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DIAGNOSTIC PATHOLOGY MEDICAL GROUP LIFE PLAN 401k Plan overview

Plan NameDIAGNOSTIC PATHOLOGY MEDICAL GROUP LIFE PLAN
Plan identification number 503

DIAGNOSTIC PATHOLOGY MEDICAL GROUP LIFE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Other welfare benefit cover

401k Sponsoring company profile

DIAGNOSTIC PATHOLOGY MEDICAL GROUP, INC. has sponsored the creation of one or more 401k plans.

Company Name:DIAGNOSTIC PATHOLOGY MEDICAL GROUP, INC.
Employer identification number (EIN):942227764
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DIAGNOSTIC PATHOLOGY MEDICAL GROUP LIFE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032013-03-01
5032012-03-01THOMAS AMOTT
5032011-03-01THOMAS AMOTT
5032009-07-01THOMAS AMOTT

Plan Statistics for DIAGNOSTIC PATHOLOGY MEDICAL GROUP LIFE PLAN

401k plan membership statisitcs for DIAGNOSTIC PATHOLOGY MEDICAL GROUP LIFE PLAN

Measure Date Value
2013: DIAGNOSTIC PATHOLOGY MEDICAL GROUP LIFE PLAN 2013 401k membership
Total participants, beginning-of-year2013-03-01140
Total number of active participants reported on line 7a of the Form 55002013-03-01136
Total of all active and inactive participants2013-03-01136
2012: DIAGNOSTIC PATHOLOGY MEDICAL GROUP LIFE PLAN 2012 401k membership
Total participants, beginning-of-year2012-03-01183
Total number of active participants reported on line 7a of the Form 55002012-03-01140
Number of retired or separated participants receiving benefits2012-03-010
Number of other retired or separated participants entitled to future benefits2012-03-010
Total of all active and inactive participants2012-03-01140
Total participants2012-03-01140
2011: DIAGNOSTIC PATHOLOGY MEDICAL GROUP LIFE PLAN 2011 401k membership
Total participants, beginning-of-year2011-03-01185
Total number of active participants reported on line 7a of the Form 55002011-03-01183
Number of retired or separated participants receiving benefits2011-03-010
Number of other retired or separated participants entitled to future benefits2011-03-010
Total of all active and inactive participants2011-03-01183
Total participants2011-03-01183
2009: DIAGNOSTIC PATHOLOGY MEDICAL GROUP LIFE PLAN 2009 401k membership
Total participants, beginning-of-year2009-07-01188
Total number of active participants reported on line 7a of the Form 55002009-07-01183
Number of retired or separated participants receiving benefits2009-07-010
Number of other retired or separated participants entitled to future benefits2009-07-010
Total of all active and inactive participants2009-07-01183
Total participants2009-07-01183

Form 5500 Responses for DIAGNOSTIC PATHOLOGY MEDICAL GROUP LIFE PLAN

2013: DIAGNOSTIC PATHOLOGY MEDICAL GROUP LIFE PLAN 2013 form 5500 responses
2013-03-01Type of plan entitySingle employer plan
2013-03-01This submission is the final filingYes
2013-03-01Plan funding arrangement – InsuranceYes
2013-03-01Plan benefit arrangement – InsuranceYes
2012: DIAGNOSTIC PATHOLOGY MEDICAL GROUP LIFE PLAN 2012 form 5500 responses
2012-03-01Type of plan entitySingle employer plan
2012-03-01Submission has been amendedNo
2012-03-01This submission is the final filingNo
2012-03-01This return/report is a short plan year return/report (less than 12 months)No
2012-03-01Plan is a collectively bargained planNo
2012-03-01Plan funding arrangement – InsuranceYes
2012-03-01Plan benefit arrangement – InsuranceYes
2011: DIAGNOSTIC PATHOLOGY MEDICAL GROUP LIFE PLAN 2011 form 5500 responses
2011-03-01Type of plan entitySingle employer plan
2011-03-01Submission has been amendedNo
2011-03-01This submission is the final filingNo
2011-03-01This return/report is a short plan year return/report (less than 12 months)No
2011-03-01Plan is a collectively bargained planNo
2011-03-01Plan funding arrangement – InsuranceYes
2011-03-01Plan benefit arrangement – InsuranceYes
2009: DIAGNOSTIC PATHOLOGY MEDICAL GROUP LIFE PLAN 2009 form 5500 responses
2009-07-01Type of plan entitySingle employer plan
2009-07-01Submission has been amendedNo
2009-07-01This submission is the final filingNo
2009-07-01This return/report is a short plan year return/report (less than 12 months)Yes
2009-07-01Plan is a collectively bargained planNo
2009-07-01Plan funding arrangement – InsuranceYes
2009-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number604766
Policy instance 1
Insurance contract or identification number604766
Number of Individuals Covered136
Insurance policy start date2013-03-01
Insurance policy end date2014-02-28
Total amount of commissions paid to insurance brokerUSD $2,449
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,449
Insurance broker organization code?3
Insurance broker nameINTERWEST INSURANCE SERVICES
BLUE SHIELD OF CALIFORNIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract numberH30265, 920969
Policy instance 2
Insurance contract or identification numberH30265, 920969
Number of Individuals Covered42
Insurance policy start date2013-03-01
Insurance policy end date2014-02-28
Total amount of commissions paid to insurance brokerUSD $110
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $2,761
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $110
Insurance broker organization code?3
Insurance broker nameINTERWEST INSURANCE SERVICES
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number604766
Policy instance 1
Insurance contract or identification number604766
Number of Individuals Covered140
Insurance policy start date2012-03-01
Insurance policy end date2013-02-28
Total amount of commissions paid to insurance brokerUSD $2,179
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,179
Insurance broker organization code?3
Insurance broker nameINTERWEST INSURANCE SERVICES
BLUE SHIELD OF CALIFORNIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract numberH30265, 920969
Policy instance 1
Insurance contract or identification numberH30265, 920969
Number of Individuals Covered46
Insurance policy start date2011-03-01
Insurance policy end date2012-02-29
Total amount of commissions paid to insurance brokerUSD $124
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $3,091
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number604766
Policy instance 2
Insurance contract or identification number604766
Number of Individuals Covered137
Insurance policy start date2011-03-01
Insurance policy end date2012-02-29
Total amount of commissions paid to insurance brokerUSD $2,195
Life Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number048537900
Policy instance 1
Insurance contract or identification number048537900
Number of Individuals Covered137
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $1,413
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $24,521
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,413
Insurance broker organization code?3
Insurance broker nameJAMES BULOTTI
BLUE SHIELD OF CALIFORNIA LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61557 )
Policy contract numberH30265, 920969
Policy instance 2
Insurance contract or identification numberH30265, 920969
Number of Individuals Covered48
Insurance policy start date2010-03-02
Insurance policy end date2011-02-28
Total amount of commissions paid to insurance brokerUSD $152
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $3,037
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $152
Insurance broker organization code?3
Insurance broker nameINTERWEST INSURANCE SERVICES

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