401k Plan data: FRIENDSHIP-BEAVER DAM 401(K) RETIREMENT PLAN plan

FRIENDSHIP-BEAVER DAM 401(K) RETIREMENT PLAN 401k Plan overview

Plan Name	FRIENDSHIP-BEAVER DAM 401(K) RETIREMENT PLAN
Plan identification number	001

FRIENDSHIP-BEAVER DAM 401(K) RETIREMENT 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

FRIENDSHIP HEALTH & REHAB, LLC has sponsored the creation of one or more 401k plans.

Company Name: FRIENDSHIP HEALTH & REHAB, LLC

Employer identification number (EIN): 461992006

NAIC Classification: 621399
NAIC Description: Offices of All Other Miscellaneous Health Practitioners

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FRIENDSHIP-BEAVER DAM 401(K) RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2016-01-01
001 2015-01-01
001 2014-01-01

Plan Statistics for FRIENDSHIP-BEAVER DAM 401(K) RETIREMENT PLAN

401k plan membership statisitcs for FRIENDSHIP-BEAVER DAM 401(K) RETIREMENT PLAN

Measure Date Value
2015: FRIENDSHIP-BEAVER DAM 401(K) RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 168
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 172
Number of retired or separated participants receiving benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 172
Total participants 2015-01-01 172
Number of participants with account balances 2015-01-01 5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: FRIENDSHIP-BEAVER DAM 401(K) RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 165
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 166
Number of retired or separated participants receiving benefits 2014-01-01 2
Total of all active and inactive participants 2014-01-01 168
Total participants 2014-01-01 168
Number of participants with account balances 2014-01-01 9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0

Measure	Date	Value
2015: FRIENDSHIP-BEAVER DAM 401(K) RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	168
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	172
Number of retired or separated participants receiving benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	172
Total participants	2015-01-01	172
Number of participants with account balances	2015-01-01	5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: FRIENDSHIP-BEAVER DAM 401(K) RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	165
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	166
Number of retired or separated participants receiving benefits	2014-01-01	2
Total of all active and inactive participants	2014-01-01	168
Total participants	2014-01-01	168
Number of participants with account balances	2014-01-01	9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0

Financial Data on FRIENDSHIP-BEAVER DAM 401(K) RETIREMENT PLAN

Measure	Date	Value
2015 : FRIENDSHIP-BEAVER DAM 401(K) RETIREMENT PLAN 2015 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$9,799
Total of all expenses incurred	2015-12-31	$13,082
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$12,976
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$9,659
Value of total assets at end of year	2015-12-31	$17,929
Value of total assets at beginning of year	2015-12-31	$21,212
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$106
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$438
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2015-12-31	$0
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$500,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$9,659
Participant contributions at end of year	2015-12-31	$800
Participant contributions at beginning of year	2015-12-31	$8,226
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$-3,283
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$17,929
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$21,212
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$9,106
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$4,785
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$8,023
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$8,201
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-298
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Income. Dividends from common stock	2015-12-31	$438
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$12,976
Contract administrator fees	2015-12-31	$106
Did the plan have assets held for investment	2015-12-31	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	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	DEMING MALONE LIVESAY & OSTROFF CPA
Accountancy firm EIN	2015-12-31	611064249
2014 : FRIENDSHIP-BEAVER DAM 401(K) RETIREMENT PLAN 2014 401k financial data
Total income from all sources (including contributions)	2014-12-31	$21,904
Total of all expenses incurred	2014-12-31	$692
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$692
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$21,842
Value of total assets at end of year	2014-12-31	$21,212
Value of total assets at beginning of year	2014-12-31	$0
Total interest from all sources	2014-12-31	$9
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$140
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Was this plan covered by a fidelity bond	2014-12-31	No
If this is an individual account plan, was there a blackout period	2014-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$21,842
Participant contributions at end of year	2014-12-31	$8,226
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$21,212
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$21,212
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$4,785
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$0
Value of interest in pooled separate accounts at end of year	2014-12-31	$0
Interest earned on other investments	2014-12-31	$9
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$8,201
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$-87
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Income. Dividends from common stock	2014-12-31	$140
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$692
Did the plan have assets held for investment	2014-12-31	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	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	DEMING MALONE LIVESAY & OSTROFF CPA
Accountancy firm EIN	2014-12-31	611064249

Form 5500 Responses for FRIENDSHIP-BEAVER DAM 401(K) RETIREMENT PLAN

2015: FRIENDSHIP-BEAVER DAM 401(K) RETIREMENT PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: FRIENDSHIP-BEAVER DAM 401(K) RETIREMENT PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	First time form 5500 has been submitted	Yes
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

SECURITY BENEFIT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68675 )

Policy contract number

502058

Policy instance

Insurance contract or identification number	502058
Number of Individuals Covered	7
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0

SECURITY BENEFIT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68675 )

Policy contract number

502058

Policy instance

Insurance contract or identification number	502058
Number of Individuals Covered	9
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0

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Company Name:	FRIENDSHIP HEALTH & REHAB, LLC
Employer identification number (EIN):	461992006
NAIC Classification:	621399
NAIC Description:	Offices of All Other Miscellaneous Health Practitioners