401k Plan data: PROVIDER SERVICES, INC. RETIREMENT PLAN plan

PROVIDER SERVICES, INC. RETIREMENT PLAN 401k Plan overview

Plan Name	PROVIDER SERVICES, INC. RETIREMENT PLAN
Plan identification number	001

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

401k Sponsoring company profile

PROVIDER SERVICES has sponsored the creation of one or more 401k plans.

Company Name: PROVIDER SERVICES

Employer identification number (EIN): 810681796

NAIC Classification: 623000
NAIC Description: Nursing and Residential Care Facilities

Additional information about PROVIDER SERVICES

Jurisdiction of Incorporation: Ohio Secretary of State Business Services Division

Incorporation Date: 2005-11-16

Company Identification Number: 1581849

Legal Registered Office Address: 2500 COUNTRY CLUB BLVD
SUITE 255
NORTH OLMSTED
United States of America (USA)
44070

More information about PROVIDER SERVICES

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PROVIDER SERVICES, INC. RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2013-01-01 JOHN KRYSTOWSKI JOHN KRYSTOWSKI 2014-07-31
001 2012-01-01 JOHN KRYSTOWSKI JOHN KRYSTOWSKI 2013-10-11
001 2011-01-01 JOHN KRYSTOWSKI JOHN KRYSTOWSKI 2012-10-16

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2013-01-01	JOHN KRYSTOWSKI	JOHN KRYSTOWSKI	2014-07-31
001	2012-01-01	JOHN KRYSTOWSKI	JOHN KRYSTOWSKI	2013-10-11
001	2011-01-01	JOHN KRYSTOWSKI	JOHN KRYSTOWSKI	2012-10-16

Plan Statistics for PROVIDER SERVICES, INC. RETIREMENT PLAN

401k plan membership statisitcs for PROVIDER SERVICES, INC. RETIREMENT PLAN

Measure Date Value
2013: PROVIDER SERVICES, INC. RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 9,026
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 8,878
Number of retired or separated participants receiving benefits 2013-01-01 2
Number of other retired or separated participants entitled to future benefits 2013-01-01 164
Total of all active and inactive participants 2013-01-01 9,044
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 9,044
Number of participants with account balances 2013-01-01 3,081
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 10
2012: PROVIDER SERVICES, INC. RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 8,528
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 8,891
Number of retired or separated participants receiving benefits 2012-01-01 1
Number of other retired or separated participants entitled to future benefits 2012-01-01 134
Total of all active and inactive participants 2012-01-01 9,026
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 9,026
Number of participants with account balances 2012-01-01 2,726
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 1,797
2011: PROVIDER SERVICES, INC. RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 5,059
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 8,394
Number of retired or separated participants receiving benefits 2011-01-01 1
Number of other retired or separated participants entitled to future benefits 2011-01-01 133
Total of all active and inactive participants 2011-01-01 8,528
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 8,528
Number of participants with account balances 2011-01-01 2,483
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 1,230

Measure	Date	Value
2013: PROVIDER SERVICES, INC. RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	9,026
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	8,878
Number of retired or separated participants receiving benefits	2013-01-01	2
Number of other retired or separated participants entitled to future benefits	2013-01-01	164
Total of all active and inactive participants	2013-01-01	9,044
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	9,044
Number of participants with account balances	2013-01-01	3,081
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	10
2012: PROVIDER SERVICES, INC. RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	8,528
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	8,891
Number of retired or separated participants receiving benefits	2012-01-01	1
Number of other retired or separated participants entitled to future benefits	2012-01-01	134
Total of all active and inactive participants	2012-01-01	9,026
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	9,026
Number of participants with account balances	2012-01-01	2,726
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	1,797
2011: PROVIDER SERVICES, INC. RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	5,059
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	8,394
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	133
Total of all active and inactive participants	2011-01-01	8,528
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	8,528
Number of participants with account balances	2011-01-01	2,483
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	1,230

