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| Plan Name | ROCKET CITY FAMILY MEDICINE LLC 401K PROFIT SHARING PLAN |
| Plan identification number | 001 |
| 401k Plan Type | Defined Contribution Pension |
| Plan Features/Benefits |
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| Company Name: | ROCKET CITY FAMILY MEDICINE, LLC |
| Employer identification number (EIN): | 853080942 |
| NAIC Classification: | 621111 |
| NAIC Description: | Offices of Physicians (except Mental Health Specialists) |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 001 | 2022-01-01 | ||||
| 001 | 2021-09-01 |
| Measure | Date | Value |
|---|---|---|
| 2022: ROCKET CITY FAMILY MEDICINE LLC 401K PROFIT SHARING PLAN 2022 401k membership | ||
| Total participants, beginning-of-year | 2022-01-01 | 14 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 9 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 4 |
| Total of all active and inactive participants | 2022-01-01 | 13 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2022-01-01 | 0 |
| Total participants | 2022-01-01 | 13 |
| Number of participants with account balances | 2022-01-01 | 13 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2022-01-01 | 2 |
| 2021: ROCKET CITY FAMILY MEDICINE LLC 401K PROFIT SHARING PLAN 2021 401k membership | ||
| Total participants, beginning-of-year | 2021-09-01 | 13 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-09-01 | 12 |
| Number of retired or separated participants receiving benefits | 2021-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-09-01 | 2 |
| Total of all active and inactive participants | 2021-09-01 | 14 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2021-09-01 | 0 |
| Total participants | 2021-09-01 | 14 |
| Number of participants with account balances | 2021-09-01 | 14 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2021-09-01 | 0 |
| Measure | Date | Value |
|---|---|---|
| 2022 : ROCKET CITY FAMILY MEDICINE LLC 401K PROFIT SHARING PLAN 2022 401k financial data | ||
| Total income from all sources | 2022-12-31 | $133,810 |
| Expenses. Total of all expenses incurred | 2022-12-31 | $1,882 |
| Benefits paid (including direct rollovers) | 2022-12-31 | $1,832 |
| Total plan assets at end of year | 2022-12-31 | $381,169 |
| Total plan assets at beginning of year | 2022-12-31 | $249,241 |
| Value of fidelity bond covering the plan | 2022-12-31 | $50,000 |
| Total contributions received or receivable from participants | 2022-12-31 | $62,846 |
| Other income received | 2022-12-31 | $-38,123 |
| Net income (gross income less expenses) | 2022-12-31 | $131,928 |
| Net plan assets at end of year (total assets less liabilities) | 2022-12-31 | $381,169 |
| Net plan assets at beginning of year (total assets less liabilities) | 2022-12-31 | $249,241 |
| Total contributions received or receivable from employer(s) | 2022-12-31 | $109,087 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2022-12-31 | $50 |
| 2021 : ROCKET CITY FAMILY MEDICINE LLC 401K PROFIT SHARING PLAN 2021 401k financial data | ||
| Total income from all sources | 2021-12-31 | $249,241 |
| Expenses. Total of all expenses incurred | 2021-12-31 | $0 |
| Total plan assets at end of year | 2021-12-31 | $249,241 |
| Total plan assets at beginning of year | 2021-12-31 | $0 |
| Value of fidelity bond covering the plan | 2021-12-31 | $20,000 |
| Total contributions received or receivable from participants | 2021-12-31 | $44,675 |
| Contributions received from other sources (not participants or employers) | 2021-12-31 | $98,941 |
| Other income received | 2021-12-31 | $80 |
| Net income (gross income less expenses) | 2021-12-31 | $249,241 |
| Net plan assets at end of year (total assets less liabilities) | 2021-12-31 | $249,241 |
| Net plan assets at beginning of year (total assets less liabilities) | 2021-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2021-12-31 | $105,545 |
| 2022: ROCKET CITY FAMILY MEDICINE LLC 401K PROFIT SHARING PLAN 2022 form 5500 responses | ||
|---|---|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Submission has been amended | No |
| 2022-01-01 | This submission is the final filing | No |
| 2022-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2022-01-01 | Plan is a collectively bargained plan | No |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan funding arrangement – Trust | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement - Trust | Yes |
| 2021: ROCKET CITY FAMILY MEDICINE LLC 401K PROFIT SHARING PLAN 2021 form 5500 responses | ||
| 2021-09-01 | Type of plan entity | Single employer plan |
| 2021-09-01 | First time form 5500 has been submitted | Yes |
| 2021-09-01 | Submission has been amended | No |
| 2021-09-01 | This submission is the final filing | No |
| 2021-09-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2021-09-01 | Plan is a collectively bargained plan | No |
| 2021-09-01 | Plan funding arrangement – Trust | Yes |
| 2021-09-01 | Plan benefit arrangement - Trust | Yes |
| TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 811299-000 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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