401k Plan data: FLORIDA EMERGENCY PHYSICIANS WELFARE BENEFIT PLAN plan

FLORIDA EMERGENCY PHYSICIANS WELFARE BENEFIT PLAN 401k Plan overview

Plan Name	FLORIDA EMERGENCY PHYSICIANS WELFARE BENEFIT PLAN
Plan identification number	501

FLORIDA EMERGENCY PHYSICIANS WELFARE BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Long-term disability cover

401k Sponsoring company profile

FLORIDA EMERGENCY PHYSICIANS has sponsored the creation of one or more 401k plans.

Company Name: FLORIDA EMERGENCY PHYSICIANS

Employer identification number (EIN): 591281714

NAIC Classification: 621399
NAIC Description: Offices of All Other Miscellaneous Health Practitioners

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FLORIDA EMERGENCY PHYSICIANS WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2015-01-01 ERNEST PAGE II, MD
501 2014-01-01 ERNEST PAGE II, MD
501 2013-01-01 ERNEST PAGE II, MD
501 2012-01-01 ERNEST PAGE II, MD
501 2011-01-01 ERNEST PAGE II, MD
501 2010-01-01 KAHANG CHAN
501 2009-01-01 KAHANG CHAN KAHANG CHAN 2010-10-11

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
501	2015-01-01	ERNEST PAGE II, MD
501	2014-01-01	ERNEST PAGE II, MD
501	2013-01-01	ERNEST PAGE II, MD
501	2012-01-01	ERNEST PAGE II, MD
501	2011-01-01	ERNEST PAGE II, MD
501	2010-01-01	KAHANG CHAN
501	2009-01-01	KAHANG CHAN	KAHANG CHAN	2010-10-11

Plan Statistics for FLORIDA EMERGENCY PHYSICIANS WELFARE BENEFIT PLAN

401k plan membership statisitcs for FLORIDA EMERGENCY PHYSICIANS WELFARE BENEFIT PLAN

Measure Date Value
2015: FLORIDA EMERGENCY PHYSICIANS WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 174
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 210
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 210
2014: FLORIDA EMERGENCY PHYSICIANS WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 0
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 174
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 174
2013: FLORIDA EMERGENCY PHYSICIANS WELFARE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 132
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 150
Total of all active and inactive participants 2013-01-01 150
2012: FLORIDA EMERGENCY PHYSICIANS WELFARE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 144
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 132
Total of all active and inactive participants 2012-01-01 132
2011: FLORIDA EMERGENCY PHYSICIANS WELFARE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 139
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 132
Total of all active and inactive participants 2011-01-01 132
2010: FLORIDA EMERGENCY PHYSICIANS WELFARE BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 116
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 133
Number of retired or separated participants receiving benefits 2010-01-01 4
Number of other retired or separated participants entitled to future benefits 2010-01-01 0
Total of all active and inactive participants 2010-01-01 137
2009: FLORIDA EMERGENCY PHYSICIANS WELFARE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 119
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 116
Number of retired or separated participants receiving benefits 2009-01-01 8
Number of other retired or separated participants entitled to future benefits 2009-01-01 0
Total of all active and inactive participants 2009-01-01 124

Measure	Date	Value
2015: FLORIDA EMERGENCY PHYSICIANS WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	174
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	210
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	210
2014: FLORIDA EMERGENCY PHYSICIANS WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	0
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	174
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	174
2013: FLORIDA EMERGENCY PHYSICIANS WELFARE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	132
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	150
Total of all active and inactive participants	2013-01-01	150
2012: FLORIDA EMERGENCY PHYSICIANS WELFARE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	144
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	132
Total of all active and inactive participants	2012-01-01	132
2011: FLORIDA EMERGENCY PHYSICIANS WELFARE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	139
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	132
Total of all active and inactive participants	2011-01-01	132
2010: FLORIDA EMERGENCY PHYSICIANS WELFARE BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	116
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	133
Number of retired or separated participants receiving benefits	2010-01-01	4
Number of other retired or separated participants entitled to future benefits	2010-01-01	0
Total of all active and inactive participants	2010-01-01	137
2009: FLORIDA EMERGENCY PHYSICIANS WELFARE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	119
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	116
Number of retired or separated participants receiving benefits	2009-01-01	8
Number of other retired or separated participants entitled to future benefits	2009-01-01	0
Total of all active and inactive participants	2009-01-01	124

Form 5500 Responses for FLORIDA EMERGENCY PHYSICIANS WELFARE BENEFIT PLAN

2015: FLORIDA EMERGENCY PHYSICIANS WELFARE BENEFIT PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: FLORIDA EMERGENCY PHYSICIANS WELFARE BENEFIT PLAN 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 benefit arrangement – Insurance	Yes
2013: FLORIDA EMERGENCY PHYSICIANS WELFARE BENEFIT PLAN 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 benefit arrangement – Insurance	Yes
2012: FLORIDA EMERGENCY PHYSICIANS WELFARE BENEFIT PLAN 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 benefit arrangement – Insurance	Yes
2011: FLORIDA EMERGENCY PHYSICIANS WELFARE BENEFIT PLAN 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 benefit arrangement – Insurance	Yes
2010: FLORIDA EMERGENCY PHYSICIANS WELFARE BENEFIT PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	Yes
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2009: FLORIDA EMERGENCY PHYSICIANS WELFARE BENEFIT PLAN 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 benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

