401k Plan data: MEDICAL ANESTHESIA CONSULTANTS MEDICAL GROUP INC 401K PROFIT SHARING PLAN plan

MEDICAL ANESTHESIA CONSULTANTS MEDICAL GROUP INC 401K PROFIT SHARING PLAN 401k Plan overview

Plan Name	MEDICAL ANESTHESIA CONSULTANTS MEDICAL GROUP INC 401K PROFIT SHARING PLAN
Plan identification number	002

MEDICAL ANESTHESIA CONSULTANTS MEDICAL GROUP INC 401K PROFIT SHARING PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
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.
Participant-directed brokerage accounts provided as an investment option under the plan.
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.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).
Life insurance

401k Sponsoring company profile

MEDICAL ANESTHESIA CONSULTANTS MEDICAL GROUP INC has sponsored the creation of one or more 401k plans.

Company Name: MEDICAL ANESTHESIA CONSULTANTS MEDICAL GROUP INC

Employer identification number (EIN): 680117704

NAIC Classification: 621399
NAIC Description: Offices of All Other Miscellaneous Health Practitioners

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MEDICAL ANESTHESIA CONSULTANTS MEDICAL GROUP INC 401K PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2017-01-01
002 2016-01-01
002 2015-01-01
002 2014-01-01
002 2013-01-01
002 2012-01-01 DAVID FITZGERALD DAVID FITZGERALD 2013-09-10
002 2011-01-01 PENSION FILERS
002 2010-01-01 PENSION FILERS
002 2009-01-01 ASSOCIATED PENSION CONSULTANTS

Plan Statistics for MEDICAL ANESTHESIA CONSULTANTS MEDICAL GROUP INC 401K PROFIT SHARING PLAN

401k plan membership statisitcs for MEDICAL ANESTHESIA CONSULTANTS MEDICAL GROUP INC 401K PROFIT SHARING PLAN

Measure Date Value
2014: MEDICAL ANESTHESIA CONSULTANTS MEDICAL GROUP INC 401K PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 112
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 100
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 3
Total of all active and inactive participants 2014-01-01 103
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 103
Number of participants with account balances 2014-01-01 22
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: MEDICAL ANESTHESIA CONSULTANTS MEDICAL GROUP INC 401K PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 109
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 100
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 12
Total of all active and inactive participants 2013-01-01 112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 112
Number of participants with account balances 2013-01-01 112
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: MEDICAL ANESTHESIA CONSULTANTS MEDICAL GROUP INC 401K PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 95
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 95
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 12
Total of all active and inactive participants 2012-01-01 107
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 107
Number of participants with account balances 2012-01-01 107
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: MEDICAL ANESTHESIA CONSULTANTS MEDICAL GROUP INC 401K PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 90
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 83
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 10
Total of all active and inactive participants 2011-01-01 93
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 93
Number of participants with account balances 2011-01-01 93
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: MEDICAL ANESTHESIA CONSULTANTS MEDICAL GROUP INC 401K PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 98
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 77
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 13
Total of all active and inactive participants 2010-01-01 90
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 90
Number of participants with account balances 2010-01-01 90
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: MEDICAL ANESTHESIA CONSULTANTS MEDICAL GROUP INC 401K PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 100
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 90
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 17
Total of all active and inactive participants 2009-01-01 107
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 107
Number of participants with account balances 2009-01-01 107
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2014: MEDICAL ANESTHESIA CONSULTANTS MEDICAL GROUP INC 401K PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	112
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	100
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	3
Total of all active and inactive participants	2014-01-01	103
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	103
Number of participants with account balances	2014-01-01	22
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: MEDICAL ANESTHESIA CONSULTANTS MEDICAL GROUP INC 401K PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	109
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	100
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	12
Total of all active and inactive participants	2013-01-01	112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	112
Number of participants with account balances	2013-01-01	112
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: MEDICAL ANESTHESIA CONSULTANTS MEDICAL GROUP INC 401K PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	95
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	95
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	12
Total of all active and inactive participants	2012-01-01	107
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	107
Number of participants with account balances	2012-01-01	107
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: MEDICAL ANESTHESIA CONSULTANTS MEDICAL GROUP INC 401K PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	90
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	83
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	10
Total of all active and inactive participants	2011-01-01	93
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	93
Number of participants with account balances	2011-01-01	93
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: MEDICAL ANESTHESIA CONSULTANTS MEDICAL GROUP INC 401K PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	98
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	77
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	13
Total of all active and inactive participants	2010-01-01	90
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	90
Number of participants with account balances	2010-01-01	90
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: MEDICAL ANESTHESIA CONSULTANTS MEDICAL GROUP INC 401K PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	100
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	90
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	17
Total of all active and inactive participants	2009-01-01	107
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	107
Number of participants with account balances	2009-01-01	107
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on MEDICAL ANESTHESIA CONSULTANTS MEDICAL GROUP INC 401K PROFIT SHARING PLAN

