401k Plan data: TETON RETINAL INSTITUTE, P.A. 401(K) PLAN plan

TETON RETINAL INSTITUTE, P.A. 401(K) PLAN 401k Plan overview

Plan Name	TETON RETINAL INSTITUTE, P.A. 401(K) PLAN
Plan identification number	001

TETON RETINAL INSTITUTE, P.A. 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
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.
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

TETON RETINAL INSTITUTE, P.A. has sponsored the creation of one or more 401k plans.

Company Name: TETON RETINAL INSTITUTE, P.A.

Employer identification number (EIN): 820463316

NAIC Classification: 621320
NAIC Description: Offices of Optometrists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TETON RETINAL INSTITUTE, P.A. 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2017-01-01 DARRYL G. MOFFETT, JR
001 2016-01-01 DARRYL G. MOFFETT, JR
001 2015-01-01 DARRYL G. MOFFETT, JR
001 2014-01-01 DARRYL G. MOFFETT, JR
001 2013-01-01 DARRYL G. MOFFETT, JR
001 2012-01-01 DARRYL G. MOFFETT, JR
001 2011-01-01 DARRYL G. MOFFETT, JR
001 2010-01-01 DARRYL G. MOFFETT, JR DARRYL G. MOFFETT, JR. 2011-10-11
001 2009-01-01 DARRYL G. MOFFETT, JR DARRYL G. MOFFETT, JR. 2010-10-13
001 2008-01-01 DARRYL G. MOFFETT, JR DARRYL G. MOFFETT, JR. 2010-10-13
001 2007-01-01 DARRYL G. MOFFETT, JR DARRYL G. MOFFETT, JR. 2010-09-24

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2017-01-01	DARRYL G. MOFFETT, JR
001	2016-01-01	DARRYL G. MOFFETT, JR
001	2015-01-01	DARRYL G. MOFFETT, JR
001	2014-01-01	DARRYL G. MOFFETT, JR
001	2013-01-01	DARRYL G. MOFFETT, JR
001	2012-01-01	DARRYL G. MOFFETT, JR
001	2011-01-01	DARRYL G. MOFFETT, JR
001	2010-01-01	DARRYL G. MOFFETT, JR	DARRYL G. MOFFETT, JR.	2011-10-11
001	2009-01-01	DARRYL G. MOFFETT, JR	DARRYL G. MOFFETT, JR.	2010-10-13
001	2008-01-01	DARRYL G. MOFFETT, JR	DARRYL G. MOFFETT, JR.	2010-10-13
001	2007-01-01	DARRYL G. MOFFETT, JR	DARRYL G. MOFFETT, JR.	2010-09-24

