401k Plan data: BRIAN J. LEBERTHON MD, A MEDICAL CORPORATION PENSION PLAN plan

BRIAN J. LEBERTHON MD, A MEDICAL CORPORATION PENSION PLAN 401k Plan overview

Plan Name	BRIAN J. LEBERTHON MD, A MEDICAL CORPORATION PENSION PLAN
Plan identification number	001

BRIAN J. LEBERTHON MD, A MEDICAL CORPORATION PENSION PLAN Benefits

401k Plan Type	Other Pension Benefit
Plan Features/Benefits	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

BRIAN J. LEBERTHON MD, A MEDICAL CORPORATION has sponsored the creation of one or more 401k plans.

Company Name: BRIAN J. LEBERTHON MD, A MEDICAL CORPORATION

Employer identification number (EIN): 830408692

NAIC Classification: 621111
NAIC Description: Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BRIAN J. LEBERTHON MD, A MEDICAL CORPORATION PENSION PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2017-01-01
001 2016-01-01
001 2015-01-01
001 2014-01-01
001 2013-01-01
001 2012-01-01 BRIAN J. LEBERTHON BRIAN J. LEBERTHON 2013-10-04
001 2011-01-01 BRIAN J. LEBERTHON BRIAN J. LEBERTHON 2012-07-12
001 2010-01-01 BRIAN J. LEBERTHON BRIAN J. LEBERTHON 2011-09-23
001 2009-01-01 NELSON YEUNG

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2017-01-01
001	2016-01-01
001	2015-01-01
001	2014-01-01
001	2013-01-01
001	2012-01-01	BRIAN J. LEBERTHON	BRIAN J. LEBERTHON	2013-10-04
001	2011-01-01	BRIAN J. LEBERTHON	BRIAN J. LEBERTHON	2012-07-12
001	2010-01-01	BRIAN J. LEBERTHON	BRIAN J. LEBERTHON	2011-09-23
001	2009-01-01	NELSON YEUNG

