401k Plan data: BALCONES DERMATOLOGY 401(K) PLAN plan

BALCONES DERMATOLOGY 401(K) PLAN 401k Plan overview

Plan Name	BALCONES DERMATOLOGY 401(K) PLAN
Plan identification number	001

BALCONES DERMATOLOGY 401(K) 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
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.
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.
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

BALCONES DERMATOLOGY ASSOCIATES, PA has sponsored the creation of one or more 401k plans.

Company Name: BALCONES DERMATOLOGY ASSOCIATES, PA

Employer identification number (EIN): 364713833

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BALCONES DERMATOLOGY 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01 HEIDI HUNTER 2023-07-03
001 2021-01-01 HEIDI HUNTER 2022-07-26
001 2020-01-01 HEIDI HUNTER 2021-06-02
001 2018-01-01 HEIDI HUNTER 2019-07-15
001 2017-01-01 HEIDI HUNTER 2018-05-03
001 2016-01-01 HEIDI HUNTER 2017-05-22
001 2015-01-01 DAVID A. BUSHORE, MD 2016-07-18
001 2014-01-01 LES REVZON 2015-03-04
001 2013-01-01 LES REVZON LES REVZON 2014-06-11
001 2012-01-01 DAVID A BUSHORE

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2022-01-01	HEIDI HUNTER	2023-07-03
001	2021-01-01	HEIDI HUNTER	2022-07-26
001	2020-01-01	HEIDI HUNTER	2021-06-02
001	2018-01-01	HEIDI HUNTER	2019-07-15
001	2017-01-01	HEIDI HUNTER	2018-05-03
001	2016-01-01	HEIDI HUNTER	2017-05-22
001	2015-01-01	DAVID A. BUSHORE, MD	2016-07-18
001	2014-01-01	LES REVZON	2015-03-04
001	2013-01-01	LES REVZON		LES REVZON	2014-06-11
001	2012-01-01	DAVID A BUSHORE

Plan Statistics for BALCONES DERMATOLOGY 401(K) PLAN

401k plan membership statisitcs for BALCONES DERMATOLOGY 401(K) PLAN

Measure Date Value
2013: BALCONES DERMATOLOGY 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 9
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 14
Number of retired or separated participants receiving benefits 2013-01-01 1
Total of all active and inactive participants 2013-01-01 15
Total participants 2013-01-01 15
2012: BALCONES DERMATOLOGY 401(K) 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 9
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 0
Total of all active and inactive participants 2012-01-01 9
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 9
Number of participants with account balances 2012-01-01 9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0

Measure	Date	Value
2013: BALCONES DERMATOLOGY 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	9
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	14
Number of retired or separated participants receiving benefits	2013-01-01	1
Total of all active and inactive participants	2013-01-01	15
Total participants	2013-01-01	15
2012: BALCONES DERMATOLOGY 401(K) 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	9
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	0
Total of all active and inactive participants	2012-01-01	9
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	9
Number of participants with account balances	2012-01-01	9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0

Financial Data on BALCONES DERMATOLOGY 401(K) PLAN

Measure	Date	Value
2013 : BALCONES DERMATOLOGY 401(K) PLAN 2013 401k financial data
Total income from all sources	2013-12-31	$209,344
Expenses. Total of all expenses incurred	2013-12-31	$4,486
Benefits paid (including direct rollovers)	2013-12-31	$0
Total plan assets at end of year	2013-12-31	$1,075,123
Total plan assets at beginning of year	2013-12-31	$870,265
Value of fidelity bond covering the plan	2013-12-31	$200,000
Total contributions received or receivable from participants	2013-12-31	$51,687
Contributions received from other sources (not participants or employers)	2013-12-31	$16,889
Other income received	2013-12-31	$120,156
Net income (gross income less expenses)	2013-12-31	$204,858
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$1,075,123
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$870,265
Assets. Value of participant loans	2013-12-31	$54,031
Total contributions received or receivable from employer(s)	2013-12-31	$20,612
Expenses. Administrative service providers (salaries,fees and commissions)	2013-12-31	$4,486
2012 : BALCONES DERMATOLOGY 401(K) PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$871,799
Expenses. Total of all expenses incurred	2012-12-31	$1,534
Benefits paid (including direct rollovers)	2012-12-31	$1,534
Total plan assets at end of year	2012-12-31	$870,265
Total plan assets at beginning of year	2012-12-31	$0
Value of fidelity bond covering the plan	2012-12-31	$200,000
Total contributions received or receivable from participants	2012-12-31	$38,144
Contributions received from other sources (not participants or employers)	2012-12-31	$778,303
Other income received	2012-12-31	$38,595
Net income (gross income less expenses)	2012-12-31	$870,265
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$870,265
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$0
Assets. Value of participant loans	2012-12-31	$66,890
Total contributions received or receivable from employer(s)	2012-12-31	$16,757

Form 5500 Responses for BALCONES DERMATOLOGY 401(K) PLAN

2013: BALCONES DERMATOLOGY 401(K) PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: BALCONES DERMATOLOGY 401(K) PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	First time form 5500 has been submitted	Yes
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

104016

Policy instance

Insurance contract or identification number	104016
Number of Individuals Covered	14
Insurance policy start date	2013-01-01
Insurance policy end date	2013-08-01
Total amount of commissions paid to insurance broker	USD $942
Total amount of fees paid to insurance company	USD $4
Commission paid to Insurance Broker	USD $942
Insurance broker organization code?	3
Insurance broker name	CAMBRIDGE INVESTMENT RESEARCH

Potentially related plans

BALCONES DERMATOLOGY RETIREMENT PLAN [EIN = 742872868]

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Company Name:	BALCONES DERMATOLOGY ASSOCIATES, PA
Employer identification number (EIN):	364713833
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)