401k Plan data: FAMILY MEDICINE, P.C. EMPLOYEES' PROFIT SHARING PLAN plan

FAMILY MEDICINE, P.C. EMPLOYEES' PROFIT SHARING PLAN 401k Plan overview

Plan Name	FAMILY MEDICINE, P.C. EMPLOYEES' PROFIT SHARING PLAN
Plan identification number	002

FAMILY MEDICINE, P.C. EMPLOYEES' PROFIT SHARING PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
Profit-sharing
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

FAMILY MEDICINE, P.C. has sponsored the creation of one or more 401k plans.

Company Name: FAMILY MEDICINE, P.C.

Employer identification number (EIN): 850214205

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FAMILY MEDICINE, P.C. EMPLOYEES' PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2016-01-01 WILLIAM G HENDERSON 2016-11-25 WILLIAM G HENDERSON 2016-11-25
002 2015-01-01 WILLIAM HENDERSON WILLIAM HENDERSON 2016-03-21
002 2014-01-01 WILLIAM HENDERSON WILLIAM HENDERSON 2015-10-05
002 2013-01-01 WILLIAM G HENDERSON
002 2012-01-01 WILLIAM G HENDERSON
002 2011-01-01 WILLIAM G HENDERSON
002 2010-01-01 WILLIAM G HENDERSON
002 2009-01-01 WILLIAM G HENDERSON

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2016-01-01	WILLIAM G HENDERSON	2016-11-25	WILLIAM G HENDERSON	2016-11-25
002	2015-01-01	WILLIAM HENDERSON		WILLIAM HENDERSON	2016-03-21
002	2014-01-01	WILLIAM HENDERSON		WILLIAM HENDERSON	2015-10-05
002	2013-01-01	WILLIAM G HENDERSON
002	2012-01-01	WILLIAM G HENDERSON
002	2011-01-01	WILLIAM G HENDERSON
002	2010-01-01	WILLIAM G HENDERSON
002	2009-01-01	WILLIAM G HENDERSON

Plan Statistics for FAMILY MEDICINE, P.C. EMPLOYEES' PROFIT SHARING PLAN

401k plan membership statisitcs for FAMILY MEDICINE, P.C. EMPLOYEES' PROFIT SHARING PLAN

Measure Date Value
2015: FAMILY MEDICINE, P.C. EMPLOYEES' PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 19
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 18
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 3
Total of all active and inactive participants 2015-01-01 21
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 21
Number of participants with account balances 2015-01-01 10
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: FAMILY MEDICINE, P.C. EMPLOYEES' PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 18
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 15
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 18
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 18
Number of participants with account balances 2014-01-01 10
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: FAMILY MEDICINE, P.C. EMPLOYEES' PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 10
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 6
Number of other retired or separated participants entitled to future benefits 2013-01-01 4
Total of all active and inactive participants 2013-01-01 10
Total participants 2013-01-01 10
Number of participants with account balances 2013-01-01 10
2012: FAMILY MEDICINE, P.C. EMPLOYEES' PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 10
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 8
Number of other retired or separated participants entitled to future benefits 2012-01-01 2
Total of all active and inactive participants 2012-01-01 10
Total participants 2012-01-01 10
Number of participants with account balances 2012-01-01 10
2011: FAMILY MEDICINE, P.C. EMPLOYEES' PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 10
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 8
Number of other retired or separated participants entitled to future benefits 2011-01-01 2
Total of all active and inactive participants 2011-01-01 10
Total participants 2011-01-01 10
Number of participants with account balances 2011-01-01 10
2010: FAMILY MEDICINE, P.C. EMPLOYEES' PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 10
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 9
Number of other retired or separated participants entitled to future benefits 2010-01-01 1
Total of all active and inactive participants 2010-01-01 10
Total participants 2010-01-01 10
Number of participants with account balances 2010-01-01 10
2009: FAMILY MEDICINE, P.C. EMPLOYEES' PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 10
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 9
Number of other retired or separated participants entitled to future benefits 2009-01-01 1
Total of all active and inactive participants 2009-01-01 10
Total participants 2009-01-01 10
Number of participants with account balances 2009-01-01 10