Plan Statistics for TETON RETINAL INSTITUTE, P.A. 401(K) PLAN

401k plan membership statisitcs for TETON RETINAL INSTITUTE, P.A. 401(K) PLAN

Measure Date Value
2017: TETON RETINAL INSTITUTE, P.A. 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 1
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 0
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 0
Total of all active and inactive participants 2017-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 0
Number of participants with account balances 2017-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: TETON RETINAL INSTITUTE, P.A. 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 14
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 1
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 1
Number of participants with account balances 2016-01-01 1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: TETON RETINAL INSTITUTE, P.A. 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 13
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 10
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 4
Total of all active and inactive participants 2015-01-01 14
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 14
Number of participants with account balances 2015-01-01 14
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: TETON RETINAL INSTITUTE, P.A. 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 14
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 11
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 2
Total of all active and inactive participants 2014-01-01 13
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 13
Number of participants with account balances 2014-01-01 12
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: TETON RETINAL INSTITUTE, P.A. 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 11
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 10
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 2
Total of all active and inactive participants 2013-01-01 12
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 12
Number of participants with account balances 2013-01-01 12
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: TETON RETINAL INSTITUTE, P.A. 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 11
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 8
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 11
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 11
Number of participants with account balances 2012-01-01 11
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: TETON RETINAL INSTITUTE, P.A. 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 9
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 10
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 11
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 11
Number of participants with account balances 2011-01-01 11
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: TETON RETINAL INSTITUTE, P.A. 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 9
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 9
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 0
Total of all active and inactive participants 2010-01-01 9
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 9
Number of participants with account balances 2010-01-01 9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: TETON RETINAL INSTITUTE, P.A. 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 9
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 9
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 0
Total of all active and inactive participants 2009-01-01 9
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 9
Number of participants with account balances 2009-01-01 1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0
2008: TETON RETINAL INSTITUTE, P.A. 401(K) PLAN 2008 401k membership
Total participants, beginning-of-year 2008-01-01 3
Total number of active participants reported on line 7a of the Form 5500 2008-01-01 1
Number of retired or separated participants receiving benefits 2008-01-01 0
Number of other retired or separated participants entitled to future benefits 2008-01-01 0
Total of all active and inactive participants 2008-01-01 1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2008-01-01 0
Total participants 2008-01-01 1
Number of participants with account balances 2008-01-01 1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2008-01-01 0
2007: TETON RETINAL INSTITUTE, P.A. 401(K) PLAN 2007 401k membership
Total participants, beginning-of-year 2007-01-01 3
Total number of active participants reported on line 7a of the Form 5500 2007-01-01 3
Number of retired or separated participants receiving benefits 2007-01-01 0
Number of other retired or separated participants entitled to future benefits 2007-01-01 0
Total of all active and inactive participants 2007-01-01 3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2007-01-01 0
Total participants 2007-01-01 3
Number of participants with account balances 2007-01-01 1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2007-01-01 0

Measure	Date	Value
2017: TETON RETINAL INSTITUTE, P.A. 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	1
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	0
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	0
Total of all active and inactive participants	2017-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	0
Number of participants with account balances	2017-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: TETON RETINAL INSTITUTE, P.A. 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	14
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	1
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	1
Number of participants with account balances	2016-01-01	1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: TETON RETINAL INSTITUTE, P.A. 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	13
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	10
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	4
Total of all active and inactive participants	2015-01-01	14
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	14
Number of participants with account balances	2015-01-01	14
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: TETON RETINAL INSTITUTE, P.A. 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	14
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	11
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	2
Total of all active and inactive participants	2014-01-01	13
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	13
Number of participants with account balances	2014-01-01	12
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: TETON RETINAL INSTITUTE, P.A. 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	11
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	10
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	2
Total of all active and inactive participants	2013-01-01	12
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	12
Number of participants with account balances	2013-01-01	12
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: TETON RETINAL INSTITUTE, P.A. 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	11
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	8
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	11
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	11
Number of participants with account balances	2012-01-01	11
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: TETON RETINAL INSTITUTE, P.A. 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	9
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	10
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	11
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	11
Number of participants with account balances	2011-01-01	11
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: TETON RETINAL INSTITUTE, P.A. 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	9
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	9
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	0
Total of all active and inactive participants	2010-01-01	9
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	9
Number of participants with account balances	2010-01-01	9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: TETON RETINAL INSTITUTE, P.A. 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	9
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	9
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	0
Total of all active and inactive participants	2009-01-01	9
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	9
Number of participants with account balances	2009-01-01	1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0
2008: TETON RETINAL INSTITUTE, P.A. 401(K) PLAN 2008 401k membership
Total participants, beginning-of-year	2008-01-01	3
Total number of active participants reported on line 7a of the Form 5500	2008-01-01	1
Number of retired or separated participants receiving benefits	2008-01-01	0
Number of other retired or separated participants entitled to future benefits	2008-01-01	0
Total of all active and inactive participants	2008-01-01	1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2008-01-01	0
Total participants	2008-01-01	1
Number of participants with account balances	2008-01-01	1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2008-01-01	0
2007: TETON RETINAL INSTITUTE, P.A. 401(K) PLAN 2007 401k membership
Total participants, beginning-of-year	2007-01-01	3
Total number of active participants reported on line 7a of the Form 5500	2007-01-01	3
Number of retired or separated participants receiving benefits	2007-01-01	0
Number of other retired or separated participants entitled to future benefits	2007-01-01	0
Total of all active and inactive participants	2007-01-01	3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2007-01-01	0
Total participants	2007-01-01	3
Number of participants with account balances	2007-01-01	1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2007-01-01	0

