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| Plan Name | THE ISLAND INTERVENTIONAL PAIN MANAGEMENT PENSION PLAN |
| Plan identification number | 002 |
| 401k Plan Type | Defined Benefit Pension |
| Plan Features/Benefits |
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| Company Name: | ISLAND INTERVENTIONAL PAIN MANAGEMENT PLLC |
| Employer identification number (EIN): | 473904155 |
| 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 |
|---|---|---|---|---|---|
| 002 | 2018-01-01 | RAJMANI KRISHNAN | 2019-10-14 | RAJMANI KRISHNAN | 2019-10-14 |
| Measure | Date | Value |
|---|---|---|
| 2018: THE ISLAND INTERVENTIONAL PAIN MANAGEMENT PENSION PLAN 2018 401k membership | ||
| Total participants, beginning-of-year | 2018-01-01 | 2 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 2 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 0 |
| Total of all active and inactive participants | 2018-01-01 | 2 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2018-01-01 | 0 |
| Total participants | 2018-01-01 | 2 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2018-01-01 | 0 |
| Measure | Date | Value |
|---|---|---|
| 2018 : THE ISLAND INTERVENTIONAL PAIN MANAGEMENT PENSION PLAN 2018 401k financial data | ||
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2018-12-31 | $0 |
| 2018: THE ISLAND INTERVENTIONAL PAIN MANAGEMENT PENSION PLAN 2018 form 5500 responses | ||
|---|---|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Submission has been amended | No |
| 2018-01-01 | This submission is the final filing | No |
| 2018-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-01-01 | Plan is a collectively bargained plan | No |
| 2018-01-01 | Plan funding arrangement – Section 412(e)(3) insurance Contracts | Yes |
| 2018-01-01 | Plan benefit arrangement – Section 412(e)(3) insurance Contracts | Yes |
| MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 ) | |||||||||||||
| Policy contract number | 22364811, ETC. | ||||||||||||
| Policy instance | 1 | ||||||||||||
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| MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 ) | |||||||||||||
| Policy contract number | 570001987, ETC. | ||||||||||||
| Policy instance | 2 | ||||||||||||
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