401k Plan data: PINNACLE MANAGEMENT INCENTIVE SAVINGS PLAN plan

PINNACLE MANAGEMENT INCENTIVE SAVINGS PLAN 401k Plan overview

Plan Name	PINNACLE MANAGEMENT INCENTIVE SAVINGS PLAN
Plan identification number	001

PINNACLE MANAGEMENT INCENTIVE SAVINGS 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

HEALTH SOURCE FINANCIAL, LLC. has sponsored the creation of one or more 401k plans.

Company Name: HEALTH SOURCE FINANCIAL, LLC.

Employer identification number (EIN): 611377500

NAIC Classification: 541600

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PINNACLE MANAGEMENT INCENTIVE SAVINGS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2013-01-01 JUDY BRENDA JUDY BRENDA 2014-08-26
001 2012-01-01 JUDY BRENDA JUDY BRENDA 2013-07-29
001 2011-01-01 JUDY BRENDA
001 2009-01-01 CHARLES N. CONLEY CHARLES N. CONLEY 2010-08-19

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2013-01-01	JUDY BRENDA	JUDY BRENDA	2014-08-26
001	2012-01-01	JUDY BRENDA	JUDY BRENDA	2013-07-29
001	2011-01-01	JUDY BRENDA
001	2009-01-01	CHARLES N. CONLEY	CHARLES N. CONLEY	2010-08-19

Plan Statistics for PINNACLE MANAGEMENT INCENTIVE SAVINGS PLAN

401k plan membership statisitcs for PINNACLE MANAGEMENT INCENTIVE SAVINGS PLAN

Measure Date Value
2013: PINNACLE MANAGEMENT INCENTIVE SAVINGS PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 6
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 0
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 0
Total of all active and inactive participants 2013-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 0
Number of participants with account balances 2013-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: PINNACLE MANAGEMENT INCENTIVE SAVINGS PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 6
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 3
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 6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 6
Number of participants with account balances 2012-01-01 3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: PINNACLE MANAGEMENT INCENTIVE SAVINGS PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 20
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 14
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 1
Total of all active and inactive participants 2011-01-01 15
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 15
Number of participants with account balances 2011-01-01 15
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: PINNACLE MANAGEMENT INCENTIVE SAVINGS PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 17
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 17
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 4
Total of all active and inactive participants 2009-01-01 21
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 21
Number of participants with account balances 2009-01-01 17
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 1

Measure	Date	Value
2013: PINNACLE MANAGEMENT INCENTIVE SAVINGS PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	6
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	0
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	0
Total of all active and inactive participants	2013-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	0
Number of participants with account balances	2013-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: PINNACLE MANAGEMENT INCENTIVE SAVINGS PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	6
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	3
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	6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	6
Number of participants with account balances	2012-01-01	3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: PINNACLE MANAGEMENT INCENTIVE SAVINGS PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	20
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	14
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	1
Total of all active and inactive participants	2011-01-01	15
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	15
Number of participants with account balances	2011-01-01	15
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: PINNACLE MANAGEMENT INCENTIVE SAVINGS PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	17
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	17
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	4
Total of all active and inactive participants	2009-01-01	21
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	21
Number of participants with account balances	2009-01-01	17
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	1

