401k Plan data: FREDERICK PRIMARY CARE ASSOCIATES, PA EMPLOYEE HEALTHCARE PLAN plan

FREDERICK PRIMARY CARE ASSOCIATES, PA EMPLOYEE HEALTHCARE PLAN 401k Plan overview

Plan Name	FREDERICK PRIMARY CARE ASSOCIATES, PA EMPLOYEE HEALTHCARE PLAN
Plan identification number	501

FREDERICK PRIMARY CARE ASSOCIATES, PA EMPLOYEE HEALTHCARE PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision)

401k Sponsoring company profile

FREDERICK PRIMARY CARE ASSOCIATES, PA has sponsored the creation of one or more 401k plans.

Company Name: FREDERICK PRIMARY CARE ASSOCIATES, PA

Employer identification number (EIN): 521995720

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FREDERICK PRIMARY CARE ASSOCIATES, PA EMPLOYEE HEALTHCARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2014-10-01 KAREN SLOPER KAREN SLOPER 2016-04-25
501 2013-10-01 KAREN SLOPER KAREN SLOPER 2015-04-28
501 2012-10-01 KAREN SLOPER KAREN SLOPER 2014-05-01
501 2011-10-01 KAREN SLOPER KAREN SLOPER 2013-05-16

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
501	2014-10-01	KAREN SLOPER	KAREN SLOPER	2016-04-25
501	2013-10-01	KAREN SLOPER	KAREN SLOPER	2015-04-28
501	2012-10-01	KAREN SLOPER	KAREN SLOPER	2014-05-01
501	2011-10-01	KAREN SLOPER	KAREN SLOPER	2013-05-16

Plan Statistics for FREDERICK PRIMARY CARE ASSOCIATES, PA EMPLOYEE HEALTHCARE PLAN

401k plan membership statisitcs for FREDERICK PRIMARY CARE ASSOCIATES, PA EMPLOYEE HEALTHCARE PLAN

Measure Date Value
2014: FREDERICK PRIMARY CARE ASSOCIATES, PA EMPLOYEE HEALTHCARE PLAN 2014 401k membership
Total participants, beginning-of-year 2014-10-01 109
Total number of active participants reported on line 7a of the Form 5500 2014-10-01 121
Number of retired or separated participants receiving benefits 2014-10-01 0
Number of other retired or separated participants entitled to future benefits 2014-10-01 0
Total of all active and inactive participants 2014-10-01 121
Total participants 2014-10-01 121
2013: FREDERICK PRIMARY CARE ASSOCIATES, PA EMPLOYEE HEALTHCARE PLAN 2013 401k membership
Total participants, beginning-of-year 2013-10-01 102
Total number of active participants reported on line 7a of the Form 5500 2013-10-01 109
Total of all active and inactive participants 2013-10-01 109
Total participants 2013-10-01 109
2012: FREDERICK PRIMARY CARE ASSOCIATES, PA EMPLOYEE HEALTHCARE PLAN 2012 401k membership
Total participants, beginning-of-year 2012-10-01 106
Total number of active participants reported on line 7a of the Form 5500 2012-10-01 102
Number of retired or separated participants receiving benefits 2012-10-01 0
Number of other retired or separated participants entitled to future benefits 2012-10-01 0
Total of all active and inactive participants 2012-10-01 102
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-10-01 0
Total participants 2012-10-01 102
2011: FREDERICK PRIMARY CARE ASSOCIATES, PA EMPLOYEE HEALTHCARE PLAN 2011 401k membership
Total participants, beginning-of-year 2011-10-01 104
Total number of active participants reported on line 7a of the Form 5500 2011-10-01 109
Number of retired or separated participants receiving benefits 2011-10-01 0
Number of other retired or separated participants entitled to future benefits 2011-10-01 0
Total of all active and inactive participants 2011-10-01 109
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-10-01 0
Total participants 2011-10-01 109

Measure	Date	Value
2014: FREDERICK PRIMARY CARE ASSOCIATES, PA EMPLOYEE HEALTHCARE PLAN 2014 401k membership
Total participants, beginning-of-year	2014-10-01	109
Total number of active participants reported on line 7a of the Form 5500	2014-10-01	121
Number of retired or separated participants receiving benefits	2014-10-01	0
Number of other retired or separated participants entitled to future benefits	2014-10-01	0
Total of all active and inactive participants	2014-10-01	121
Total participants	2014-10-01	121
2013: FREDERICK PRIMARY CARE ASSOCIATES, PA EMPLOYEE HEALTHCARE PLAN 2013 401k membership
Total participants, beginning-of-year	2013-10-01	102
Total number of active participants reported on line 7a of the Form 5500	2013-10-01	109
Total of all active and inactive participants	2013-10-01	109
Total participants	2013-10-01	109
2012: FREDERICK PRIMARY CARE ASSOCIATES, PA EMPLOYEE HEALTHCARE PLAN 2012 401k membership
Total participants, beginning-of-year	2012-10-01	106
Total number of active participants reported on line 7a of the Form 5500	2012-10-01	102
Number of retired or separated participants receiving benefits	2012-10-01	0
Number of other retired or separated participants entitled to future benefits	2012-10-01	0
Total of all active and inactive participants	2012-10-01	102
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-10-01	0
Total participants	2012-10-01	102
2011: FREDERICK PRIMARY CARE ASSOCIATES, PA EMPLOYEE HEALTHCARE PLAN 2011 401k membership
Total participants, beginning-of-year	2011-10-01	104
Total number of active participants reported on line 7a of the Form 5500	2011-10-01	109
Number of retired or separated participants receiving benefits	2011-10-01	0
Number of other retired or separated participants entitled to future benefits	2011-10-01	0
Total of all active and inactive participants	2011-10-01	109
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-10-01	0
Total participants	2011-10-01	109