Financial Data on TETON RETINAL INSTITUTE, P.A. 401(K) PLAN

Measure	Date	Value
2017 : TETON RETINAL INSTITUTE, P.A. 401(K) PLAN 2017 401k financial data
Transfers to/from the plan	2017-12-31	$0
Total plan liabilities at end of year	2017-12-31	$0
Total plan liabilities at beginning of year	2017-12-31	$0
Total income from all sources	2017-12-31	$-15,000
Expenses. Total of all expenses incurred	2017-12-31	$250,000
Benefits paid (including direct rollovers)	2017-12-31	$250,000
Total plan assets at end of year	2017-12-31	$0
Total plan assets at beginning of year	2017-12-31	$265,000
Total contributions received or receivable from participants	2017-12-31	$0
Expenses. Other expenses not covered elsewhere	2017-12-31	$0
Contributions received from other sources (not participants or employers)	2017-12-31	$0
Other income received	2017-12-31	$-15,000
Noncash contributions received	2017-12-31	$0
Net income (gross income less expenses)	2017-12-31	$-265,000
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$0
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$265,000
Assets. Value of real-estate (other than employer real property)	2017-12-31	$0
Total contributions received or receivable from employer(s)	2017-12-31	$0
Value of certain deemed distributions of participant loans	2017-12-31	$0
Value of corrective distributions	2017-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2017-12-31	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$250,000
2016 : TETON RETINAL INSTITUTE, P.A. 401(K) PLAN 2016 401k financial data
Total plan liabilities at end of year	2016-12-31	$0
Total plan liabilities at beginning of year	2016-12-31	$0
Total income from all sources	2016-12-31	$12,046
Expenses. Total of all expenses incurred	2016-12-31	$414,281
Benefits paid (including direct rollovers)	2016-12-31	$410,976
Total plan assets at end of year	2016-12-31	$265,000
Total plan assets at beginning of year	2016-12-31	$667,235
Total contributions received or receivable from participants	2016-12-31	$0
Expenses. Other expenses not covered elsewhere	2016-12-31	$0
Contributions received from other sources (not participants or employers)	2016-12-31	$0
Other income received	2016-12-31	$12,046
Noncash contributions received	2016-12-31	$0
Net income (gross income less expenses)	2016-12-31	$-402,235
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$265,000
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$667,235
Assets. Value of real-estate (other than employer real property)	2016-12-31	$265,000
Total contributions received or receivable from employer(s)	2016-12-31	$0
Value of certain deemed distributions of participant loans	2016-12-31	$0
Value of corrective distributions	2016-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2016-12-31	$3,305
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$75,000
2015 : TETON RETINAL INSTITUTE, P.A. 401(K) PLAN 2015 401k financial data
Total plan liabilities at end of year	2015-12-31	$0
Total plan liabilities at beginning of year	2015-12-31	$0
Total income from all sources	2015-12-31	$-86,773
Expenses. Total of all expenses incurred	2015-12-31	$328,607
Benefits paid (including direct rollovers)	2015-12-31	$327,202
Total plan assets at end of year	2015-12-31	$667,235
Total plan assets at beginning of year	2015-12-31	$1,082,615
Total contributions received or receivable from participants	2015-12-31	$1,948
Contributions received from other sources (not participants or employers)	2015-12-31	$0
Other income received	2015-12-31	$-111,574
Noncash contributions received	2015-12-31	$0
Net income (gross income less expenses)	2015-12-31	$-415,380
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$667,235
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$1,082,615
Assets. Value of participant loans	2015-12-31	$5,455
Assets. Value of real-estate (other than employer real property)	2015-12-31	$321,675
Total contributions received or receivable from employer(s)	2015-12-31	$22,853
Value of certain deemed distributions of participant loans	2015-12-31	$0
Value of corrective distributions	2015-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2015-12-31	$1,405
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
2014 : TETON RETINAL INSTITUTE, P.A. 401(K) PLAN 2014 401k financial data
Total plan liabilities at end of year	2014-12-31	$0
Total plan liabilities at beginning of year	2014-12-31	$0
Total income from all sources	2014-12-31	$199,132
Expenses. Total of all expenses incurred	2014-12-31	$38,187
Benefits paid (including direct rollovers)	2014-12-31	$28,854
Total plan assets at end of year	2014-12-31	$1,082,615
Total plan assets at beginning of year	2014-12-31	$921,670
Value of fidelity bond covering the plan	2014-12-31	$330,000
Total contributions received or receivable from participants	2014-12-31	$7,968
Expenses. Other expenses not covered elsewhere	2014-12-31	$0
