401k Plan data: RMCVA PROFIT SHARING PLAN plan

RMCVA PROFIT SHARING PLAN 401k Plan overview

Plan Name	RMCVA PROFIT SHARING PLAN
Plan identification number	003

RMCVA PROFIT SHARING 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
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.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Participant-directed brokerage accounts provided as an investment option under the plan.
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.

401k Sponsoring company profile

ROCKY MOUNTAIN CARDIOVASCULAR ASSOCIATES, P.C. has sponsored the creation of one or more 401k plans.

Company Name: ROCKY MOUNTAIN CARDIOVASCULAR ASSOCIATES, P.C.

Employer identification number (EIN): 840644785

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan RMCVA PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
003 2014-01-01
003 2013-01-01
003 2012-01-01 NORTH AMERICAN EMPLOYER SOLUTIONS NORTH AMERICAN EMPLOYER SOLUTIONS 2016-03-27
003 2011-01-01
003 2010-01-01
003 2009-01-01

Plan Statistics for RMCVA PROFIT SHARING PLAN

401k plan membership statisitcs for RMCVA PROFIT SHARING PLAN

Measure Date Value
2012: RMCVA PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 161
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 0
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 26
Total of all active and inactive participants 2012-01-01 26
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 26
Number of participants with account balances 2012-01-01 26
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0

Measure	Date	Value
2012: RMCVA PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	161
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	0
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	26
Total of all active and inactive participants	2012-01-01	26
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	26
Number of participants with account balances	2012-01-01	26
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0

Financial Data on RMCVA PROFIT SHARING PLAN

Measure	Date	Value
2012 : RMCVA PROFIT SHARING PLAN 2012 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2012-12-31	$893,008
Total unrealized appreciation/depreciation of assets	2012-12-31	$893,008
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$35,609
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$44,942
Total income from all sources (including contributions)	2012-12-31	$1,030,714
Total of all expenses incurred	2012-12-31	$12,766,875
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$12,731,738
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$48,329
Value of total assets at end of year	2012-12-31	$6,771,184
Value of total assets at beginning of year	2012-12-31	$18,507,345
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$35,137
Total interest from all sources	2012-12-31	$1,587
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$87,790
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2012-12-31	$0
Total dividends received from registered investment company shares (eg mutual funds)	2012-12-31	$87,790
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2012-12-31	$0
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$1,050,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$0
Participant contributions at beginning of year	2012-12-31	$0
Participant contributions at end of year	2012-12-31	$0
Participant contributions at beginning of year	2012-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2012-12-31	$35,192
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2012-12-31	$55,635
Total non interest bearing cash at end of year	2012-12-31	$8,933
Total non interest bearing cash at beginning of year	2012-12-31	$18,933
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$-11,736,161
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$6,771,184
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$18,507,345
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Assets. partnership/joint venture interests at beginning of year	2012-12-31	$53,740
Investment advisory and management fees	2012-12-31	$35,137
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$6,766,471
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$17,548,070
Value of interest in pooled separate accounts at end of year	2012-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-12-31	$1,138
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-12-31	$907,371
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-12-31	$907,371
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-12-31	$1,587
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$120,526
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$297,396
Asset value of US Government securities at end of year	2012-12-31	$0
Asset value of US Government securities at beginning of year	2012-12-31	$5,471
Net investment gain or loss from common/collective trusts	2012-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Assets. Value of employer real property at end of year	2012-12-31	$0
Assets. Value of employer real property at beginning of year	2012-12-31	$0
Contributions received in cash from employer	2012-12-31	$48,329
Employer contributions (assets) at end of year	2012-12-31	$3,575
Employer contributions (assets) at beginning of year	2012-12-31	$51,904
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$12,731,738
Asset. Corporate debt instrument preferred debt at beginning of year	2012-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2012-12-31	$85,607
Asset. Corporate debt instrument debt (other) at beginning of year	2012-12-31	$1,964,333
Assets. Corporate common stocks other than exployer securities at end of year	2012-12-31	$63,747
Assets. Corporate common stocks other than exployer securities at beginning of year	2012-12-31	$4,511,818
Liabilities. Value of benefit claims payable at end of year	2012-12-31	$35,609
Liabilities. Value of benefit claims payable at beginning of year	2012-12-31	$44,942
Did the plan have assets held for investment	2012-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	No
Opinion of an independent qualified public accountant for this plan	2012-12-31	Unqualified
Accountancy firm name	2012-12-31	CAUSEY DEMGEN & MOORE PC
Accountancy firm EIN	2012-12-31	841158905
2011 : RMCVA PROFIT SHARING PLAN 2011 401k financial data
Total income from all sources (including contributions)	2011-12-31	$522,106
Total of all expenses incurred	2011-12-31	$4,274,433
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$4,274,433
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$1,013,861
Value of total assets at end of year	2011-12-31	$18,708,433
Value of total assets at beginning of year	2011-12-31	$22,460,760
Total interest from all sources	2011-12-31	$3,327
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2011-12-31	$0
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$1,050,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$373,991
Participant contributions at end of year	2011-12-31	$0
Participant contributions at beginning of year	2011-12-31	$125,607
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Income. Non cash contributions	2011-12-31	$-1,598
Value of net income/loss	2011-12-31	$-3,752,327
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$18,708,433
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$22,460,760
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$18,708,433
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$22,335,153
Interest on participant loans	2011-12-31	$3,327
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-495,082
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$641,468
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$4,274,433
Did the plan have assets held for investment	2011-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	No
Opinion of an independent qualified public accountant for this plan	2011-12-31	Unqualified

Form 5500 Responses for RMCVA PROFIT SHARING PLAN

2012: RMCVA PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	Yes
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: RMCVA PROFIT SHARING PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	Yes
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2010: RMCVA PROFIT SHARING 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	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2009: RMCVA PROFIT SHARING PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
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

Insurance Providers Used on plan

C.M. LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93432 )

Policy contract number

ODY15309314

Policy instance

Insurance contract or identification number	ODY15309314
Number of Individuals Covered	1
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31

VARIABLE ANNUITY LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 70238 )

Policy contract number

63566

Policy instance

Insurance contract or identification number	63566
Number of Individuals Covered	1
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31

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Company Name:	ROCKY MOUNTAIN CARDIOVASCULAR ASSOCIATES, P.C.
Employer identification number (EIN):	840644785
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
003	2014-01-01
003	2013-01-01
003	2012-01-01	NORTH AMERICAN EMPLOYER SOLUTIONS	NORTH AMERICAN EMPLOYER SOLUTIONS	2016-03-27
003	2011-01-01
003	2010-01-01
003	2009-01-01