401k Plan data: MIDWEST HEALTH PLAN, INC. 401(K) PLAN plan

MIDWEST HEALTH PLAN, INC. 401(K) PLAN 401k Plan overview

Plan Name	MIDWEST HEALTH PLAN, INC. 401(K) PLAN
Plan identification number	001

MIDWEST HEALTH PLAN, INC. 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

MIDWEST HEALTH PLAN, INC. has sponsored the creation of one or more 401k plans.

Company Name: MIDWEST HEALTH PLAN, INC.

Employer identification number (EIN): 383123777

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MIDWEST HEALTH PLAN, INC. 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2017-01-01
001 2016-01-01
001 2015-01-01
001 2014-01-01 ALLEN KESSLER 2015-06-12
001 2013-01-01 ALLEN KESSLER 2014-07-03
001 2012-01-01 ALLEN KESSLER 2013-05-13
001 2011-01-01 ALLEN KESSLER 2012-07-05 ALLEN KESSLER 2012-07-05
001 2010-01-01 ALLEN KESSLER 2011-06-27 ALLEN KESSLER 2011-06-27

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2017-01-01
001	2016-01-01
001	2015-01-01
001	2014-01-01	ALLEN KESSLER	2015-06-12
001	2013-01-01	ALLEN KESSLER	2014-07-03
001	2012-01-01	ALLEN KESSLER	2013-05-13
001	2011-01-01	ALLEN KESSLER	2012-07-05	ALLEN KESSLER	2012-07-05
001	2010-01-01	ALLEN KESSLER	2011-06-27	ALLEN KESSLER	2011-06-27

Plan Statistics for MIDWEST HEALTH PLAN, INC. 401(K) PLAN

401k plan membership statisitcs for MIDWEST HEALTH PLAN, INC. 401(K) PLAN

Measure Date Value
2017: MIDWEST HEALTH PLAN, INC. 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 156
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 0
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 0
Total of all active and inactive participants 2017-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 0
Number of participants with account balances 2017-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: MIDWEST HEALTH PLAN, INC. 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 192
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 124
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 34
Total of all active and inactive participants 2016-01-01 158
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 158
Number of participants with account balances 2016-01-01 84
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: MIDWEST HEALTH PLAN, INC. 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 158
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 135
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 26
Total of all active and inactive participants 2015-01-01 161
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 161
Number of participants with account balances 2015-01-01 89
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0

Measure	Date	Value
2017: MIDWEST HEALTH PLAN, INC. 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	156
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	0
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	0
Total of all active and inactive participants	2017-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	0
Number of participants with account balances	2017-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: MIDWEST HEALTH PLAN, INC. 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	192
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	124
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	34
Total of all active and inactive participants	2016-01-01	158
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	158
Number of participants with account balances	2016-01-01	84
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: MIDWEST HEALTH PLAN, INC. 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	158
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	135
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	26
Total of all active and inactive participants	2015-01-01	161
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	161
Number of participants with account balances	2015-01-01	89
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0

Financial Data on MIDWEST HEALTH PLAN, INC. 401(K) PLAN

Measure	Date	Value
2017 : MIDWEST HEALTH PLAN, INC. 401(K) PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total transfer of assets from this plan	2017-12-31	$3,036,210
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$978,358
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$1,816,363
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$1,814,308
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$344,899
Value of total assets at end of year	2017-12-31	$0
Value of total assets at beginning of year	2017-12-31	$3,874,215
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$2,055
Total interest from all sources	2017-12-31	$2,645
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$170,972
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2017-12-31	$0
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$170,972
Administrative expenses professional fees incurred	2017-12-31	$2,055
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$500,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$238,263
Participant contributions at end of year	2017-12-31	$0
Participant contributions at beginning of year	2017-12-31	$72,549
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$-838,005
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$3,874,215
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$3,740,200
Interest on participant loans	2017-12-31	$2,645
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2017-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2017-12-31	$53,903
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2017-12-31	$53,903
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$459,842
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$106,636
Employer contributions (assets) at end of year	2017-12-31	$0
Employer contributions (assets) at beginning of year	2017-12-31	$7,563
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$1,814,308
Did the plan have assets held for investment	2017-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	No
Opinion of an independent qualified public accountant for this plan	2017-12-31	Unqualified
Accountancy firm name	2017-12-31	GEORGE JOHNSON & COMPANY
Accountancy firm EIN	2017-12-31	382029668
2016 : MIDWEST HEALTH PLAN, INC. 401(K) PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$663,311
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$1,035,789
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$1,033,329
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$416,250
Value of total assets at end of year	2016-12-31	$3,874,215
Value of total assets at beginning of year	2016-12-31	$4,246,693
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$2,460
Total interest from all sources	2016-12-31	$3,497
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$144,773
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$144,773
Administrative expenses professional fees incurred	2016-12-31	$2,460
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$500,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$277,529
Participant contributions at end of year	2016-12-31	$72,549
Participant contributions at beginning of year	2016-12-31	$103,017
Participant contributions at end of year	2016-12-31	$0
Participant contributions at beginning of year	2016-12-31	$980
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$-372,478
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$3,874,215
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$4,246,693
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$3,740,200
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$3,924,575
Interest on participant loans	2016-12-31	$3,497
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2016-12-31	$53,903
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2016-12-31	$214,249
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2016-12-31	$214,249
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$98,791
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$138,721
Employer contributions (assets) at end of year	2016-12-31	$7,563
Employer contributions (assets) at beginning of year	2016-12-31	$3,872
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$1,033,329
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	No
Opinion of an independent qualified public accountant for this plan	2016-12-31	Unqualified
Accountancy firm name	2016-12-31	GEORGE JOHNSON & COMPANY
Accountancy firm EIN	2016-12-31	382029668
2015 : MIDWEST HEALTH PLAN, INC. 401(K) PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$617,361
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$717,009
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$714,404
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$571,615
Value of total assets at end of year	2015-12-31	$4,246,693
Value of total assets at beginning of year	2015-12-31	$4,346,341
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$2,605
Total interest from all sources	2015-12-31	$2,254
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$188,510
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$188,510
Administrative expenses professional fees incurred	2015-12-31	$2,605
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$500,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$338,501
Participant contributions at end of year	2015-12-31	$103,017
Participant contributions at beginning of year	2015-12-31	$28,733
Participant contributions at end of year	2015-12-31	$980
Participant contributions at beginning of year	2015-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$53,379
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$-99,648
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$4,246,693
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$4,346,341
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$3,924,575
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$4,088,552
Interest on participant loans	2015-12-31	$2,254
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2015-12-31	$214,249
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2015-12-31	$215,990
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2015-12-31	$215,990
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-145,018
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$179,735
Employer contributions (assets) at end of year	2015-12-31	$3,872
Employer contributions (assets) at beginning of year	2015-12-31	$13,066
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$714,404
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	No
Opinion of an independent qualified public accountant for this plan	2015-12-31	Unqualified
Accountancy firm name	2015-12-31	GEORGE JOHNSON & COMPANY
Accountancy firm EIN	2015-12-31	382029668

Form 5500 Responses for MIDWEST HEALTH PLAN, INC. 401(K) PLAN

2017: MIDWEST HEALTH PLAN, INC. 401(K) PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	Yes
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: MIDWEST HEALTH PLAN, INC. 401(K) PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: MIDWEST HEALTH PLAN, INC. 401(K) PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	MIDWEST HEALTH PLAN, INC.
Employer identification number (EIN):	383123777
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)