401k Plan data: BRIGHAM CITY WOMENS CENTER 401(K) PLAN plan

BRIGHAM CITY WOMENS CENTER 401(K) PLAN 401k Plan overview

Plan Name	BRIGHAM CITY WOMENS CENTER 401(K) PLAN
Plan identification number	001

BRIGHAM CITY WOMENS CENTER 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.
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.
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

BRIGHAM CITY WOMENS CENTER has sponsored the creation of one or more 401k plans.

Company Name: BRIGHAM CITY WOMENS CENTER

Employer identification number (EIN): 870617661

NAIC Classification: 621111
NAIC Description: Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BRIGHAM CITY WOMENS CENTER 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2016-01-01 RAQUEL DIBBLE
001 2015-01-01 CARLOS DIBBLE CARLOS DIBBLE 2016-06-28
001 2014-01-01 RAQUEL DIBBLE RAQUEL DIBBLE 2015-09-23
001 2013-01-01 RAQUEL DIBBLE RAQUEL DIBBLE 2014-07-14
001 2012-01-01 RAQUEL DIBBLE RAQUEL DIBBLE 2013-10-15
001 2011-01-01 CARLSO DIBBLE CARLSO DIBBLE 2012-06-20
001 2010-01-01 CARLOS DIBBLE CARLOS DIBBLE 2011-07-13
001 2009-01-01 CARLOS DIBBLE CARLOS DIBBLE 2010-07-14
001 2009-01-01 CARLOS DIBBLE CARLOS DIBBLE 2010-07-20

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2016-01-01	RAQUEL DIBBLE
001	2015-01-01	CARLOS DIBBLE	CARLOS DIBBLE	2016-06-28
001	2014-01-01	RAQUEL DIBBLE	RAQUEL DIBBLE	2015-09-23
001	2013-01-01	RAQUEL DIBBLE	RAQUEL DIBBLE	2014-07-14
001	2012-01-01	RAQUEL DIBBLE	RAQUEL DIBBLE	2013-10-15
001	2011-01-01	CARLSO DIBBLE	CARLSO DIBBLE	2012-06-20
001	2010-01-01	CARLOS DIBBLE	CARLOS DIBBLE	2011-07-13
001	2009-01-01	CARLOS DIBBLE	CARLOS DIBBLE	2010-07-14
001	2009-01-01	CARLOS DIBBLE	CARLOS DIBBLE	2010-07-20

Plan Statistics for BRIGHAM CITY WOMENS CENTER 401(K) PLAN

401k plan membership statisitcs for BRIGHAM CITY WOMENS CENTER 401(K) PLAN

Measure Date Value
2016: BRIGHAM CITY WOMENS CENTER 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 5
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 0
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 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 0
Number of participants with account balances 2016-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: BRIGHAM CITY WOMENS CENTER 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 5
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 0
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 5
Total of all active and inactive participants 2015-01-01 5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 5
Number of participants with account balances 2015-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: BRIGHAM CITY WOMENS CENTER 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 9
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 0
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 5
Total of all active and inactive participants 2014-01-01 5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 5
Number of participants with account balances 2014-01-01 5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: BRIGHAM CITY WOMENS CENTER 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 8
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 7
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 9
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 9
Number of participants with account balances 2013-01-01 5
2012: BRIGHAM CITY WOMENS CENTER 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 8
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 6
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 2
Total of all active and inactive participants 2012-01-01 8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 8
Number of participants with account balances 2012-01-01 5
2011: BRIGHAM CITY WOMENS CENTER 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 8
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 7
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 8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 8
Number of participants with account balances 2011-01-01 5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: BRIGHAM CITY WOMENS CENTER 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 8
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 7
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 1
Total of all active and inactive participants 2010-01-01 8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 8
Number of participants with account balances 2010-01-01 5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: BRIGHAM CITY WOMENS CENTER 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 8
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 8
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 8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 8
Number of participants with account balances 2009-01-01 5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2016: BRIGHAM CITY WOMENS CENTER 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	5
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	0
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	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	0
Number of participants with account balances	2016-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: BRIGHAM CITY WOMENS CENTER 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	5
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	0
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	5
Total of all active and inactive participants	2015-01-01	5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	5
Number of participants with account balances	2015-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: BRIGHAM CITY WOMENS CENTER 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	9
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	0
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	5
Total of all active and inactive participants	2014-01-01	5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	5
Number of participants with account balances	2014-01-01	5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: BRIGHAM CITY WOMENS CENTER 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	8
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	7
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	9
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	9
Number of participants with account balances	2013-01-01	5
2012: BRIGHAM CITY WOMENS CENTER 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	8
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	6
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	2
Total of all active and inactive participants	2012-01-01	8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	8
Number of participants with account balances	2012-01-01	5
2011: BRIGHAM CITY WOMENS CENTER 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	8
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	7
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	8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	8
Number of participants with account balances	2011-01-01	5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: BRIGHAM CITY WOMENS CENTER 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	8
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	7
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	1
Total of all active and inactive participants	2010-01-01	8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	8
Number of participants with account balances	2010-01-01	5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: BRIGHAM CITY WOMENS CENTER 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	8
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	8
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	8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	8
Number of participants with account balances	2009-01-01	5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on BRIGHAM CITY WOMENS CENTER 401(K) PLAN

