401k Plan data: HUMAN SERVICE AGENCY 401(K) RETIREMENT PLAN plan

HUMAN SERVICE AGENCY 401(K) RETIREMENT PLAN 401k Plan overview

Plan Name	HUMAN SERVICE AGENCY 401(K) RETIREMENT PLAN
Plan identification number	002

HUMAN SERVICE AGENCY 401(K) 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

HUMAN SERVICE AGENCY has sponsored the creation of one or more 401k plans.

Company Name: HUMAN SERVICE AGENCY

Employer identification number (EIN): 460275247

NAIC Classification: 621420
NAIC Description: Outpatient Mental Health and Substance Abuse Centers

Additional information about HUMAN SERVICE AGENCY

Jurisdiction of Incorporation: South Dakota Secretary of State

Incorporation Date:

Company Identification Number: NS000389

More information about HUMAN SERVICE AGENCY

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HUMAN SERVICE AGENCY 401(K) RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2011-07-01 MICHELLE SPIES MICHELLE SPIES 2015-04-16
002 2009-07-01 CHARLES SHERMAN CHARLES SHERMAN 2011-03-31

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2011-07-01	MICHELLE SPIES		MICHELLE SPIES	2015-04-16
002	2009-07-01	CHARLES SHERMAN		CHARLES SHERMAN	2011-03-31

Plan Statistics for HUMAN SERVICE AGENCY 401(K) RETIREMENT PLAN

401k plan membership statisitcs for HUMAN SERVICE AGENCY 401(K) RETIREMENT PLAN

Measure Date Value
2011: HUMAN SERVICE AGENCY 401(K) RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-07-01 214
Total number of active participants reported on line 7a of the Form 5500 2011-07-01 0
Number of retired or separated participants receiving benefits 2011-07-01 0
Number of other retired or separated participants entitled to future benefits 2011-07-01 0
Total of all active and inactive participants 2011-07-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-07-01 0
Total participants 2011-07-01 0
Number of participants with account balances 2011-07-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-07-01 0
2009: HUMAN SERVICE AGENCY 401(K) RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-07-01 239
Total number of active participants reported on line 7a of the Form 5500 2009-07-01 204
Number of retired or separated participants receiving benefits 2009-07-01 0
Number of other retired or separated participants entitled to future benefits 2009-07-01 17
Total of all active and inactive participants 2009-07-01 221
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-07-01 0
Total participants 2009-07-01 221
Number of participants with account balances 2009-07-01 130
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-07-01 5

Measure	Date	Value
2011: HUMAN SERVICE AGENCY 401(K) RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-07-01	214
Total number of active participants reported on line 7a of the Form 5500	2011-07-01	0
Number of retired or separated participants receiving benefits	2011-07-01	0
Number of other retired or separated participants entitled to future benefits	2011-07-01	0
Total of all active and inactive participants	2011-07-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-07-01	0
Total participants	2011-07-01	0
Number of participants with account balances	2011-07-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-07-01	0
2009: HUMAN SERVICE AGENCY 401(K) RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-07-01	239
Total number of active participants reported on line 7a of the Form 5500	2009-07-01	204
Number of retired or separated participants receiving benefits	2009-07-01	0
Number of other retired or separated participants entitled to future benefits	2009-07-01	17
Total of all active and inactive participants	2009-07-01	221
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-07-01	0
Total participants	2009-07-01	221
Number of participants with account balances	2009-07-01	130
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-07-01	5

