401k Plan data: THE NORTH BALTIMORE CENTER, INC. 401(K) PROFIT SHARING PLAN plan

THE NORTH BALTIMORE CENTER, INC. 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan Name	THE NORTH BALTIMORE CENTER, INC. 401(K) PROFIT SHARING PLAN
Plan identification number	002

THE NORTH BALTIMORE CENTER, INC. 401(K) 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.
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

MOSAIC COMMUNITY SERVICES, INC. has sponsored the creation of one or more 401k plans.

Company Name: MOSAIC COMMUNITY SERVICES, INC.

Employer identification number (EIN): 521338141

NAIC Classification: 621420
NAIC Description: Outpatient Mental Health and Substance Abuse Centers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE NORTH BALTIMORE CENTER, INC. 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2012-01-01 DIANE MAISTROS DIANE MAISTROS 2012-12-20
002 2011-01-01 DIANE MAISTROS DIANE MAISTROS 2012-08-20

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2012-01-01	DIANE MAISTROS		DIANE MAISTROS	2012-12-20
002	2011-01-01	DIANE MAISTROS		DIANE MAISTROS	2012-08-20

Plan Statistics for THE NORTH BALTIMORE CENTER, INC. 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for THE NORTH BALTIMORE CENTER, INC. 401(K) PROFIT SHARING PLAN

Measure Date Value
2012: THE NORTH BALTIMORE CENTER, INC. 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 205
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 0
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 0
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: THE NORTH BALTIMORE CENTER, INC. 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 179
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 161
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 44
Total of all active and inactive participants 2011-01-01 205
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 205
Number of participants with account balances 2011-01-01 136
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0

Measure	Date	Value
2012: THE NORTH BALTIMORE CENTER, INC. 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	205
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	0
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	0
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: THE NORTH BALTIMORE CENTER, INC. 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	179
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	161
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	44
Total of all active and inactive participants	2011-01-01	205
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	205
Number of participants with account balances	2011-01-01	136
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0

Financial Data on THE NORTH BALTIMORE CENTER, INC. 401(K) PROFIT SHARING PLAN

Measure	Date	Value
2012 : THE NORTH BALTIMORE CENTER, INC. 401(K) PROFIT SHARING PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-07-06	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-07-06	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-07-06	$0
Total income from all sources (including contributions)	2012-07-06	$20,474
Total loss/gain on sale of assets	2012-07-06	$0
Total of all expenses incurred	2012-07-06	$636,771
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-07-06	$631,281
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-07-06	$0
Value of total assets at end of year	2012-07-06	$0
Value of total assets at beginning of year	2012-07-06	$616,297
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-07-06	$5,490
Total interest from all sources	2012-07-06	$0
Total dividends received (eg from common stock, registered investment company shares)	2012-07-06	$3,992
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-07-06	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2012-07-06	$0
Total dividends received from registered investment company shares (eg mutual funds)	2012-07-06	$3,992
Was this plan covered by a fidelity bond	2012-07-06	Yes
Value of fidelity bond cover	2012-07-06	$363,100
If this is an individual account plan, was there a blackout period	2012-07-06	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-07-06	$0
Were there any nonexempt tranactions with any party-in-interest	2012-07-06	No
Participant contributions at beginning of year	2012-07-06	$0
Administrative expenses (other) incurred	2012-07-06	$5,490
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-07-06	No
Value of net income/loss	2012-07-06	$-616,297
Value of net assets at end of year (total assets less liabilities)	2012-07-06	$0
Value of net assets at beginning of year (total assets less liabilities)	2012-07-06	$616,297
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-07-06	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-07-06	No
Were any leases to which the plan was party in default or uncollectible	2012-07-06	No
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-07-06	$607,473
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-07-06	$8,824
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-07-06	$8,824
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-07-06	$16,482
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-07-06	No
Was there a failure to transmit to the plan any participant contributions	2012-07-06	No
Has the plan failed to provide any benefit when due under the plan	2012-07-06	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-07-06	$631,281
Did the plan have assets held for investment	2012-07-06	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	2012-07-06	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-07-06	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-07-06	Yes
Opinion of an independent qualified public accountant for this plan	2012-07-06	Disclaimer
Accountancy firm name	2012-07-06	HERTZBACH & COMPANY, PA
Accountancy firm EIN	2012-07-06	521158459
2011 : THE NORTH BALTIMORE CENTER, INC. 401(K) PROFIT SHARING PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$36,608
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$70,750
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$63,451
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$0
Value of total assets at end of year	2011-12-31	$616,297
Value of total assets at beginning of year	2011-12-31	$650,439
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$7,299
Total interest from all sources	2011-12-31	$1
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2011-12-31	$0
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$363,100
If this is an individual account plan, was there a blackout period	2011-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Participant contributions at beginning of year	2011-12-31	$100
Administrative expenses (other) incurred	2011-12-31	$7,299
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	$-34,142
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$616,297
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$650,439
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	$607,473
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$640,474
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-12-31	$8,824
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-12-31	$9,865
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-12-31	$9,865
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-12-31	$1
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$36,607
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	$63,451
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	HERTZBACH & COMPANY, PA
Accountancy firm EIN	2011-12-31	521158459
2010 : THE NORTH BALTIMORE CENTER, INC. 401(K) PROFIT SHARING PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total income from all sources (including contributions)	2010-12-31	$106,360
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$273,869
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$264,479
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$21,142
Value of total assets at end of year	2010-12-31	$650,439
Value of total assets at beginning of year	2010-12-31	$817,948
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$9,390
Total interest from all sources	2010-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$28,003
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2010-12-31	$0
Total dividends received from registered investment company shares (eg mutual funds)	2010-12-31	$28,003
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$50,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$21,142
Participant contributions at end of year	2010-12-31	$100
Participant contributions at beginning of year	2010-12-31	$2,011
Administrative expenses (other) incurred	2010-12-31	$9,390
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	$-167,509
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$650,439
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$817,948
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	$640,474
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$815,837
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2010-12-31	$9,865
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2010-12-31	$100
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2010-12-31	$100
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2010-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$57,215
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	Yes
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	$264,479
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2010-12-31	No
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	HERTZBACH & CO
Accountancy firm EIN	2010-12-31	521375363

Form 5500 Responses for THE NORTH BALTIMORE CENTER, INC. 401(K) PROFIT SHARING PLAN

2012: THE NORTH BALTIMORE CENTER, INC. 401(K) 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: THE NORTH BALTIMORE CENTER, INC. 401(K) 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

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Company Name:	MOSAIC COMMUNITY SERVICES, INC.
Employer identification number (EIN):	521338141
NAIC Classification:	621420
NAIC Description:	Outpatient Mental Health and Substance Abuse Centers