Financial Data on BRIAN J. LEBERTHON MD, A MEDICAL CORPORATION PENSION PLAN

Measure	Date	Value
2015 : BRIAN J. LEBERTHON MD, A MEDICAL CORPORATION PENSION PLAN 2015 401k financial data
Transfers to/from the plan	2015-12-31	$0
Total plan liabilities at end of year	2015-12-31	$0
Total plan liabilities at beginning of year	2015-12-31	$0
Total income from all sources	2015-12-31	$345,547
Expenses. Total of all expenses incurred	2015-12-31	$0
Benefits paid (including direct rollovers)	2015-12-31	$0
Total plan assets at end of year	2015-12-31	$2,841,117
Total plan assets at beginning of year	2015-12-31	$2,495,570
Total contributions received or receivable from participants	2015-12-31	$0
Expenses. Other expenses not covered elsewhere	2015-12-31	$0
Contributions received from other sources (not participants or employers)	2015-12-31	$0
Other income received	2015-12-31	$31,032
Noncash contributions received	2015-12-31	$0
Net income (gross income less expenses)	2015-12-31	$345,547
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$2,841,117
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$2,495,570
Total contributions received or receivable from employer(s)	2015-12-31	$314,515
Value of certain deemed distributions of participant loans	2015-12-31	$0
Value of corrective distributions	2015-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2015-12-31	$0
2014 : BRIAN J. LEBERTHON MD, A MEDICAL CORPORATION PENSION PLAN 2014 401k financial data
Transfers to/from the plan	2014-12-31	$0
Total plan liabilities at end of year	2014-12-31	$0
Total plan liabilities at beginning of year	2014-12-31	$0
Total income from all sources	2014-12-31	$339,215
Expenses. Total of all expenses incurred	2014-12-31	$0
Benefits paid (including direct rollovers)	2014-12-31	$0
Total plan assets at end of year	2014-12-31	$2,495,570
Total plan assets at beginning of year	2014-12-31	$2,156,355
Total contributions received or receivable from participants	2014-12-31	$0
Expenses. Other expenses not covered elsewhere	2014-12-31	$0
Contributions received from other sources (not participants or employers)	2014-12-31	$0
Other income received	2014-12-31	$28,186
Noncash contributions received	2014-12-31	$0
Net income (gross income less expenses)	2014-12-31	$339,215
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$2,495,570
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$2,156,355
Total contributions received or receivable from employer(s)	2014-12-31	$311,029
Value of certain deemed distributions of participant loans	2014-12-31	$0
Value of corrective distributions	2014-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2014-12-31	$0
2013 : BRIAN J. LEBERTHON MD, A MEDICAL CORPORATION PENSION PLAN 2013 401k financial data
Transfers to/from the plan	2013-12-31	$0
Total plan liabilities at end of year	2013-12-31	$0
Total plan liabilities at beginning of year	2013-12-31	$0
Total income from all sources	2013-12-31	$339,087
Expenses. Total of all expenses incurred	2013-12-31	$0
Benefits paid (including direct rollovers)	2013-12-31	$0
Total plan assets at end of year	2013-12-31	$2,156,355
Total plan assets at beginning of year	2013-12-31	$1,817,268
Total contributions received or receivable from participants	2013-12-31	$0
Expenses. Other expenses not covered elsewhere	2013-12-31	$0
Contributions received from other sources (not participants or employers)	2013-12-31	$0
Other income received	2013-12-31	$25,516
Noncash contributions received	2013-12-31	$0
Net income (gross income less expenses)	2013-12-31	$339,087
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$2,156,355
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$1,817,268
Total contributions received or receivable from employer(s)	2013-12-31	$313,571
Value of certain deemed distributions of participant loans	2013-12-31	$0
Value of corrective distributions	2013-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2013-12-31	$0
2012 : BRIAN J. LEBERTHON MD, A MEDICAL CORPORATION PENSION PLAN 2012 401k financial data
Transfers to/from the plan	2012-12-31	$0
Total plan liabilities at end of year	2012-12-31	$0
Total plan liabilities at beginning of year	2012-12-31	$0
Total income from all sources	2012-12-31	$521,196
Expenses. Total of all expenses incurred	2012-12-31	$0
Benefits paid (including direct rollovers)	2012-12-31	$0
Total plan assets at end of year	2012-12-31	$1,817,268
Total plan assets at beginning of year	2012-12-31	$1,296,072
Total contributions received or receivable from participants	2012-12-31	$0
Expenses. Other expenses not covered elsewhere	2012-12-31	$0
Contributions received from other sources (not participants or employers)	2012-12-31	$0
Other income received	2012-12-31	$216,524
Noncash contributions received	2012-12-31	$0
Net income (gross income less expenses)	2012-12-31	$521,196
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$1,817,268
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$1,296,072
Total contributions received or receivable from employer(s)	2012-12-31	$304,672
Value of certain deemed distributions of participant loans	2012-12-31	$0
Value of corrective distributions	2012-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2012-12-31	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
2011 : BRIAN J. LEBERTHON MD, A MEDICAL CORPORATION PENSION PLAN 2011 401k financial data
Transfers to/from the plan	2011-12-31	$0
Total plan liabilities at end of year	2011-12-31	$0
Total plan liabilities at beginning of year	2011-12-31	$0
Total income from all sources	2011-12-31	$137,075
Expenses. Total of all expenses incurred	2011-12-31	$0
Benefits paid (including direct rollovers)	2011-12-31	$0
Total plan assets at end of year	2011-12-31	$1,296,072
Total plan assets at beginning of year	2011-12-31	$1,158,997
Total contributions received or receivable from participants	2011-12-31	$0
Expenses. Other expenses not covered elsewhere	2011-12-31	$0
Contributions received from other sources (not participants or employers)	2011-12-31	$0
Other income received	2011-12-31	$0
Noncash contributions received	2011-12-31	$-177,510
Net income (gross income less expenses)	2011-12-31	$137,075
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$1,296,072
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$1,158,997
Total contributions received or receivable from employer(s)	2011-12-31	$314,585
Value of certain deemed distributions of participant loans	2011-12-31	$0
Value of corrective distributions	2011-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$0
2010 : BRIAN J. LEBERTHON MD, A MEDICAL CORPORATION PENSION PLAN 2010 401k financial data
Transfers to/from the plan	2010-12-31	$0
Total plan liabilities at end of year	2010-12-31	$0
Total plan liabilities at beginning of year	2010-12-31	$0
Total income from all sources	2010-12-31	$321,500
Expenses. Total of all expenses incurred	2010-12-31	$0
Benefits paid (including direct rollovers)	2010-12-31	$0
Total plan assets at end of year	2010-12-31	$1,158,997
Total plan assets at beginning of year	2010-12-31	$837,497
Total contributions received or receivable from participants	2010-12-31	$0
Expenses. Other expenses not covered elsewhere	2010-12-31	$0
Contributions received from other sources (not participants or employers)	2010-12-31	$0
Other income received	2010-12-31	$25,488
Noncash contributions received	2010-12-31	$0
Net income (gross income less expenses)	2010-12-31	$321,500
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$1,158,997
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$837,497
Total contributions received or receivable from employer(s)	2010-12-31	$296,012
Value of certain deemed distributions of participant loans	2010-12-31	$0
Value of corrective distributions	2010-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$0

Form 5500 Responses for BRIAN J. LEBERTHON MD, A MEDICAL CORPORATION PENSION PLAN

2015: BRIAN J. LEBERTHON MD, A MEDICAL CORPORATION PENSION PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Section 412(e)(3) insurance Contracts	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Section 412(e)(3) insurance Contracts	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: BRIAN J. LEBERTHON MD, A MEDICAL CORPORATION PENSION 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 – Section 412(e)(3) insurance Contracts	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Section 412(e)(3) insurance Contracts	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: BRIAN J. LEBERTHON MD, A MEDICAL CORPORATION PENSION 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 – Section 412(e)(3) insurance Contracts	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Section 412(e)(3) insurance Contracts	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: BRIAN J. LEBERTHON MD, A MEDICAL CORPORATION PENSION 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 – Section 412(e)(3) insurance Contracts	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Section 412(e)(3) insurance Contracts	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: BRIAN J. LEBERTHON MD, A MEDICAL CORPORATION PENSION 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 – Section 412(e)(3) insurance Contracts	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Section 412(e)(3) insurance Contracts	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: BRIAN J. LEBERTHON MD, A MEDICAL CORPORATION PENSION 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 – Section 412(e)(3) insurance Contracts	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Section 412(e)(3) insurance Contracts	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: BRIAN J. LEBERTHON MD, A MEDICAL CORPORATION PENSION 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 – Section 412(e)(3) insurance Contracts	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Section 412(e)(3) insurance Contracts	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

TRANSAMERICA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number
Policy instance	1
TRANSAMERICA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number
Policy instance	1
TRANSAMERICA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number
Policy instance	1

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Company Name:	BRIAN J. LEBERTHON MD, A MEDICAL CORPORATION
Employer identification number (EIN):	830408692
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)