635243

Policy instance

Insurance contract or identification number	635243
Number of Individuals Covered	175
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $2,162
Are there contracts with allocated funds for individual policies?	Yes
Life Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,162
Insurance broker organization code?	3
Insurance broker name	VAUGHN GROUP INC

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

380022

Policy instance

Insurance contract or identification number	380022
Number of Individuals Covered	537
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $144,836
Are there contracts with allocated funds for individual policies?	Yes
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $142,836
Additional information about fees paid to insurance broker	NA NA
Insurance broker organization code?	3
Insurance broker name

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

635243

Policy instance

Insurance contract or identification number	635243
Number of Individuals Covered	54
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $5,242
Are there contracts with allocated funds for individual policies?	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,242
Insurance broker organization code?	3
Insurance broker name	VAUGHN GROUP INC

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

635243

Policy instance

Insurance contract or identification number	635243
Number of Individuals Covered	175
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $2,275
Are there contracts with allocated funds for individual policies?	Yes
Life Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,952
Insurance broker organization code?	3
Insurance broker name	NFP INSURANCE SERVICES

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

635243

Policy instance

Insurance contract or identification number	635243
Number of Individuals Covered	54
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $5,998
Are there contracts with allocated funds for individual policies?	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,100
Insurance broker organization code?	3
Insurance broker name	NFP INSURANCE SERVICES INC

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

380022

Policy instance

Insurance contract or identification number	380022
Number of Individuals Covered	409
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $128,528
Are there contracts with allocated funds for individual policies?	Yes
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,143,068
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $128,528
Additional information about fees paid to insurance broker	NA NA
Insurance broker organization code?	3
Insurance broker name	VAUGHN GROUP INC

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

625243

Policy instance

Insurance contract or identification number	625243
Number of Individuals Covered	40
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $5,470
Long Term Disability Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,750
Insurance broker organization code?	3
Insurance broker name	NFP INSURANCE SERVICES INC

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

635243

Policy instance

Insurance contract or identification number	635243
Number of Individuals Covered	146
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $2,161
Are there contracts with allocated funds for individual policies?	Yes
Life Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,849
Insurance broker organization code?	3
Insurance broker name	NFP INSURANCE SERVICES INC

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

380022

Policy instance

Insurance contract or identification number	380022
Number of Individuals Covered	377
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $98,244
Are there contracts with allocated funds for individual policies?	Yes
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,653,880
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $98,244
Insurance broker organization code?	3
Insurance broker name	VAUGHN GROUP INC

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

625243

Policy instance

Insurance contract or identification number	625243
Number of Individuals Covered	46
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $5,273
Are there contracts with allocated funds for individual policies?	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,503
Insurance broker organization code?	3
Insurance broker name	NFP INSURANCE SERVICES INC

UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

380022

Policy instance

Insurance contract or identification number	380022
Number of Individuals Covered	381
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $112,671
Are there contracts with allocated funds for individual policies?	Yes
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,729,267
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $112,671
Insurance broker organization code?	3
Insurance broker name	VAUGHN GROUP INC

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

635243

Policy instance

Insurance contract or identification number	635243
Number of Individuals Covered	132
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $1,984
Are there contracts with allocated funds for individual policies?	Yes
Life Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,659
Insurance broker organization code?	3
Insurance broker name	NFP INSURANCE SERVICES INC

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

635243

Policy instance

Insurance contract or identification number	635243
Number of Individuals Covered	139
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $1,887
Are there contracts with allocated funds for individual policies?	Yes
Life Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

635243

Policy instance

Insurance contract or identification number	635243
Number of Individuals Covered	38
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $4,860
Long Term Disability Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

380022

Policy instance

Insurance contract or identification number	380022
Number of Individuals Covered	373
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $90,364
Are there contracts with allocated funds for individual policies?	Yes
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,490,309
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

380022

Policy instance

Insurance contract or identification number	380022
Number of Individuals Covered	354
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $83,478
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,401,237
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $83,478
Additional information about fees paid to insurance broker	NA
Insurance broker organization code?	3
Insurance broker name	THE VAUGHAN GROUP

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

635243

Policy instance

Insurance contract or identification number	635243
Number of Individuals Covered	129
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $1,497
Life Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,497
Additional information about fees paid to insurance broker	NA
Insurance broker organization code?	3
Insurance broker name	VAUGHAN GROUP INC

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

635243

Policy instance

Insurance contract or identification number	635243
Number of Individuals Covered	37
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $4,084
Long Term Disability Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,084
Additional information about fees paid to insurance broker	NA
Insurance broker organization code?	3
Insurance broker name	VAUGHAN GROUP INC

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Company Name:	FLORIDA EMERGENCY PHYSICIANS
Employer identification number (EIN):	591281714
NAIC Classification:	621399
NAIC Description:	Offices of All Other Miscellaneous Health Practitioners