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| Plan Name | GROUP TERM LIFE AND AD&D |
| Plan identification number | 505 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | WATSON CLINIC LLP |
| Employer identification number (EIN): | 590704934 |
| NAIC Classification: | 621111 |
| NAIC Description: | Offices of Physicians (except Mental Health Specialists) |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 505 | 2011-01-01 | LEE ANN BROOKS | |||
| 505 | 2009-01-01 | LEE ANN BROOKS |
| Measure | Date | Value |
|---|---|---|
| 2011: GROUP TERM LIFE AND AD&D 2011 401k membership | ||
| Total participants, beginning-of-year | 2011-01-01 | 1,515 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 0 |
| Total of all active and inactive participants | 2011-01-01 | 0 |
| Total participants | 2011-01-01 | 0 |
| 2009: GROUP TERM LIFE AND AD&D 2009 401k membership | ||
| Total participants, beginning-of-year | 2009-01-01 | 1,493 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 1,527 |
| Total of all active and inactive participants | 2009-01-01 | 1,527 |
| Total participants | 2009-01-01 | 1,527 |
| 2011: GROUP TERM LIFE AND AD&D 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 | Yes |
| 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 – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: GROUP TERM LIFE AND AD&D 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 benefit arrangement – Insurance | Yes |
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