Financial Data on HUMAN SERVICE AGENCY 401(K) RETIREMENT PLAN

Measure	Date	Value
2012 : HUMAN SERVICE AGENCY 401(K) RETIREMENT PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-06-30	$0
Total transfer of assets from this plan	2012-06-30	$1,901,476
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-06-30	$0
Total income from all sources (including contributions)	2012-06-30	$66,201
Total loss/gain on sale of assets	2012-06-30	$0
Total of all expenses incurred	2012-06-30	$90,145
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-06-30	$68,462
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-06-30	$77,365
Value of total assets at end of year	2012-06-30	$1,901,476
Value of total assets at beginning of year	2012-06-30	$1,925,420
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-06-30	$21,683
Total interest from all sources	2012-06-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2012-06-30	$17,427
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-06-30	$17,427
Was this plan covered by a fidelity bond	2012-06-30	Yes
Value of fidelity bond cover	2012-06-30	$500,000
If this is an individual account plan, was there a blackout period	2012-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2012-06-30	No
Contributions received from participants	2012-06-30	$77,365
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2012-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2012-06-30	$0
Other income not declared elsewhere	2012-06-30	$5,677
Administrative expenses (other) incurred	2012-06-30	$21,683
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-06-30	No
Value of net income/loss	2012-06-30	$-23,944
Value of net assets at end of year (total assets less liabilities)	2012-06-30	$1,901,476
Value of net assets at beginning of year (total assets less liabilities)	2012-06-30	$1,925,420
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-06-30	No
Were any leases to which the plan was party in default or uncollectible	2012-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-06-30	$1,641,119
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-06-30	$1,668,446
Value of interest in common/collective trusts at end of year	2012-06-30	$260,357
Value of interest in common/collective trusts at beginning of year	2012-06-30	$256,974
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-06-30	$-38,955
Net investment gain/loss from pooled separate accounts	2012-06-30	$0
Net investment gain or loss from common/collective trusts	2012-06-30	$4,687
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-06-30	No
Was there a failure to transmit to the plan any participant contributions	2012-06-30	No
Has the plan failed to provide any benefit when due under the plan	2012-06-30	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-06-30	$68,462
Did the plan have assets held for investment	2012-06-30	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	2012-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-06-30	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2012-06-30	Disclaimer
Accountancy firm name	2012-06-30	VILHAUER RAML & SNYDER P.C.
Accountancy firm EIN	2012-06-30	460414067
2011 : HUMAN SERVICE AGENCY 401(K) RETIREMENT PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-06-30	$4,184
Total income from all sources (including contributions)	2011-06-30	$472,584
Total loss/gain on sale of assets	2011-06-30	$0
Total of all expenses incurred	2011-06-30	$206,893
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-06-30	$194,400
Value of total corrective distributions	2011-06-30	$2,006
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-06-30	$86,482
Value of total assets at end of year	2011-06-30	$1,925,420
Value of total assets at beginning of year	2011-06-30	$1,663,913
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-06-30	$10,487
Total interest from all sources	2011-06-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2011-06-30	$16,632
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-06-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2011-06-30	$16,632
Was this plan covered by a fidelity bond	2011-06-30	Yes
Value of fidelity bond cover	2011-06-30	$500,000
If this is an individual account plan, was there a blackout period	2011-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2011-06-30	No
Contributions received from participants	2011-06-30	$80,216
Income. Received or receivable in cash from other sources (including rollovers)	2011-06-30	$6,266
Other income not declared elsewhere	2011-06-30	$2,759
Administrative expenses (other) incurred	2011-06-30	$10,487
Liabilities. Value of operating payables at beginning of year	2011-06-30	$2,350
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-06-30	No
Value of net income/loss	2011-06-30	$265,691
Value of net assets at end of year (total assets less liabilities)	2011-06-30	$1,925,420
Value of net assets at beginning of year (total assets less liabilities)	2011-06-30	$1,659,729
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-06-30	No
Were any leases to which the plan was party in default or uncollectible	2011-06-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-06-30	$1,668,446
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-06-30	$1,359,858
Value of interest in common/collective trusts at end of year	2011-06-30	$256,974
Value of interest in common/collective trusts at beginning of year	2011-06-30	$304,055
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-06-30	$359,991
Net investment gain or loss from common/collective trusts	2011-06-30	$6,720
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-06-30	No
Was there a failure to transmit to the plan any participant contributions	2011-06-30	No
Has the plan failed to provide any benefit when due under the plan	2011-06-30	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-06-30	$194,400
Liabilities. Value of benefit claims payable at beginning of year	2011-06-30	$1,834
Did the plan have assets held for investment	2011-06-30	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	2011-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2011-06-30	Disclaimer
Accountancy firm name	2011-06-30	VILHAUER RAML & SNYDER P.C.
Accountancy firm EIN	2011-06-30	460414067
2010 : HUMAN SERVICE AGENCY 401(K) RETIREMENT PLAN 2010 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-06-30	$0

Form 5500 Responses for HUMAN SERVICE AGENCY 401(K) RETIREMENT PLAN

2011: HUMAN SERVICE AGENCY 401(K) RETIREMENT PLAN 2011 form 5500 responses
2011-07-01	Type of plan entity	Single employer plan
2011-07-01	Submission has been amended	Yes
2011-07-01	This submission is the final filing	Yes
2011-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-07-01	Plan is a collectively bargained plan	No
2011-07-01	Plan funding arrangement – Trust	Yes
2011-07-01	Plan benefit arrangement - Trust	Yes
2009: HUMAN SERVICE AGENCY 401(K) RETIREMENT PLAN 2009 form 5500 responses
2009-07-01	Type of plan entity	Single employer plan
2009-07-01	Submission has been amended	No
2009-07-01	This submission is the final filing	No
2009-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-07-01	Plan is a collectively bargained plan	No
2009-07-01	Plan funding arrangement – Trust	Yes
2009-07-01	Plan benefit arrangement - Trust	Yes

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Company Name:	HUMAN SERVICE AGENCY
Employer identification number (EIN):	460275247
NAIC Classification:	621420
NAIC Description:	Outpatient Mental Health and Substance Abuse Centers

Jurisdiction of Incorporation:	South Dakota Secretary of State
Incorporation Date:
Company Identification Number:	NS000389