401k Plan data: ARCHER FAMILY MEDICAL GROUP RETIREMENT PLAN plan

ARCHER FAMILY MEDICAL GROUP RETIREMENT PLAN 401k Plan overview

Plan Name	ARCHER FAMILY MEDICAL GROUP RETIREMENT PLAN
Plan identification number	001

ARCHER FAMILY MEDICAL GROUP RETIREMENT 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.
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.
Plan covering Self-Employed individuals.
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

ARCHER FAMILY MEDICAL GROUP, L.L.C. has sponsored the creation of one or more 401k plans.

Company Name: ARCHER FAMILY MEDICAL GROUP, L.L.C.

Employer identification number (EIN): 364487413

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ARCHER FAMILY MEDICAL GROUP RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01
001 2021-01-01
001 2020-01-01
001 2019-01-01
001 2018-01-01
001 2017-01-01
001 2016-01-01 DAVID B. LEVY, M.D. 2017-08-28 DAVID B. LEVY, M.D. 2017-08-28
001 2015-01-01 DAVID B. LEVY, M.D. 2016-09-23 DAVID B. LEVY, M.D. 2016-09-23
001 2014-01-01 DAVID B. LEVY, M.D. 2015-10-14 DAVID B. LEVY, M.D. 2015-10-14
001 2013-01-01 DAVID B. LEVY, M.D. 2014-10-11 DAVID B. LEVY, M.D. 2014-10-11
001 2012-01-01 DAVID B. LEVY, M.D. 2013-10-08 DAVID B. LEVY, M.D. 2013-10-08
001 2011-01-01 DAVID B. LEVY, M.D. 2012-08-27 DAVID B. LEVY, M.D. 2012-08-27
001 2010-01-01 DAVID B. LEVY, M.D. 2011-10-06 DAVID B. LEVY, M.D. 2011-10-06
001 2007-01-01 DAVID B. LEVY, M.D. DAVID B. LEVY, M.D. 2011-10-06
001 2005-01-01 DAVID B. LEVY, M.D. DAVID B. LEVY, M.D. 2011-10-06

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2022-01-01
001	2021-01-01
001	2020-01-01
001	2019-01-01
001	2018-01-01
001	2017-01-01
001	2016-01-01	DAVID B. LEVY, M.D.	2017-08-28	DAVID B. LEVY, M.D.	2017-08-28
001	2015-01-01	DAVID B. LEVY, M.D.	2016-09-23	DAVID B. LEVY, M.D.	2016-09-23
001	2014-01-01	DAVID B. LEVY, M.D.	2015-10-14	DAVID B. LEVY, M.D.	2015-10-14
001	2013-01-01	DAVID B. LEVY, M.D.	2014-10-11	DAVID B. LEVY, M.D.	2014-10-11
001	2012-01-01	DAVID B. LEVY, M.D.	2013-10-08	DAVID B. LEVY, M.D.	2013-10-08
001	2011-01-01	DAVID B. LEVY, M.D.	2012-08-27	DAVID B. LEVY, M.D.	2012-08-27
001	2010-01-01	DAVID B. LEVY, M.D.	2011-10-06	DAVID B. LEVY, M.D.	2011-10-06
001	2007-01-01	DAVID B. LEVY, M.D.		DAVID B. LEVY, M.D.	2011-10-06
001	2005-01-01	DAVID B. LEVY, M.D.		DAVID B. LEVY, M.D.	2011-10-06

Plan Statistics for ARCHER FAMILY MEDICAL GROUP RETIREMENT PLAN

401k plan membership statisitcs for ARCHER FAMILY MEDICAL GROUP RETIREMENT PLAN

Measure Date Value
2007: ARCHER FAMILY MEDICAL GROUP RETIREMENT PLAN 2007 401k membership
Total participants, beginning-of-year 2007-01-01 15
Total number of active participants reported on line 7a of the Form 5500 2007-01-01 12
Number of retired or separated participants receiving benefits 2007-01-01 0
Number of other retired or separated participants entitled to future benefits 2007-01-01 3
Total of all active and inactive participants 2007-01-01 15
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2007-01-01 0
Total participants 2007-01-01 15
Number of participants with account balances 2007-01-01 15
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2007-01-01 0
2005: ARCHER FAMILY MEDICAL GROUP RETIREMENT PLAN 2005 401k membership
Total participants, beginning-of-year 2005-01-01 14
Total number of active participants reported on line 7a of the Form 5500 2005-01-01 12
Number of retired or separated participants receiving benefits 2005-01-01 0
Number of other retired or separated participants entitled to future benefits 2005-01-01 2
Total of all active and inactive participants 2005-01-01 14
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2005-01-01 0
Total participants 2005-01-01 14
Number of participants with account balances 2005-01-01 14
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2005-01-01 0