Financial Data on PROVIDER SERVICES, INC. RETIREMENT PLAN

Measure	Date	Value
2013 : PROVIDER SERVICES, INC. RETIREMENT PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$10,175,723
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$3,620,003
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$3,362,649
Expenses. Certain deemed distributions of participant loans	2013-12-31	$1,566
Value of total corrective distributions	2013-12-31	$82,480
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$5,452,966
Value of total assets at end of year	2013-12-31	$34,311,780
Value of total assets at beginning of year	2013-12-31	$27,756,060
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$173,308
Total interest from all sources	2013-12-31	$139,071
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$1,406,525
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-12-31	$1,406,525
Administrative expenses professional fees incurred	2013-12-31	$0
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$470,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$4,593,281
Participant contributions at end of year	2013-12-31	$796,350
Participant contributions at beginning of year	2013-12-31	$761,956
Assets. Other investments not covered elsewhere at end of year	2013-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2013-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$445,231
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2013-12-31	$0
Other income not declared elsewhere	2013-12-31	$0
Administrative expenses (other) incurred	2013-12-31	$304
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$6,555,720
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$34,311,780
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$27,756,060
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Investment advisory and management fees	2013-12-31	$129,797
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$32,199,218
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$25,804,212
Value of interest in pooled separate accounts at end of year	2013-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$0
Interest on participant loans	2013-12-31	$25,704
Interest earned on other investments	2013-12-31	$113,367
Value of interest in common/collective trusts at end of year	2013-12-31	$0
Value of interest in common/collective trusts at beginning of year	2013-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$1,316,212
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$1,189,892
Expenses. Payments to insurance carriers foe the provision of benefits	2013-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$3,177,161
Net investment gain/loss from pooled separate accounts	2013-12-31	$0
Net investment gain or loss from common/collective trusts	2013-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Assets. Invements in employer securities at end of year	2013-12-31	$0
Assets. Invements in employer securities at beginning of year	2013-12-31	$0
Contributions received in cash from employer	2013-12-31	$414,454
Income. Dividends from common stock	2013-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$3,362,649
Contract administrator fees	2013-12-31	$43,207
Did the plan have assets held for investment	2013-12-31	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	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	CORRIGAN & KRAUSE
Accountancy firm EIN	2013-12-31	371574855
2012 : PROVIDER SERVICES, INC. RETIREMENT PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$7,588,497
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$4,314,521
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$4,145,554
Expenses. Certain deemed distributions of participant loans	2012-12-31	$13,654
Value of total corrective distributions	2012-12-31	$23,021
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$4,465,872
Value of total assets at end of year	2012-12-31	$27,756,060
Value of total assets at beginning of year	2012-12-31	$24,482,084
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$132,292
Total interest from all sources	2012-12-31	$83,669
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$951,063
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-12-31	$951,063
Administrative expenses professional fees incurred	2012-12-31	$0
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$470,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$3,895,217
Participant contributions at end of year	2012-12-31	$761,956
Participant contributions at beginning of year	2012-12-31	$613,138
Assets. Other investments not covered elsewhere at end of year	2012-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2012-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$234,816
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2012-12-31	$0
Other income not declared elsewhere	2012-12-31	$0
Administrative expenses (other) incurred	2012-12-31	$1,495
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$3,273,976
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$27,756,060
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$24,482,084
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Investment advisory and management fees	2012-12-31	$89,234
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$25,804,212
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$22,332,643
Value of interest in pooled separate accounts at end of year	2012-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$0
Interest on participant loans	2012-12-31	$21,910
Interest earned on other investments	2012-12-31	$61,759
Value of interest in common/collective trusts at end of year	2012-12-31	$0
Value of interest in common/collective trusts at beginning of year	2012-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$1,189,892
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$1,536,303
Expenses. Payments to insurance carriers foe the provision of benefits	2012-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$2,087,893
Net investment gain/loss from pooled separate accounts	2012-12-31	$0
Net investment gain or loss from common/collective trusts	2012-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Assets. Invements in employer securities at end of year	2012-12-31	$0
Assets. Invements in employer securities at beginning of year	2012-12-31	$0
Contributions received in cash from employer	2012-12-31	$335,839
Income. Dividends from common stock	2012-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$4,145,554
Contract administrator fees	2012-12-31	$41,563
Did the plan have assets held for investment	2012-12-31	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	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	CORRIGAN KRAUSE
Accountancy firm EIN	2012-12-31	371574855
2011 : PROVIDER SERVICES, INC. RETIREMENT PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total transfer of assets to this plan	2011-12-31	$6,109,520
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	$3,496,209
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$2,499,546
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$2,296,691
Expenses. Certain deemed distributions of participant loans	2011-12-31	$13,990
Value of total corrective distributions	2011-12-31	$117,902
