401k Plan data: DUKANE OBSTETRICS & GYNECOLOGY, LTD. PROFIT SHARING PLAN AND TRUST plan

DUKANE OBSTETRICS & GYNECOLOGY, LTD. PROFIT SHARING PLAN AND TRUST 401k Plan overview

Plan Name	DUKANE OBSTETRICS & GYNECOLOGY, LTD. PROFIT SHARING PLAN AND TRUST
Plan identification number	002

DUKANE OBSTETRICS & GYNECOLOGY, LTD. PROFIT SHARING PLAN AND TRUST 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
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
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.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
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

DUKANE OBSTETRICS & GYNECOLOGY LTD has sponsored the creation of one or more 401k plans.

Company Name: DUKANE OBSTETRICS & GYNECOLOGY LTD

Employer identification number (EIN): 362755147

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DUKANE OBSTETRICS & GYNECOLOGY, LTD. PROFIT SHARING PLAN AND TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2018-01-01 JENNIFER POLZ 2018-12-12 JENNIFER POLZ 2018-12-12
002 2018-01-01 JENNIFER POLZ 2018-12-11 JENNIFER POLZ 2018-12-11
002 2017-01-01 JENNIFER M. POLZ 2018-06-05 JENNIFER M. POLZ 2018-06-05
002 2016-01-01 JENNIFER M. POLZ 2017-07-20
002 2015-01-01 JENNIFER LEW 2016-05-23
002 2014-01-01 JENNIFER LEW
002 2013-01-01 STEWART ODELL MD
002 2012-01-01 STEWART ODELL MD
002 2011-01-01 STEWART ODELL MD
002 2009-01-01 STEWART ODELL MD

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2018-01-01	JENNIFER POLZ	2018-12-12	JENNIFER POLZ	2018-12-12
002	2018-01-01	JENNIFER POLZ	2018-12-11	JENNIFER POLZ	2018-12-11
002	2017-01-01	JENNIFER M. POLZ	2018-06-05	JENNIFER M. POLZ	2018-06-05
002	2016-01-01	JENNIFER M. POLZ	2017-07-20
002	2015-01-01	JENNIFER LEW	2016-05-23
002	2014-01-01	JENNIFER LEW
002	2013-01-01	STEWART ODELL MD
002	2012-01-01	STEWART ODELL MD
002	2011-01-01	STEWART ODELL MD
002	2009-01-01	STEWART ODELL MD