Measure	Date	Value
2016 : BRIGHAM CITY WOMENS CENTER 401(K) PLAN 2016 401k financial data
Total income from all sources	2016-12-31	$4,843
Expenses. Total of all expenses incurred	2016-12-31	$342,893
Benefits paid (including direct rollovers)	2016-12-31	$342,858
Total plan assets at end of year	2016-12-31	$0
Total plan assets at beginning of year	2016-12-31	$338,050
Other income received	2016-12-31	$4,843
Net income (gross income less expenses)	2016-12-31	$-338,050
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$0
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$338,050
Expenses. Administrative service providers (salaries,fees and commissions)	2016-12-31	$35
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
2015 : BRIGHAM CITY WOMENS CENTER 401(K) PLAN 2015 401k financial data
Total income from all sources	2015-12-31	$-570
Expenses. Total of all expenses incurred	2015-12-31	$27,958
Benefits paid (including direct rollovers)	2015-12-31	$27,923
Total plan assets at end of year	2015-12-31	$338,050
Total plan assets at beginning of year	2015-12-31	$366,578
Other income received	2015-12-31	$-570
Net income (gross income less expenses)	2015-12-31	$-28,528
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$338,050
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$366,578
Assets. Value of participant loans	2015-12-31	$64,343
Expenses. Administrative service providers (salaries,fees and commissions)	2015-12-31	$35
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
2014 : BRIGHAM CITY WOMENS CENTER 401(K) PLAN 2014 401k financial data
Total income from all sources	2014-12-31	$19,648
Expenses. Total of all expenses incurred	2014-12-31	$40,128
Benefits paid (including direct rollovers)	2014-12-31	$40,093
Total plan assets at end of year	2014-12-31	$366,578
Total plan assets at beginning of year	2014-12-31	$387,058
Total contributions received or receivable from participants	2014-12-31	$4,371
Other income received	2014-12-31	$13,091
Net income (gross income less expenses)	2014-12-31	$-20,480
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$366,578
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$387,058
Assets. Value of participant loans	2014-12-31	$85,534
Total contributions received or receivable from employer(s)	2014-12-31	$2,186
Expenses. Administrative service providers (salaries,fees and commissions)	2014-12-31	$35
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
2013 : BRIGHAM CITY WOMENS CENTER 401(K) PLAN 2013 401k financial data
Total plan liabilities at beginning of year	2013-12-31	$2,383
Total income from all sources	2013-12-31	$88,965
Expenses. Total of all expenses incurred	2013-12-31	$12,571
Total plan assets at end of year	2013-12-31	$387,058
Total plan assets at beginning of year	2013-12-31	$313,047
Value of fidelity bond covering the plan	2013-12-31	$41,000
Total contributions received or receivable from participants	2013-12-31	$7,276
Other income received	2013-12-31	$78,051
Net income (gross income less expenses)	2013-12-31	$76,394
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$387,058
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$310,664
Assets. Value of participant loans	2013-12-31	$5,796
Total contributions received or receivable from employer(s)	2013-12-31	$3,638
Value of certain deemed distributions of participant loans	2013-12-31	$12,536
Expenses. Administrative service providers (salaries,fees and commissions)	2013-12-31	$35
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
2012 : BRIGHAM CITY WOMENS CENTER 401(K) PLAN 2012 401k financial data
Total plan liabilities at end of year	2012-12-31	$2,383
Total income from all sources	2012-12-31	$44,715
Expenses. Total of all expenses incurred	2012-12-31	$2,418
Total plan assets at end of year	2012-12-31	$313,047
Total plan assets at beginning of year	2012-12-31	$268,367
Value of fidelity bond covering the plan	2012-12-31	$41,000
Total contributions received or receivable from participants	2012-12-31	$9,226
Other income received	2012-12-31	$31,296
Net income (gross income less expenses)	2012-12-31	$42,297
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$310,664
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$268,367
Assets. Value of participant loans	2012-12-31	$22,056
Total contributions received or receivable from employer(s)	2012-12-31	$4,193
Value of corrective distributions	2012-12-31	$2,383
Expenses. Administrative service providers (salaries,fees and commissions)	2012-12-31	$35
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
2011 : BRIGHAM CITY WOMENS CENTER 401(K) PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$1,988
Expenses. Total of all expenses incurred	2011-12-31	$35
Total plan assets at end of year	2011-12-31	$268,367
Total plan assets at beginning of year	2011-12-31	$266,414
Value of fidelity bond covering the plan	2011-12-31	$41,000
Total contributions received or receivable from participants	2011-12-31	$5,784
Other income received	2011-12-31	$-6,132
Net income (gross income less expenses)	2011-12-31	$1,953
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$268,367
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$266,414
Assets. Value of participant loans	2011-12-31	$36,920
Total contributions received or receivable from employer(s)	2011-12-31	$2,336
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$35
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
2010 : BRIGHAM CITY WOMENS CENTER 401(K) PLAN 2010 401k financial data
Total plan liabilities at beginning of year	2010-12-31	$1,759
Total income from all sources	2010-12-31	$42,983
Expenses. Total of all expenses incurred	2010-12-31	$2,835
Benefits paid (including direct rollovers)	2010-12-31	$2,800
Total plan assets at end of year	2010-12-31	$266,414
Total plan assets at beginning of year	2010-12-31	$228,025
Value of fidelity bond covering the plan	2010-12-31	$41,000
Total contributions received or receivable from participants	2010-12-31	$6,085
Other income received	2010-12-31	$34,616
Net income (gross income less expenses)	2010-12-31	$40,148
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$266,414
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$226,266
Assets. Value of participant loans	2010-12-31	$27,766
Total contributions received or receivable from employer(s)	2010-12-31	$2,282
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$35
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
2009 : BRIGHAM CITY WOMENS CENTER 401(K) PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for BRIGHAM CITY WOMENS CENTER 401(K) PLAN

