401k Plan data: PROVIDER BUSINESS RESOURCE, INC 401(K) PLAN plan

PROVIDER BUSINESS RESOURCE, INC 401(K) PLAN 401k Plan overview

Plan Name	PROVIDER BUSINESS RESOURCE, INC 401(K) PLAN
Plan identification number	001

PROVIDER BUSINESS RESOURCE, INC 401(K) 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.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

PROVIDER BUSINESS RESOURCE, INC has sponsored the creation of one or more 401k plans.

Company Name: PROVIDER BUSINESS RESOURCE, INC

Employer identification number (EIN): 562039184

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PROVIDER BUSINESS RESOURCE, INC 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2014-01-01 JO ANN PALMER 2015-08-17
001 2013-01-01 JO ANN PALMER 2014-10-08
001 2012-01-01 JOANN PALMER 2013-10-09
001 2011-01-01 JOANN PALMER 2012-07-03
001 2010-01-01 W GENE WINTERS W GENE WINTERS 2011-10-10
001 2009-01-01 W GENE WINTERS W GENE WINTERS 2010-10-15

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2014-01-01	JO ANN PALMER	2015-08-17
001	2013-01-01	JO ANN PALMER	2014-10-08
001	2012-01-01	JOANN PALMER	2013-10-09
001	2011-01-01	JOANN PALMER	2012-07-03
001	2010-01-01	W GENE WINTERS		W GENE WINTERS	2011-10-10
001	2009-01-01	W GENE WINTERS		W GENE WINTERS	2010-10-15

Plan Statistics for PROVIDER BUSINESS RESOURCE, INC 401(K) PLAN

401k plan membership statisitcs for PROVIDER BUSINESS RESOURCE, INC 401(K) PLAN

Measure Date Value
2010: PROVIDER BUSINESS RESOURCE, INC 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 100
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 52
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 38
Total of all active and inactive participants 2010-01-01 90
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 90
Number of participants with account balances 2010-01-01 59
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: PROVIDER BUSINESS RESOURCE, INC 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 124
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 78
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 33
Total of all active and inactive participants 2009-01-01 111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 111
Number of participants with account balances 2009-01-01 66
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2010: PROVIDER BUSINESS RESOURCE, INC 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	100
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	52
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	38
Total of all active and inactive participants	2010-01-01	90
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	90
Number of participants with account balances	2010-01-01	59
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: PROVIDER BUSINESS RESOURCE, INC 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	124
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	78
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	33
Total of all active and inactive participants	2009-01-01	111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	111
Number of participants with account balances	2009-01-01	66
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on PROVIDER BUSINESS RESOURCE, INC 401(K) PLAN

Measure	Date	Value
2010 : PROVIDER BUSINESS RESOURCE, INC 401(K) 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	$127,647
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$68,306
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$64,279
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$64,557
Value of total assets at end of year	2010-12-31	$712,752
Value of total assets at beginning of year	2010-12-31	$653,411
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$4,027
Total interest from all sources	2010-12-31	$10,058
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$10,996
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2010-12-31	$10,996
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$500,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$38,773
Participant contributions at end of year	2010-12-31	$30,227
Participant contributions at beginning of year	2010-12-31	$44,630
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$8,405
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	$59,341
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$712,752
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$653,411
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
Investment advisory and management fees	2010-12-31	$4,027
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$432,002
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$375,549
Interest on participant loans	2010-12-31	$1,735
Interest earned on other investments	2010-12-31	$8,323
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$250,523
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$233,232
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$42,036
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	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$17,379
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$64,279
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	PYA, PC
Accountancy firm EIN	2010-12-31	621517792

Form 5500 Responses for PROVIDER BUSINESS RESOURCE, INC 401(K) PLAN

2010: PROVIDER BUSINESS RESOURCE, INC 401(K) PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2009: PROVIDER BUSINESS RESOURCE, INC 401(K) 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 – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )

Policy contract number

62053

Policy instance

Insurance contract or identification number	62053
Number of Individuals Covered	60
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	PROVIDER BUSINESS RESOURCE, INC
Employer identification number (EIN):	562039184
NAIC Classification:	622000
NAIC Description:	Hospitals