401k Plan data: THE PENSION PLAN OF CHILD GUIDANCE CLINIC OF WATERBURY, INC. plan

THE PENSION PLAN OF CHILD GUIDANCE CLINIC OF WATERBURY, INC. 401k Plan overview

Plan Name	THE PENSION PLAN OF CHILD GUIDANCE CLINIC OF WATERBURY, INC.
Plan identification number	001

THE PENSION PLAN OF CHILD GUIDANCE CLINIC OF WATERBURY, INC. Benefits

401k Plan Type

Defined Benefit Pension

Plan Features/Benefits

Benefits are primarily pay related
Covered by PBGC - Plan is covered under the PBGC insurance program (see ERISA section 4021).
Plan covered by PBGC that was terminated and closed out for PBGC purposes - Before the end of the plan year (or a prior plan year), (1) the plan terminated in a standard (or distress) termination and completed the distribution of plan assets in satisfaction of all benefit liabilities (or all ERISA Title IV benefits for distress termination); or (2) a trustee was appointed for a terminated plan pursuant to ERISA section 4042.
Frozen Plan - As of the last day of the plan year, the plan provides that no participant will get any new benefit accrual (whether because of service or compensation).
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

WELLMORE, INC. has sponsored the creation of one or more 401k plans.

Company Name: WELLMORE, INC.

Employer identification number (EIN): 060669107

NAIC Classification: 621112
NAIC Description: Offices of Physicians, Mental Health Specialists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE PENSION PLAN OF CHILD GUIDANCE CLINIC OF WATERBURY, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2011-07-01 MARCIA L. GEDDES
001 2009-07-01 MARCIA L. GEDDES

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2011-07-01	MARCIA L. GEDDES
001	2009-07-01	MARCIA L. GEDDES

Plan Statistics for THE PENSION PLAN OF CHILD GUIDANCE CLINIC OF WATERBURY, INC.

401k plan membership statisitcs for THE PENSION PLAN OF CHILD GUIDANCE CLINIC OF WATERBURY, INC.

Measure Date Value
2011: THE PENSION PLAN OF CHILD GUIDANCE CLINIC OF WATERBURY, INC. 2011 401k membership
Total participants, beginning-of-year 2011-07-01 66
Total number of active participants reported on line 7a of the Form 5500 2011-07-01 0
Number of retired or separated participants receiving benefits 2011-07-01 0
Number of other retired or separated participants entitled to future benefits 2011-07-01 0
Total of all active and inactive participants 2011-07-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-07-01 0
Total participants 2011-07-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-07-01 0
2009: THE PENSION PLAN OF CHILD GUIDANCE CLINIC OF WATERBURY, INC. 2009 401k membership
Total participants, beginning-of-year 2009-07-01 67
Total number of active participants reported on line 7a of the Form 5500 2009-07-01 19
Number of retired or separated participants receiving benefits 2009-07-01 1
Number of other retired or separated participants entitled to future benefits 2009-07-01 47
Total of all active and inactive participants 2009-07-01 67
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-07-01 0
Total participants 2009-07-01 67
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-07-01 0

Measure	Date	Value
2011: THE PENSION PLAN OF CHILD GUIDANCE CLINIC OF WATERBURY, INC. 2011 401k membership
Total participants, beginning-of-year	2011-07-01	66
Total number of active participants reported on line 7a of the Form 5500	2011-07-01	0
Number of retired or separated participants receiving benefits	2011-07-01	0
Number of other retired or separated participants entitled to future benefits	2011-07-01	0
Total of all active and inactive participants	2011-07-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-07-01	0
Total participants	2011-07-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-07-01	0
2009: THE PENSION PLAN OF CHILD GUIDANCE CLINIC OF WATERBURY, INC. 2009 401k membership
Total participants, beginning-of-year	2009-07-01	67
Total number of active participants reported on line 7a of the Form 5500	2009-07-01	19
Number of retired or separated participants receiving benefits	2009-07-01	1
Number of other retired or separated participants entitled to future benefits	2009-07-01	47
Total of all active and inactive participants	2009-07-01	67
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-07-01	0
Total participants	2009-07-01	67
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-07-01	0

Financial Data on THE PENSION PLAN OF CHILD GUIDANCE CLINIC OF WATERBURY, INC.

