401k Plan data: JAYNE S. GURTLER, MD, LAURA A. BRINZ, MD, & JANET BURROFF, MD APMC 401(K) PLAN plan

JAYNE S. GURTLER, MD, LAURA A. BRINZ, MD, & JANET BURROFF, MD APMC 401(K) PLAN 401k Plan overview

Plan Name	JAYNE S. GURTLER, MD, LAURA A. BRINZ, MD, & JANET BURROFF, MD APMC 401(K) PLAN
Plan identification number	002

JAYNE S. GURTLER, MD, LAURA A. BRINZ, MD, & JANET BURROFF, MD APMC 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.
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.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

JAYNE S GURTLER, MD, LAURA A BRINZ, MD, & JANET BU has sponsored the creation of one or more 401k plans.

Company Name: JAYNE S GURTLER, MD, LAURA A BRINZ, MD, & JANET BU

Employer identification number (EIN): 720943358

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan JAYNE S. GURTLER, MD, LAURA A. BRINZ, MD, & JANET BURROFF, MD APMC 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2015-01-01 GEORGE FLORANE
002 2014-01-01 GEORGE FLORANE
002 2013-01-01 JAYNE S. GURTLER 2014-07-18 JAYNE S. GURTLER 2014-07-18
002 2012-01-01 JAYNE GURTLER 2013-07-24
002 2011-01-01 JAYNE GURTLER 2012-08-09
002 2009-01-01 JAYNE GURTLER
002 2009-01-01 JAYNE GURTLER

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2015-01-01	GEORGE FLORANE
002	2014-01-01	GEORGE FLORANE
002	2013-01-01	JAYNE S. GURTLER	2014-07-18	JAYNE S. GURTLER	2014-07-18
002	2012-01-01	JAYNE GURTLER	2013-07-24
002	2011-01-01	JAYNE GURTLER	2012-08-09
002	2009-01-01	JAYNE GURTLER
002	2009-01-01	JAYNE GURTLER

Plan Statistics for JAYNE S. GURTLER, MD, LAURA A. BRINZ, MD, & JANET BURROFF, MD APMC 401(K) PLAN

401k plan membership statisitcs for JAYNE S. GURTLER, MD, LAURA A. BRINZ, MD, & JANET BURROFF, MD APMC 401(K) PLAN

Measure Date Value
2015: JAYNE S. GURTLER, MD, LAURA A. BRINZ, MD, & JANET BURROFF, MD APMC 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 20
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 0
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 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 0
Number of participants with account balances 2015-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: JAYNE S. GURTLER, MD, LAURA A. BRINZ, MD, & JANET BURROFF, MD APMC 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 31
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 14
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 6
Total of all active and inactive participants 2014-01-01 20
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 20
Number of participants with account balances 2014-01-01 19
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2009: JAYNE S. GURTLER, MD, LAURA A. BRINZ, MD, & JANET BURROFF, MD APMC 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 24
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 14
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 10
Total of all active and inactive participants 2009-01-01 24
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 24
Number of participants with account balances 2009-01-01 24
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 3

Measure	Date	Value
2015: JAYNE S. GURTLER, MD, LAURA A. BRINZ, MD, & JANET BURROFF, MD APMC 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	20
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	0
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	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	0
Number of participants with account balances	2015-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: JAYNE S. GURTLER, MD, LAURA A. BRINZ, MD, & JANET BURROFF, MD APMC 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	31
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	14
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	6
Total of all active and inactive participants	2014-01-01	20
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	20
Number of participants with account balances	2014-01-01	19
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2009: JAYNE S. GURTLER, MD, LAURA A. BRINZ, MD, & JANET BURROFF, MD APMC 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	24
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	14
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	10
Total of all active and inactive participants	2009-01-01	24
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	24
Number of participants with account balances	2009-01-01	24
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	3

