401k Plan data: CHAPIN & HAVLICEK PHYSICAL THERAPY, LLC 401(K) RETIREMENT PLAN plan

CHAPIN & HAVLICEK PHYSICAL THERAPY, LLC 401(K) RETIREMENT PLAN 401k Plan overview

Plan Name	CHAPIN & HAVLICEK PHYSICAL THERAPY, LLC 401(K) RETIREMENT PLAN
Plan identification number	001

CHAPIN & HAVLICEK PHYSICAL THERAPY, LLC 401(K) RETIREMENT PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
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.
Plan covering Self-Employed individuals.
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

CHAPIN & HAVLICEK PHYSICAL THERAPY, LLC has sponsored the creation of one or more 401k plans.

Company Name: CHAPIN & HAVLICEK PHYSICAL THERAPY, LLC

Employer identification number (EIN): 061451918

NAIC Classification: 621340
NAIC Description: Offices of Physical, Occupational and Speech Therapists, and Audiologists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CHAPIN & HAVLICEK PHYSICAL THERAPY, LLC 401(K) RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2015-01-01 FRED HAVLICEK 2016-10-11
001 2014-01-01 FRED HAVLICEK
001 2013-01-01 FRED HAVLICEK
001 2012-01-01 FRED HAVLICEK
001 2011-01-01 FRED HAVLICEK
001 2010-01-01 FRED HAVLICEK

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2015-01-01	FRED HAVLICEK	2016-10-11
001	2014-01-01	FRED HAVLICEK
001	2013-01-01	FRED HAVLICEK
001	2012-01-01	FRED HAVLICEK
001	2011-01-01	FRED HAVLICEK
001	2010-01-01	FRED HAVLICEK

Plan Statistics for CHAPIN & HAVLICEK PHYSICAL THERAPY, LLC 401(K) RETIREMENT PLAN

401k plan membership statisitcs for CHAPIN & HAVLICEK PHYSICAL THERAPY, LLC 401(K) RETIREMENT PLAN

Measure Date Value
2014: CHAPIN & HAVLICEK PHYSICAL THERAPY, LLC 401(K) RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 15
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 13
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 2
Total of all active and inactive participants 2014-01-01 15
Total participants 2014-01-01 15
Number of participants with account balances 2014-01-01 12
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: CHAPIN & HAVLICEK PHYSICAL THERAPY, LLC 401(K) RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 19
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 13
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 2
Total of all active and inactive participants 2013-01-01 15
Total participants 2013-01-01 15
Number of participants with account balances 2013-01-01 12
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: CHAPIN & HAVLICEK PHYSICAL THERAPY, LLC 401(K) RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 14
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 16
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 3
Total of all active and inactive participants 2012-01-01 19
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 19
Number of participants with account balances 2012-01-01 16
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: CHAPIN & HAVLICEK PHYSICAL THERAPY, LLC 401(K) RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 13
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 12
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 2
Total of all active and inactive participants 2011-01-01 14
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 14
Number of participants with account balances 2011-01-01 14
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: CHAPIN & HAVLICEK PHYSICAL THERAPY, LLC 401(K) RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 0
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 13
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 0
Total of all active and inactive participants 2010-01-01 13
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 13
Number of participants with account balances 2010-01-01 13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0

Measure	Date	Value
2014: CHAPIN & HAVLICEK PHYSICAL THERAPY, LLC 401(K) RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	15
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	13
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	2
Total of all active and inactive participants	2014-01-01	15
Total participants	2014-01-01	15
Number of participants with account balances	2014-01-01	12
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: CHAPIN & HAVLICEK PHYSICAL THERAPY, LLC 401(K) RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	19
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	13
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	2
Total of all active and inactive participants	2013-01-01	15
Total participants	2013-01-01	15
Number of participants with account balances	2013-01-01	12
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: CHAPIN & HAVLICEK PHYSICAL THERAPY, LLC 401(K) RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	14
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	16
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	3
Total of all active and inactive participants	2012-01-01	19
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	19
Number of participants with account balances	2012-01-01	16
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: CHAPIN & HAVLICEK PHYSICAL THERAPY, LLC 401(K) RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	13
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	12
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	2
Total of all active and inactive participants	2011-01-01	14
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	14
Number of participants with account balances	2011-01-01	14
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: CHAPIN & HAVLICEK PHYSICAL THERAPY, LLC 401(K) RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	0
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	13
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	0
Total of all active and inactive participants	2010-01-01	13
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	13
Number of participants with account balances	2010-01-01	13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0