Measure	Date	Value
2007: ARCHER FAMILY MEDICAL GROUP RETIREMENT PLAN 2007 401k membership
Total participants, beginning-of-year	2007-01-01	15
Total number of active participants reported on line 7a of the Form 5500	2007-01-01	12
Number of retired or separated participants receiving benefits	2007-01-01	0
Number of other retired or separated participants entitled to future benefits	2007-01-01	3
Total of all active and inactive participants	2007-01-01	15
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2007-01-01	0
Total participants	2007-01-01	15
Number of participants with account balances	2007-01-01	15
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2007-01-01	0
2005: ARCHER FAMILY MEDICAL GROUP RETIREMENT PLAN 2005 401k membership
Total participants, beginning-of-year	2005-01-01	14
Total number of active participants reported on line 7a of the Form 5500	2005-01-01	12
Number of retired or separated participants receiving benefits	2005-01-01	0
Number of other retired or separated participants entitled to future benefits	2005-01-01	2
Total of all active and inactive participants	2005-01-01	14
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2005-01-01	0
Total participants	2005-01-01	14
Number of participants with account balances	2005-01-01	14
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2005-01-01	0

Financial Data on ARCHER FAMILY MEDICAL GROUP RETIREMENT PLAN

Measure	Date	Value
2008 : ARCHER FAMILY MEDICAL GROUP RETIREMENT PLAN 2008 401k financial data
Total income from all sources	2008-12-31	$-168,992
Expenses. Total of all expenses incurred	2008-12-31	$326
Benefits paid (including direct rollovers)	2008-12-31	$266
Total plan assets at end of year	2008-12-31	$596,073
Total plan assets at beginning of year	2008-12-31	$765,391
Total contributions received or receivable from participants	2008-12-31	$71,448
Other income received	2008-12-31	$-262,421
Net income (gross income less expenses)	2008-12-31	$-169,318
Net plan assets at end of year (total assets less liabilities)	2008-12-31	$596,073
Net plan assets at beginning of year (total assets less liabilities)	2008-12-31	$765,391
Total contributions received or receivable from employer(s)	2008-12-31	$21,981
Expenses. Administrative service providers (salaries,fees and commissions)	2008-12-31	$60
2007 : ARCHER FAMILY MEDICAL GROUP RETIREMENT PLAN 2007 401k financial data
Total income from all sources	2007-12-31	$160,009
Expenses. Total of all expenses incurred	2007-12-31	$13,328
Benefits paid (including direct rollovers)	2007-12-31	$13,208
Total plan assets at end of year	2007-12-31	$765,391
Total plan assets at beginning of year	2007-12-31	$618,710
Total contributions received or receivable from participants	2007-12-31	$83,209
Other income received	2007-12-31	$52,169
Net income (gross income less expenses)	2007-12-31	$146,681
Net plan assets at end of year (total assets less liabilities)	2007-12-31	$765,391
Net plan assets at beginning of year (total assets less liabilities)	2007-12-31	$618,710
Total contributions received or receivable from employer(s)	2007-12-31	$24,631
Expenses. Administrative service providers (salaries,fees and commissions)	2007-12-31	$120
2006 : ARCHER FAMILY MEDICAL GROUP RETIREMENT PLAN 2006 401k financial data
Total income from all sources	2006-12-31	$167,309
Expenses. Total of all expenses incurred	2006-12-31	$4,566
Benefits paid (including direct rollovers)	2006-12-31	$4,506
Total plan assets at end of year	2006-12-31	$618,710
Total plan assets at beginning of year	2006-12-31	$455,967
Total contributions received or receivable from participants	2006-12-31	$84,058
Other income received	2006-12-31	$58,017
Net income (gross income less expenses)	2006-12-31	$162,743
Net plan assets at end of year (total assets less liabilities)	2006-12-31	$618,710
