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| Plan Name | DERMATOLOGY CENTER OF NORTHWEST INDIANA PROFIT SHARING PLAN & TRUST |
| Plan identification number | 005 |
| 401k Plan Type | Defined Contribution Pension |
| Plan Features/Benefits |
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| Company Name: | MITCHELL LESLIE BRESSACK MD |
| Employer identification number (EIN): | 363065762 |
| NAIC Classification: | 621111 |
| NAIC Description: | Offices of Physicians (except Mental Health Specialists) |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 005 | 2015-01-01 | MITCHELL BRESSACK | 2016-05-23 | MITCHELL BRESSACK | 2016-05-23 |
| 005 | 2015-01-01 | MITCHELL BRESSACK | 2016-05-23 | MITCHELL BRESSACK | 2016-05-23 |
| 005 | 2014-01-01 | MITCHELL BRESSACK | 2015-06-24 | MITCHELL BRESSACK | 2015-06-24 |
| 005 | 2013-01-01 | MITCHELL BRESSACK | 2014-06-11 | MITCHELL BRESSACK | 2014-06-11 |
| 005 | 2012-01-01 | MITCHELL BRESSACK | 2013-05-15 | MITCHELL BRESSACK | 2013-05-15 |
| 005 | 2011-01-01 | MITCHELL BRESSACK | 2012-05-16 | MITCHELL BRESSACK | 2012-05-16 |
| 005 | 2009-01-01 | MITCHELL BRESSACK | MITCHELL BRESSACK | 2010-06-30 |
| Measure | Date | Value |
|---|---|---|
| 2009: DERMATOLOGY CENTER OF NORTHWEST INDIANA PROFIT SHARING PLAN & TRUST 2009 401k membership | ||
| Total participants, beginning-of-year | 2009-01-01 | 5 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 4 |
| 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 | 4 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2009-01-01 | 0 |
| Total participants | 2009-01-01 | 4 |
| Number of participants with account balances | 2009-01-01 | 4 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2009-01-01 | 0 |
| Measure | Date | Value |
|---|---|---|
| 2010 : DERMATOLOGY CENTER OF NORTHWEST INDIANA PROFIT SHARING PLAN & TRUST 2010 401k financial data | ||
| Total income from all sources | 2010-12-31 | $244,691 |
| Expenses. Total of all expenses incurred | 2010-12-31 | $0 |
| Total plan assets at end of year | 2010-12-31 | $2,415,460 |
| Total plan assets at beginning of year | 2010-12-31 | $2,170,769 |
| Value of fidelity bond covering the plan | 2010-12-31 | $250,000 |
| Total contributions received or receivable from participants | 2010-12-31 | $0 |
| Assets. Value of loans (other than to participants) | 2010-12-31 | $24,087 |
| Contributions received from other sources (not participants or employers) | 2010-12-31 | $0 |
| Other income received | 2010-12-31 | $192,920 |
| Net income (gross income less expenses) | 2010-12-31 | $244,691 |
| Net plan assets at end of year (total assets less liabilities) | 2010-12-31 | $2,415,460 |
| Net plan assets at beginning of year (total assets less liabilities) | 2010-12-31 | $2,170,769 |
| Total contributions received or receivable from employer(s) | 2010-12-31 | $51,771 |
| 2009: DERMATOLOGY CENTER OF NORTHWEST INDIANA PROFIT SHARING PLAN & TRUST 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 funding arrangement – Trust | Yes |
| 2009-01-01 | Plan benefit arrangement - Trust | Yes |
| MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 ) | |||||||||||||||||||||||
| Policy contract number | 007609469 | ||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||
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