401k Plan data: SALTZER MEDICAL GROUP, P.A. HEALTH INSURANCE PLAN plan

SALTZER MEDICAL GROUP, P.A. HEALTH INSURANCE PLAN 401k Plan overview

Plan Name	SALTZER MEDICAL GROUP, P.A. HEALTH INSURANCE PLAN
Plan identification number	502

SALTZER MEDICAL GROUP, P.A. HEALTH INSURANCE PLAN Benefits

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

401k Sponsoring company profile

SALTZER MEDICAL GROUP, P.A. has sponsored the creation of one or more 401k plans.

Company Name: SALTZER MEDICAL GROUP, P.A.

Employer identification number (EIN): 820299231

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SALTZER MEDICAL GROUP, P.A. HEALTH INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
502 2012-01-01 CINDY HODGES CINDY HODGES 2013-07-30
502 2011-01-01 CINDY HODGES CINDY HODGES 2012-09-05
502 2010-01-01 CINDY HODGES NANCY POWELL 2011-07-27
502 2009-01-01 CINDY HODGES NANCY POWELL 2010-07-26

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
502	2012-01-01	CINDY HODGES	CINDY HODGES	2013-07-30
502	2011-01-01	CINDY HODGES	CINDY HODGES	2012-09-05
502	2010-01-01	CINDY HODGES	NANCY POWELL	2011-07-27
502	2009-01-01	CINDY HODGES	NANCY POWELL	2010-07-26

Plan Statistics for SALTZER MEDICAL GROUP, P.A. HEALTH INSURANCE PLAN

401k plan membership statisitcs for SALTZER MEDICAL GROUP, P.A. HEALTH INSURANCE PLAN

Measure Date Value
2012: SALTZER MEDICAL GROUP, P.A. HEALTH INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 300
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 243
Total of all active and inactive participants 2012-01-01 243
2011: SALTZER MEDICAL GROUP, P.A. HEALTH INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 276
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 300
Total of all active and inactive participants 2011-01-01 300
2010: SALTZER MEDICAL GROUP, P.A. HEALTH INSURANCE PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 313
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 276
Total of all active and inactive participants 2010-01-01 276
2009: SALTZER MEDICAL GROUP, P.A. HEALTH INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 286
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 313
Total of all active and inactive participants 2009-01-01 313

Measure	Date	Value
2012: SALTZER MEDICAL GROUP, P.A. HEALTH INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	300
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	243
Total of all active and inactive participants	2012-01-01	243
2011: SALTZER MEDICAL GROUP, P.A. HEALTH INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	276
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	300
Total of all active and inactive participants	2011-01-01	300
2010: SALTZER MEDICAL GROUP, P.A. HEALTH INSURANCE PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	313
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	276
Total of all active and inactive participants	2010-01-01	276
2009: SALTZER MEDICAL GROUP, P.A. HEALTH INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	286
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	313
Total of all active and inactive participants	2009-01-01	313

Form 5500 Responses for SALTZER MEDICAL GROUP, P.A. HEALTH INSURANCE PLAN

2012: SALTZER MEDICAL GROUP, P.A. HEALTH INSURANCE 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 funding arrangement – General assets of the sponsor	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: SALTZER MEDICAL GROUP, P.A. HEALTH INSURANCE 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 funding arrangement – General assets of the sponsor	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2010: SALTZER MEDICAL GROUP, P.A. HEALTH INSURANCE 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 funding arrangement – General assets of the sponsor	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: SALTZER MEDICAL GROUP, P.A. HEALTH INSURANCE 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 funding arrangement – General assets of the sponsor	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

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Company Name:	SALTZER MEDICAL GROUP, P.A.
Employer identification number (EIN):	820299231
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)