401k Plan data: LONG ISLAND SKIN CANCER & DERM. SURGERY, P.C. 401(K) PLAN plan

LONG ISLAND SKIN CANCER & DERM. SURGERY, P.C. 401(K) PLAN 401k Plan overview

Plan Name	LONG ISLAND SKIN CANCER & DERM. SURGERY, P.C. 401(K) PLAN
Plan identification number	001

LONG ISLAND SKIN CANCER & DERM. SURGERY, P.C. 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

LONG ISLAND SKIN CANCER & DERM. SURGERY, P.C. has sponsored the creation of one or more 401k plans.

Company Name: LONG ISLAND SKIN CANCER & DERM. SURGERY, P.C.

Employer identification number (EIN): 061744064

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LONG ISLAND SKIN CANCER & DERM. SURGERY, P.C. 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2012-01-01 MARCIA HOLLANDER MARCIA HOLLANDER 2013-10-11
001 2011-01-01 MARCIA HOLLANDER
001 2009-01-01 MARCIA HOLLANDER

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2012-01-01	MARCIA HOLLANDER	MARCIA HOLLANDER	2013-10-11
001	2011-01-01	MARCIA HOLLANDER
001	2009-01-01	MARCIA HOLLANDER

Plan Statistics for LONG ISLAND SKIN CANCER & DERM. SURGERY, P.C. 401(K) PLAN

401k plan membership statisitcs for LONG ISLAND SKIN CANCER & DERM. SURGERY, P.C. 401(K) PLAN

Measure Date Value
2012: LONG ISLAND SKIN CANCER & DERM. SURGERY, P.C. 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 24
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 0
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 0
Total of all active and inactive participants 2012-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 0
Number of participants with account balances 2012-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: LONG ISLAND SKIN CANCER & DERM. SURGERY, P.C. 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 21
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 21
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 3
Total of all active and inactive participants 2011-01-01 24
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 24
Number of participants with account balances 2011-01-01 19
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: LONG ISLAND SKIN CANCER & DERM. SURGERY, P.C. 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 19
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 12
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 1
Total of all active and inactive participants 2009-01-01 13
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 13
Number of participants with account balances 2009-01-01 13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 2

Measure	Date	Value
2012: LONG ISLAND SKIN CANCER & DERM. SURGERY, P.C. 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	24
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	0
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	0
Total of all active and inactive participants	2012-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	0
Number of participants with account balances	2012-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: LONG ISLAND SKIN CANCER & DERM. SURGERY, P.C. 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	21
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	21
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	3
Total of all active and inactive participants	2011-01-01	24
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	24
Number of participants with account balances	2011-01-01	19
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: LONG ISLAND SKIN CANCER & DERM. SURGERY, P.C. 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	19
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	12
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	1
Total of all active and inactive participants	2009-01-01	13
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	13
Number of participants with account balances	2009-01-01	13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	2

Financial Data on LONG ISLAND SKIN CANCER & DERM. SURGERY, P.C. 401(K) PLAN

Measure	Date	Value
2012 : LONG ISLAND SKIN CANCER & DERM. SURGERY, P.C. 401(K) PLAN 2012 401k financial data
Total income from all sources	2012-12-20	$347,314
Expenses. Total of all expenses incurred	2012-12-20	$1,189,881
Benefits paid (including direct rollovers)	2012-12-20	$1,189,856
Total plan assets at end of year	2012-12-20	$0
Total plan assets at beginning of year	2012-12-20	$842,567
Value of fidelity bond covering the plan	2012-12-20	$1,000,000
Total contributions received or receivable from participants	2012-12-20	$97,133
Other income received	2012-12-20	$82,217
Net income (gross income less expenses)	2012-12-20	$-842,567
Net plan assets at end of year (total assets less liabilities)	2012-12-20	$0
Net plan assets at beginning of year (total assets less liabilities)	2012-12-20	$842,567
Assets. Value of participant loans	2012-12-20	$0
Total contributions received or receivable from employer(s)	2012-12-20	$167,964
Expenses. Administrative service providers (salaries,fees and commissions)	2012-12-20	$25
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-20	$0
2011 : LONG ISLAND SKIN CANCER & DERM. SURGERY, P.C. 401(K) PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$182,366
Expenses. Total of all expenses incurred	2011-12-31	$25,125
Benefits paid (including direct rollovers)	2011-12-31	$25,000
Total plan assets at end of year	2011-12-31	$842,567
Total plan assets at beginning of year	2011-12-31	$685,326
Value of fidelity bond covering the plan	2011-12-31	$1,000,000
Total contributions received or receivable from participants	2011-12-31	$97,386
Other income received	2011-12-31	$-13,766
Net income (gross income less expenses)	2011-12-31	$157,241
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$842,567
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$685,326
Assets. Value of participant loans	2011-12-31	$23,399
Total contributions received or receivable from employer(s)	2011-12-31	$98,746
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$125
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
2010 : LONG ISLAND SKIN CANCER & DERM. SURGERY, P.C. 401(K) PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$277,692
Expenses. Total of all expenses incurred	2010-12-31	$100
Total plan assets at end of year	2010-12-31	$685,326
Total plan assets at beginning of year	2010-12-31	$407,734
Value of fidelity bond covering the plan	2010-12-31	$1,000,000
Total contributions received or receivable from participants	2010-12-31	$111,989
Other income received	2010-12-31	$71,361
Net income (gross income less expenses)	2010-12-31	$277,592
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$685,326
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$407,734
Assets. Value of participant loans	2010-12-31	$18,186
Total contributions received or receivable from employer(s)	2010-12-31	$94,342
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$100
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0

Form 5500 Responses for LONG ISLAND SKIN CANCER & DERM. SURGERY, P.C. 401(K) PLAN

2012: LONG ISLAND SKIN CANCER & DERM. SURGERY, P.C. 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	Yes
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: LONG ISLAND SKIN CANCER & DERM. SURGERY, P.C. 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 funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: LONG ISLAND SKIN CANCER & DERM. SURGERY, P.C. 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 funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	LONG ISLAND SKIN CANCER & DERM. SURGERY, P.C.
Employer identification number (EIN):	061744064
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)