401k Plan data: COLORADO DERMATOLOGY INSTITUTE 401(K) PLAN plan

COLORADO DERMATOLOGY INSTITUTE 401(K) PLAN 401k Plan overview

Plan Name	COLORADO DERMATOLOGY INSTITUTE 401(K) PLAN
Plan identification number	001

COLORADO DERMATOLOGY INSTITUTE 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.
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

RATIONAL DERMATOLOGY, INC. has sponsored the creation of one or more 401k plans.

Company Name: RATIONAL DERMATOLOGY, INC.

Employer identification number (EIN): 270409334

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COLORADO DERMATOLOGY INSTITUTE 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01 MICHAEL VANDERFORD 2023-10-03
001 2021-01-01 ROSANNA GORMAN 2022-10-04
001 2020-01-01 ROBERT LANTZY 2021-10-14
001 2019-01-01 ROBERT LANTZY 2020-10-13
001 2018-01-01 JEFFRY ANDERSON 2019-09-03
001 2017-01-01 JEFFRY ANDERSON 2018-08-18
001 2016-01-01 JEFFRY ANDERSON 2017-06-14
001 2015-01-01 JEFFRY ANDERSON 2016-07-15
001 2014-01-01 JEFFRY ANDERSON 2015-07-31
001 2013-01-01 REAGAN ANDERSON 2014-09-17
001 2012-01-01 REAGAN ANDERSON REAGAN ANDERSON 2013-07-11
001 2011-01-01 REAGAN ANDERSON REAGAN ANDERSON 2012-06-26

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2022-01-01	MICHAEL VANDERFORD	2023-10-03
001	2021-01-01	ROSANNA GORMAN	2022-10-04
001	2020-01-01	ROBERT LANTZY	2021-10-14
001	2019-01-01	ROBERT LANTZY	2020-10-13
001	2018-01-01	JEFFRY ANDERSON	2019-09-03
001	2017-01-01	JEFFRY ANDERSON	2018-08-18
001	2016-01-01	JEFFRY ANDERSON	2017-06-14
001	2015-01-01	JEFFRY ANDERSON	2016-07-15
001	2014-01-01	JEFFRY ANDERSON	2015-07-31
001	2013-01-01	REAGAN ANDERSON	2014-09-17
001	2012-01-01	REAGAN ANDERSON		REAGAN ANDERSON	2013-07-11
001	2011-01-01	REAGAN ANDERSON		REAGAN ANDERSON	2012-06-26

Plan Statistics for COLORADO DERMATOLOGY INSTITUTE 401(K) PLAN

401k plan membership statisitcs for COLORADO DERMATOLOGY INSTITUTE 401(K) PLAN

Measure Date Value
2012: COLORADO DERMATOLOGY INSTITUTE 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 12
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 12
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 12
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 12
Number of participants with account balances 2012-01-01 8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: COLORADO DERMATOLOGY INSTITUTE 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 0
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 9
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 0
Total of all active and inactive participants 2011-01-01 9
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 9
Number of participants with account balances 2011-01-01 7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0

Measure	Date	Value
2012: COLORADO DERMATOLOGY INSTITUTE 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	12
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	12
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	12
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	12
Number of participants with account balances	2012-01-01	8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: COLORADO DERMATOLOGY INSTITUTE 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	0
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	9
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	0
Total of all active and inactive participants	2011-01-01	9
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	9
Number of participants with account balances	2011-01-01	7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0

Financial Data on COLORADO DERMATOLOGY INSTITUTE 401(K) PLAN

Measure	Date	Value
2012 : COLORADO DERMATOLOGY INSTITUTE 401(K) PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$73,756
Total plan assets at end of year	2012-12-31	$128,249
Total plan assets at beginning of year	2012-12-31	$54,493
Value of fidelity bond covering the plan	2012-12-31	$50,000
Total contributions received or receivable from participants	2012-12-31	$51,987
Other income received	2012-12-31	$8,308
Net income (gross income less expenses)	2012-12-31	$73,756
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$128,249
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$54,493
Total contributions received or receivable from employer(s)	2012-12-31	$13,461
2011 : COLORADO DERMATOLOGY INSTITUTE 401(K) PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$54,493
Total plan assets at end of year	2011-12-31	$54,493
Total plan assets at beginning of year	2011-12-31	$0
Value of fidelity bond covering the plan	2011-12-31	$50,000
Total contributions received or receivable from participants	2011-12-31	$43,627
Other income received	2011-12-31	$-159
Net income (gross income less expenses)	2011-12-31	$54,493
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$54,493
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$0
Total contributions received or receivable from employer(s)	2011-12-31	$11,025

Form 5500 Responses for COLORADO DERMATOLOGY INSTITUTE 401(K) PLAN

2012: COLORADO DERMATOLOGY INSTITUTE 401(K) PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: COLORADO DERMATOLOGY INSTITUTE 401(K) PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	First time form 5500 has been submitted	Yes
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

617342

Policy instance

Insurance contract or identification number	617342
Number of Individuals Covered	12
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $319
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $319
Insurance broker organization code?	3
Insurance broker name	NORTHWESTERN MUTUAL INVESTMENT SERV

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

617342

Policy instance

Insurance contract or identification number	617342
Number of Individuals Covered	11
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $86
Total amount of fees paid to insurance company	USD $1,000
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

Potentially related plans

COLORADO DERMATOLOGY GROUP, PLLC 401(K) PLAN [EIN = 813218047]

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Company Name:	RATIONAL DERMATOLOGY, INC.
Employer identification number (EIN):	270409334
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)