401k Plan data: MEDICAL PRACTICE MANAGEMENT, INC 401(K) PROFIT SHARING PLAN plan

MEDICAL PRACTICE MANAGEMENT, INC 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan Name	MEDICAL PRACTICE MANAGEMENT, INC 401(K) PROFIT SHARING PLAN
Plan identification number	001

MEDICAL PRACTICE MANAGEMENT, INC 401(K) PROFIT SHARING PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Money purchase (other than target benefit)
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

MEDICAL PRACTICE MANAGEMENT, INC has sponsored the creation of one or more 401k plans.

Company Name: MEDICAL PRACTICE MANAGEMENT, INC

Employer identification number (EIN): 621094701

NAIC Classification: 541600

Additional information about MEDICAL PRACTICE MANAGEMENT, INC

Jurisdiction of Incorporation: State of Delaware Division of Corporations

Incorporation Date:

Company Identification Number: 2818733

More information about MEDICAL PRACTICE MANAGEMENT, INC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MEDICAL PRACTICE MANAGEMENT, INC 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01 TAMMY LEE 2023-07-30
001 2021-01-01 TRACI SHERIFF 2022-06-06
001 2020-01-01 TRACI SHERIFF 2021-09-29 TRACI SHERIFF 2021-09-29
001 2019-01-01 TRACI SHERIFF 2020-09-10 TRACI SHERIFF 2020-09-10
001 2018-01-01 TRACI SHERIFF 2019-09-24
001 2017-01-01 TRACI SHERIFF 2018-06-28 TRACI SHERIFF 2018-06-28
001 2016-01-01 GLENN ALLEN 2017-05-24 GLENN ALLEN 2017-05-24
001 2015-01-01 GLENN ALLEN 2016-05-23 GLENN ALLEN 2016-05-23
001 2014-01-01 GLENN ALLEN
001 2013-01-01 GLENN ALLEN
001 2012-01-01 GLENN ALLEN
001 2011-01-01 GLENN ALLEN
001 2009-01-01 GLENN ALLEN

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2022-01-01	TAMMY LEE	2023-07-30
001	2021-01-01	TRACI SHERIFF	2022-06-06
001	2020-01-01	TRACI SHERIFF	2021-09-29	TRACI SHERIFF	2021-09-29
001	2019-01-01	TRACI SHERIFF	2020-09-10	TRACI SHERIFF	2020-09-10
001	2018-01-01	TRACI SHERIFF	2019-09-24
001	2017-01-01	TRACI SHERIFF	2018-06-28	TRACI SHERIFF	2018-06-28
001	2016-01-01	GLENN ALLEN	2017-05-24	GLENN ALLEN	2017-05-24
001	2015-01-01	GLENN ALLEN	2016-05-23	GLENN ALLEN	2016-05-23
001	2014-01-01	GLENN ALLEN
001	2013-01-01	GLENN ALLEN
001	2012-01-01	GLENN ALLEN
001	2011-01-01	GLENN ALLEN
001	2009-01-01	GLENN ALLEN

Plan Statistics for MEDICAL PRACTICE MANAGEMENT, INC 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for MEDICAL PRACTICE MANAGEMENT, INC 401(K) PROFIT SHARING PLAN

Measure Date Value
2014: MEDICAL PRACTICE MANAGEMENT, INC 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 17
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 2
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 18
Total of all active and inactive participants 2014-01-01 20
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 20
Number of participants with account balances 2014-01-01 20
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: MEDICAL PRACTICE MANAGEMENT, INC 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 17
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 2
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 21
Total of all active and inactive participants 2013-01-01 23
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 23
Number of participants with account balances 2013-01-01 23
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 26
2012: MEDICAL PRACTICE MANAGEMENT, INC 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 25
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 2
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 22
Total of all active and inactive participants 2012-01-01 24
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 24
Number of participants with account balances 2012-01-01 2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 30
2011: MEDICAL PRACTICE MANAGEMENT, INC 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 23
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 14
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 12
Total of all active and inactive participants 2011-01-01 26
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 26
Number of participants with account balances 2011-01-01 26
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: MEDICAL PRACTICE MANAGEMENT, INC 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 30
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 14
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 13
Total of all active and inactive participants 2009-01-01 27
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 27
Number of participants with account balances 2009-01-01 27
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 1

