CORPORATION DEFINED CONTRIBUTION PLAN AND TAX DEFERRED ANNUITY

Measure	Date	Value
2012 : PARTNERS IN HEALTH, A NONPROFIT CORPORATION DEFINED CONTRIBUTION PLAN AND TAX DEFERRED ANNUITY 2012 401k financial data
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	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$87,518
Total income from all sources (including contributions)	2012-12-31	$147,549
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$769,349
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$769,349
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$0
Value of total assets at end of year	2012-12-31	$1,297,165
Value of total assets at beginning of year	2012-12-31	$2,006,483
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$0
Total interest from all sources	2012-12-31	$3,689
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2012-12-31	$0
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$265,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
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
Assets. Other investments not covered elsewhere at end of year	2012-12-31	$1,161,183
Assets. Other investments not covered elsewhere at beginning of year	2012-12-31	$1,809,147
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2012-12-31	$87,518
Other income not declared elsewhere	2012-12-31	$136,344
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
Value of net income/loss	2012-12-31	$-621,800
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$1,297,165
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$1,918,965
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
Value of interest in pooled separate accounts at end of year	2012-12-31	$67,531
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$79,302
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-12-31	$3,689
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$68,451
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$118,034
Net investment gain/loss from pooled separate accounts	2012-12-31	$7,516
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$769,349
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
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	MAYER HOFFMAN MCCANN PC
Accountancy firm EIN	2012-12-31	431947695
2011 : PARTNERS IN HEALTH, A NONPROFIT CORPORATION DEFINED CONTRIBUTION PLAN AND TAX DEFERRED ANNUITY 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$87,518
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$86,708
Total income from all sources (including contributions)	2011-12-31	$436,226
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$64,844
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$64,844
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$436,788
Value of total assets at end of year	2011-12-31	$2,006,483
Value of total assets at beginning of year	2011-12-31	$1,634,291
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$0
Total interest from all sources	2011-12-31	$3,665
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2011-12-31	$0
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$265,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$304,354
Participant contributions at beginning of year	2011-12-31	$12,208
Assets. Other investments not covered elsewhere at end of year	2011-12-31	$1,809,147
Assets. Other investments not covered elsewhere at beginning of year	2011-12-31	$1,486,725
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2011-12-31	$87,518
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2011-12-31	$86,708
Other income not declared elsewhere	2011-12-31	$-11,989
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
Value of net income/loss	2011-12-31	$371,382
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$1,918,965
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$1,547,583
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
Value of interest in pooled separate accounts at end of year	2011-12-31	$79,302
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$48,917
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-12-31	$3,665
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$118,034
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$80,897
Net investment gain/loss from pooled separate accounts	2011-12-31	$7,762
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
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	$132,434
Employer contributions (assets) at beginning of year	2011-12-31	$5,544
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$64,844
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
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	MAYER HOFFMAN MCCANN PC
Accountancy firm EIN	2011-12-31	431947695
Total unrealized appreciation/depreciation of assets	2011-10-22	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-10-22	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-10-22	$86,708
Total income from all sources (including contributions)	2011-10-22	$431,337
Total loss/gain on sale of assets	2011-10-22	$0
Total of all expenses incurred	2011-10-22	$1,978,920
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-10-22	$1,978,920
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-10-22	$436,788
Value of total assets at end of year	2011-10-22	$0
Value of total assets at beginning of year	2011-10-22	$1,634,291
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-10-22	$0
Total interest from all sources	2011-10-22	$3,507
Total dividends received (eg from common stock, registered investment company shares)	2011-10-22	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-10-22	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2011-10-22	$0
Was this plan covered by a fidelity bond	2011-10-22	Yes
Value of fidelity bond cover	2011-10-22	$265,000
If this is an individual account plan, was there a blackout period	2011-10-22	No
Were there any nonexempt tranactions with any party-in-interest	2011-10-22	No
Contributions received from participants	2011-10-22	$304,354
Participant contributions at end of year	2011-10-22	$0
Participant contributions at beginning of year	2011-10-22	$12,208
Assets. Other investments not covered elsewhere at end of year	2011-10-22	$0
Assets. Other investments not covered elsewhere at beginning of year	2011-10-22	$1,486,725
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2011-10-22	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2011-10-22	$86,708
Other income not declared elsewhere	2011-10-22	$-16,720
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-10-22	No
Value of net income/loss	2011-10-22	$-1,547,583
Value of net assets at end of year (total assets less liabilities)	2011-10-22	$0
Value of net assets at beginning of year (total assets less liabilities)	2011-10-22	$1,547,583
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-10-22	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-10-22	No
Were any leases to which the plan was party in default or uncollectible	2011-10-22	No
Value of interest in pooled separate accounts at end of year	2011-10-22	$0
Value of interest in pooled separate accounts at beginning of year	2011-10-22	$48,917
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-10-22	$3,507
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-10-22	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-10-22	$80,897
Net investment gain/loss from pooled separate accounts	2011-10-22	$7,762
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-10-22	No
Was there a failure to transmit to the plan any participant contributions	2011-10-22	No
Has the plan failed to provide any benefit when due under the plan	2011-10-22	No
Contributions received in cash from employer	2011-10-22	$132,434
Employer contributions (assets) at end of year	2011-10-22	$0
Employer contributions (assets) at beginning of year	2011-10-22	$5,544
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-10-22	$1,978,920
Did the plan have assets held for investment	2011-10-22	No
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	2011-10-22	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-10-22	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-10-22	Yes
Opinion of an independent qualified public accountant for this plan	2011-10-22	Disclaimer
Accountancy firm name	2011-10-22	MAYER HOFFMAN MCCANN PC
Accountancy firm EIN	2011-10-22	431947695

Form 5500 Responses for PARTNERS IN HEALTH, A NONPROFIT CORPORATION DEFINED CONTRIBUTION PLAN AND TAX DEFERRED ANNUITY

2012: PARTNERS IN HEALTH, A NONPROFIT CORPORATION DEFINED CONTRIBUTION PLAN AND TAX DEFERRED ANNUITY 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 funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: PARTNERS IN HEALTH, A NONPROFIT CORPORATION DEFINED CONTRIBUTION PLAN AND TAX DEFERRED ANNUITY 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	Yes
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 – 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
2008: PARTNERS IN HEALTH, A NONPROFIT CORPORATION DEFINED CONTRIBUTION PLAN AND TAX DEFERRED ANNUITY 2008 form 5500 responses
2008-01-01	Type of plan entity	Single employer plan
2008-01-01	First time form 5500 has been submitted	Yes
2008-01-01	Submission has been amended	No
2008-01-01	This submission is the final filing	No
2008-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2008-01-01	Plan is a collectively bargained plan	No

Insurance Providers Used on plan

TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )

Policy contract number

403120

Policy instance

Insurance contract or identification number	403120
Number of Individuals Covered	112
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $0
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?	Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

TIAA-CREF (National Association of Insurance Commissioners NAIC id number: 69345 )

Policy contract number

403120

Policy instance

Insurance contract or identification number	403120
Number of Individuals Covered	0
Insurance policy start date	2011-01-01
Insurance policy end date	2011-10-22
Total amount of commissions paid to insurance broker	USD $0
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?	Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	PARTNERS IN HEALTH, A NONPROFIT CORPORATION
Employer identification number (EIN):	043567502
NAIC Classification:	624100
NAIC Description:	Individual and Family Services