Measure	Date	Value
2015: FAMILY MEDICINE, P.C. EMPLOYEES' PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	19
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	18
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	3
Total of all active and inactive participants	2015-01-01	21
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	21
Number of participants with account balances	2015-01-01	10
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: FAMILY MEDICINE, P.C. EMPLOYEES' PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	18
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	15
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	18
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	18
Number of participants with account balances	2014-01-01	10
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: FAMILY MEDICINE, P.C. EMPLOYEES' PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	10
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	6
Number of other retired or separated participants entitled to future benefits	2013-01-01	4
Total of all active and inactive participants	2013-01-01	10
Total participants	2013-01-01	10
Number of participants with account balances	2013-01-01	10
2012: FAMILY MEDICINE, P.C. EMPLOYEES' PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	10
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	8
Number of other retired or separated participants entitled to future benefits	2012-01-01	2
Total of all active and inactive participants	2012-01-01	10
Total participants	2012-01-01	10
Number of participants with account balances	2012-01-01	10
2011: FAMILY MEDICINE, P.C. EMPLOYEES' PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	10
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	8
Number of other retired or separated participants entitled to future benefits	2011-01-01	2
Total of all active and inactive participants	2011-01-01	10
Total participants	2011-01-01	10
Number of participants with account balances	2011-01-01	10
2010: FAMILY MEDICINE, P.C. EMPLOYEES' PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	10
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	9
Number of other retired or separated participants entitled to future benefits	2010-01-01	1
Total of all active and inactive participants	2010-01-01	10
Total participants	2010-01-01	10
Number of participants with account balances	2010-01-01	10
2009: FAMILY MEDICINE, P.C. EMPLOYEES' PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	10
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	9
Number of other retired or separated participants entitled to future benefits	2009-01-01	1
Total of all active and inactive participants	2009-01-01	10
Total participants	2009-01-01	10
Number of participants with account balances	2009-01-01	10

