401k Plan data: FGTBA HEALTH PLAN plan

FGTBA HEALTH PLAN 401k Plan overview

Plan Name	FGTBA HEALTH PLAN
Plan identification number	501

FGTBA HEALTH PLAN Benefits

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

401k Sponsoring company profile

FLORIDA GULF TO BAY ANESTHESIOLOGY ASSOCIATES, P.A. has sponsored the creation of one or more 401k plans.

Company Name: FLORIDA GULF TO BAY ANESTHESIOLOGY ASSOCIATES, P.A.

Employer identification number (EIN): 650791956

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FGTBA HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2013-06-01
501 2012-06-01 DEVANAND MANGAR
501 2012-01-01 DEVANAND MANGAR
501 2011-01-01 DEVANAND MANGAR
501 2010-01-01 DEVAWAND MANGAR
501 2009-01-01 DEVAWAND MANGAR
501 2006-01-01 DEVAWAND MANGAR
501 2005-10-01 DEVAWAND MANGAR

Plan Statistics for FGTBA HEALTH PLAN

401k plan membership statisitcs for FGTBA HEALTH PLAN

Measure Date Value
2013: FGTBA HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year 2013-06-01 197
Total number of active participants reported on line 7a of the Form 5500 2013-06-01 216
Number of retired or separated participants receiving benefits 2013-06-01 0
Number of other retired or separated participants entitled to future benefits 2013-06-01 0
Total of all active and inactive participants 2013-06-01 216
2012: FGTBA HEALTH PLAN 2012 401k membership
Total participants, beginning-of-year 2012-06-01 220
Total number of active participants reported on line 7a of the Form 5500 2012-06-01 197
Number of retired or separated participants receiving benefits 2012-06-01 0
Number of other retired or separated participants entitled to future benefits 2012-06-01 0
Total of all active and inactive participants 2012-06-01 197
Total participants, beginning-of-year 2012-01-01 267
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 220
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 2012-01-01 220
2011: FGTBA HEALTH PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 237
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 263
Number of retired or separated participants receiving benefits 2011-01-01 4
Number of other retired or separated participants entitled to future benefits 2011-01-01 0
Total of all active and inactive participants 2011-01-01 267
2010: FGTBA HEALTH PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 217
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 237
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 0
Total of all active and inactive participants 2010-01-01 237
2009: FGTBA HEALTH PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 187
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 186
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 0
Total of all active and inactive participants 2009-01-01 186
2006: FGTBA HEALTH PLAN 2006 401k membership
Total participants, beginning-of-year 2006-01-01 133
Total number of active participants reported on line 7a of the Form 5500 2006-01-01 132
Number of retired or separated participants receiving benefits 2006-01-01 0
Number of other retired or separated participants entitled to future benefits 2006-01-01 0
Total of all active and inactive participants 2006-01-01 132
2005: FGTBA HEALTH PLAN 2005 401k membership
Total participants, beginning-of-year 2005-10-01 0
Total number of active participants reported on line 7a of the Form 5500 2005-10-01 133
Number of retired or separated participants receiving benefits 2005-10-01 0
Number of other retired or separated participants entitled to future benefits 2005-10-01 0
Total of all active and inactive participants 2005-10-01 133

Measure	Date	Value
2013: FGTBA HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year	2013-06-01	197
Total number of active participants reported on line 7a of the Form 5500	2013-06-01	216
Number of retired or separated participants receiving benefits	2013-06-01	0
Number of other retired or separated participants entitled to future benefits	2013-06-01	0
Total of all active and inactive participants	2013-06-01	216
2012: FGTBA HEALTH PLAN 2012 401k membership
Total participants, beginning-of-year	2012-06-01	220
Total number of active participants reported on line 7a of the Form 5500	2012-06-01	197
Number of retired or separated participants receiving benefits	2012-06-01	0
Number of other retired or separated participants entitled to future benefits	2012-06-01	0
Total of all active and inactive participants	2012-06-01	197
Total participants, beginning-of-year	2012-01-01	267
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	220
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	220
2011: FGTBA HEALTH PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	237
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	263
Number of retired or separated participants receiving benefits	2011-01-01	4
Number of other retired or separated participants entitled to future benefits	2011-01-01	0
Total of all active and inactive participants	2011-01-01	267
2010: FGTBA HEALTH PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	217
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	237
Number of retired or separated participants receiving benefits	2010-01-01	0
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	237
2009: FGTBA HEALTH PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	187
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	186
Number of retired or separated participants receiving benefits	2009-01-01	0
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	186
2006: FGTBA HEALTH PLAN 2006 401k membership
Total participants, beginning-of-year	2006-01-01	133
Total number of active participants reported on line 7a of the Form 5500	2006-01-01	132
Number of retired or separated participants receiving benefits	2006-01-01	0
Number of other retired or separated participants entitled to future benefits	2006-01-01	0
Total of all active and inactive participants	2006-01-01	132
2005: FGTBA HEALTH PLAN 2005 401k membership
Total participants, beginning-of-year	2005-10-01	0
Total number of active participants reported on line 7a of the Form 5500	2005-10-01	133
Number of retired or separated participants receiving benefits	2005-10-01	0
Number of other retired or separated participants entitled to future benefits	2005-10-01	0
Total of all active and inactive participants	2005-10-01	133

Form 5500 Responses for FGTBA HEALTH PLAN

2013: FGTBA HEALTH PLAN 2013 form 5500 responses
2013-06-01	Type of plan entity	Single employer plan
2013-06-01	Plan funding arrangement – Insurance	Yes
2013-06-01	Plan benefit arrangement – Insurance	Yes
2012: FGTBA HEALTH PLAN 2012 form 5500 responses
2012-06-01	Type of plan entity	Single employer plan
2012-06-01	Plan funding arrangement – Insurance	Yes
2012-06-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: FGTBA HEALTH 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: FGTBA HEALTH PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2009: FGTBA HEALTH PLAN 2009 form 5500 responses
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2006: FGTBA HEALTH PLAN 2006 form 5500 responses
2006-01-01	Type of plan entity	Single employer plan
2006-01-01	Plan funding arrangement – Insurance	Yes
2006-01-01	Plan benefit arrangement – Insurance	Yes
2005: FGTBA HEALTH PLAN 2005 form 5500 responses
2005-10-01	Type of plan entity	Single employer plan
2005-10-01	First time form 5500 has been submitted	Yes
2005-10-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2005-10-01	Plan funding arrangement – Insurance	Yes
2005-10-01	Plan benefit arrangement – Insurance	Yes

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Company Name:	FLORIDA GULF TO BAY ANESTHESIOLOGY ASSOCIATES, P.A.
Employer identification number (EIN):	650791956
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)

Plan id#	Filing Submission Date	Name of Administrator
501	2013-06-01
501	2012-06-01	DEVANAND MANGAR
501	2012-01-01	DEVANAND MANGAR
501	2011-01-01	DEVANAND MANGAR
501	2010-01-01	DEVAWAND MANGAR
501	2009-01-01	DEVAWAND MANGAR
501	2006-01-01	DEVAWAND MANGAR
501	2005-10-01	DEVAWAND MANGAR