401k Plan data: THE INDIANA ORTHOPAEDIC CENTER EMPLOYEE BENEFIT PLAN plan

THE INDIANA ORTHOPAEDIC CENTER EMPLOYEE BENEFIT PLAN 401k Plan overview

Plan Name	THE INDIANA ORTHOPAEDIC CENTER EMPLOYEE BENEFIT PLAN
Plan identification number	501

THE INDIANA ORTHOPAEDIC CENTER EMPLOYEE BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Dental

401k Sponsoring company profile

THE INDIANA ORTHOPAEDIC CENTER, P.C . has sponsored the creation of one or more 401k plans.

Company Name: THE INDIANA ORTHOPAEDIC CENTER, P.C .

Employer identification number (EIN): 352002612

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE INDIANA ORTHOPAEDIC CENTER EMPLOYEE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2012-02-01 GARY LEWELLEN 2013-11-15
501 2011-02-01 GARY LEWELLEN 2012-11-09
501 2010-02-01 GARY LEWELLEN 2011-10-17
501 2009-02-01 GARY LEWELLEN

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
501	2012-02-01	GARY LEWELLEN	2013-11-15
501	2011-02-01	GARY LEWELLEN	2012-11-09
501	2010-02-01	GARY LEWELLEN	2011-10-17
501	2009-02-01	GARY LEWELLEN

Plan Statistics for THE INDIANA ORTHOPAEDIC CENTER EMPLOYEE BENEFIT PLAN

401k plan membership statisitcs for THE INDIANA ORTHOPAEDIC CENTER EMPLOYEE BENEFIT PLAN

Measure Date Value
2009: THE INDIANA ORTHOPAEDIC CENTER EMPLOYEE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-02-01 73
Total number of active participants reported on line 7a of the Form 5500 2009-02-01 65
Number of retired or separated participants receiving benefits 2009-02-01 0
Number of other retired or separated participants entitled to future benefits 2009-02-01 0
Total of all active and inactive participants 2009-02-01 65

Measure	Date	Value
2009: THE INDIANA ORTHOPAEDIC CENTER EMPLOYEE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-02-01	73
Total number of active participants reported on line 7a of the Form 5500	2009-02-01	65
Number of retired or separated participants receiving benefits	2009-02-01	0
Number of other retired or separated participants entitled to future benefits	2009-02-01	0
Total of all active and inactive participants	2009-02-01	65

Financial Data on THE INDIANA ORTHOPAEDIC CENTER EMPLOYEE BENEFIT PLAN

Measure	Date	Value
2011 : THE INDIANA ORTHOPAEDIC CENTER EMPLOYEE BENEFIT PLAN 2011 401k financial data
Total plan liabilities at end of year	2011-01-31	$0
Total plan liabilities at beginning of year	2011-01-31	$14,065
Total income from all sources	2011-01-31	$659,489
Expenses. Total of all expenses incurred	2011-01-31	$748,205
Benefits paid (including direct rollovers)	2011-01-31	$655,172
Total plan assets at end of year	2011-01-31	$0
Total plan assets at beginning of year	2011-01-31	$102,781
Value of fidelity bond covering the plan	2011-01-31	$25,000
Total contributions received or receivable from participants	2011-01-31	$77,155
Expenses. Other expenses not covered elsewhere	2011-01-31	$155
Other income received	2011-01-31	$33
Net income (gross income less expenses)	2011-01-31	$-88,716
Net plan assets at end of year (total assets less liabilities)	2011-01-31	$0
Net plan assets at beginning of year (total assets less liabilities)	2011-01-31	$88,716
Total contributions received or receivable from employer(s)	2011-01-31	$582,301
Value of corrective distributions	2011-01-31	$71,777
Expenses. Administrative service providers (salaries,fees and commissions)	2011-01-31	$21,101

Form 5500 Responses for THE INDIANA ORTHOPAEDIC CENTER EMPLOYEE BENEFIT PLAN

2009: THE INDIANA ORTHOPAEDIC CENTER EMPLOYEE BENEFIT PLAN 2009 form 5500 responses
2009-02-01	Type of plan entity	Single employer plan
2009-02-01	Submission has been amended	No
2009-02-01	This submission is the final filing	No
2009-02-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-02-01	Plan is a collectively bargained plan	No
2009-02-01	Plan funding arrangement – Insurance	Yes
2009-02-01	Plan funding arrangement – Trust	Yes
2009-02-01	Plan benefit arrangement – Insurance	Yes
2009-02-01	Plan benefit arrangement - Trust	Yes

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Company Name:	THE INDIANA ORTHOPAEDIC CENTER, P.C .
Employer identification number (EIN):	352002612
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)