Measure	Date	Value
2014: MEDICAL PRACTICE MANAGEMENT, INC 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	17
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	2
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	18
Total of all active and inactive participants	2014-01-01	20
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	20
Number of participants with account balances	2014-01-01	20
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: MEDICAL PRACTICE MANAGEMENT, INC 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	17
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	2
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	21
Total of all active and inactive participants	2013-01-01	23
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	23
Number of participants with account balances	2013-01-01	23
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	26
2012: MEDICAL PRACTICE MANAGEMENT, INC 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	25
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	2
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	22
Total of all active and inactive participants	2012-01-01	24
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	24
Number of participants with account balances	2012-01-01	2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	30
2011: MEDICAL PRACTICE MANAGEMENT, INC 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	23
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	14
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	12
Total of all active and inactive participants	2011-01-01	26
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	26
Number of participants with account balances	2011-01-01	26
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: MEDICAL PRACTICE MANAGEMENT, INC 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	30
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	14
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	13
Total of all active and inactive participants	2009-01-01	27
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	27
Number of participants with account balances	2009-01-01	27
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	1

Financial Data on MEDICAL PRACTICE MANAGEMENT, INC 401(K) PROFIT SHARING PLAN

Measure	Date	Value
2014 : MEDICAL PRACTICE MANAGEMENT, INC 401(K) PROFIT SHARING PLAN 2014 401k financial data
Transfers to/from the plan	2014-12-31	$0
Total income from all sources	2014-12-31	$46,871
Expenses. Total of all expenses incurred	2014-12-31	$140,533
Benefits paid (including direct rollovers)	2014-12-31	$139,382
Total plan assets at end of year	2014-12-31	$547,297
Total plan assets at beginning of year	2014-12-31	$640,959
Value of fidelity bond covering the plan	2014-12-31	$500,000
Total contributions received or receivable from participants	2014-12-31	$0
Expenses. Other expenses not covered elsewhere	2014-12-31	$1,151
Contributions received from other sources (not participants or employers)	2014-12-31	$0
Other income received	2014-12-31	$34,659
Net income (gross income less expenses)	2014-12-31	$-93,662
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$547,297
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$640,959
Assets. Value of participant loans	2014-12-31	$2,568
Total contributions received or receivable from employer(s)	2014-12-31	$12,212
Value of certain deemed distributions of participant loans	2014-12-31	$0
Value of corrective distributions	2014-12-31	$0
Funding deficiency by the employer to the plan for this plan year	2014-12-31	$0
Minimum employer required contribution for this plan year	2014-12-31	$0
Amount contributed by the employer to the plan for this plan year	2014-12-31	$0
2013 : MEDICAL PRACTICE MANAGEMENT, INC 401(K) PROFIT SHARING PLAN 2013 401k financial data
Transfers to/from the plan	2013-12-31	$0
Total income from all sources	2013-12-31	$165,833
Expenses. Total of all expenses incurred	2013-12-31	$709,552
Benefits paid (including direct rollovers)	2013-12-31	$708,543
Total plan assets at end of year	2013-12-31	$640,959
Total plan assets at beginning of year	2013-12-31	$1,184,678
Value of fidelity bond covering the plan	2013-12-31	$500,000
Total contributions received or receivable from participants	2013-12-31	$0
Expenses. Other expenses not covered elsewhere	2013-12-31	$1,009
Contributions received from other sources (not participants or employers)	2013-12-31	$0
Other income received	2013-12-31	$149,960
Net income (gross income less expenses)	2013-12-31	$-543,719
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$640,959
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$1,184,678
Assets. Value of participant loans	2013-12-31	$10,108
Total contributions received or receivable from employer(s)	2013-12-31	$15,873
Value of certain deemed distributions of participant loans	2013-12-31	$0
Value of corrective distributions	2013-12-31	$0
Funding deficiency by the employer to the plan for this plan year	2013-12-31	$0
Minimum employer required contribution for this plan year	2013-12-31	$0
Amount contributed by the employer to the plan for this plan year	2013-12-31	$0
2012 : MEDICAL PRACTICE MANAGEMENT, INC 401(K) PROFIT SHARING PLAN 2012 401k financial data
Transfers to/from the plan	2012-12-31	$0
Total income from all sources	2012-12-31	$211,294
Expenses. Total of all expenses incurred	2012-12-31	$24,187
Benefits paid (including direct rollovers)	2012-12-31	$23,007
Total plan assets at end of year	2012-12-31	$1,184,608
Total plan assets at beginning of year	2012-12-31	$997,501
Value of fidelity bond covering the plan	2012-12-31	$500,000
Total contributions received or receivable from participants	2012-12-31	$14,219
Expenses. Other expenses not covered elsewhere	2012-12-31	$1,180
Contributions received from other sources (not participants or employers)	2012-12-31	$0
Other income received	2012-12-31	$153,258
Net income (gross income less expenses)	2012-12-31	$187,107
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$1,184,608
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$997,501
Assets. Value of participant loans	2012-12-31	$0
Total contributions received or receivable from employer(s)	2012-12-31	$43,817
Value of certain deemed distributions of participant loans	2012-12-31	$0
Value of corrective distributions	2012-12-31	$0
Funding deficiency by the employer to the plan for this plan year	2012-12-31	$0
Minimum employer required contribution for this plan year	2012-12-31	$0
Amount contributed by the employer to the plan for this plan year	2012-12-31	$0
2011 : MEDICAL PRACTICE MANAGEMENT, INC 401(K) PROFIT SHARING PLAN 2011 401k financial data
Transfers to/from the plan	2011-12-31	$0
Total income from all sources	2011-12-31	$16,432
Expenses. Total of all expenses incurred	2011-12-31	$2,405
Benefits paid (including direct rollovers)	2011-12-31	$1,204
Total plan assets at end of year	2011-12-31	$997,501
Total plan assets at beginning of year	2011-12-31	$983,474
Value of fidelity bond covering the plan	2011-12-31	$500,000
Total contributions received or receivable from participants	2011-12-31	$28,005
Expenses. Other expenses not covered elsewhere	2011-12-31	$1,201
Contributions received from other sources (not participants or employers)	2011-12-31	$0
Other income received	2011-12-31	$-53,040
Net income (gross income less expenses)	2011-12-31	$14,027
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$997,501
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$983,474
Assets. Value of participant loans	2011-12-31	$0
Total contributions received or receivable from employer(s)	2011-12-31	$41,467
Value of certain deemed distributions of participant loans	2011-12-31	$0
Value of corrective distributions	2011-12-31	$0
Funding deficiency by the employer to the plan for this plan year	2011-12-31	$0
Minimum employer required contribution for this plan year	2011-12-31	$0
Amount contributed by the employer to the plan for this plan year	2011-12-31	$0
2010 : MEDICAL PRACTICE MANAGEMENT, INC 401(K) PROFIT SHARING PLAN 2010 401k financial data
Transfers to/from the plan	2010-12-31	$0
Total income from all sources	2010-12-31	$170,302
Expenses. Total of all expenses incurred	2010-12-31	$55,073
Benefits paid (including direct rollovers)	2010-12-31	$54,158
Total plan assets at end of year	2010-12-31	$983,474
Total plan assets at beginning of year	2010-12-31	$868,245
Value of fidelity bond covering the plan	2010-12-31	$500,000
Total contributions received or receivable from participants	2010-12-31	$29,247
Expenses. Other expenses not covered elsewhere	2010-12-31	$915
Contributions received from other sources (not participants or employers)	2010-12-31	$0
Other income received	2010-12-31	$100,613
Net income (gross income less expenses)	2010-12-31	$115,229
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$983,474
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$868,245
Assets. Value of participant loans	2010-12-31	$0
Total contributions received or receivable from employer(s)	2010-12-31	$40,442
Value of certain deemed distributions of participant loans	2010-12-31	$0
Value of corrective distributions	2010-12-31	$0
Funding deficiency by the employer to the plan for this plan year	2010-12-31	$0
Minimum employer required contribution for this plan year	2010-12-31	$0
Amount contributed by the employer to the plan for this plan year	2010-12-31	$0
2009 : MEDICAL PRACTICE MANAGEMENT, INC 401(K) PROFIT SHARING PLAN 2009 401k financial data
Funding deficiency by the employer to the plan for this plan year	2009-12-31	$0
Minimum employer required contribution for this plan year	2009-12-31	$0
Amount contributed by the employer to the plan for this plan year	2009-12-31	$0

