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THREE NOTCH MED CENTER 401K PS PLAN 401k Plan overview

Plan NameTHREE NOTCH MED CENTER 401K PS PLAN
Plan identification number 001

THREE NOTCH MED CENTER 401K PS PLAN Benefits

401k Plan TypeDefined 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

THREE NOTCH MEDICAL CENTER, P.C. has sponsored the creation of one or more 401k plans.

Company Name:THREE NOTCH MEDICAL CENTER, P.C.
Employer identification number (EIN):630890070
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THREE NOTCH MED CENTER 401K PS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01TERESA MADDOX2023-10-13
0012021-01-01TERESA MADDOX2022-07-21 TERESA MADDOX2022-07-21
0012020-01-01TERESA MADDOX2021-08-30
0012019-01-01TERESA MADDOX2020-07-08
0012018-01-01TERESA MADDOX2019-10-03
0012017-01-01TERESA MADDOX2018-06-26
0012016-01-01TERESA MADDOX2017-06-19
0012015-01-01JOHN MADDOX2016-06-20
0012014-01-01JOHN MADDOX
0012014-01-01JOHN MADDOX
0012014-01-01JOHN MADDOX
0012013-01-01JOHN MADDOX
0012012-01-01JOHN MADDOX JOHN MADDOX2013-06-17
0012011-01-01JOHN MADDOX
0012010-01-01JOHN MADDOX2011-09-07 JOHN MADDOX2011-09-07

Plan Statistics for THREE NOTCH MED CENTER 401K PS PLAN

401k plan membership statisitcs for THREE NOTCH MED CENTER 401K PS PLAN

Measure Date Value
2014: THREE NOTCH MED CENTER 401K PS PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0118
Total number of active participants reported on line 7a of the Form 55002014-01-0116
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-012
Total of all active and inactive participants2014-01-0118
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0118
Number of participants with account balances2014-01-019
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: THREE NOTCH MED CENTER 401K PS PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0118
Total number of active participants reported on line 7a of the Form 55002013-01-0117
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-011
Total of all active and inactive participants2013-01-0118
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-0118
Number of participants with account balances2013-01-019
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: THREE NOTCH MED CENTER 401K PS PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0120
Total number of active participants reported on line 7a of the Form 55002012-01-0119
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-011
Total of all active and inactive participants2012-01-0120
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0120
Number of participants with account balances2012-01-0119
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: THREE NOTCH MED CENTER 401K PS PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0110
Total number of active participants reported on line 7a of the Form 55002011-01-019
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-011
Total of all active and inactive participants2011-01-0110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-0110
Number of participants with account balances2011-01-0110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010

