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FIRST AMERICAN HEALTH CARE OF GEORGIA, INC. PENSION PLAN 401k Plan overview

Plan NameFIRST AMERICAN HEALTH CARE OF GEORGIA, INC. PENSION PLAN
Plan identification number 001

FIRST AMERICAN HEALTH CARE OF GEORGIA, INC. PENSION PLAN Benefits

401k Plan TypeDefined 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

TBN OF TN, INC. has sponsored the creation of one or more 401k plans.

Company Name:TBN OF TN, INC.
Employer identification number (EIN):621194761

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FIRST AMERICAN HEALTH CARE OF GEORGIA, INC. PENSION PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012009-01-01PAM DIETRICH PAM DIETRICH2010-10-08

Plan Statistics for FIRST AMERICAN HEALTH CARE OF GEORGIA, INC. PENSION PLAN

401k plan membership statisitcs for FIRST AMERICAN HEALTH CARE OF GEORGIA, INC. PENSION PLAN

Measure Date Value
2009: FIRST AMERICAN HEALTH CARE OF GEORGIA, INC. PENSION PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01228
Total number of active participants reported on line 7a of the Form 55002009-01-010
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-01124
Total of all active and inactive participants2009-01-01124
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-01124
Number of participants with account balances2009-01-01124
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on FIRST AMERICAN HEALTH CARE OF GEORGIA, INC. PENSION PLAN

Measure Date Value
2010 : FIRST AMERICAN HEALTH CARE OF GEORGIA, INC. PENSION PLAN 2010 401k financial data
Total income from all sources (including contributions)2010-12-31$2,533
Total of all expenses incurred2010-12-31$335,903
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$326,931
Value of total assets at end of year2010-12-31$1,019,838
Value of total assets at beginning of year2010-12-31$1,353,208
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$8,972
Total interest from all sources2010-12-31$2,533
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31Yes
Administrative expenses professional fees incurred2010-12-31$2,750
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$300,000
If this is an individual account plan, was there a blackout period2010-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
Funding deficiency by the employer to the plan for this plan year2010-12-31$0
Minimum employer required contribution for this plan year2010-12-31$0
Amount contributed by the employer to the plan for this plan year2010-12-31$0
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2010-12-31$319
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$-333,370
Value of net assets at end of year (total assets less liabilities)2010-12-31$1,019,838
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$1,353,208
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2010-12-31$1,019,838
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2010-12-31$1,352,889
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2010-12-31$1,352,889
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$2,533
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31Yes
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$326,931
Contract administrator fees2010-12-31$6,222
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32010-12-31No
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31No
Opinion of an independent qualified public accountant for this plan2010-12-31Qualified
Accountancy firm name2010-12-31WATKINS UIBERALL, PLLC
Accountancy firm EIN2010-12-31621804252
2009 : FIRST AMERICAN HEALTH CARE OF GEORGIA, INC. PENSION PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2009-12-31$0
Funding deficiency by the employer to the plan for this plan year2009-12-31$0
Minimum employer required contribution for this plan year2009-12-31$0
Amount contributed by the employer to the plan for this plan year2009-12-31$0

Form 5500 Responses for FIRST AMERICAN HEALTH CARE OF GEORGIA, INC. PENSION PLAN

2009: FIRST AMERICAN HEALTH CARE OF GEORGIA, INC. PENSION PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement - TrustYes

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