Net plan assets at beginning of year (total assets less liabilities)	2006-12-31	$455,967
Total contributions received or receivable from employer(s)	2006-12-31	$25,234
Expenses. Administrative service providers (salaries,fees and commissions)	2006-12-31	$60
2005 : ARCHER FAMILY MEDICAL GROUP RETIREMENT PLAN 2005 401k financial data
Total income from all sources	2005-12-31	$135,747
Expenses. Total of all expenses incurred	2005-12-31	$3,128
Benefits paid (including direct rollovers)	2005-12-31	$3,008
Total plan assets at end of year	2005-12-31	$455,967
Total plan assets at beginning of year	2005-12-31	$323,348
Total contributions received or receivable from participants	2005-12-31	$76,885
Other income received	2005-12-31	$34,737
Net income (gross income less expenses)	2005-12-31	$132,619
Net plan assets at end of year (total assets less liabilities)	2005-12-31	$455,967
Net plan assets at beginning of year (total assets less liabilities)	2005-12-31	$323,348
Total contributions received or receivable from employer(s)	2005-12-31	$24,125
Expenses. Administrative service providers (salaries,fees and commissions)	2005-12-31	$120
2004 : ARCHER FAMILY MEDICAL GROUP RETIREMENT PLAN 2004 401k financial data
Total income from all sources	2004-12-31	$128,686
Expenses. Total of all expenses incurred	2004-12-31	$0
Total plan assets at end of year	2004-12-31	$323,348
Total plan assets at beginning of year	2004-12-31	$194,662
Total contributions received or receivable from participants	2004-12-31	$67,533
Contributions received from other sources (not participants or employers)	2004-12-31	$10,586
Other income received	2004-12-31	$27,693
Net income (gross income less expenses)	2004-12-31	$128,686
Net plan assets at end of year (total assets less liabilities)	2004-12-31	$323,348
Net plan assets at beginning of year (total assets less liabilities)	2004-12-31	$194,662
Total contributions received or receivable from employer(s)	2004-12-31	$22,874
2003 : ARCHER FAMILY MEDICAL GROUP RETIREMENT PLAN 2003 401k financial data
Total income from all sources	2003-12-31	$194,662
Expenses. Total of all expenses incurred	2003-12-31	$0
Total plan assets at end of year	2003-12-31	$194,662
Total plan assets at beginning of year	2003-12-31	$0
Total contributions received or receivable from participants	2003-12-31	$49,398
Contributions received from other sources (not participants or employers)	2003-12-31	$86,538
Other income received	2003-12-31	$8,726
Net income (gross income less expenses)	2003-12-31	$194,662
Net plan assets at end of year (total assets less liabilities)	2003-12-31	$194,662
Net plan assets at beginning of year (total assets less liabilities)	2003-12-31	$0
Total contributions received or receivable from employer(s)	2003-12-31	$50,000

Form 5500 Responses for ARCHER FAMILY MEDICAL GROUP RETIREMENT PLAN

2007: ARCHER FAMILY MEDICAL GROUP RETIREMENT PLAN 2007 form 5500 responses
2007-01-01	Type of plan entity	Single employer plan
2007-01-01	Submission has been amended	No
2007-01-01	This submission is the final filing	No
2007-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2007-01-01	Plan is a collectively bargained plan	No
2007-01-01	Plan funding arrangement – Trust	Yes
2007-01-01	Plan benefit arrangement - Trust	Yes
2005: ARCHER FAMILY MEDICAL GROUP RETIREMENT PLAN 2005 form 5500 responses
2005-01-01	Type of plan entity	Single employer plan
2005-01-01	Submission has been amended	No
2005-01-01	This submission is the final filing	No
2005-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2005-01-01	Plan is a collectively bargained plan	No
2005-01-01	Plan funding arrangement – Trust	Yes
2005-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	ARCHER FAMILY MEDICAL GROUP, L.L.C.
Employer identification number (EIN):	364487413
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)