401k Plan data: GORE FAMILY CLINIC CASH BALANCE PENSION PLAN plan

GORE FAMILY CLINIC CASH BALANCE PENSION PLAN 401k Plan overview

Plan Name	GORE FAMILY CLINIC CASH BALANCE PENSION PLAN
Plan identification number	002

GORE FAMILY CLINIC CASH BALANCE PENSION PLAN Benefits

401k Plan Type

Defined Benefit Pension

Plan Features/Benefits

Benefits are primarily pay related
Cash balance or similar plan - Plan has a "cash balance" formula. For this purpose, a "cash balance" formula is a benefit formula in a defined benefit plan by whatever name (for example, personal account plan, pension equity plan, life cycle plan, cash account plan, etc.) that rather than, or in addition to, expressing the accrued benefit as a life annuity commencing at normal retirement age, defines benefits for each employee in terms more common to a defined contribution plan such as a single sum distribution amount (for example, 10 percent of final average pay times years of service, or the amount of the employee's hypothetical account balance).

401k Sponsoring company profile

GORE FAMILY CLINIC has sponsored the creation of one or more 401k plans.

Company Name: GORE FAMILY CLINIC

Employer identification number (EIN): 731302791

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GORE FAMILY CLINIC CASH BALANCE PENSION PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2013-01-01 WILLIAM ANDERSON 2014-09-22
002 2012-01-01 WILLIAM ANDERSON 2013-10-07
002 2011-01-01 WILLIAM ANDERSON 2012-10-01
002 2010-01-01 WILLIAM ANDERSON 2011-09-20
002 2008-01-01 WILLIAM ANDERSON, M.D. WILLIAM ANDERSON, M.D. 2010-09-30

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2013-01-01	WILLIAM ANDERSON	2014-09-22
002	2012-01-01	WILLIAM ANDERSON	2013-10-07
002	2011-01-01	WILLIAM ANDERSON	2012-10-01
002	2010-01-01	WILLIAM ANDERSON	2011-09-20
002	2008-01-01	WILLIAM ANDERSON, M.D.		WILLIAM ANDERSON, M.D.	2010-09-30

Plan Statistics for GORE FAMILY CLINIC CASH BALANCE PENSION PLAN

401k plan membership statisitcs for GORE FAMILY CLINIC CASH BALANCE PENSION PLAN

Measure Date Value
2008: GORE FAMILY CLINIC CASH BALANCE PENSION PLAN 2008 401k membership
Total participants, beginning-of-year 2008-01-01 4
Total number of active participants reported on line 7a of the Form 5500 2008-01-01 4
Number of retired or separated participants receiving benefits 2008-01-01 0
Number of other retired or separated participants entitled to future benefits 2008-01-01 0
Total of all active and inactive participants 2008-01-01 4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2008-01-01 0
Total participants 2008-01-01 4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2008-01-01 0

Measure	Date	Value
2008: GORE FAMILY CLINIC CASH BALANCE PENSION PLAN 2008 401k membership
Total participants, beginning-of-year	2008-01-01	4
Total number of active participants reported on line 7a of the Form 5500	2008-01-01	4
Number of retired or separated participants receiving benefits	2008-01-01	0
Number of other retired or separated participants entitled to future benefits	2008-01-01	0
Total of all active and inactive participants	2008-01-01	4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2008-01-01	0
Total participants	2008-01-01	4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2008-01-01	0

Form 5500 Responses for GORE FAMILY CLINIC CASH BALANCE PENSION PLAN

2008: GORE FAMILY CLINIC CASH BALANCE PENSION PLAN 2008 form 5500 responses
2008-01-01	Type of plan entity	Single employer plan
2008-01-01	Submission has been amended	Yes
2008-01-01	This submission is the final filing	No
2008-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2008-01-01	Plan is a collectively bargained plan	No
2008-01-01	Plan funding arrangement – Trust	Yes
2008-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	GORE FAMILY CLINIC
Employer identification number (EIN):	731302791
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)