Financial Data on FAMILY MEDICINE, P.C. EMPLOYEES' PROFIT SHARING PLAN

Measure	Date	Value
2015 : FAMILY MEDICINE, P.C. EMPLOYEES' PROFIT SHARING 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 income from all sources	2015-12-31	$20,412
Expenses. Total of all expenses incurred	2015-12-31	$32,101
Benefits paid (including direct rollovers)	2015-12-31	$28,861
Total plan assets at end of year	2015-12-31	$1,620,118
Total plan assets at beginning of year	2015-12-31	$1,631,807
Value of fidelity bond covering the plan	2015-12-31	$150,000
Total contributions received or receivable from participants	2015-12-31	$0
Expenses. Other expenses not covered elsewhere	2015-12-31	$3,240
Contributions received from other sources (not participants or employers)	2015-12-31	$0
Other income received	2015-12-31	$20,412
Noncash contributions received	2015-12-31	$0
Net income (gross income less expenses)	2015-12-31	$-11,689
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$1,620,118
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$1,631,807
Total contributions received or receivable from employer(s)	2015-12-31	$0
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 : FAMILY MEDICINE, P.C. EMPLOYEES' PROFIT SHARING PLAN 2014 401k financial data
Total income from all sources	2014-12-31	$218,838
Expenses. Total of all expenses incurred	2014-12-31	$5,404
Benefits paid (including direct rollovers)	2014-12-31	$0
Total plan assets at end of year	2014-12-31	$1,631,807
Total plan assets at beginning of year	2014-12-31	$1,418,373
Value of fidelity bond covering the plan	2014-12-31	$150,000
Expenses. Other expenses not covered elsewhere	2014-12-31	$5,404
Other income received	2014-12-31	$218,838
Net income (gross income less expenses)	2014-12-31	$213,434
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$1,631,807
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$1,418,373
Value of certain deemed distributions of participant loans	2014-12-31	$0
2013 : FAMILY MEDICINE, P.C. EMPLOYEES' PROFIT SHARING PLAN 2013 401k financial data
Total income from all sources	2013-12-31	$287,523
Expenses. Total of all expenses incurred	2013-12-31	$5,404
Benefits paid (including direct rollovers)	2013-12-31	$5,404
Total plan assets at end of year	2013-12-31	$1,418,373
Total plan assets at beginning of year	2013-12-31	$1,136,254
Value of fidelity bond covering the plan	2013-12-31	$150,000
Other income received	2013-12-31	$287,523
Net income (gross income less expenses)	2013-12-31	$282,119
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$1,418,373
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$1,136,254
2012 : FAMILY MEDICINE, P.C. EMPLOYEES' PROFIT SHARING PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$144,413
Expenses. Total of all expenses incurred	2012-12-31	$5,404
Benefits paid (including direct rollovers)	2012-12-31	$5,404
Total plan assets at end of year	2012-12-31	$1,136,254
Total plan assets at beginning of year	2012-12-31	$997,245
Value of fidelity bond covering the plan	2012-12-31	$120,000
Other income received	2012-12-31	$144,413
Net income (gross income less expenses)	2012-12-31	$139,009
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$1,136,254
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$997,245
2011 : FAMILY MEDICINE, P.C. EMPLOYEES' PROFIT SHARING PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$-1,188
Expenses. Total of all expenses incurred	2011-12-31	$5,404
Benefits paid (including direct rollovers)	2011-12-31	$5,404
Total plan assets at end of year	2011-12-31	$997,245
Total plan assets at beginning of year	2011-12-31	$1,003,837
Value of fidelity bond covering the plan	2011-12-31	$110,000
Other income received	2011-12-31	$-1,188
Net income (gross income less expenses)	2011-12-31	$-6,592
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$997,245
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$1,003,837
2010 : FAMILY MEDICINE, P.C. EMPLOYEES' PROFIT SHARING PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$129,488
Expenses. Total of all expenses incurred	2010-12-31	$5,404
Benefits paid (including direct rollovers)	2010-12-31	$5,404
Total plan assets at end of year	2010-12-31	$1,003,837
Total plan assets at beginning of year	2010-12-31	$879,753
Value of fidelity bond covering the plan	2010-12-31	$110,000
Other income received	2010-12-31	$129,488
Net income (gross income less expenses)	2010-12-31	$124,084
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$1,003,837
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$879,753

Form 5500 Responses for FAMILY MEDICINE, P.C. EMPLOYEES' PROFIT SHARING PLAN

2015: FAMILY MEDICINE, P.C. EMPLOYEES' PROFIT SHARING 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 – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: FAMILY MEDICINE, P.C. EMPLOYEES' 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: FAMILY MEDICINE, P.C. EMPLOYEES' PROFIT SHARING PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
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: FAMILY MEDICINE, P.C. EMPLOYEES' PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
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: FAMILY MEDICINE, P.C. EMPLOYEES' PROFIT SHARING PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
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: FAMILY MEDICINE, P.C. EMPLOYEES' PROFIT SHARING PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
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: FAMILY MEDICINE, P.C. EMPLOYEES' PROFIT SHARING PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
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

PAN AMERICAN ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 93459 )

Policy contract number

9200072450

Policy instance

Insurance contract or identification number	9200072450
Number of Individuals Covered	1
Insurance policy start date	2014-07-01
Insurance policy end date	2015-07-01
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0

PAN AMERICAN ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 93459 )

Policy contract number

9200072450

Policy instance

Insurance contract or identification number	9200072450
Number of Individuals Covered	1
Insurance policy start date	2013-07-01
Insurance policy end date	2014-07-01
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0

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Company Name:	FAMILY MEDICINE, P.C.
Employer identification number (EIN):	850214205
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)