401k Plan data: CENTRAL ILLINOIS XRAY 401K PLAN plan

CENTRAL ILLINOIS XRAY 401K PLAN 401k Plan overview

Plan Name	CENTRAL ILLINOIS XRAY 401K PLAN
Plan identification number	001

CENTRAL ILLINOIS XRAY 401K 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

CENTRAL ILLINOIS XRAY has sponsored the creation of one or more 401k plans.

Company Name: CENTRAL ILLINOIS XRAY

Employer identification number (EIN): 371099104

NAIC Classification: 541990
NAIC Description: All Other Professional, Scientific, and Technical Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CENTRAL ILLINOIS XRAY 401K PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2015-01-01 DAWN PATTON
001 2014-01-01 DAWN ALTSHUE
001 2013-01-01 DAWN ALTSHUE
001 2012-01-01 JIMMY LARSEN JIMMY LARSEN 2013-04-24
001 2011-01-01 JIMMY LARSEN
001 2010-01-01 JIMMY LARSEN
001 2009-01-01 JIMMY LARSEN

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2015-01-01	DAWN PATTON
001	2014-01-01	DAWN ALTSHUE
001	2013-01-01	DAWN ALTSHUE
001	2012-01-01	JIMMY LARSEN	JIMMY LARSEN	2013-04-24
001	2011-01-01	JIMMY LARSEN
001	2010-01-01	JIMMY LARSEN
001	2009-01-01	JIMMY LARSEN

Plan Statistics for CENTRAL ILLINOIS XRAY 401K PLAN

401k plan membership statisitcs for CENTRAL ILLINOIS XRAY 401K PLAN

Measure Date Value
2015: CENTRAL ILLINOIS XRAY 401K PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 7
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 8
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 8
Number of participants with account balances 2015-01-01 6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: CENTRAL ILLINOIS XRAY 401K PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 7
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 7
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 7
Number of participants with account balances 2014-01-01 7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: CENTRAL ILLINOIS XRAY 401K PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 7
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 7
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 0
Total of all active and inactive participants 2013-01-01 7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 7
Number of participants with account balances 2013-01-01 6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: CENTRAL ILLINOIS XRAY 401K PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 7
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 7
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 0
Total of all active and inactive participants 2012-01-01 7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 7
Number of participants with account balances 2012-01-01 7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: CENTRAL ILLINOIS XRAY 401K PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 8
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 7
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 7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 7
Number of participants with account balances 2011-01-01 7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: CENTRAL ILLINOIS XRAY 401K PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 7
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 8
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 0
Total of all active and inactive participants 2010-01-01 8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 8
Number of participants with account balances 2010-01-01 6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: CENTRAL ILLINOIS XRAY 401K PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 5
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 6
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 0
Total of all active and inactive participants 2009-01-01 6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 6
Number of participants with account balances 2009-01-01 6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2015: CENTRAL ILLINOIS XRAY 401K PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	7
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	8
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	8
Number of participants with account balances	2015-01-01	6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: CENTRAL ILLINOIS XRAY 401K PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	7
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	7
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	7
Number of participants with account balances	2014-01-01	7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: CENTRAL ILLINOIS XRAY 401K PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	7
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	7
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	0
Total of all active and inactive participants	2013-01-01	7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	7
Number of participants with account balances	2013-01-01	6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: CENTRAL ILLINOIS XRAY 401K PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	7
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	7
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	0
Total of all active and inactive participants	2012-01-01	7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	7
Number of participants with account balances	2012-01-01	7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: CENTRAL ILLINOIS XRAY 401K PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	8
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	7
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	7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	7
Number of participants with account balances	2011-01-01	7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: CENTRAL ILLINOIS XRAY 401K PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	7
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	8
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	0
Total of all active and inactive participants	2010-01-01	8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	8
Number of participants with account balances	2010-01-01	6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: CENTRAL ILLINOIS XRAY 401K PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	5
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	6
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	0
Total of all active and inactive participants	2009-01-01	6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	6
Number of participants with account balances	2009-01-01	6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on CENTRAL ILLINOIS XRAY 401K PLAN