Form 5500 Responses for FREDERICK PRIMARY CARE ASSOCIATES, PA EMPLOYEE HEALTHCARE PLAN

2014: FREDERICK PRIMARY CARE ASSOCIATES, PA EMPLOYEE HEALTHCARE PLAN 2014 form 5500 responses
2014-10-01	Type of plan entity	Single employer plan
2014-10-01	Submission has been amended	No
2014-10-01	This submission is the final filing	No
2014-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-10-01	Plan is a collectively bargained plan	No
2014-10-01	Plan funding arrangement – Insurance	Yes
2014-10-01	Plan benefit arrangement – Insurance	Yes
2013: FREDERICK PRIMARY CARE ASSOCIATES, PA EMPLOYEE HEALTHCARE PLAN 2013 form 5500 responses
2013-10-01	Type of plan entity	Single employer plan
2013-10-01	Submission has been amended	No
2013-10-01	This submission is the final filing	No
2013-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-10-01	Plan is a collectively bargained plan	No
2013-10-01	Plan funding arrangement – Insurance	Yes
2013-10-01	Plan benefit arrangement – Insurance	Yes
2012: FREDERICK PRIMARY CARE ASSOCIATES, PA EMPLOYEE HEALTHCARE PLAN 2012 form 5500 responses
2012-10-01	Type of plan entity	Single employer plan
2012-10-01	Submission has been amended	No
2012-10-01	This submission is the final filing	No
2012-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-10-01	Plan is a collectively bargained plan	No
2012-10-01	Plan funding arrangement – Insurance	Yes
2012-10-01	Plan benefit arrangement – Insurance	Yes
2011: FREDERICK PRIMARY CARE ASSOCIATES, PA EMPLOYEE HEALTHCARE PLAN 2011 form 5500 responses
2011-10-01	Type of plan entity	Single employer plan
2011-10-01	First time form 5500 has been submitted	Yes
2011-10-01	Submission has been amended	No
2011-10-01	This submission is the final filing	No
2011-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-10-01	Plan is a collectively bargained plan	No
2011-10-01	Plan funding arrangement – Insurance	Yes
2011-10-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

CAREFIRST BLUECHOICE (National Association of Insurance Commissioners NAIC id number: 96202 )

Policy contract number

17GU

Policy instance

Insurance contract or identification number	17GU
Number of Individuals Covered	121
Insurance policy start date	2014-10-01
Insurance policy end date	2015-09-30
Total amount of commissions paid to insurance broker	USD $40,034
Total amount of fees paid to insurance company	USD $8,499
Are there contracts with allocated funds for individual policies?	No
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	Yes
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
Welfare Benefit Premiums Paid to Carrier	USD $1,143,827
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	50
Additional information about fees paid to insurance broker	WHOLESALER FEE $49.61
Insurance broker organization code?	5
Commission paid to Insurance Broker	USD $40,034
Insurance broker name	BB&T INSURANCE SERVICES

CAREFIRST BLUECHOICE (National Association of Insurance Commissioners NAIC id number: 96202 )

Policy contract number

17GU

Policy instance

Insurance contract or identification number	17GU
Number of Individuals Covered	109
Insurance policy start date	2013-10-01
Insurance policy end date	2014-09-30
Total amount of commissions paid to insurance broker	USD $32,390
Total amount of fees paid to insurance company	USD $10,811
Are there contracts with allocated funds for individual policies?	No
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	Yes
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
Welfare Benefit Premiums Paid to Carrier	USD $925,441
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $32,390
Amount paid for insurance broker fees	10811
Additional information about fees paid to insurance broker	MEDICAL CONTRACTS X PCPM (112 X $96.13) $10766.56 NON-MONETARY INCENTIVE $44.69
Insurance broker organization code?	3
Insurance broker name	BB&T INSURANCE SERVICES

CAREFIRST BLUECHOICE (National Association of Insurance Commissioners NAIC id number: 96202 )

Policy contract number

17GU

Policy instance

Insurance contract or identification number	17GU
Number of Individuals Covered	102
Insurance policy start date	2012-10-01
Insurance policy end date	2013-09-30
Total amount of commissions paid to insurance broker	USD $29,552
Total amount of fees paid to insurance company	USD $18,616
Are there contracts with allocated funds for individual policies?	No
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	Yes
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
Welfare Benefit Premiums Paid to Carrier	USD $844,345
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	8165
Additional information about fees paid to insurance broker	WHOLESALER FEE
Insurance broker name	BB&T INSURANCE SERVICES INC

CAREFIRST BLUECHOICE (National Association of Insurance Commissioners NAIC id number: 96202 )

Policy contract number

17GU

Policy instance

Insurance contract or identification number	17GU
Number of Individuals Covered	109
Insurance policy start date	2011-10-01
Insurance policy end date	2012-09-30
Total amount of commissions paid to insurance broker	USD $28,669
Total amount of fees paid to insurance company	USD $17,896
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $819,108
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	FREDERICK PRIMARY CARE ASSOCIATES, PA
Employer identification number (EIN):	521995720
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)