Financial Data on THREE NOTCH MED CENTER 401K PS PLAN

Measure Date Value
2014 : THREE NOTCH MED CENTER 401K PS PLAN 2014 401k financial data
Transfers to/from the plan2014-12-31$0
Total income from all sources2014-12-31$129,689
Expenses. Total of all expenses incurred2014-12-31$0
Benefits paid (including direct rollovers)2014-12-31$0
Total plan assets at end of year2014-12-31$1,498,968
Total plan assets at beginning of year2014-12-31$1,369,279
Value of fidelity bond covering the plan2014-12-31$75,000
Total contributions received or receivable from participants2014-12-31$54,055
Expenses. Other expenses not covered elsewhere2014-12-31$0
Contributions received from other sources (not participants or employers)2014-12-31$0
Other income received2014-12-31$56,158
Net income (gross income less expenses)2014-12-31$129,689
Net plan assets at end of year (total assets less liabilities)2014-12-31$1,498,968
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$1,369,279
Assets. Value of participant loans2014-12-31$0
Total contributions received or receivable from employer(s)2014-12-31$19,476
Value of certain deemed distributions of participant loans2014-12-31$0
Value of corrective distributions2014-12-31$0
2013 : THREE NOTCH MED CENTER 401K PS PLAN 2013 401k financial data
Transfers to/from the plan2013-12-31$0
Total income from all sources2013-12-31$295,541
Expenses. Total of all expenses incurred2013-12-31$0
Benefits paid (including direct rollovers)2013-12-31$0
Total plan assets at end of year2013-12-31$1,369,279
Total plan assets at beginning of year2013-12-31$1,073,738
Value of fidelity bond covering the plan2013-12-31$75,000
Total contributions received or receivable from participants2013-12-31$54,489
Expenses. Other expenses not covered elsewhere2013-12-31$0
Contributions received from other sources (not participants or employers)2013-12-31$0
Other income received2013-12-31$219,341
Net income (gross income less expenses)2013-12-31$295,541
Net plan assets at end of year (total assets less liabilities)2013-12-31$1,369,279
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$1,073,738
Assets. Value of participant loans2013-12-31$0
Total contributions received or receivable from employer(s)2013-12-31$21,711
Value of certain deemed distributions of participant loans2013-12-31$0
Value of corrective distributions2013-12-31$0
2012 : THREE NOTCH MED CENTER 401K PS PLAN 2012 401k financial data
Transfers to/from the plan2012-12-31$0
Total income from all sources2012-12-31$208,465
Expenses. Total of all expenses incurred2012-12-31$28,504
Benefits paid (including direct rollovers)2012-12-31$27,350
Total plan assets at end of year2012-12-31$1,073,738
Total plan assets at beginning of year2012-12-31$893,777
Value of fidelity bond covering the plan2012-12-31$75,000
Total contributions received or receivable from participants2012-12-31$53,392
Expenses. Other expenses not covered elsewhere2012-12-31$25
Contributions received from other sources (not participants or employers)2012-12-31$0
Other income received2012-12-31$132,982
Net income (gross income less expenses)2012-12-31$179,961
Net plan assets at end of year (total assets less liabilities)2012-12-31$1,073,738
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$893,777
Assets. Value of participant loans2012-12-31$0
Total contributions received or receivable from employer(s)2012-12-31$22,091
Value of certain deemed distributions of participant loans2012-12-31$0
Value of corrective distributions2012-12-31$1,129
Funding deficiency by the employer to the plan for this plan year2012-12-31$0
Minimum employer required contribution for this plan year2012-12-31$0
Amount contributed by the employer to the plan for this plan year2012-12-31$0
2011 : THREE NOTCH MED CENTER 401K PS PLAN 2011 401k financial data
Transfers to/from the plan2011-12-31$0
Total income from all sources2011-12-31$54,927
Expenses. Total of all expenses incurred2011-12-31$0
Benefits paid (including direct rollovers)2011-12-31$0
Total plan assets at end of year2011-12-31$893,777
Total plan assets at beginning of year2011-12-31$838,850
Value of fidelity bond covering the plan2011-12-31$75,000
Total contributions received or receivable from participants2011-12-31$69,119
Expenses. Other expenses not covered elsewhere2011-12-31$0
Contributions received from other sources (not participants or employers)2011-12-31$0
Other income received2011-12-31$-26,629
Net income (gross income less expenses)2011-12-31$54,927
Net plan assets at end of year (total assets less liabilities)2011-12-31$893,777
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$838,850
Assets. Value of participant loans2011-12-31$0
Total contributions received or receivable from employer(s)2011-12-31$12,437
Value of certain deemed distributions of participant loans2011-12-31$0
Value of corrective distributions2011-12-31$0

Form 5500 Responses for THREE NOTCH MED CENTER 401K PS PLAN

2014: THREE NOTCH MED CENTER 401K PS PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: THREE NOTCH MED CENTER 401K PS PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: THREE NOTCH MED CENTER 401K PS PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: THREE NOTCH MED CENTER 401K PS PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-826735
Policy instance 1
Insurance contract or identification numberGA-826735
Number of Individuals Covered9
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $4,169
Total amount of fees paid to insurance companyUSD $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 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?Yes
Health Insurance Welfare BenefitNo
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,169
Insurance broker organization code?3
Insurance broker nameEDWARD D JONES & CO L P.
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-826735
Policy instance 1
Insurance contract or identification numberGA-826735
Number of Individuals Covered9
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $3,437
Total amount of fees paid to insurance companyUSD $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 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?Yes
Health Insurance Welfare BenefitNo
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,437
Insurance broker organization code?3
Insurance broker nameEDWARD D JONES & CO
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-826735
Policy instance 1
Insurance contract or identification numberGA-826735
Number of Individuals Covered19
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $1,086
Total amount of fees paid to insurance companyUSD $958
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 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?Yes
Health Insurance Welfare BenefitNo
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,086
Insurance broker organization code?3
Amount paid for insurance broker fees958
Additional information about fees paid to insurance brokerSALES/MARKETING
Insurance broker nameEDWARD D JONES & CO
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-826735
Policy instance 1
Insurance contract or identification numberGA-826735
Number of Individuals Covered10
Insurance policy start date2011-07-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $9,604
Total amount of fees paid to insurance companyUSD $105
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 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?Yes
Health Insurance Welfare BenefitNo
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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