401k Plan data: VISITING NURSE SERVICES OF THE NW 401(K) PLAN plan

VISITING NURSE SERVICES OF THE NW 401(K) PLAN 401k Plan overview

Plan Name	VISITING NURSE SERVICES OF THE NW 401(K) PLAN
Plan identification number	002

VISITING NURSE SERVICES OF THE NW 401(K) 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

VISITING NURSES SERVICES OF THE NORTHWEST has sponsored the creation of one or more 401k plans.

Company Name: VISITING NURSES SERVICES OF THE NORTHWEST

Employer identification number (EIN): 910729017

NAIC Classification: 621610
NAIC Description: Home Health Care Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan VISITING NURSE SERVICES OF THE NW 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2011-01-01 REBECCA BROWN
002 2009-01-01 STEVE ANDERSON JOANNE SUFFIS 2010-10-14

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2011-01-01	REBECCA BROWN
002	2009-01-01	STEVE ANDERSON		JOANNE SUFFIS	2010-10-14

Plan Statistics for VISITING NURSE SERVICES OF THE NW 401(K) PLAN

401k plan membership statisitcs for VISITING NURSE SERVICES OF THE NW 401(K) PLAN

Measure Date Value
2011: VISITING NURSE SERVICES OF THE NW 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 197
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 127
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 57
Total of all active and inactive participants 2011-01-01 184
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 184
Number of participants with account balances 2011-01-01 103
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: VISITING NURSE SERVICES OF THE NW 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 254
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 172
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 14
Total of all active and inactive participants 2009-01-01 186
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 186
Number of participants with account balances 2009-01-01 128
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2011: VISITING NURSE SERVICES OF THE NW 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	197
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	127
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	57
Total of all active and inactive participants	2011-01-01	184
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	184
Number of participants with account balances	2011-01-01	103
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: VISITING NURSE SERVICES OF THE NW 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	254
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	172
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	14
Total of all active and inactive participants	2009-01-01	186
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	186
Number of participants with account balances	2009-01-01	128
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on VISITING NURSE SERVICES OF THE NW 401(K) PLAN

Measure	Date	Value
2012 : VISITING NURSE SERVICES OF THE NW 401(K) PLAN 2012 401k financial data
Total transfer of assets from this plan	2012-04-01	$2,986,987
Total income from all sources (including contributions)	2012-04-01	$197,257
Total of all expenses incurred	2012-04-01	$56,561
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-04-01	$56,561
Value of total assets at end of year	2012-04-01	$0
Value of total assets at beginning of year	2012-04-01	$2,846,291
Total interest from all sources	2012-04-01	$216
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-04-01	No
Was this plan covered by a fidelity bond	2012-04-01	Yes
Value of fidelity bond cover	2012-04-01	$500,000
If this is an individual account plan, was there a blackout period	2012-04-01	No
Were there any nonexempt tranactions with any party-in-interest	2012-04-01	No
Participant contributions at end of year	2012-04-01	$0
Participant contributions at beginning of year	2012-04-01	$17,879
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-04-01	No
Value of net income/loss	2012-04-01	$140,696
Value of net assets at end of year (total assets less liabilities)	2012-04-01	$0
Value of net assets at beginning of year (total assets less liabilities)	2012-04-01	$2,846,291
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-04-01	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-04-01	No
Were any leases to which the plan was party in default or uncollectible	2012-04-01	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-04-01	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-04-01	$1,962,314
Interest on participant loans	2012-04-01	$216
Value of interest in common/collective trusts at end of year	2012-04-01	$0
Value of interest in common/collective trusts at beginning of year	2012-04-01	$866,016
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-04-01	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-04-01	$82
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-04-01	$82
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-04-01	$190,954
Net investment gain or loss from common/collective trusts	2012-04-01	$6,087
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-04-01	No
Was there a failure to transmit to the plan any participant contributions	2012-04-01	No
Has the plan failed to provide any benefit when due under the plan	2012-04-01	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-04-01	$56,561
Did the plan have assets held for investment	2012-04-01	No
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	2012-04-01	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-04-01	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-04-01	Yes
Opinion of an independent qualified public accountant for this plan	2012-04-01	Disclaimer
Accountancy firm name	2012-04-01	FARRELL & CO., PS
Accountancy firm EIN	2012-04-01	911582493
2011 : VISITING NURSE SERVICES OF THE NW 401(K) PLAN 2011 401k financial data
Total income from all sources (including contributions)	2011-12-31	$8,278
Total of all expenses incurred	2011-12-31	$383,228
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$383,128
Value of total assets at end of year	2011-12-31	$2,846,291
Value of total assets at beginning of year	2011-12-31	$3,221,241
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$100
Total interest from all sources	2011-12-31	$1,685
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$500,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Participant contributions at end of year	2011-12-31	$17,879
Participant contributions at beginning of year	2011-12-31	$29,837
Administrative expenses (other) incurred	2011-12-31	$100
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$-374,950
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$2,846,291
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$3,221,241
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$1,962,314
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$2,139,434
Interest on participant loans	2011-12-31	$1,685
Value of interest in common/collective trusts at end of year	2011-12-31	$866,016
Value of interest in common/collective trusts at beginning of year	2011-12-31	$1,051,889
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-12-31	$82
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-12-31	$81
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-12-31	$81
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-35,484
Net investment gain or loss from common/collective trusts	2011-12-31	$42,077
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$383,128
Did the plan have assets held for investment	2011-12-31	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	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	FARRELL & CO., P.S.
Accountancy firm EIN	2011-12-31	911582493
2010 : VISITING NURSE SERVICES OF THE NW 401(K) PLAN 2010 401k financial data
Total income from all sources (including contributions)	2010-12-31	$377,342
Total of all expenses incurred	2010-12-31	$399,182
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$398,882
Value of total assets at end of year	2010-12-31	$3,221,241
Value of total assets at beginning of year	2010-12-31	$3,243,081
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$300
Total interest from all sources	2010-12-31	$712
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$500,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Participant contributions at end of year	2010-12-31	$29,837
Participant contributions at beginning of year	2010-12-31	$31,225
Administrative expenses (other) incurred	2010-12-31	$300
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$-21,840
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$3,221,241
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$3,243,081
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$2,139,434
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$2,160,358
Interest on participant loans	2010-12-31	$712
Value of interest in common/collective trusts at end of year	2010-12-31	$1,051,889
Value of interest in common/collective trusts at beginning of year	2010-12-31	$1,051,417
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2010-12-31	$81
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2010-12-31	$81
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2010-12-31	$81
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$304,638
Net investment gain or loss from common/collective trusts	2010-12-31	$71,992
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$398,882
Did the plan have assets held for investment	2010-12-31	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	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	FARRELL & CO., P.S.
Accountancy firm EIN	2010-12-31	911582493

Form 5500 Responses for VISITING NURSE SERVICES OF THE NW 401(K) PLAN

2011: VISITING NURSE SERVICES OF THE NW 401(K) PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: VISITING NURSE SERVICES OF THE NW 401(K) 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	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	VISITING NURSES SERVICES OF THE NORTHWEST
Employer identification number (EIN):	910729017
NAIC Classification:	621610
NAIC Description:	Home Health Care Services