401k Plan data: CENTRALIZED LABORATORY SERVICES, INC. SALARY SAVINGS AND PROFIT SHARING PLAN plan

CENTRALIZED LABORATORY SERVICES, INC. SALARY SAVINGS AND PROFIT SHARING PLAN 401k Plan overview

Plan Name	CENTRALIZED LABORATORY SERVICES, INC. SALARY SAVINGS AND PROFIT SHARING PLAN
Plan identification number	011

CENTRALIZED LABORATORY SERVICES, INC. SALARY SAVINGS AND PROFIT SHARING 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.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

HEALTH INSURANCE PLAN OF GREATER NEW YORK has sponsored the creation of one or more 401k plans.

Company Name: HEALTH INSURANCE PLAN OF GREATER NEW YORK

Employer identification number (EIN): 131828429

NAIC Classification: 524140

Additional information about HEALTH INSURANCE PLAN OF GREATER NEW YORK

Jurisdiction of Incorporation: New York Department of State

Incorporation Date: 1944-10-05

Company Identification Number: 44664

Legal Registered Office Address: ATTENTION: GENERAL COUNSEL
55 WATER STREET
NEW YORK
United States of America (USA)
10041

More information about HEALTH INSURANCE PLAN OF GREATER NEW YORK

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CENTRALIZED LABORATORY SERVICES, INC. SALARY SAVINGS AND PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
011 2012-01-01 PATRICIA GRANNUM JOAN RUBY 2012-10-08
011 2011-01-01 PATRICIA GRANNUM JOAN RUBY 2012-10-08
011 2009-01-01 PATRICIA GRANNUM RACHEL AMALFITANO 2010-10-12

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
011	2012-01-01	PATRICIA GRANNUM	JOAN RUBY	2012-10-08
011	2011-01-01	PATRICIA GRANNUM	JOAN RUBY	2012-10-08
011	2009-01-01	PATRICIA GRANNUM	RACHEL AMALFITANO	2010-10-12

Plan Statistics for CENTRALIZED LABORATORY SERVICES, INC. SALARY SAVINGS AND PROFIT SHARING PLAN

401k plan membership statisitcs for CENTRALIZED LABORATORY SERVICES, INC. SALARY SAVINGS AND PROFIT SHARING PLAN

Measure Date Value
2012: CENTRALIZED LABORATORY SERVICES, INC. SALARY SAVINGS AND PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 39
Total of all active and inactive participants 2012-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 0
Number of participants with account balances 2012-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: CENTRALIZED LABORATORY SERVICES, INC. SALARY SAVINGS AND PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 43
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 34
Number of retired or separated participants receiving benefits 2011-01-01 1
Number of other retired or separated participants entitled to future benefits 2011-01-01 4
Total of all active and inactive participants 2011-01-01 39
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 39
Number of participants with account balances 2011-01-01 5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: CENTRALIZED LABORATORY SERVICES, INC. SALARY SAVINGS AND PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 62
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 50
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 11
Total of all active and inactive participants 2009-01-01 61
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 61
Number of participants with account balances 2009-01-01 12
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2012: CENTRALIZED LABORATORY SERVICES, INC. SALARY SAVINGS AND PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	39
Total of all active and inactive participants	2012-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	0
Number of participants with account balances	2012-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: CENTRALIZED LABORATORY SERVICES, INC. SALARY SAVINGS AND PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	43
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	34
Number of retired or separated participants receiving benefits	2011-01-01	1
Number of other retired or separated participants entitled to future benefits	2011-01-01	4
Total of all active and inactive participants	2011-01-01	39
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	39
Number of participants with account balances	2011-01-01	5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: CENTRALIZED LABORATORY SERVICES, INC. SALARY SAVINGS AND PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	62
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	50
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	11
Total of all active and inactive participants	2009-01-01	61
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	61
Number of participants with account balances	2009-01-01	12
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on CENTRALIZED LABORATORY SERVICES, INC. SALARY SAVINGS AND PROFIT SHARING PLAN

Measure	Date	Value
2012 : CENTRALIZED LABORATORY SERVICES, INC. SALARY SAVINGS AND PROFIT SHARING PLAN 2012 401k financial data
Total income from all sources	2012-03-21	$4,923
Expenses. Total of all expenses incurred	2012-03-21	$81,544
Benefits paid (including direct rollovers)	2012-03-21	$81,544
Total plan assets at end of year	2012-03-21	$0
Total plan assets at beginning of year	2012-03-21	$76,621
Value of fidelity bond covering the plan	2012-03-21	$250,000
Other income received	2012-03-21	$4,923
Net income (gross income less expenses)	2012-03-21	$-76,621
Net plan assets at end of year (total assets less liabilities)	2012-03-21	$0
Net plan assets at beginning of year (total assets less liabilities)	2012-03-21	$76,621
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-03-21	$0
2011 : CENTRALIZED LABORATORY SERVICES, INC. SALARY SAVINGS AND PROFIT SHARING PLAN 2011 401k financial data
Transfers to/from the plan	2011-12-31	$-87,926
Total income from all sources	2011-12-31	$4,557
Expenses. Total of all expenses incurred	2011-12-31	$82,708
Benefits paid (including direct rollovers)	2011-12-31	$82,708
Total plan assets at end of year	2011-12-31	$76,621
Total plan assets at beginning of year	2011-12-31	$242,698
Value of fidelity bond covering the plan	2011-12-31	$250,000
Other income received	2011-12-31	$4,557
Net income (gross income less expenses)	2011-12-31	$-78,151
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$76,621
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$242,698
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
2010 : CENTRALIZED LABORATORY SERVICES, INC. SALARY SAVINGS AND PROFIT SHARING PLAN 2010 401k financial data
Transfers to/from the plan	2010-12-31	$0
Total plan liabilities at end of year	2010-12-31	$808
Total plan liabilities at beginning of year	2010-12-31	$9,268
Total income from all sources	2010-12-31	$167,155
Expenses. Total of all expenses incurred	2010-12-31	$1,059,619
Benefits paid (including direct rollovers)	2010-12-31	$1,032,362
Total plan assets at end of year	2010-12-31	$1,272,730
Total plan assets at beginning of year	2010-12-31	$2,173,654
Value of fidelity bond covering the plan	2010-12-31	$250,000
Total contributions received or receivable from participants	2010-12-31	$0
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	$167,155
Noncash contributions received	2010-12-31	$0
Net income (gross income less expenses)	2010-12-31	$-892,464
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$1,271,922
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$2,164,386
Total contributions received or receivable from employer(s)	2010-12-31	$0
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	$27,257
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
2009 : CENTRALIZED LABORATORY SERVICES, INC. SALARY SAVINGS AND PROFIT SHARING PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for CENTRALIZED LABORATORY SERVICES, INC. SALARY SAVINGS AND PROFIT SHARING PLAN

2012: CENTRALIZED LABORATORY SERVICES, INC. SALARY SAVINGS AND PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	Yes
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: CENTRALIZED LABORATORY SERVICES, INC. SALARY SAVINGS AND PROFIT SHARING PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: CENTRALIZED LABORATORY SERVICES, INC. SALARY SAVINGS AND PROFIT SHARING 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	No
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	HEALTH INSURANCE PLAN OF GREATER NEW YORK
Employer identification number (EIN):	131828429
NAIC Classification:	524140

Jurisdiction of Incorporation:	New York Department of State
Incorporation Date:	1944-10-05
Company Identification Number:	44664
Legal Registered Office Address:	ATTENTION: GENERAL COUNSEL 55 WATER STREET NEW YORK United States of America (USA) 10041