Contributions received from other sources (not participants or employers)	2014-12-31	$1,566
Other income received	2014-12-31	$156,924
Noncash contributions received	2014-12-31	$0
Net income (gross income less expenses)	2014-12-31	$160,945
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$1,082,615
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$921,670
Assets. Value of participant loans	2014-12-31	$5,533
Assets. Value of real-estate (other than employer real property)	2014-12-31	$321,675
Total contributions received or receivable from employer(s)	2014-12-31	$32,674
Value of certain deemed distributions of participant loans	2014-12-31	$6,997
Value of corrective distributions	2014-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2014-12-31	$2,336
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
2013 : TETON RETINAL INSTITUTE, P.A. 401(K) PLAN 2013 401k financial data
Total income from all sources	2013-12-31	$177,626
Expenses. Total of all expenses incurred	2013-12-31	$2,900
Benefits paid (including direct rollovers)	2013-12-31	$0
Total plan assets at end of year	2013-12-31	$921,670
Total plan assets at beginning of year	2013-12-31	$746,944
Value of fidelity bond covering the plan	2013-12-31	$330,000
Total contributions received or receivable from participants	2013-12-31	$8,462
Other income received	2013-12-31	$139,654
Net income (gross income less expenses)	2013-12-31	$174,726
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$921,670
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$746,944
Assets. Value of participant loans	2013-12-31	$6,879
Assets. Value of real-estate (other than employer real property)	2013-12-31	$321,675
Total contributions received or receivable from employer(s)	2013-12-31	$29,510
Value of certain deemed distributions of participant loans	2013-12-31	$0
Value of corrective distributions	2013-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2013-12-31	$2,900
2012 : TETON RETINAL INSTITUTE, P.A. 401(K) PLAN 2012 401k financial data
Total plan liabilities at beginning of year	2012-12-31	$0
Total income from all sources	2012-12-31	$52,130
Expenses. Total of all expenses incurred	2012-12-31	$951
Total plan assets at end of year	2012-12-31	$746,944
Total plan assets at beginning of year	2012-12-31	$695,765
Value of fidelity bond covering the plan	2012-12-31	$250,000
Total contributions received or receivable from participants	2012-12-31	$8,029
Other income received	2012-12-31	$44,101
Net income (gross income less expenses)	2012-12-31	$51,179
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$746,944
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$695,765
Assets. Value of real-estate (other than employer real property)	2012-12-31	$534,571
Expenses. Administrative service providers (salaries,fees and commissions)	2012-12-31	$951
2011 : TETON RETINAL INSTITUTE, P.A. 401(K) PLAN 2011 401k financial data
Total plan liabilities at end of year	2011-12-31	$0
Total plan liabilities at beginning of year	2011-12-31	$0
Total income from all sources	2011-12-31	$104,068
Expenses. Total of all expenses incurred	2011-12-31	$2,743
Total plan assets at end of year	2011-12-31	$695,765
Total plan assets at beginning of year	2011-12-31	$594,440
Value of fidelity bond covering the plan	2011-12-31	$250,000
Total contributions received or receivable from participants	2011-12-31	$30,584
Contributions received from other sources (not participants or employers)	2011-12-31	$29,991
Other income received	2011-12-31	$-18,762
Net income (gross income less expenses)	2011-12-31	$101,325
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$695,765
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$594,440
Assets. Value of real-estate (other than employer real property)	2011-12-31	$248,675
Total contributions received or receivable from employer(s)	2011-12-31	$62,255
Value of certain deemed distributions of participant loans	2011-12-31	$2,743
2010 : TETON RETINAL INSTITUTE, P.A. 401(K) PLAN 2010 401k financial data
Total plan liabilities at end of year	2010-12-31	$0
Total plan liabilities at beginning of year	2010-12-31	$0
Total income from all sources	2010-12-31	$284,996
Expenses. Total of all expenses incurred	2010-12-31	$0
Total plan assets at end of year	2010-12-31	$594,440
Total plan assets at beginning of year	2010-12-31	$309,444
Value of fidelity bond covering the plan	2010-12-31	$250,000
Total contributions received or receivable from participants	2010-12-31	$22,000
Other income received	2010-12-31	$213,966
Net income (gross income less expenses)	2010-12-31	$284,996
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$594,440
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$309,444
Assets. Value of assets in partnership/joint-venture interests	2010-12-31	$161,975
Assets. Value of real-estate (other than employer real property)	2010-12-31	$246,675
Total contributions received or receivable from employer(s)	2010-12-31	$49,030