Financial Data on CHAPIN & HAVLICEK PHYSICAL THERAPY, LLC 401(K) RETIREMENT PLAN

Measure	Date	Value
2014 : CHAPIN & HAVLICEK PHYSICAL THERAPY, LLC 401(K) RETIREMENT PLAN 2014 401k financial data
Total income from all sources	2014-12-31	$26,444
Expenses. Total of all expenses incurred	2014-12-31	$33,981
Benefits paid (including direct rollovers)	2014-12-31	$33,981
Total plan assets at end of year	2014-12-31	$325,006
Total plan assets at beginning of year	2014-12-31	$332,543
Value of fidelity bond covering the plan	2014-12-31	$265,000
Other income received	2014-12-31	$15,196
Net income (gross income less expenses)	2014-12-31	$-7,537
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$325,006
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$332,543
Total contributions received or receivable from employer(s)	2014-12-31	$11,248
2013 : CHAPIN & HAVLICEK PHYSICAL THERAPY, LLC 401(K) RETIREMENT PLAN 2013 401k financial data
Total income from all sources	2013-12-31	$93,263
Expenses. Total of all expenses incurred	2013-12-31	$5,626
Benefits paid (including direct rollovers)	2013-12-31	$5,626
Total plan assets at end of year	2013-12-31	$332,543
Total plan assets at beginning of year	2013-12-31	$244,906
Value of fidelity bond covering the plan	2013-12-31	$265,000
Total contributions received or receivable from participants	2013-12-31	$13,707
Contributions received from other sources (not participants or employers)	2013-12-31	$27,704
Other income received	2013-12-31	$51,852
Net income (gross income less expenses)	2013-12-31	$87,637
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$332,543
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$244,906
Total contributions received or receivable from employer(s)	2013-12-31	$0
2012 : CHAPIN & HAVLICEK PHYSICAL THERAPY, LLC 401(K) RETIREMENT PLAN 2012 401k financial data
Transfers to/from the plan	2012-12-31	$0
Total plan liabilities at beginning of year	2012-12-31	$0
Total income from all sources	2012-12-31	$97,184
Expenses. Total of all expenses incurred	2012-12-31	$16,428
Benefits paid (including direct rollovers)	2012-12-31	$16,428
Total plan assets at end of year	2012-12-31	$244,906
Total plan assets at beginning of year	2012-12-31	$164,150
Value of fidelity bond covering the plan	2012-12-31	$265,000
Total contributions received or receivable from participants	2012-12-31	$50,913
Expenses. Other expenses not covered elsewhere	2012-12-31	$0
Contributions received from other sources (not participants or employers)	2012-12-31	$0
Other income received	2012-12-31	$22,064
Noncash contributions received	2012-12-31	$0
Net income (gross income less expenses)	2012-12-31	$80,756
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$244,906
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$164,150
Total contributions received or receivable from employer(s)	2012-12-31	$24,207
Value of certain deemed distributions of participant loans	2012-12-31	$0
Value of corrective distributions	2012-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2012-12-31	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
2011 : CHAPIN & HAVLICEK PHYSICAL THERAPY, LLC 401(K) RETIREMENT PLAN 2011 401k financial data
Transfers to/from the plan	2011-12-31	$0
Total plan liabilities at end of year	2011-12-31	$0
Total plan liabilities at beginning of year	2011-12-31	$0
Total income from all sources	2011-12-31	$79,957
Expenses. Total of all expenses incurred	2011-12-31	$7,342
Benefits paid (including direct rollovers)	2011-12-31	$7,342
Total plan assets at end of year	2011-12-31	$164,150
Total plan assets at beginning of year	2011-12-31	$91,535
Value of fidelity bond covering the plan	2011-12-31	$265,000
Total contributions received or receivable from participants	2011-12-31	$53,890
Expenses. Other expenses not covered elsewhere	2011-12-31	$0
Contributions received from other sources (not participants or employers)	2011-12-31	$0
Other income received	2011-12-31	$-4,338
Noncash contributions received	2011-12-31	$0
Net income (gross income less expenses)	2011-12-31	$72,615
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$164,150
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$91,535
Total contributions received or receivable from employer(s)	2011-12-31	$30,405
Value of certain deemed distributions of participant loans	2011-12-31	$0
Value of corrective distributions	2011-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
2010 : CHAPIN & HAVLICEK PHYSICAL THERAPY, LLC 401(K) RETIREMENT PLAN 2010 401k financial data
Transfers to/from the plan	2010-12-31	$0
Total plan liabilities at end of year	2010-12-31	$0
Total plan liabilities at beginning of year	2010-12-31	$0
Total income from all sources	2010-12-31	$91,535
Expenses. Total of all expenses incurred	2010-12-31	$0
Benefits paid (including direct rollovers)	2010-12-31	$0
Total plan assets at end of year	2010-12-31	$91,535
Total plan assets at beginning of year	2010-12-31	$0
Total contributions received or receivable from participants	2010-12-31	$53,669
Expenses. Other expenses not covered elsewhere	2010-12-31	$0
Contributions received from other sources (not participants or employers)	2010-12-31	$0
Other income received	2010-12-31	$4,477
Noncash contributions received	2010-12-31	$0
Net income (gross income less expenses)	2010-12-31	$91,535
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$91,535
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$0
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2010-12-31	$2,441
Total contributions received or receivable from employer(s)	2010-12-31	$33,389
Value of certain deemed distributions of participant loans	2010-12-31	$0
Value of corrective distributions	2010-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$0

Form 5500 Responses for CHAPIN & HAVLICEK PHYSICAL THERAPY, LLC 401(K) RETIREMENT PLAN

2014: CHAPIN & HAVLICEK PHYSICAL THERAPY, LLC 401(K) RETIREMENT PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: CHAPIN & HAVLICEK PHYSICAL THERAPY, LLC 401(K) RETIREMENT PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: CHAPIN & HAVLICEK PHYSICAL THERAPY, LLC 401(K) RETIREMENT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: CHAPIN & HAVLICEK PHYSICAL THERAPY, LLC 401(K) RETIREMENT 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
2010: CHAPIN & HAVLICEK PHYSICAL THERAPY, LLC 401(K) RETIREMENT PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	First time form 5500 has been submitted	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	CHAPIN & HAVLICEK PHYSICAL THERAPY, LLC
Employer identification number (EIN):	061451918
NAIC Classification:	621340
NAIC Description:	Offices of Physical, Occupational and Speech Therapists, and Audiologists