Measure	Date	Value
2014 : MEDICAL ANESTHESIA CONSULTANTS MEDICAL GROUP INC 401K PROFIT SHARING PLAN 2014 401k financial data
Total plan liabilities at end of year	2014-12-31	$985
Total plan liabilities at beginning of year	2014-12-31	$0
Total income from all sources	2014-12-31	$2,115,160
Expenses. Total of all expenses incurred	2014-12-31	$42,958,991
Benefits paid (including direct rollovers)	2014-12-31	$42,466,201
Total plan assets at end of year	2014-12-31	$2,159,834
Total plan assets at beginning of year	2014-12-31	$43,002,680
Value of fidelity bond covering the plan	2014-12-31	$1,000,000
Other income received	2014-12-31	$2,115,160
Net income (gross income less expenses)	2014-12-31	$-40,843,831
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$2,158,849
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$43,002,680
Assets. Value of participant loans	2014-12-31	$94,912
Assets. Value of assets in partnership/joint-venture interests	2014-12-31	$0
Value of corrective distributions	2014-12-31	$397,826
Expenses. Administrative service providers (salaries,fees and commissions)	2014-12-31	$94,964
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
2013 : MEDICAL ANESTHESIA CONSULTANTS MEDICAL GROUP INC 401K PROFIT SHARING PLAN 2013 401k financial data
Total plan liabilities at end of year	2013-12-31	$0
Total plan liabilities at beginning of year	2013-12-31	$14,289
Total income from all sources	2013-12-31	$9,751,016
Expenses. Total of all expenses incurred	2013-12-31	$4,213,909
Benefits paid (including direct rollovers)	2013-12-31	$4,080,208
Total plan assets at end of year	2013-12-31	$43,002,680
Total plan assets at beginning of year	2013-12-31	$37,479,862
Value of fidelity bond covering the plan	2013-12-31	$1,000,000
Total contributions received or receivable from participants	2013-12-31	$1,546,097
Contributions received from other sources (not participants or employers)	2013-12-31	$2,735
Other income received	2013-12-31	$5,522,057
Net income (gross income less expenses)	2013-12-31	$5,537,107
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$43,002,680
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$37,465,573
Assets. Value of participant loans	2013-12-31	$343,936
Assets. Value of assets in partnership/joint-venture interests	2013-12-31	$1,050,800
Total contributions received or receivable from employer(s)	2013-12-31	$2,680,127
Expenses. Administrative service providers (salaries,fees and commissions)	2013-12-31	$133,701
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
2012 : MEDICAL ANESTHESIA CONSULTANTS MEDICAL GROUP INC 401K PROFIT SHARING PLAN 2012 401k financial data
Total plan liabilities at end of year	2012-12-31	$14,289
Total plan liabilities at beginning of year	2012-12-31	$0
Total income from all sources	2012-12-31	$7,175,456
Expenses. Total of all expenses incurred	2012-12-31	$1,956,763
Benefits paid (including direct rollovers)	2012-12-31	$1,792,659
Total plan assets at end of year	2012-12-31	$37,479,862
Total plan assets at beginning of year	2012-12-31	$32,246,880
Value of fidelity bond covering the plan	2012-12-31	$1,000,000
Total contributions received or receivable from participants	2012-12-31	$1,413,683
Contributions received from other sources (not participants or employers)	2012-12-31	$20,847
Other income received	2012-12-31	$3,185,323
Net income (gross income less expenses)	2012-12-31	$5,218,693
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$37,465,573
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$32,246,880
Assets. Value of participant loans	2012-12-31	$338,198
Assets. Value of assets in partnership/joint-venture interests	2012-12-31	$896,600
Total contributions received or receivable from employer(s)	2012-12-31	$2,555,603
Expenses. Administrative service providers (salaries,fees and commissions)	2012-12-31	$164,104
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
2011 : MEDICAL ANESTHESIA CONSULTANTS MEDICAL GROUP INC 401K PROFIT SHARING PLAN 2011 401k financial data
Total plan liabilities at end of year	2011-12-31	$0
Total plan liabilities at beginning of year	2011-12-31	$58,388
Total income from all sources	2011-12-31	$2,546,042
Expenses. Total of all expenses incurred	2011-12-31	$784,492
Benefits paid (including direct rollovers)	2011-12-31	$650,901
Total plan assets at end of year	2011-12-31	$32,246,880
Total plan assets at beginning of year	2011-12-31	$30,543,718
Value of fidelity bond covering the plan	2011-12-31	$1,000,000
Total contributions received or receivable from participants	2011-12-31	$1,218,550
Contributions received from other sources (not participants or employers)	2011-12-31	$8,925
Other income received	2011-12-31	$-1,059,379
Net income (gross income less expenses)	2011-12-31	$1,761,550
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$32,246,880
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$30,485,330
Assets. Value of participant loans	2011-12-31	$424,669
Assets. Value of assets in partnership/joint-venture interests	2011-12-31	$808,000
Total contributions received or receivable from employer(s)	2011-12-31	$2,377,946
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$133,591
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
2010 : MEDICAL ANESTHESIA CONSULTANTS MEDICAL GROUP INC 401K PROFIT SHARING PLAN 2010 401k financial data
Transfers to/from the plan	2010-12-31	$-668,926
Total plan liabilities at end of year	2010-12-31	$58,388
Total plan liabilities at beginning of year	2010-12-31	$50,000
Total income from all sources	2010-12-31	$5,854,260
Expenses. Total of all expenses incurred	2010-12-31	$2,283,589
Benefits paid (including direct rollovers)	2010-12-31	$2,175,639
Total plan assets at end of year	2010-12-31	$30,543,718
Total plan assets at beginning of year	2010-12-31	$27,633,585
Value of fidelity bond covering the plan	2010-12-31	$1,000,000
Total contributions received or receivable from participants	2010-12-31	$1,252,699
Contributions received from other sources (not participants or employers)	2010-12-31	$38,634
Other income received	2010-12-31	$2,325,011
Net income (gross income less expenses)	2010-12-31	$3,570,671
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$30,485,330
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$27,583,585
Assets. Value of participant loans	2010-12-31	$169,012
Assets. Value of assets in partnership/joint-venture interests	2010-12-31	$678,600
Total contributions received or receivable from employer(s)	2010-12-31	$2,237,916
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$107,950
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
2009 : MEDICAL ANESTHESIA CONSULTANTS MEDICAL GROUP INC 401K PROFIT SHARING PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for MEDICAL ANESTHESIA CONSULTANTS MEDICAL GROUP INC 401K PROFIT SHARING PLAN