Form 5500 Responses for TETON RETINAL INSTITUTE, P.A. 401(K) PLAN

2017: TETON RETINAL INSTITUTE, P.A. 401(K) PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	Yes
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: TETON RETINAL INSTITUTE, P.A. 401(K) PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: TETON RETINAL INSTITUTE, P.A. 401(K) 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 – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: TETON RETINAL INSTITUTE, P.A. 401(K) PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
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 – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: TETON RETINAL INSTITUTE, P.A. 401(K) 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	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	No
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: TETON RETINAL INSTITUTE, P.A. 401(K) 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 – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: TETON RETINAL INSTITUTE, P.A. 401(K) 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
2010: TETON RETINAL INSTITUTE, P.A. 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 – Trust	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: TETON RETINAL INSTITUTE, P.A. 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 – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes
2008: TETON RETINAL INSTITUTE, P.A. 401(K) PLAN 2008 form 5500 responses
2008-01-01	Type of plan entity	Single employer plan
2008-01-01	Submission has been amended	Yes
2008-01-01	This submission is the final filing	No
2008-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2008-01-01	Plan is a collectively bargained plan	No
2008-01-01	Plan funding arrangement – Trust	Yes
2008-01-01	Plan benefit arrangement - Trust	Yes
2007: TETON RETINAL INSTITUTE, P.A. 401(K) PLAN 2007 form 5500 responses
2007-01-01	Type of plan entity	Single employer plan
2007-01-01	Submission has been amended	No
2007-01-01	This submission is the final filing	No
2007-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2007-01-01	Plan is a collectively bargained plan	No
2007-01-01	Plan funding arrangement – Trust	Yes
2007-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

101495

Policy instance

Insurance contract or identification number	101495
Number of Individuals Covered	10
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 $1,159
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
Amount paid for insurance broker fees	961
Additional information about fees paid to insurance broker	BROKER COMMISION
Insurance broker organization code?	3
Insurance broker name	ROCKY MOUNTAIN EMPLOYEE BENEFITS, I

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

101495

Policy instance

Insurance contract or identification number	101495
Number of Individuals Covered	14
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 $1,165
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
Amount paid for insurance broker fees	942
Additional information about fees paid to insurance broker	BROKER COMMISION
Insurance broker organization code?	3
Insurance broker name	ROCKY MOUNTAIN EMPLOYEE BENEFITS, I

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

101495

Policy instance

Insurance contract or identification number	101495
Number of Individuals Covered	11
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $864
Total amount of fees paid to insurance company	USD $135
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
Commission paid to Insurance Broker	USD $864
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	BROKER COMMISION
Insurance broker organization code?	3
Insurance broker name	ROCKY MOUNTAIN EMPLOYEE BENEFITS, I

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

101495

Policy instance

Insurance contract or identification number	101495
Number of Individuals Covered	11
Insurance policy start date	2012-05-09
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $13
Total amount of fees paid to insurance company	USD $168
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
Amount paid for insurance broker fees	168
Additional information about fees paid to insurance broker	TPA COMPENSATION
Insurance broker organization code?	5
Commission paid to Insurance Broker	USD $13
Insurance broker name	KEYCORP INSURANCE AGENCY USA INC

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

101495

Policy instance

Insurance contract or identification number	101495
Number of Individuals Covered	11
Insurance policy start date	2011-05-09
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $1,281
Total amount of fees paid to insurance company	USD $937
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:	TETON RETINAL INSTITUTE, P.A.
Employer identification number (EIN):	820463316
NAIC Classification:	621320
NAIC Description:	Offices of Optometrists