401k Plan data: NICHOLS MOHS & SKIN SURGERY PC 401K PROFIT SHARING PLAN plan

NICHOLS MOHS & SKIN SURGERY PC 401K PROFIT SHARING PLAN 401k Plan overview

Plan Name	NICHOLS MOHS & SKIN SURGERY PC 401K PROFIT SHARING PLAN
Plan identification number	001

NICHOLS MOHS & SKIN SURGERY PC 401K PROFIT SHARING PLAN Benefits

401k Plan Type

Defined 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.
Partial participant-directed account plan - Participants have the opportunity to direct the investment of a portion of 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.

401k Sponsoring company profile

NICHOLS MOHS & SKIN SURGERY, P.C. has sponsored the creation of one or more 401k plans.

Company Name: NICHOLS MOHS & SKIN SURGERY, P.C.

Employer identification number (EIN): 264163759

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NICHOLS MOHS & SKIN SURGERY PC 401K PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01 G. RICHARD NICHOLS 2023-06-26 G. RICHARD NICHOLS 2023-06-26
001 2021-01-01 G. RICHARD NICHOLS 2022-06-29 G. RICHARD NICHOLS 2022-06-29
001 2020-01-01 G. RICHARD NICHOLS 2021-07-26 G. RICHARD NICHOLS 2021-07-26
001 2019-01-01 G. RICHARD NICHOLS 2020-08-20 G. RICHARD NICHOLS 2020-08-20
001 2018-01-01 G. RICHARD NICHOLS 2019-09-23 G. RICHARD NICHOLS 2019-09-23
001 2017-01-01 G. RICHARD NICHOLS 2018-07-30 G. RICHARD NICHOLS 2018-07-30
001 2016-01-01 G. RICHARD NICHOLS G. RICHARD NICHOLS 2017-09-25
001 2015-01-01 G. RICHARD NICHOLS 2016-09-26 G. RICHARD NICHOLS 2016-09-26
001 2014-01-01 G. RICHARD NICHOLS 2015-05-28 G. RICHARD NICHOLS 2015-05-28
001 2013-01-01 G. RICHARD NICHOLS 2014-07-28 G. RICHARD NICHOLS 2014-07-28
001 2012-01-01 G. RICHARD NICHOLS G. RICHARD NICHOLS 2013-06-24
001 2011-01-01 G. RICHARD NICHOLS G. RICHARD NICHOLS 2012-08-01
001 2010-07-01 G. RICHARD NICHOLS 2011-06-27 G. RICHARD NICHOLS 2011-06-27

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2022-01-01	G. RICHARD NICHOLS	2023-06-26	G. RICHARD NICHOLS	2023-06-26
001	2021-01-01	G. RICHARD NICHOLS	2022-06-29	G. RICHARD NICHOLS	2022-06-29
001	2020-01-01	G. RICHARD NICHOLS	2021-07-26	G. RICHARD NICHOLS	2021-07-26
001	2019-01-01	G. RICHARD NICHOLS	2020-08-20	G. RICHARD NICHOLS	2020-08-20
001	2018-01-01	G. RICHARD NICHOLS	2019-09-23	G. RICHARD NICHOLS	2019-09-23
001	2017-01-01	G. RICHARD NICHOLS	2018-07-30	G. RICHARD NICHOLS	2018-07-30
001	2016-01-01	G. RICHARD NICHOLS		G. RICHARD NICHOLS	2017-09-25
001	2015-01-01	G. RICHARD NICHOLS	2016-09-26	G. RICHARD NICHOLS	2016-09-26
001	2014-01-01	G. RICHARD NICHOLS	2015-05-28	G. RICHARD NICHOLS	2015-05-28
001	2013-01-01	G. RICHARD NICHOLS	2014-07-28	G. RICHARD NICHOLS	2014-07-28
001	2012-01-01	G. RICHARD NICHOLS		G. RICHARD NICHOLS	2013-06-24
001	2011-01-01	G. RICHARD NICHOLS		G. RICHARD NICHOLS	2012-08-01
001	2010-07-01	G. RICHARD NICHOLS	2011-06-27	G. RICHARD NICHOLS	2011-06-27

Plan Statistics for NICHOLS MOHS & SKIN SURGERY PC 401K PROFIT SHARING PLAN

401k plan membership statisitcs for NICHOLS MOHS & SKIN SURGERY PC 401K PROFIT SHARING PLAN

