401k Plan data: NORTH SHORE CARDIOLOGISTS, S.C. PROFIT SHARING AND SAVINGS PLAN AND TRUST plan

NORTH SHORE CARDIOLOGISTS, S.C. PROFIT SHARING AND SAVINGS PLAN AND TRUST 401k Plan overview

Plan Name	NORTH SHORE CARDIOLOGISTS, S.C. PROFIT SHARING AND SAVINGS PLAN AND TRUST
Plan identification number	002

NORTH SHORE CARDIOLOGISTS, S.C. PROFIT SHARING AND SAVINGS PLAN AND TRUST 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.
Participant-directed brokerage accounts provided as an investment option under the plan.

401k Sponsoring company profile

NORTH SHORE CARDIOLOGISTS, S.C. has sponsored the creation of one or more 401k plans.

Company Name: NORTH SHORE CARDIOLOGISTS, S.C.

Employer identification number (EIN): 363341068

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NORTH SHORE CARDIOLOGISTS, S.C. PROFIT SHARING AND SAVINGS PLAN AND TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2013-01-01 JAY H. ALEXANDER, M.D. 2014-04-29 JAY H. ALEXANDER, M.D. 2014-04-29
002 2012-01-01 JAY H. ALEXANDER, M.D. 2013-05-30 JAY H. ALEXANDER, M.D. 2013-05-30
002 2011-01-01 M THERESE TERLAP
002 2010-01-01 M THERESE TERLAP
002 2009-01-01 THERESE TERLAP

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2013-01-01	JAY H. ALEXANDER, M.D.	2014-04-29	JAY H. ALEXANDER, M.D.	2014-04-29
002	2012-01-01	JAY H. ALEXANDER, M.D.	2013-05-30	JAY H. ALEXANDER, M.D.	2013-05-30
002	2011-01-01	M THERESE TERLAP
002	2010-01-01	M THERESE TERLAP
002	2009-01-01	THERESE TERLAP

Plan Statistics for NORTH SHORE CARDIOLOGISTS, S.C. PROFIT SHARING AND SAVINGS PLAN AND TRUST

401k plan membership statisitcs for NORTH SHORE CARDIOLOGISTS, S.C. PROFIT SHARING AND SAVINGS PLAN AND TRUST

Measure Date Value
2011: NORTH SHORE CARDIOLOGISTS, S.C. PROFIT SHARING AND SAVINGS PLAN AND TRUST 2011 401k membership
Total participants, beginning-of-year 2011-01-01 97
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 43
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 8
Total of all active and inactive participants 2011-01-01 51
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 51
Number of participants with account balances 2011-01-01 21
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: NORTH SHORE CARDIOLOGISTS, S.C. PROFIT SHARING AND SAVINGS PLAN AND TRUST 2010 401k membership
Total participants, beginning-of-year 2010-01-01 104
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 61
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 36
Total of all active and inactive participants 2010-01-01 97
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 97
Number of participants with account balances 2010-01-01 74
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: NORTH SHORE CARDIOLOGISTS, S.C. PROFIT SHARING AND SAVINGS PLAN AND TRUST 2009 401k membership
Total participants, beginning-of-year 2009-01-01 105
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 102
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 2
Total of all active and inactive participants 2009-01-01 104
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 104
Number of participants with account balances 2009-01-01 74
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2011: NORTH SHORE CARDIOLOGISTS, S.C. PROFIT SHARING AND SAVINGS PLAN AND TRUST 2011 401k membership
Total participants, beginning-of-year	2011-01-01	97
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	43
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	8
Total of all active and inactive participants	2011-01-01	51
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	51
Number of participants with account balances	2011-01-01	21
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: NORTH SHORE CARDIOLOGISTS, S.C. PROFIT SHARING AND SAVINGS PLAN AND TRUST 2010 401k membership
Total participants, beginning-of-year	2010-01-01	104
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	61
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	36
Total of all active and inactive participants	2010-01-01	97
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	97
Number of participants with account balances	2010-01-01	74
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: NORTH SHORE CARDIOLOGISTS, S.C. PROFIT SHARING AND SAVINGS PLAN AND TRUST 2009 401k membership
Total participants, beginning-of-year	2009-01-01	105
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	102
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	2
Total of all active and inactive participants	2009-01-01	104
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	104
Number of participants with account balances	2009-01-01	74
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on NORTH SHORE CARDIOLOGISTS, S.C. PROFIT SHARING AND SAVINGS PLAN AND TRUST

Measure	Date	Value
2011 : NORTH SHORE CARDIOLOGISTS, S.C. PROFIT SHARING AND SAVINGS PLAN AND TRUST 2011 401k financial data
Total income from all sources	2011-12-31	$-652,079
Expenses. Total of all expenses incurred	2011-12-31	$10,627,107
Benefits paid (including direct rollovers)	2011-12-31	$10,623,357
Total plan assets at end of year	2011-12-31	$237,740
Total plan assets at beginning of year	2011-12-31	$11,516,926
Value of fidelity bond covering the plan	2011-12-31	$500,000
Other income received	2011-12-31	$-722,628
Net income (gross income less expenses)	2011-12-31	$-11,279,186
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$237,740
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$11,516,926
Total contributions received or receivable from employer(s)	2011-12-31	$70,549
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$3,750
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
2010 : NORTH SHORE CARDIOLOGISTS, S.C. PROFIT SHARING AND SAVINGS PLAN AND TRUST 2010 401k financial data
Total income from all sources	2010-12-31	$1,462,946
Expenses. Total of all expenses incurred	2010-12-31	$211,918
Benefits paid (including direct rollovers)	2010-12-31	$210,068
Total plan assets at end of year	2010-12-31	$11,516,926
Total plan assets at beginning of year	2010-12-31	$10,265,898
Value of fidelity bond covering the plan	2010-12-31	$500,000
Total contributions received or receivable from participants	2010-12-31	$264,155
Other income received	2010-12-31	$1,127,051
Net income (gross income less expenses)	2010-12-31	$1,251,028
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$11,516,926
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$10,265,898
Assets. Value of participant loans	2010-12-31	$81,306
Total contributions received or receivable from employer(s)	2010-12-31	$71,740
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$1,850
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
2009 : NORTH SHORE CARDIOLOGISTS, S.C. PROFIT SHARING AND SAVINGS PLAN AND TRUST 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for NORTH SHORE CARDIOLOGISTS, S.C. PROFIT SHARING AND SAVINGS PLAN AND TRUST

2011: NORTH SHORE CARDIOLOGISTS, S.C. PROFIT SHARING AND SAVINGS PLAN AND TRUST 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 is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: NORTH SHORE CARDIOLOGISTS, S.C. PROFIT SHARING AND SAVINGS PLAN AND TRUST 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	Yes
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: NORTH SHORE CARDIOLOGISTS, S.C. PROFIT SHARING AND SAVINGS PLAN AND 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 – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	NORTH SHORE CARDIOLOGISTS, S.C.
Employer identification number (EIN):	363341068
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)