Financial Data on DUKANE OBSTETRICS & GYNECOLOGY, LTD. PROFIT SHARING PLAN AND TRUST

Measure	Date	Value
2014 : DUKANE OBSTETRICS & GYNECOLOGY, LTD. PROFIT SHARING PLAN AND TRUST 2014 401k financial data
Total income from all sources	2014-12-31	$412,435
Expenses. Total of all expenses incurred	2014-12-31	$135,131
Benefits paid (including direct rollovers)	2014-12-31	$135,131
Total plan assets at end of year	2014-12-31	$4,014,629
Total plan assets at beginning of year	2014-12-31	$3,737,325
Value of fidelity bond covering the plan	2014-12-31	$280,000
Total contributions received or receivable from participants	2014-12-31	$62,832
Other income received	2014-12-31	$190,041
Net income (gross income less expenses)	2014-12-31	$277,304
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$4,014,629
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$3,737,325
Total contributions received or receivable from employer(s)	2014-12-31	$159,562
2013 : DUKANE OBSTETRICS & GYNECOLOGY, LTD. PROFIT SHARING PLAN AND TRUST 2013 401k financial data
Total income from all sources	2013-12-31	$827,989
Expenses. Total of all expenses incurred	2013-12-31	$397,294
Benefits paid (including direct rollovers)	2013-12-31	$397,294
Total plan assets at end of year	2013-12-31	$3,737,325
Total plan assets at beginning of year	2013-12-31	$3,306,630
Value of fidelity bond covering the plan	2013-12-31	$280,000
Total contributions received or receivable from participants	2013-12-31	$68,280
Other income received	2013-12-31	$702,609
Net income (gross income less expenses)	2013-12-31	$430,695
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$3,737,325
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$3,306,630
Total contributions received or receivable from employer(s)	2013-12-31	$57,100
2012 : DUKANE OBSTETRICS & GYNECOLOGY, LTD. PROFIT SHARING PLAN AND TRUST 2012 401k financial data
Total income from all sources	2012-12-31	$475,394
Expenses. Total of all expenses incurred	2012-12-31	$155,935
Benefits paid (including direct rollovers)	2012-12-31	$155,935
Total plan assets at end of year	2012-12-31	$3,306,630
Total plan assets at beginning of year	2012-12-31	$2,987,171
Value of fidelity bond covering the plan	2012-12-31	$280,000
Total contributions received or receivable from participants	2012-12-31	$94,393
Other income received	2012-12-31	$348,380
Net income (gross income less expenses)	2012-12-31	$319,459
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$3,306,630
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$2,987,171
Total contributions received or receivable from employer(s)	2012-12-31	$32,621
2011 : DUKANE OBSTETRICS & GYNECOLOGY, LTD. PROFIT SHARING PLAN AND TRUST 2011 401k financial data
Total income from all sources	2011-12-31	$10,339
Expenses. Total of all expenses incurred	2011-12-31	$89,668
Benefits paid (including direct rollovers)	2011-12-31	$89,668
Total plan assets at end of year	2011-12-31	$2,987,171
Total plan assets at beginning of year	2011-12-31	$3,066,500
Value of fidelity bond covering the plan	2011-12-31	$280,000
Total contributions received or receivable from participants	2011-12-31	$58,809
Other income received	2011-12-31	$-77,040
Net income (gross income less expenses)	2011-12-31	$-79,329
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$2,987,171
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$3,066,500
Total contributions received or receivable from employer(s)	2011-12-31	$28,570
2010 : DUKANE OBSTETRICS & GYNECOLOGY, LTD. PROFIT SHARING PLAN AND TRUST 2010 401k financial data
Total income from all sources	2010-12-31	$389,332
Expenses. Total of all expenses incurred	2010-12-31	$81,098
Benefits paid (including direct rollovers)	2010-12-31	$75,498
Total plan assets at end of year	2010-12-31	$3,066,500
Total plan assets at beginning of year	2010-12-31	$2,758,266
Value of fidelity bond covering the plan	2010-12-31	$250,000
Total contributions received or receivable from participants	2010-12-31	$65,685
Expenses. Other expenses not covered elsewhere	2010-12-31	$5,600
Other income received	2010-12-31	$299,982
Net income (gross income less expenses)	2010-12-31	$308,234
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$3,066,500
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$2,758,266
Total contributions received or receivable from employer(s)	2010-12-31	$23,665

Form 5500 Responses for DUKANE OBSTETRICS & GYNECOLOGY, LTD. PROFIT SHARING PLAN AND TRUST

2014: DUKANE OBSTETRICS & GYNECOLOGY, LTD. PROFIT SHARING PLAN AND TRUST 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
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: DUKANE OBSTETRICS & GYNECOLOGY, LTD. PROFIT SHARING PLAN AND TRUST 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: DUKANE OBSTETRICS & GYNECOLOGY, LTD. PROFIT SHARING PLAN AND TRUST 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: DUKANE OBSTETRICS & GYNECOLOGY, LTD. PROFIT SHARING PLAN AND TRUST 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
2009: DUKANE OBSTETRICS & GYNECOLOGY, LTD. PROFIT SHARING PLAN AND TRUST 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

SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number	048-5799-00
Policy instance	1
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number	048-5799-00
Policy instance	1
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number	048-5799-00
Policy instance	1
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number	048-5799-00
Policy instance	1

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Company Name:	DUKANE OBSTETRICS & GYNECOLOGY LTD
Employer identification number (EIN):	362755147
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)