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EMPLOYEE HEALTH PLAN OF TRI COUNTY INTERNAL MEDICINE, PC 401k Plan overview

Plan NameEMPLOYEE HEALTH PLAN OF TRI COUNTY INTERNAL MEDICINE, PC
Plan identification number 502

EMPLOYEE HEALTH PLAN OF TRI COUNTY INTERNAL MEDICINE, PC Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)

401k Sponsoring company profile

TRI COUNTY INTERNAL MEDICINE P has sponsored the creation of one or more 401k plans.

Company Name:TRI COUNTY INTERNAL MEDICINE P
Employer identification number (EIN):582635783
NAIC Classification:339900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEE HEALTH PLAN OF TRI COUNTY INTERNAL MEDICINE, PC

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-05-01
5022021-08-01

Plan Statistics for EMPLOYEE HEALTH PLAN OF TRI COUNTY INTERNAL MEDICINE, PC

401k plan membership statisitcs for EMPLOYEE HEALTH PLAN OF TRI COUNTY INTERNAL MEDICINE, PC

Measure Date Value
2022: EMPLOYEE HEALTH PLAN OF TRI COUNTY INTERNAL MEDICINE, PC 2022 401k membership
Total participants, beginning-of-year2022-05-0114
Total number of active participants reported on line 7a of the Form 55002022-05-0114
Number of retired or separated participants receiving benefits2022-05-010
Number of other retired or separated participants entitled to future benefits2022-05-010
Total of all active and inactive participants2022-05-0114
2021: EMPLOYEE HEALTH PLAN OF TRI COUNTY INTERNAL MEDICINE, PC 2021 401k membership
Total participants, beginning-of-year2021-08-0112
Total number of active participants reported on line 7a of the Form 55002021-08-0110
Number of retired or separated participants receiving benefits2021-08-010
Number of other retired or separated participants entitled to future benefits2021-08-010
Total of all active and inactive participants2021-08-0110

Financial Data on EMPLOYEE HEALTH PLAN OF TRI COUNTY INTERNAL MEDICINE, PC

Measure Date Value
2023 : EMPLOYEE HEALTH PLAN OF TRI COUNTY INTERNAL MEDICINE, PC 2023 401k financial data
Total income from all sources2023-04-30$143,653
Expenses. Total of all expenses incurred2023-04-30$146,117
Benefits paid (including direct rollovers)2023-04-30$65,895
Total plan assets at beginning of year2023-04-30$2,464
Value of fidelity bond covering the plan2023-04-30$10,000
Expenses. Other expenses not covered elsewhere2023-04-30$80,222
Net income (gross income less expenses)2023-04-30$-2,464
Net plan assets at end of year (total assets less liabilities)2023-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2023-04-30$2,464
Total contributions received or receivable from employer(s)2023-04-30$143,653
2022 : EMPLOYEE HEALTH PLAN OF TRI COUNTY INTERNAL MEDICINE, PC 2022 401k financial data
Total income from all sources2022-04-30$88,941
Expenses. Total of all expenses incurred2022-04-30$88,941
Benefits paid (including direct rollovers)2022-04-30$45,030
Total plan assets at end of year2022-04-30$0
Value of fidelity bond covering the plan2022-04-30$5,000
Expenses. Other expenses not covered elsewhere2022-04-30$43,911
Net income (gross income less expenses)2022-04-30$0
Net plan assets at end of year (total assets less liabilities)2022-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2022-04-30$0
Total contributions received or receivable from employer(s)2022-04-30$88,941

Form 5500 Responses for EMPLOYEE HEALTH PLAN OF TRI COUNTY INTERNAL MEDICINE, PC

2022: EMPLOYEE HEALTH PLAN OF TRI COUNTY INTERNAL MEDICINE, PC 2022 form 5500 responses
2022-05-01Type of plan entitySingle employer plan
2022-05-01Submission has been amendedNo
2022-05-01This submission is the final filingNo
2022-05-01This return/report is a short plan year return/report (less than 12 months)No
2022-05-01Plan is a collectively bargained planNo
2022-05-01Plan funding arrangement – InsuranceYes
2022-05-01Plan funding arrangement – TrustYes
2022-05-01Plan benefit arrangement – InsuranceYes
2022-05-01Plan benefit arrangement - TrustYes
2021: EMPLOYEE HEALTH PLAN OF TRI COUNTY INTERNAL MEDICINE, PC 2021 form 5500 responses
2021-08-01Type of plan entitySingle employer plan
2021-08-01First time form 5500 has been submittedYes
2021-08-01Submission has been amendedNo
2021-08-01This submission is the final filingNo
2021-08-01This return/report is a short plan year return/report (less than 12 months)Yes
2021-08-01Plan is a collectively bargained planNo
2021-08-01Plan funding arrangement – InsuranceYes
2021-08-01Plan funding arrangement – TrustYes
2021-08-01Plan benefit arrangement – InsuranceYes
2021-08-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number75030 NFA 0855
Policy instance 1
Insurance contract or identification number75030 NFA 0855
Number of Individuals Covered13
Insurance policy start date2022-08-01
Insurance policy end date2023-04-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $63,690
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number75030 NFA 0855
Policy instance 1
Insurance contract or identification number75030 NFA 0855
Number of Individuals Covered20
Insurance policy start date2021-08-01
Insurance policy end date2022-04-30
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $38,459
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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