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$3,648,410
Value of total assets at end of year	2011-12-31	$24,482,084
Value of total assets at beginning of year	2011-12-31	$17,375,901
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$70,963
Total interest from all sources	2011-12-31	$53,643
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$575,183
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2011-12-31	$575,183
Administrative expenses professional fees incurred	2011-12-31	$0
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$470,000
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
Contributions received from participants	2011-12-31	$3,018,193
Participant contributions at end of year	2011-12-31	$613,138
Participant contributions at beginning of year	2011-12-31	$328,176
Assets. Other investments not covered elsewhere at end of year	2011-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2011-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$384,881
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2011-12-31	$0
Other income not declared elsewhere	2011-12-31	$0
Administrative expenses (other) incurred	2011-12-31	$300
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	$996,663
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$24,482,084
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$17,375,901
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
Investment advisory and management fees	2011-12-31	$49,626
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$22,332,643
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$16,206,859
Value of interest in pooled separate accounts at end of year	2011-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$0
Interest on participant loans	2011-12-31	$16,070
Interest earned on other investments	2011-12-31	$37,573
Value of interest in common/collective trusts at end of year	2011-12-31	$0
Value of interest in common/collective trusts at beginning of year	2011-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$1,536,303
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$840,866
Expenses. Payments to insurance carriers foe the provision of benefits	2011-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-781,027
Net investment gain/loss from pooled separate accounts	2011-12-31	$0
Net investment gain or loss from common/collective trusts	2011-12-31	$0
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
Assets. Invements in employer securities at end of year	2011-12-31	$0
Assets. Invements in employer securities at beginning of year	2011-12-31	$0
Contributions received in cash from employer	2011-12-31	$245,336
Income. Dividends from common stock	2011-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$2,296,691
Contract administrator fees	2011-12-31	$21,037
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	CORRIGAN KRAUSE
Accountancy firm EIN	2011-12-31	341574855
2010 : PROVIDER SERVICES, INC. RETIREMENT 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	$5,219,448
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$1,480,169
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$1,395,547
Expenses. Certain deemed distributions of participant loans	2010-12-31	$-8
Value of total corrective distributions	2010-12-31	$32,988
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$2,418,531
Value of total assets at end of year	2010-12-31	$17,375,901
Value of total assets at beginning of year	2010-12-31	$13,636,622
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$51,642
Total interest from all sources	2010-12-31	$188,108
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$403,229
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	$403,229
Administrative expenses professional fees incurred	2010-12-31	$0
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$250,000
If this is an individual account plan, was there a blackout period	2010-12-31	Yes
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	$2,119,400
Participant contributions at end of year	2010-12-31	$328,176
Participant contributions at beginning of year	2010-12-31	$86,081
Assets. Other investments not covered elsewhere at beginning of year	2010-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$166,539
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2010-12-31	$0
Other income not declared elsewhere	2010-12-31	$25,961
Administrative expenses (other) incurred	2010-12-31	$125
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	$3,739,279
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$17,375,901
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$13,636,622
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	$32,684
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$16,206,859
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$0
Value of interest in pooled separate accounts at end of year	2010-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$10,660,960
Interest on participant loans	2010-12-31	$6,319
Interest earned on other investments	2010-12-31	$181,774
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2010-12-31	$15
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$840,866
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$2,889,581
Expenses. Payments to insurance carriers foe the provision of benefits	2010-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$1,918,707
Net investment gain/loss from pooled separate accounts	2010-12-31	$264,912
Net investment gain or loss from common/collective trusts	2010-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	Yes
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
Assets. Invements in employer securities at end of year	2010-12-31	$0
Assets. Invements in employer securities at beginning of year	2010-12-31	$0
Contributions received in cash from employer	2010-12-31	$132,592
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$1,395,547
Contract administrator fees	2010-12-31	$18,833
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	Yes
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	MOLONEY AND NOVOTNY, LLC
Accountancy firm EIN	2010-12-31	340677006

Form 5500 Responses for PROVIDER SERVICES, INC. RETIREMENT PLAN

2013: PROVIDER SERVICES, INC. RETIREMENT PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Mulitple employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	Yes
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: PROVIDER SERVICES, INC. RETIREMENT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Mulitple 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
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: PROVIDER SERVICES, INC. RETIREMENT PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Mulitple 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
2011-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	PROVIDER SERVICES
Employer identification number (EIN):	810681796
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities

Jurisdiction of Incorporation:	Ohio Secretary of State Business Services Division
Incorporation Date:	2005-11-16
Company Identification Number:	1581849
Legal Registered Office Address:	2500 COUNTRY CLUB BLVD SUITE 255 NORTH OLMSTED United States of America (USA) 44070