401k Plan data: BEAR RIVER MEDICAL ARTS PC 401(K) PLAN plan

BEAR RIVER MEDICAL ARTS PC 401(K) PLAN 401k Plan overview

Plan Name	BEAR RIVER MEDICAL ARTS PC 401(K) PLAN
Plan identification number	002

BEAR RIVER MEDICAL ARTS PC 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.
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.
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

BEAR RIVER MEDICAL ARTS, PC has sponsored the creation of one or more 401k plans.

Company Name: BEAR RIVER MEDICAL ARTS, PC

Employer identification number (EIN): 870570172

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BEAR RIVER MEDICAL ARTS PC 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2022-01-01 JAN-ERIK SCHOW 2023-04-13
002 2021-01-01 JAN-ERIK SCHOW 2022-07-05
002 2020-01-01 JAN-ERIK SCHOW 2021-05-07
002 2019-01-01 JAN-ERIK SCHOW 2020-10-14
002 2018-01-01 JAN-ERIK SCHOW 2019-09-10
002 2017-01-01 JAN SCHOW 2018-10-15
002 2016-01-01 JAN SCHOW 2017-09-25
002 2015-01-01 JAN SCHOW 2016-10-12
002 2014-01-01 JAN SCHOW 2015-10-15
002 2013-01-01 JAN SCHOW 2015-11-24
002 2012-01-01 JAN ERIK SCHOW MD 2013-05-09 JAN ERIK SCHOW MD 2013-05-09
002 2011-01-01 JAN ERIC SCHAW JAN ERIC SCHAW 2012-03-14
002 2010-01-01 JAN ERIC SCHAW JAN ERIC SCHAW 2011-04-25

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2022-01-01	JAN-ERIK SCHOW	2023-04-13
002	2021-01-01	JAN-ERIK SCHOW	2022-07-05
002	2020-01-01	JAN-ERIK SCHOW	2021-05-07
002	2019-01-01	JAN-ERIK SCHOW	2020-10-14
002	2018-01-01	JAN-ERIK SCHOW	2019-09-10
002	2017-01-01	JAN SCHOW	2018-10-15
002	2016-01-01	JAN SCHOW	2017-09-25
002	2015-01-01	JAN SCHOW	2016-10-12
002	2014-01-01	JAN SCHOW	2015-10-15
002	2013-01-01	JAN SCHOW	2015-11-24
002	2012-01-01	JAN ERIK SCHOW MD	2013-05-09	JAN ERIK SCHOW MD	2013-05-09
002	2011-01-01	JAN ERIC SCHAW		JAN ERIC SCHAW	2012-03-14
002	2010-01-01	JAN ERIC SCHAW		JAN ERIC SCHAW	2011-04-25

Plan Statistics for BEAR RIVER MEDICAL ARTS PC 401(K) PLAN

401k plan membership statisitcs for BEAR RIVER MEDICAL ARTS PC 401(K) PLAN

Measure Date Value
2011: BEAR RIVER MEDICAL ARTS PC 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 12
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 14
Number of retired or separated participants receiving benefits 2011-01-01 0
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 14
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 14
Number of participants with account balances 2011-01-01 7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: BEAR RIVER MEDICAL ARTS PC 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 11
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 12
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 12
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 12
Number of participants with account balances 2010-01-01 6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0

Measure	Date	Value
2011: BEAR RIVER MEDICAL ARTS PC 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	12
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	14
Number of retired or separated participants receiving benefits	2011-01-01	0
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	14
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	14
Number of participants with account balances	2011-01-01	7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: BEAR RIVER MEDICAL ARTS PC 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	11
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	12
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	12
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	12
Number of participants with account balances	2010-01-01	6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0

Financial Data on BEAR RIVER MEDICAL ARTS PC 401(K) PLAN

Measure	Date	Value
2011 : BEAR RIVER MEDICAL ARTS PC 401(K) PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$22,718
Expenses. Total of all expenses incurred	2011-12-31	$1,273
Total plan assets at end of year	2011-12-31	$303,228
Total plan assets at beginning of year	2011-12-31	$281,783
Value of fidelity bond covering the plan	2011-12-31	$30,000
Total contributions received or receivable from participants	2011-12-31	$35,619
Contributions received from other sources (not participants or employers)	2011-12-31	$0
Other income received	2011-12-31	$-22,359
Net income (gross income less expenses)	2011-12-31	$21,445
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$303,228
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$281,783
Total contributions received or receivable from employer(s)	2011-12-31	$9,458
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$1,273
2010 : BEAR RIVER MEDICAL ARTS PC 401(K) PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$68,853
Expenses. Total of all expenses incurred	2010-12-31	$0
Total plan assets at end of year	2010-12-31	$289,050
Total plan assets at beginning of year	2010-12-31	$220,197
Value of fidelity bond covering the plan	2010-12-31	$30,000
Total contributions received or receivable from participants	2010-12-31	$36,777
Contributions received from other sources (not participants or employers)	2010-12-31	$0
Other income received	2010-12-31	$21,215
Net income (gross income less expenses)	2010-12-31	$68,853
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$289,050
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$220,197
Total contributions received or receivable from employer(s)	2010-12-31	$10,861

Form 5500 Responses for BEAR RIVER MEDICAL ARTS PC 401(K) PLAN

2011: BEAR RIVER MEDICAL ARTS PC 401(K) PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
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
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: BEAR RIVER MEDICAL ARTS PC 401(K) PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
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
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

GP 77971

Policy instance

Insurance contract or identification number	GP 77971
Number of Individuals Covered	7
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $653
Total amount of fees paid to insurance company	USD $794
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

GP 77971

Policy instance

Insurance contract or identification number	GP 77971
Number of Individuals Covered	6
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $5,567
Total amount of fees paid to insurance company	USD $20
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $5,567
Amount paid for insurance broker fees	20
Additional information about fees paid to insurance broker	ANN SERVICING
Insurance broker organization code?	4
Insurance broker name	LINCOLN FINANCIAL ADVISORS

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Company Name:	BEAR RIVER MEDICAL ARTS, PC
Employer identification number (EIN):	870570172
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)