Financial Data on PINNACLE MANAGEMENT INCENTIVE SAVINGS PLAN

Measure	Date	Value
2013 : PINNACLE MANAGEMENT INCENTIVE SAVINGS PLAN 2013 401k financial data
Total income from all sources	2013-02-28	$2
Expenses. Total of all expenses incurred	2013-02-28	$60
Benefits paid (including direct rollovers)	2013-02-28	$60
Total plan assets at end of year	2013-02-28	$0
Total plan assets at beginning of year	2013-02-28	$58
Value of fidelity bond covering the plan	2013-02-28	$100,000
Total contributions received or receivable from participants	2013-02-28	$0
Expenses. Other expenses not covered elsewhere	2013-02-28	$0
Contributions received from other sources (not participants or employers)	2013-02-28	$0
Other income received	2013-02-28	$2
Net income (gross income less expenses)	2013-02-28	$-58
Net plan assets at end of year (total assets less liabilities)	2013-02-28	$0
Net plan assets at beginning of year (total assets less liabilities)	2013-02-28	$58
Total contributions received or receivable from employer(s)	2013-02-28	$0
Funding deficiency by the employer to the plan for this plan year	2013-02-28	$0
Minimum employer required contribution for this plan year	2013-02-28	$0
Amount contributed by the employer to the plan for this plan year	2013-02-28	$0
2012 : PINNACLE MANAGEMENT INCENTIVE SAVINGS PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$78,460
Expenses. Total of all expenses incurred	2012-12-31	$469,449
Benefits paid (including direct rollovers)	2012-12-31	$469,061
Total plan assets at end of year	2012-12-31	$58
Total plan assets at beginning of year	2012-12-31	$391,047
Value of fidelity bond covering the plan	2012-12-31	$100,000
Total contributions received or receivable from participants	2012-12-31	$18,049
Expenses. Other expenses not covered elsewhere	2012-12-31	$388
Contributions received from other sources (not participants or employers)	2012-12-31	$0
Other income received	2012-12-31	$42,639
Net income (gross income less expenses)	2012-12-31	$-390,989
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$58
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$391,047
Assets. Value of participant loans	2012-12-31	$0
Total contributions received or receivable from employer(s)	2012-12-31	$17,772
Value of certain deemed distributions of participant loans	2012-12-31	$0
Value of corrective distributions	2012-12-31	$0
Funding deficiency by the employer to the plan for this plan year	2012-12-31	$0
Minimum employer required contribution for this plan year	2012-12-31	$0
Amount contributed by the employer to the plan for this plan year	2012-12-31	$0
2011 : PINNACLE MANAGEMENT INCENTIVE SAVINGS PLAN 2011 401k financial data
Transfers to/from the plan	2011-12-31	$0
Total income from all sources	2011-12-31	$63,355
Expenses. Total of all expenses incurred	2011-12-31	$38,950
Benefits paid (including direct rollovers)	2011-12-31	$38,785
Total plan assets at end of year	2011-12-31	$391,047
Total plan assets at beginning of year	2011-12-31	$366,642
Value of fidelity bond covering the plan	2011-12-31	$100,000
Total contributions received or receivable from participants	2011-12-31	$38,450
Expenses. Other expenses not covered elsewhere	2011-12-31	$165
Contributions received from other sources (not participants or employers)	2011-12-31	$0
Other income received	2011-12-31	$-8,438
Net income (gross income less expenses)	2011-12-31	$24,405
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$391,047
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$366,642
Assets. Value of participant loans	2011-12-31	$0
Total contributions received or receivable from employer(s)	2011-12-31	$33,343
Value of certain deemed distributions of participant loans	2011-12-31	$0
Value of corrective distributions	2011-12-31	$0
Funding deficiency by the employer to the plan for this plan year	2011-12-31	$0
Minimum employer required contribution for this plan year	2011-12-31	$0
Amount contributed by the employer to the plan for this plan year	2011-12-31	$0
2010 : PINNACLE MANAGEMENT INCENTIVE SAVINGS PLAN 2010 401k financial data
Transfers to/from the plan	2010-12-31	$0
Total income from all sources	2010-12-31	$111,636
Expenses. Total of all expenses incurred	2010-12-31	$66,255
Benefits paid (including direct rollovers)	2010-12-31	$66,097
Total plan assets at end of year	2010-12-31	$366,642
Total plan assets at beginning of year	2010-12-31	$321,261
Value of fidelity bond covering the plan	2010-12-31	$100,000
Total contributions received or receivable from participants	2010-12-31	$40,742
Expenses. Other expenses not covered elsewhere	2010-12-31	$158
Contributions received from other sources (not participants or employers)	2010-12-31	$0
Other income received	2010-12-31	$35,248
Net income (gross income less expenses)	2010-12-31	$45,381
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$366,642
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$321,261
Assets. Value of participant loans	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	$1,526
Total contributions received or receivable from employer(s)	2010-12-31	$35,646
Value of certain deemed distributions of participant loans	2010-12-31	$0
Value of corrective distributions	2010-12-31	$0
Funding deficiency by the employer to the plan for this plan year	2010-12-31	$0
Minimum employer required contribution for this plan year	2010-12-31	$0
Amount contributed by the employer to the plan for this plan year	2010-12-31	$0

Form 5500 Responses for PINNACLE MANAGEMENT INCENTIVE SAVINGS PLAN

2013: PINNACLE MANAGEMENT INCENTIVE SAVINGS PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	Yes
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: PINNACLE MANAGEMENT INCENTIVE SAVINGS 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	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: PINNACLE MANAGEMENT INCENTIVE SAVINGS 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 – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2009: PINNACLE MANAGEMENT INCENTIVE SAVINGS 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 funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

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Company Name:	HEALTH SOURCE FINANCIAL, LLC.
Employer identification number (EIN):	611377500
NAIC Classification:	541600