401k Plan data: CENTER FOR INTEGRATIVE CANCER MEDICINE, P.A. RETIREMENT PLAN plan

CENTER FOR INTEGRATIVE CANCER MEDICINE, P.A. RETIREMENT PLAN 401k Plan overview

Plan Name	CENTER FOR INTEGRATIVE CANCER MEDICINE, P.A. RETIREMENT PLAN
Plan identification number	001

CENTER FOR INTEGRATIVE CANCER MEDICINE, P.A. RETIREMENT 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
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.
Prototype plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion or notification letter; and under which a seperate funding medium (for example, a seperate trust or custodial account) is established for the use of each adopting employer.

401k Sponsoring company profile

CENTER FOR INTEGRATIVE CANCER MEDICINE, P.A. has sponsored the creation of one or more 401k plans.

Company Name: CENTER FOR INTEGRATIVE CANCER MEDICINE, P.A.

Employer identification number (EIN): 300117387

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CENTER FOR INTEGRATIVE CANCER MEDICINE, P.A. RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2012-01-01 JESUS GOMEZ 2013-02-07 JESUS GOMEZ 2013-02-07
001 2011-01-01 JESUS GOMEZ 2012-10-16 JESUS GOMEZ 2012-10-16
001 2010-01-01 JESUS GOMEZ 2012-10-16 JESUS GOMEZ 2012-10-16
001 2008-01-01 KENDRA WRIGHT

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2012-01-01	JESUS GOMEZ	2013-02-07	JESUS GOMEZ	2013-02-07
001	2011-01-01	JESUS GOMEZ	2012-10-16	JESUS GOMEZ	2012-10-16
001	2010-01-01	JESUS GOMEZ	2012-10-16	JESUS GOMEZ	2012-10-16
001	2008-01-01	KENDRA WRIGHT

Plan Statistics for CENTER FOR INTEGRATIVE CANCER MEDICINE, P.A. RETIREMENT PLAN

401k plan membership statisitcs for CENTER FOR INTEGRATIVE CANCER MEDICINE, P.A. RETIREMENT PLAN

Measure Date Value
2008: CENTER FOR INTEGRATIVE CANCER MEDICINE, P.A. RETIREMENT PLAN 2008 401k membership
Total participants, beginning-of-year 2008-01-01 27
Total number of active participants reported on line 7a of the Form 5500 2008-01-01 14
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 10
Total of all active and inactive participants 2008-01-01 24
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2008-01-01 0
Total participants 2008-01-01 24
Number of participants with account balances 2008-01-01 21
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2008-01-01 1
Number of employers contributing to the scheme 2008-01-01 0

Measure	Date	Value
2008: CENTER FOR INTEGRATIVE CANCER MEDICINE, P.A. RETIREMENT PLAN 2008 401k membership
Total participants, beginning-of-year	2008-01-01	27
Total number of active participants reported on line 7a of the Form 5500	2008-01-01	14
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	10
Total of all active and inactive participants	2008-01-01	24
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2008-01-01	0
Total participants	2008-01-01	24
Number of participants with account balances	2008-01-01	21
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2008-01-01	1
Number of employers contributing to the scheme	2008-01-01	0

Financial Data on CENTER FOR INTEGRATIVE CANCER MEDICINE, P.A. RETIREMENT PLAN

Measure	Date	Value
2008 : CENTER FOR INTEGRATIVE CANCER MEDICINE, P.A. RETIREMENT PLAN 2008 401k financial data
Transfers to/from the plan	2008-12-31	$0
Total income from all sources	2008-12-31	$-39,451
Expenses. Total of all expenses incurred	2008-12-31	$22,007
Benefits paid (including direct rollovers)	2008-12-31	$18,342
Total plan assets at end of year	2008-12-31	$255,785
Total plan assets at beginning of year	2008-12-31	$317,243
Total contributions received or receivable from participants	2008-12-31	$39,214
Expenses. Other expenses not covered elsewhere	2008-12-31	$3,665
Other income received	2008-12-31	$-78,665
Net income (gross income less expenses)	2008-12-31	$-61,458
Net plan assets at end of year (total assets less liabilities)	2008-12-31	$255,785
Net plan assets at beginning of year (total assets less liabilities)	2008-12-31	$317,243
Assets. Value of participant loans	2008-12-31	$49,577

Form 5500 Responses for CENTER FOR INTEGRATIVE CANCER MEDICINE, P.A. RETIREMENT PLAN

2008: CENTER FOR INTEGRATIVE CANCER MEDICINE, P.A. RETIREMENT 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 – Insurance	Yes
2008-01-01	Plan funding arrangement – Trust	Yes
2008-01-01	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

24258

Policy instance

Insurance contract or identification number	24258
Number of Individuals Covered	23
Insurance policy start date	2008-01-01
Insurance policy end date	2008-12-31
Total amount of commissions paid to insurance broker	USD $1,381
Total amount of fees paid to insurance company	USD $150
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	CENTER FOR INTEGRATIVE CANCER MEDICINE, P.A.
Employer identification number (EIN):	300117387
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)