Financial Data on JAYNE S. GURTLER, MD, LAURA A. BRINZ, MD, & JANET BURROFF, MD APMC 401(K) PLAN

Measure	Date	Value
2015 : JAYNE S. GURTLER, MD, LAURA A. BRINZ, MD, & JANET BURROFF, MD APMC 401(K) PLAN 2015 401k financial data
Transfers to/from the plan	2015-07-17	$0
Total plan liabilities at end of year	2015-07-17	$0
Total plan liabilities at beginning of year	2015-07-17	$0
Total income from all sources	2015-07-17	$121,735
Expenses. Total of all expenses incurred	2015-07-17	$3,008,547
Benefits paid (including direct rollovers)	2015-07-17	$2,994,376
Total plan assets at end of year	2015-07-17	$0
Total plan assets at beginning of year	2015-07-17	$2,886,812
Value of fidelity bond covering the plan	2015-07-17	$300,000
Total contributions received or receivable from participants	2015-07-17	$21,499
Expenses. Other expenses not covered elsewhere	2015-07-17	$0
Contributions received from other sources (not participants or employers)	2015-07-17	$0
Other income received	2015-07-17	$100,236
Noncash contributions received	2015-07-17	$0
Net income (gross income less expenses)	2015-07-17	$-2,886,812
Net plan assets at end of year (total assets less liabilities)	2015-07-17	$0
Net plan assets at beginning of year (total assets less liabilities)	2015-07-17	$2,886,812
Total contributions received or receivable from employer(s)	2015-07-17	$0
Value of certain deemed distributions of participant loans	2015-07-17	$0
Value of corrective distributions	2015-07-17	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2015-07-17	$14,171
2014 : JAYNE S. GURTLER, MD, LAURA A. BRINZ, MD, & JANET BURROFF, MD APMC 401(K) PLAN 2014 401k financial data
Transfers to/from the plan	2014-12-31	$0
Total plan liabilities at end of year	2014-12-31	$0
Total plan liabilities at beginning of year	2014-12-31	$0
Total income from all sources	2014-12-31	$305,867
Expenses. Total of all expenses incurred	2014-12-31	$183,274
Benefits paid (including direct rollovers)	2014-12-31	$171,938
Total plan assets at end of year	2014-12-31	$2,886,812
Total plan assets at beginning of year	2014-12-31	$2,764,219
Value of fidelity bond covering the plan	2014-12-31	$300,000
Total contributions received or receivable from participants	2014-12-31	$97,270
Expenses. Other expenses not covered elsewhere	2014-12-31	$0
Contributions received from other sources (not participants or employers)	2014-12-31	$0
Other income received	2014-12-31	$104,316
Noncash contributions received	2014-12-31	$0
Net income (gross income less expenses)	2014-12-31	$122,593
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$2,886,812
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$2,764,219
Total contributions received or receivable from employer(s)	2014-12-31	$104,281
Value of certain deemed distributions of participant loans	2014-12-31	$0
Value of corrective distributions	2014-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2014-12-31	$11,336
2010 : JAYNE S. GURTLER, MD, LAURA A. BRINZ, MD, & JANET BURROFF, MD APMC 401(K) PLAN 2010 401k financial data
Transfers to/from the plan	2010-12-31	$0
Total plan liabilities at end of year	2010-12-31	$0
Total plan liabilities at beginning of year	2010-12-31	$0
Total income from all sources	2010-12-31	$321,228
Expenses. Total of all expenses incurred	2010-12-31	$8,712
Benefits paid (including direct rollovers)	2010-12-31	$8,712
Total plan assets at end of year	2010-12-31	$1,927,816
Total plan assets at beginning of year	2010-12-31	$1,615,300
Value of fidelity bond covering the plan	2010-12-31	$250,000
Total contributions received or receivable from participants	2010-12-31	$103,082
Expenses. Other expenses not covered elsewhere	2010-12-31	$0
Contributions received from other sources (not participants or employers)	2010-12-31	$0
Other income received	2010-12-31	$107,236
Noncash contributions received	2010-12-31	$0
Net income (gross income less expenses)	2010-12-31	$312,516
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$1,927,816
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$1,615,300
Total contributions received or receivable from employer(s)	2010-12-31	$110,910
Value of certain deemed distributions of participant loans	2010-12-31	$0
Value of corrective distributions	2010-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0

Form 5500 Responses for JAYNE S. GURTLER, MD, LAURA A. BRINZ, MD, & JANET BURROFF, MD APMC 401(K) PLAN

2015: JAYNE S. GURTLER, MD, LAURA A. BRINZ, MD, & JANET BURROFF, MD APMC 401(K) PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	Yes
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: JAYNE S. GURTLER, MD, LAURA A. BRINZ, MD, & JANET BURROFF, MD APMC 401(K) PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2009: JAYNE S. GURTLER, MD, LAURA A. BRINZ, MD, & JANET BURROFF, MD APMC 401(K) PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	Yes
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

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

Policy contract number

808086

Policy instance

Insurance contract or identification number	808086
Number of Individuals Covered	0
Insurance policy start date	2014-01-01
Insurance policy end date	2014-02-14
Total amount of commissions paid to insurance broker	USD $1,174
Total amount of fees paid to insurance company	USD $0
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	No
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,174
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	PROEQUITIES INC.

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-023549

Policy instance

Insurance contract or identification number	GA-023549
Number of Individuals Covered	24
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $6,417
Total amount of fees paid to insurance company	USD $802
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?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,417
Insurance broker organization code?	3
Amount paid for insurance broker fees	802
Additional information about fees paid to insurance broker	SALES/ADMINISTRATION
Insurance broker name	JULY BUSINESS SERVICES

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Company Name:	JAYNE S GURTLER, MD, LAURA A BRINZ, MD, & JANET BU
Employer identification number (EIN):	720943358
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)