Measure	Date	Value
2015 : CENTRAL ILLINOIS XRAY 401K PLAN 2015 401k financial data
Transfers to/from the plan	2015-12-31	$0
Total plan liabilities at end of year	2015-12-31	$0
Total plan liabilities at beginning of year	2015-12-31	$0
Total income from all sources	2015-12-31	$97,222
Expenses. Total of all expenses incurred	2015-12-31	$14,810
Benefits paid (including direct rollovers)	2015-12-31	$14,537
Total plan assets at end of year	2015-12-31	$309,970
Total plan assets at beginning of year	2015-12-31	$227,558
Total contributions received or receivable from participants	2015-12-31	$65,400
Expenses. Other expenses not covered elsewhere	2015-12-31	$0
Contributions received from other sources (not participants or employers)	2015-12-31	$0
Other income received	2015-12-31	$2,223
Noncash contributions received	2015-12-31	$0
Net income (gross income less expenses)	2015-12-31	$82,412
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$309,970
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$227,558
Total contributions received or receivable from employer(s)	2015-12-31	$29,599
Value of certain deemed distributions of participant loans	2015-12-31	$0
Value of corrective distributions	2015-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2015-12-31	$273
2014 : CENTRAL ILLINOIS XRAY 401K PLAN 2014 401k financial data
Transfers to/from the plan	2014-12-31	$0
Total plan liabilities at end of year	2014-12-31	$0
Total plan liabilities at beginning of year	2014-12-31	$0
Total income from all sources	2014-12-31	$118,274
Expenses. Total of all expenses incurred	2014-12-31	$240
Benefits paid (including direct rollovers)	2014-12-31	$0
Total plan assets at end of year	2014-12-31	$227,558
Total plan assets at beginning of year	2014-12-31	$109,524
Total contributions received or receivable from participants	2014-12-31	$48,978
Expenses. Other expenses not covered elsewhere	2014-12-31	$0
Contributions received from other sources (not participants or employers)	2014-12-31	$0
Other income received	2014-12-31	$2,203
Noncash contributions received	2014-12-31	$0
Net income (gross income less expenses)	2014-12-31	$118,034
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$227,558
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$109,524
Total contributions received or receivable from employer(s)	2014-12-31	$67,093
Value of certain deemed distributions of participant loans	2014-12-31	$0
Value of corrective distributions	2014-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2014-12-31	$240
2013 : CENTRAL ILLINOIS XRAY 401K PLAN 2013 401k financial data
Transfers to/from the plan	2013-12-31	$0
Total plan liabilities at end of year	2013-12-31	$0
Total income from all sources	2013-12-31	$9,332
Expenses. Total of all expenses incurred	2013-12-31	$241,425
Benefits paid (including direct rollovers)	2013-12-31	$241,207
Total plan assets at end of year	2013-12-31	$109,524
Total plan assets at beginning of year	2013-12-31	$341,617
Total contributions received or receivable from participants	2013-12-31	$2,446
Expenses. Other expenses not covered elsewhere	2013-12-31	$0
Contributions received from other sources (not participants or employers)	2013-12-31	$0
Other income received	2013-12-31	$5,255
Noncash contributions received	2013-12-31	$0
Net income (gross income less expenses)	2013-12-31	$-232,093
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$109,524
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$341,617
Total contributions received or receivable from employer(s)	2013-12-31	$1,631
Value of certain deemed distributions of participant loans	2013-12-31	$0
Value of corrective distributions	2013-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2013-12-31	$218
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
2012 : CENTRAL ILLINOIS XRAY 401K PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$53,482
Expenses. Total of all expenses incurred	2012-12-31	$240
Total plan assets at end of year	2012-12-31	$341,617
Total plan assets at beginning of year	2012-12-31	$288,375
Total contributions received or receivable from participants	2012-12-31	$24,941
Other income received	2012-12-31	$3,232
Net income (gross income less expenses)	2012-12-31	$53,242
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$341,617
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$288,375
Total contributions received or receivable from employer(s)	2012-12-31	$25,309
Expenses. Administrative service providers (salaries,fees and commissions)	2012-12-31	$240
2011 : CENTRAL ILLINOIS XRAY 401K PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$104,179
Expenses. Total of all expenses incurred	2011-12-31	$15,520
Benefits paid (including direct rollovers)	2011-12-31	$15,270
Total plan assets at end of year	2011-12-31	$288,375
Total plan assets at beginning of year	2011-12-31	$199,716
Total contributions received or receivable from participants	2011-12-31	$42,500
Other income received	2011-12-31	$-878
Net income (gross income less expenses)	2011-12-31	$88,659
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$288,375
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$199,716
Total contributions received or receivable from employer(s)	2011-12-31	$62,557
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$250
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
2010 : CENTRAL ILLINOIS XRAY 401K PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$80,554
Expenses. Total of all expenses incurred	2010-12-31	$180
Total plan assets at end of year	2010-12-31	$199,716
Total plan assets at beginning of year	2010-12-31	$119,342
Total contributions received or receivable from participants	2010-12-31	$20,500
Other income received	2010-12-31	$3,866
Net income (gross income less expenses)	2010-12-31	$80,374
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$199,716
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$119,342
Total contributions received or receivable from employer(s)	2010-12-31	$56,188
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$180
2009 : CENTRAL ILLINOIS XRAY 401K 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 CENTRAL ILLINOIS XRAY 401K PLAN

2015: CENTRAL ILLINOIS XRAY 401K PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: CENTRAL ILLINOIS XRAY 401K 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: CENTRAL ILLINOIS XRAY 401K 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: CENTRAL ILLINOIS XRAY 401K 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 funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: CENTRAL ILLINOIS XRAY 401K 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 funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: CENTRAL ILLINOIS XRAY 401K 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 funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: CENTRAL ILLINOIS XRAY 401K 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 funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	CENTRAL ILLINOIS XRAY
Employer identification number (EIN):	371099104
NAIC Classification:	541990
NAIC Description:	All Other Professional, Scientific, and Technical Services