Measure Date Value
2016: NICHOLS MOHS & SKIN SURGERY PC 401K PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 5
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 5
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 5
Number of participants with account balances 2016-01-01 5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2012: NICHOLS MOHS & SKIN SURGERY PC 401K PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 4
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 4
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 1
Total of all active and inactive participants 2012-01-01 5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 5
Number of participants with account balances 2012-01-01 5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: NICHOLS MOHS & SKIN SURGERY PC 401K PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 5
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 3
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 1
Total of all active and inactive participants 2011-01-01 4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 4
Number of participants with account balances 2011-01-01 4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 2

Measure	Date	Value
2016: NICHOLS MOHS & SKIN SURGERY PC 401K PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	5
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	5
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	5
Number of participants with account balances	2016-01-01	5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2012: NICHOLS MOHS & SKIN SURGERY PC 401K PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	4
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	4
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	1
Total of all active and inactive participants	2012-01-01	5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	5
Number of participants with account balances	2012-01-01	5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: NICHOLS MOHS & SKIN SURGERY PC 401K PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	5
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	3
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	1
Total of all active and inactive participants	2011-01-01	4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	4
Number of participants with account balances	2011-01-01	4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	2

Financial Data on NICHOLS MOHS & SKIN SURGERY PC 401K PROFIT SHARING PLAN

Measure	Date	Value
2016 : NICHOLS MOHS & SKIN SURGERY PC 401K PROFIT SHARING PLAN 2016 401k financial data
Total income from all sources	2016-12-31	$130,523
Expenses. Total of all expenses incurred	2016-12-31	$22,838
Benefits paid (including direct rollovers)	2016-12-31	$14,549
Total plan assets at end of year	2016-12-31	$524,930
Total plan assets at beginning of year	2016-12-31	$417,245
Total contributions received or receivable from participants	2016-12-31	$26,034
Expenses. Other expenses not covered elsewhere	2016-12-31	$8,289
Other income received	2016-12-31	$56,530
Net income (gross income less expenses)	2016-12-31	$107,685
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$524,930
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$417,245
Total contributions received or receivable from employer(s)	2016-12-31	$47,959
2012 : NICHOLS MOHS & SKIN SURGERY PC 401K PROFIT SHARING PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$72,452
Expenses. Total of all expenses incurred	2012-12-31	$1,815
Total plan assets at end of year	2012-12-31	$193,616
Total plan assets at beginning of year	2012-12-31	$122,979
Value of fidelity bond covering the plan	2012-12-31	$25,000
Total contributions received or receivable from participants	2012-12-31	$20,950
Other income received	2012-12-31	$7,996
Net income (gross income less expenses)	2012-12-31	$70,637
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$193,616
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$122,979
Total contributions received or receivable from employer(s)	2012-12-31	$43,506
Expenses. Administrative service providers (salaries,fees and commissions)	2012-12-31	$1,815
2011 : NICHOLS MOHS & SKIN SURGERY PC 401K PROFIT SHARING PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$61,635
Expenses. Total of all expenses incurred	2011-12-31	$2,492
Benefits paid (including direct rollovers)	2011-12-31	$1,508
Total plan assets at end of year	2011-12-31	$122,979
Total plan assets at beginning of year	2011-12-31	$63,836
Value of fidelity bond covering the plan	2011-12-31	$25,000
Total contributions received or receivable from participants	2011-12-31	$21,142
Expenses. Other expenses not covered elsewhere	2011-12-31	$984
Other income received	2011-12-31	$-3,092
Net income (gross income less expenses)	2011-12-31	$59,143
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$122,979
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$63,836
Total contributions received or receivable from employer(s)	2011-12-31	$43,585

Form 5500 Responses for NICHOLS MOHS & SKIN SURGERY PC 401K PROFIT SHARING PLAN

2016: NICHOLS MOHS & SKIN SURGERY PC 401K PROFIT SHARING PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2012: NICHOLS MOHS & SKIN SURGERY PC 401K PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: NICHOLS MOHS & SKIN SURGERY PC 401K PROFIT SHARING PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	NICHOLS MOHS & SKIN SURGERY, P.C.
Employer identification number (EIN):	264163759
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)