Form 5500 Responses for MEDICAL PRACTICE MANAGEMENT, INC 401(K) PROFIT SHARING PLAN

2014: MEDICAL PRACTICE MANAGEMENT, INC 401(K) PROFIT SHARING PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: MEDICAL PRACTICE MANAGEMENT, INC 401(K) PROFIT SHARING PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: MEDICAL PRACTICE MANAGEMENT, INC 401(K) PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: MEDICAL PRACTICE MANAGEMENT, INC 401(K) PROFIT SHARING PLAN 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 – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2009: MEDICAL PRACTICE MANAGEMENT, INC 401(K) PROFIT SHARING PLAN 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 – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-018039

Policy instance

Insurance contract or identification number	GA-018039
Number of Individuals Covered	20
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $1,549
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,549
Insurance broker organization code?	3
Insurance broker name	UBS FINANCIAL SERVICES

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-018039

Policy instance

Insurance contract or identification number	GA-018039
Number of Individuals Covered	26
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $3,374
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-018039

Policy instance

Insurance contract or identification number	GA-018039
Number of Individuals Covered	26
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $3,012
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,012
Insurance broker organization code?	3
Insurance broker name	UBS FINANCIAL SVCS INS AGCY

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Company Name:	MEDICAL PRACTICE MANAGEMENT, INC
Employer identification number (EIN):	621094701
NAIC Classification:	541600

Jurisdiction of Incorporation:	State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number:	2818733