Measure	Date	Value
2011 : THE PENSION PLAN OF CHILD GUIDANCE CLINIC OF WATERBURY, INC. 2011 401k financial data
Transfers to/from the plan	2011-09-30	$0
Total plan liabilities at end of year	2011-09-30	$0
Total plan liabilities at beginning of year	2011-09-30	$600
Total income from all sources	2011-09-30	$-116
Expenses. Total of all expenses incurred	2011-09-30	$975,721
Benefits paid (including direct rollovers)	2011-09-30	$969,742
Total plan assets at end of year	2011-09-30	$0
Total plan assets at beginning of year	2011-09-30	$976,437
Value of fidelity bond covering the plan	2011-09-30	$260,000
Total contributions received or receivable from participants	2011-09-30	$0
Expenses. Other expenses not covered elsewhere	2011-09-30	$1,200
Contributions received from other sources (not participants or employers)	2011-09-30	$0
Other income received	2011-09-30	$-116
Noncash contributions received	2011-09-30	$0
Net income (gross income less expenses)	2011-09-30	$-975,837
Net plan assets at end of year (total assets less liabilities)	2011-09-30	$0
Net plan assets at beginning of year (total assets less liabilities)	2011-09-30	$975,837
Total contributions received or receivable from employer(s)	2011-09-30	$0
Value of certain deemed distributions of participant loans	2011-09-30	$0
Value of corrective distributions	2011-09-30	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2011-09-30	$4,779
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-09-30	$0
Total plan liabilities at end of year	2011-06-30	$600
Total plan liabilities at beginning of year	2011-06-30	$0
Total income from all sources	2011-06-30	$232,674
Expenses. Total of all expenses incurred	2011-06-30	$12,665
Benefits paid (including direct rollovers)	2011-06-30	$2,308
Total plan assets at end of year	2011-06-30	$976,437
Total plan assets at beginning of year	2011-06-30	$755,828
Value of fidelity bond covering the plan	2011-06-30	$260,000
Total contributions received or receivable from participants	2011-06-30	$0
Expenses. Other expenses not covered elsewhere	2011-06-30	$10,357
Contributions received from other sources (not participants or employers)	2011-06-30	$0
Other income received	2011-06-30	$18
Noncash contributions received	2011-06-30	$0
Net income (gross income less expenses)	2011-06-30	$220,009
Net plan assets at end of year (total assets less liabilities)	2011-06-30	$975,837
Net plan assets at beginning of year (total assets less liabilities)	2011-06-30	$755,828
Total contributions received or receivable from employer(s)	2011-06-30	$232,656
Value of certain deemed distributions of participant loans	2011-06-30	$0
Value of corrective distributions	2011-06-30	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2011-06-30	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-06-30	$0
2010 : THE PENSION PLAN OF CHILD GUIDANCE CLINIC OF WATERBURY, INC. 2010 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-06-30	$0

Form 5500 Responses for THE PENSION PLAN OF CHILD GUIDANCE CLINIC OF WATERBURY, INC.

2011: THE PENSION PLAN OF CHILD GUIDANCE CLINIC OF WATERBURY, INC. 2011 form 5500 responses
2011-07-01	Type of plan entity	Single employer plan
2011-07-01	Submission has been amended	No
2011-07-01	This submission is the final filing	Yes
2011-07-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2011-07-01	Plan is a collectively bargained plan	No
2011-07-01	Plan funding arrangement – Insurance	Yes
2011-07-01	Plan funding arrangement – Trust	Yes
2011-07-01	Plan benefit arrangement – Insurance	Yes
2011-07-01	Plan benefit arrangement - Trust	Yes
2009: THE PENSION PLAN OF CHILD GUIDANCE CLINIC OF WATERBURY, INC. 2009 form 5500 responses
2009-07-01	Type of plan entity	Single employer plan
2009-07-01	Submission has been amended	No
2009-07-01	This submission is the final filing	No
2009-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-07-01	Plan is a collectively bargained plan	No
2009-07-01	Plan funding arrangement – Insurance	Yes
2009-07-01	Plan funding arrangement – Trust	Yes
2009-07-01	Plan benefit arrangement – Insurance	Yes
2009-07-01	Plan benefit arrangement - Trust	Yes

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Company Name:	WELLMORE, INC.
Employer identification number (EIN):	060669107
NAIC Classification:	621112
NAIC Description:	Offices of Physicians, Mental Health Specialists