2014: MEDICAL ANESTHESIA CONSULTANTS MEDICAL GROUP INC 401K 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
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: MEDICAL ANESTHESIA CONSULTANTS MEDICAL GROUP INC 401K 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
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: MEDICAL ANESTHESIA CONSULTANTS MEDICAL GROUP INC 401K 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
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: MEDICAL ANESTHESIA CONSULTANTS MEDICAL GROUP INC 401K 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
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: MEDICAL ANESTHESIA CONSULTANTS MEDICAL GROUP INC 401K PROFIT SHARING PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: MEDICAL ANESTHESIA CONSULTANTS MEDICAL GROUP INC 401K 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
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

4053214

Policy instance

Insurance contract or identification number	4053214
Number of Individuals Covered	1
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

4053214

Policy instance

Insurance contract or identification number	4053214
Number of Individuals Covered	1
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $17,905
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

OHIO NATIONAL LIFE ASSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 89206 )

Policy contract number

6659196/6754552

Policy instance

Insurance contract or identification number	6659196/6754552
Number of Individuals Covered	1
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

OHIO NATIONAL LIFE ASSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 89206 )

Policy contract number

6659196/6754552

Policy instance

Insurance contract or identification number	6659196/6754552
Number of Individuals Covered	1
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

4053214

Policy instance

Insurance contract or identification number	4053214
Number of Individuals Covered	1
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $37,435
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

4053214

Policy instance

Insurance contract or identification number	4053214
Number of Individuals Covered	1
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $37,435
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

OHIO NATIONAL LIFE ASSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 89206 )

Policy contract number

6659196/6754552

Policy instance

Insurance contract or identification number	6659196/6754552
Number of Individuals Covered	1
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	MEDICAL ANESTHESIA CONSULTANTS MEDICAL GROUP INC
Employer identification number (EIN):	680117704
NAIC Classification:	621399
NAIC Description:	Offices of All Other Miscellaneous Health Practitioners

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
002	2017-01-01
002	2016-01-01
002	2015-01-01
002	2014-01-01
002	2013-01-01
002	2012-01-01	DAVID FITZGERALD	DAVID FITZGERALD	2013-09-10
002	2011-01-01	PENSION FILERS
002	2010-01-01	PENSION FILERS
002	2009-01-01	ASSOCIATED PENSION CONSULTANTS