401k Plan data: WESTERN HOME EMPLOYEES RETIREMENT PLAN plan

WESTERN HOME EMPLOYEES RETIREMENT PLAN 401k Plan overview

Plan Name	WESTERN HOME EMPLOYEES RETIREMENT PLAN
Plan identification number	001

WESTERN HOME EMPLOYEES RETIREMENT 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

WESTERN HOME has sponsored the creation of one or more 401k plans.

Company Name: WESTERN HOME

Employer identification number (EIN): 420680487

NAIC Classification: 623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WESTERN HOME EMPLOYEES RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2009-01-01 KELLY MEIER

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2009-01-01	KELLY MEIER

Plan Statistics for WESTERN HOME EMPLOYEES RETIREMENT PLAN

401k plan membership statisitcs for WESTERN HOME EMPLOYEES RETIREMENT PLAN

Measure Date Value
2009: WESTERN HOME EMPLOYEES RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 485
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 456
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 17
Total of all active and inactive participants 2009-01-01 473
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 2
Total participants 2009-01-01 475
Number of participants with account balances 2009-01-01 166
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2009: WESTERN HOME EMPLOYEES RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	485
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	456
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	17
Total of all active and inactive participants	2009-01-01	473
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	2
Total participants	2009-01-01	475
Number of participants with account balances	2009-01-01	166
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on WESTERN HOME EMPLOYEES RETIREMENT PLAN

Measure	Date	Value
2009 : WESTERN HOME EMPLOYEES RETIREMENT PLAN 2009 401k financial data
Funding deficiency by the employer to the plan for this plan year	2009-12-31	$0
Minimum employer required contribution for this plan year	2009-12-31	$0
Amount contributed by the employer to the plan for this plan year	2009-12-31	$0

Form 5500 Responses for WESTERN HOME EMPLOYEES RETIREMENT PLAN

2009: WESTERN HOME 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 – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Potentially related plans

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Company Name:	WESTERN HOME
Employer identification number (EIN):	420680487
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities