401k Plan data: CHARLES F. KIVOWITZ, M.D., A PROFESSIONAL CORPORATION PROFIT SHARING PLAN plan

CHARLES F. KIVOWITZ, M.D., A PROFESSIONAL CORPORATION PROFIT SHARING PLAN 401k Plan overview

Plan Name	CHARLES F. KIVOWITZ, M.D., A PROFESSIONAL CORPORATION PROFIT SHARING PLAN
Plan identification number	002

CHARLES F. KIVOWITZ, M.D., A PROFESSIONAL CORPORATION 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

CHARLES F. KIVOWITZ, M.D., A PROFESSIONAL CORPOR has sponsored the creation of one or more 401k plans.

Company Name: CHARLES F. KIVOWITZ, M.D., A PROFESSIONAL CORPOR

Employer identification number (EIN): 953156306

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CHARLES F. KIVOWITZ, M.D., A PROFESSIONAL CORPORATION PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2021-01-01
002 2020-01-01
002 2019-01-01
002 2018-01-01
002 2017-01-01
002 2016-01-01
002 2015-01-01
002 2014-01-01
002 2013-01-01 CHARLES F KIVOWITZ MD 2014-05-06
002 2012-01-01 CHARLES F KIVOWITZ MD 2013-06-17
002 2011-01-01 CHARLES F KIVOWITZ MD 2012-05-08

Financial Data on CHARLES F. KIVOWITZ, M.D., A PROFESSIONAL CORPORATION PROFIT SHARING PLAN

Measure	Date	Value
2010 : CHARLES F. KIVOWITZ, M.D., A PROFESSIONAL CORPORATION PROFIT SHARING PLAN 2010 401k financial data
Total plan liabilities at beginning of year	2010-12-31	$0
Total income from all sources	2010-12-31	$1,203,513
Expenses. Total of all expenses incurred	2010-12-31	$23,701
Benefits paid (including direct rollovers)	2010-12-31	$2,147
Total plan assets at end of year	2010-12-31	$7,333,596
Total plan assets at beginning of year	2010-12-31	$6,153,784
Value of fidelity bond covering the plan	2010-12-31	$500,000
Total contributions received or receivable from participants	2010-12-31	$0
Expenses. Other expenses not covered elsewhere	2010-12-31	$180
Contributions received from other sources (not participants or employers)	2010-12-31	$0
Other income received	2010-12-31	$1,188,513
Noncash contributions received	2010-12-31	$0
Net income (gross income less expenses)	2010-12-31	$1,179,812
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$7,333,596
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$6,153,784
Total contributions received or receivable from employer(s)	2010-12-31	$15,000
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	$21,374
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0

Insurance Providers Used on plan

AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 63665 )

Policy contract number

19493

Policy instance

Insurance contract or identification number	19493
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
Are there contracts with allocated funds for individual policies?	Yes
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?	No
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?	Yes
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	BERNARD H. PIKE, CLU, RHU

Potentially related plans

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Company Name:	CHARLES F. KIVOWITZ, M.D., A PROFESSIONAL CORPOR
Employer identification number (EIN):	953156306
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
002	2021-01-01
002	2020-01-01
002	2019-01-01
002	2018-01-01
002	2017-01-01
002	2016-01-01
002	2015-01-01
002	2014-01-01
002	2013-01-01	CHARLES F KIVOWITZ MD	2014-05-06
002	2012-01-01	CHARLES F KIVOWITZ MD	2013-06-17
002	2011-01-01	CHARLES F KIVOWITZ MD	2012-05-08