401k Plan data: EVERETT ENT PS, INC. 401K PLAN plan

EVERETT ENT PS, INC. 401K PLAN 401k Plan overview

Plan Name	EVERETT ENT PS, INC. 401K PLAN
Plan identification number	001

EVERETT ENT PS, INC. 401K 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.
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

EVERETT ENT PS, INC. has sponsored the creation of one or more 401k plans.

Company Name: EVERETT ENT PS, INC.

Employer identification number (EIN): 911349031

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EVERETT ENT PS, INC. 401K PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2011-01-01 LAURIE PRESTON 2012-05-10
001 2010-01-01 LAURIE PRESTON 2011-05-13
001 2007-01-01 LAURIE PRESTON
001 2007-01-01 BOBBIE PENNINGTON

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2011-01-01	LAURIE PRESTON	2012-05-10
001	2010-01-01	LAURIE PRESTON	2011-05-13
001	2007-01-01	LAURIE PRESTON
001	2007-01-01	BOBBIE PENNINGTON

Plan Statistics for EVERETT ENT PS, INC. 401K PLAN

401k plan membership statisitcs for EVERETT ENT PS, INC. 401K PLAN

Measure Date Value
2007: EVERETT ENT PS, INC. 401K PLAN 2007 401k membership
Total participants, beginning-of-year 2007-01-01 15
Total number of active participants reported on line 7a of the Form 5500 2007-01-01 9
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 4
Total of all active and inactive participants 2007-01-01 13
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2007-01-01 0
Total participants 2007-01-01 13
Number of participants with account balances 2007-01-01 13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2007-01-01 1

Measure	Date	Value
2007: EVERETT ENT PS, INC. 401K PLAN 2007 401k membership
Total participants, beginning-of-year	2007-01-01	15
Total number of active participants reported on line 7a of the Form 5500	2007-01-01	9
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	4
Total of all active and inactive participants	2007-01-01	13
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2007-01-01	0
Total participants	2007-01-01	13
Number of participants with account balances	2007-01-01	13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2007-01-01	1

Financial Data on EVERETT ENT PS, INC. 401K PLAN

Measure	Date	Value
2007 : EVERETT ENT PS, INC. 401K PLAN 2007 401k financial data
Total income from all sources	2007-12-31	$44,054
Expenses. Total of all expenses incurred	2007-12-31	$0
Total plan assets at end of year	2007-12-31	$175,774
Total plan assets at beginning of year	2007-12-31	$131,720
Total contributions received or receivable from participants	2007-12-31	$23,152
Other income received	2007-12-31	$2,720
Net income (gross income less expenses)	2007-12-31	$44,054
Net plan assets at end of year (total assets less liabilities)	2007-12-31	$175,774
Net plan assets at beginning of year (total assets less liabilities)	2007-12-31	$131,720
Assets. Value of participant loans	2007-12-31	$8,378
Total contributions received or receivable from employer(s)	2007-12-31	$18,182
2006 : EVERETT ENT PS, INC. 401K PLAN 2006 401k financial data
Total plan liabilities at end of year	2006-12-31	$0
Total plan liabilities at beginning of year	2006-12-31	$0
Total income from all sources	2006-12-31	$67,367
Expenses. Total of all expenses incurred	2006-12-31	$59
Benefits paid (including direct rollovers)	2006-12-31	$59
Total plan assets at end of year	2006-12-31	$131,720
Total plan assets at beginning of year	2006-12-31	$64,412
Value of fidelity bond covering the plan	2006-12-31	$20,000
Total contributions received or receivable from participants	2006-12-31	$38,143
Expenses. Other expenses not covered elsewhere	2006-12-31	$0
Contributions received from other sources (not participants or employers)	2006-12-31	$0
Other income received	2006-12-31	$11,118
Net income (gross income less expenses)	2006-12-31	$67,308
Net plan assets at end of year (total assets less liabilities)	2006-12-31	$131,720
Net plan assets at beginning of year (total assets less liabilities)	2006-12-31	$64,412
Total contributions received or receivable from employer(s)	2006-12-31	$18,106
Value of corrective distributions	2006-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2006-12-31	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2006-12-31	$0

Form 5500 Responses for EVERETT ENT PS, INC. 401K PLAN

2007: EVERETT ENT PS, INC. 401K PLAN 2007 form 5500 responses
2007-01-01	Type of plan entity	Single employer plan
2007-01-01	Submission has been amended	Yes
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 – Insurance	Yes
2007-01-01	Plan funding arrangement – Trust	Yes
2007-01-01	Plan benefit arrangement – Insurance	Yes
2007-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )

Policy contract number

600205-000

Policy instance

Insurance contract or identification number	600205-000
Number of Individuals Covered	13
Insurance policy start date	2007-01-01
Insurance policy end date	2007-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	EVERETT ENT PS, INC.
Employer identification number (EIN):	911349031
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)