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| Plan Name | FNA & MCAP GROUP HEALTH PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | FAIRFAX NEONATAL ASSOCIATES, PC & MGT CONSULTANTS FOR AFFIL PHYS |
| Employer identification number (EIN): | 454016556 |
| 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 |
|---|---|---|---|---|---|
| 501 | 2014-01-01 | ANGELA GOLUB | |||
| 501 | 2013-01-01 | ANGELA GOLUB | |||
| 501 | 2012-01-01 | ANGELA GOLUB |
| Measure | Date | Value |
|---|---|---|
| 2014: FNA & MCAP GROUP HEALTH PLAN 2014 401k membership | ||
| Total participants, beginning-of-year | 2014-01-01 | 174 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 0 |
| Number of retired or separated participants receiving benefits | 2014-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-01-01 | 0 |
| Total of all active and inactive participants | 2014-01-01 | 0 |
| 2013: FNA & MCAP GROUP HEALTH PLAN 2013 401k membership | ||
| Total participants, beginning-of-year | 2013-01-01 | 142 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 174 |
| Total of all active and inactive participants | 2013-01-01 | 174 |
| 2012: FNA & MCAP GROUP HEALTH PLAN 2012 401k membership | ||
| Total participants, beginning-of-year | 2012-01-01 | 133 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 142 |
| Total of all active and inactive participants | 2012-01-01 | 142 |
| 2014: FNA & MCAP GROUP HEALTH PLAN 2014 form 5500 responses | ||
|---|---|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | This submission is the final filing | Yes |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2013: FNA & MCAP GROUP HEALTH PLAN 2013 form 5500 responses | ||
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2012: FNA & MCAP GROUP HEALTH PLAN 2012 form 5500 responses | ||
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | First time form 5500 has been submitted | Yes |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
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