401k Plan data: WEST GEORGIA HEALTHCARE FOR WOMEN, P.C. MONEY PURCHASE PLAN plan

WEST GEORGIA HEALTHCARE FOR WOMEN, P.C. MONEY PURCHASE PLAN 401k Plan overview

Plan Name	WEST GEORGIA HEALTHCARE FOR WOMEN, P.C. MONEY PURCHASE PLAN
Plan identification number	001

WEST GEORGIA HEALTHCARE FOR WOMEN, P.C. MONEY PURCHASE PLAN Benefits

401k Plan Type	Defined Contribution Pension
Plan Features/Benefits	Money purchase (other than target benefit) 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

WEST GEORGIA HEALTHCARE FOR WOMEN, P.C. has sponsored the creation of one or more 401k plans.

Company Name: WEST GEORGIA HEALTHCARE FOR WOMEN, P.C.

Employer identification number (EIN): 582119040

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WEST GEORGIA HEALTHCARE FOR WOMEN, P.C. MONEY PURCHASE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2012-01-01 DAVID HELTON DAVID HELTON 2014-06-16
001 2011-01-01 DR. DAVID G. HELTON
001 2009-01-01 DR. DAVID G. HELTON

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2012-01-01	DAVID HELTON	DAVID HELTON	2014-06-16
001	2011-01-01	DR. DAVID G. HELTON
001	2009-01-01	DR. DAVID G. HELTON

Plan Statistics for WEST GEORGIA HEALTHCARE FOR WOMEN, P.C. MONEY PURCHASE PLAN

401k plan membership statisitcs for WEST GEORGIA HEALTHCARE FOR WOMEN, P.C. MONEY PURCHASE PLAN

Measure Date Value
2012: WEST GEORGIA HEALTHCARE FOR WOMEN, P.C. MONEY PURCHASE PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 18
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 17
Number of other retired or separated participants entitled to future benefits 2012-01-01 1
Total of all active and inactive participants 2012-01-01 18
Total participants 2012-01-01 18
Number of participants with account balances 2012-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: WEST GEORGIA HEALTHCARE FOR WOMEN, P.C. MONEY PURCHASE PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 20
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 17
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 1
Total of all active and inactive participants 2011-01-01 18
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 18
Number of participants with account balances 2011-01-01 5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: WEST GEORGIA HEALTHCARE FOR WOMEN, P.C. MONEY PURCHASE PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 16
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 18
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 1
Total of all active and inactive participants 2009-01-01 19
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 19
Number of participants with account balances 2009-01-01 5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2012: WEST GEORGIA HEALTHCARE FOR WOMEN, P.C. MONEY PURCHASE PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	18
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	17
Number of other retired or separated participants entitled to future benefits	2012-01-01	1
Total of all active and inactive participants	2012-01-01	18
Total participants	2012-01-01	18
Number of participants with account balances	2012-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: WEST GEORGIA HEALTHCARE FOR WOMEN, P.C. MONEY PURCHASE PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	20
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	17
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	1
Total of all active and inactive participants	2011-01-01	18
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	18
Number of participants with account balances	2011-01-01	5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: WEST GEORGIA HEALTHCARE FOR WOMEN, P.C. MONEY PURCHASE PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	16
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	18
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	1
Total of all active and inactive participants	2009-01-01	19
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	19
Number of participants with account balances	2009-01-01	5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on WEST GEORGIA HEALTHCARE FOR WOMEN, P.C. MONEY PURCHASE PLAN

Measure	Date	Value
2012 : WEST GEORGIA HEALTHCARE FOR WOMEN, P.C. MONEY PURCHASE PLAN 2012 401k financial data
Transfers to/from the plan	2012-12-31	$-1,830,327
Total income from all sources	2012-12-31	$0
Expenses. Total of all expenses incurred	2012-12-31	$0
Total plan assets at end of year	2012-12-31	$0
Total plan assets at beginning of year	2012-12-31	$1,747,134
Value of fidelity bond covering the plan	2012-12-31	$200,000
Net income (gross income less expenses)	2012-12-31	$0
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$0
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$1,747,134
Assets. Value of participant loans	2012-12-31	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
2011 : WEST GEORGIA HEALTHCARE FOR WOMEN, P.C. MONEY PURCHASE PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$-48,536
Expenses. Total of all expenses incurred	2011-12-31	$0
Total plan assets at end of year	2011-12-31	$1,747,134
Total plan assets at beginning of year	2011-12-31	$1,795,670
Value of fidelity bond covering the plan	2011-12-31	$200,000
Other income received	2011-12-31	$-48,536
Net income (gross income less expenses)	2011-12-31	$-48,536
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$1,747,134
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$1,795,670
Assets. Value of participant loans	2011-12-31	$15,446
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
2010 : WEST GEORGIA HEALTHCARE FOR WOMEN, P.C. MONEY PURCHASE PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$227,047
Expenses. Total of all expenses incurred	2010-12-31	$0
Total plan assets at end of year	2010-12-31	$1,795,670
Total plan assets at beginning of year	2010-12-31	$1,568,623
Value of fidelity bond covering the plan	2010-12-31	$250,000
Other income received	2010-12-31	$227,047
Net income (gross income less expenses)	2010-12-31	$227,047
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$1,795,670
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$1,568,623
Assets. Value of participant loans	2010-12-31	$17,944

Form 5500 Responses for WEST GEORGIA HEALTHCARE FOR WOMEN, P.C. MONEY PURCHASE PLAN

2012: WEST GEORGIA HEALTHCARE FOR WOMEN, P.C. MONEY PURCHASE 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	Yes
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 – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: WEST GEORGIA HEALTHCARE FOR WOMEN, P.C. MONEY PURCHASE 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 is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: WEST GEORGIA HEALTHCARE FOR WOMEN, P.C. MONEY PURCHASE 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 – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	WEST GEORGIA HEALTHCARE FOR WOMEN, P.C.
Employer identification number (EIN):	582119040
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)