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| Plan Name | BUN RAYMOND LIM, M D, AMC PROFIT SHARING PLAN |
| Plan identification number | 003 |
| 401k Plan Type | Defined Contribution Pension |
| Plan Features/Benefits |
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| Company Name: | BUN RAYMOND LIM M.D., A MEDICAL CORPORATION |
| Employer identification number (EIN): | 954015734 |
| 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 |
|---|---|---|---|---|---|
| 003 | 2011-01-01 | NAYANIE WEERAKOON | 2012-08-21 | ||
| 003 | 2010-01-01 | BUN RAYMOND LIM | |||
| 003 | 2009-01-01 | BUN RAYMOND LIM |
| Measure | Date | Value |
|---|---|---|
| 2010: BUN RAYMOND LIM, M D, AMC PROFIT SHARING PLAN 2010 401k membership | ||
| Total participants, beginning-of-year | 2010-01-01 | 7 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 3 |
| Number of retired or separated participants receiving benefits | 2010-01-01 | 4 |
| Total of all active and inactive participants | 2010-01-01 | 7 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2010-01-01 | 0 |
| Total participants | 2010-01-01 | 7 |
| 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 |
| 2009: BUN RAYMOND LIM, M D, AMC PROFIT SHARING PLAN 2009 401k membership | ||
| Total participants, beginning-of-year | 2009-01-01 | 8 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 3 |
| Number of retired or separated participants receiving benefits | 2009-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2009-01-01 | 4 |
| Total of all active and inactive participants | 2009-01-01 | 7 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2009-01-01 | 0 |
| Total participants | 2009-01-01 | 7 |
| Number of participants with account balances | 2009-01-01 | 6 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2009-01-01 | 0 |
| Measure | Date | Value |
|---|---|---|
| 2010 : BUN RAYMOND LIM, M D, AMC PROFIT SHARING PLAN 2010 401k financial data | ||
| Total income from all sources | 2010-12-31 | $33,405 |
| Expenses. Total of all expenses incurred | 2010-12-31 | $200 |
| Total plan assets at end of year | 2010-12-31 | $642,099 |
| Total plan assets at beginning of year | 2010-12-31 | $608,894 |
| Value of fidelity bond covering the plan | 2010-12-31 | $250,000 |
| Other income received | 2010-12-31 | $33,405 |
| Net income (gross income less expenses) | 2010-12-31 | $33,205 |
| Net plan assets at end of year (total assets less liabilities) | 2010-12-31 | $642,099 |
| Net plan assets at beginning of year (total assets less liabilities) | 2010-12-31 | $608,894 |
| Assets. Value of real-estate (other than employer real property) | 2010-12-31 | $80,000 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2010-12-31 | $200 |
| 2010: BUN RAYMOND LIM, M D, AMC PROFIT SHARING 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 |
| 2009: BUN RAYMOND LIM, M D, AMC 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 |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan funding arrangement – Trust | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement - Trust | Yes |
| AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) | |||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 304618185 | ||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||
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| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) | |||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 59378786 | ||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||||||||
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