2016: BRIGHAM CITY WOMENS CENTER 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	Yes
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: BRIGHAM CITY WOMENS CENTER 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: BRIGHAM CITY WOMENS CENTER 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 – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: BRIGHAM CITY WOMENS CENTER 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 – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: BRIGHAM CITY WOMENS CENTER 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 – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: BRIGHAM CITY WOMENS CENTER 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 – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2010: BRIGHAM CITY WOMENS CENTER 401(K) PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2009: BRIGHAM CITY WOMENS CENTER 401(K) PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 78778 )

Policy contract number

210080218

Policy instance

Insurance contract or identification number	210080218
Number of Individuals Covered	5
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 $0
Commission paid to Insurance Broker	USD $0
Insurance broker organization code?	3
Insurance broker name	DAVID B WAGSTAFF

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 78778 )

Policy contract number

210080218

Policy instance

Insurance contract or identification number	210080218
Number of Individuals Covered	5
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	DAVID B WAGSTAFF

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 78778 )

Policy contract number

210080218

Policy instance

Insurance contract or identification number	210080218
Number of Individuals Covered	5
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $1,560
Commission paid to Insurance Broker	USD $1,560
Insurance broker organization code?	3
Insurance broker name	DAVID B WAGSTAFF

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 78778 )

Policy contract number

210080218

Policy instance

Insurance contract or identification number	210080218
Number of Individuals Covered	5
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $1,388

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 78778 )

Policy contract number

210080218

Policy instance

Insurance contract or identification number	210080218
Number of Individuals Covered	5
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $1,339
Total amount of fees paid to insurance company	USD $0
Commission paid to Insurance Broker	USD $1,339
Insurance broker organization code?	3
Insurance broker name	DAVID B WAGSTAFF

Potentially related plans

BRIGHAM CITY ORTHOPEDIC PROFIT SHARING PLAN [EIN = 870378943]

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Company Name:	BRIGHAM CITY WOMENS CENTER
Employer identification number (EIN):	870617661
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)