401k Plan data: COMPREHENSIVE PAIN MANAGEMENT OF THE FOX VALLEY, S.C. 401(K) CROSS-TESTED PROFIT SHARING PLAN plan

COMPREHENSIVE PAIN MANAGEMENT OF THE FOX VALLEY, S.C. 401(K) CROSS-TESTED PROFIT SHARING PLAN 401k Plan overview

Plan Name	COMPREHENSIVE PAIN MANAGEMENT OF THE FOX VALLEY, S.C. 401(K) CROSS-TESTED PROFIT SHARING PLAN
Plan identification number	001

COMPREHENSIVE PAIN MANAGEMENT OF THE FOX VALLEY, S.C. 401(K) CROSS-TESTED 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
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.
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

COMPREHENSIVE PAIN MANAGEMENT OF THE FOX VALLEY, S.C. has sponsored the creation of one or more 401k plans.

Company Name: COMPREHENSIVE PAIN MANAGEMENT OF THE FOX VALLEY, S.C.

Employer identification number (EIN): 205892243

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COMPREHENSIVE PAIN MANAGEMENT OF THE FOX VALLEY, S.C. 401(K) CROSS-TESTED PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2014-01-01
001 2013-01-01
001 2012-01-01 ALEXANDER YAKOVLEV, M.D. ALEXANDER YAKOVLEV, M.D. 2013-03-27
001 2011-01-01 ALEXANDER YAKOVLEV, M.D. ALEXANDER YAKOVLEV, M.D. 2012-04-17
001 2009-01-01 ALEXANDER YAKOVLEV, M.D. ALEXANDER YAKOVLEV, M.D. 2010-07-12

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2014-01-01
001	2013-01-01
001	2012-01-01	ALEXANDER YAKOVLEV, M.D.	ALEXANDER YAKOVLEV, M.D.	2013-03-27
001	2011-01-01	ALEXANDER YAKOVLEV, M.D.	ALEXANDER YAKOVLEV, M.D.	2012-04-17
001	2009-01-01	ALEXANDER YAKOVLEV, M.D.	ALEXANDER YAKOVLEV, M.D.	2010-07-12

Plan Statistics for COMPREHENSIVE PAIN MANAGEMENT OF THE FOX VALLEY, S.C. 401(K) CROSS-TESTED PROFIT SHARING PLAN

401k plan membership statisitcs for COMPREHENSIVE PAIN MANAGEMENT OF THE FOX VALLEY, S.C. 401(K) CROSS-TESTED PROFIT SHARING PLAN

Measure Date Value
2014: COMPREHENSIVE PAIN MANAGEMENT OF THE FOX VALLEY, S.C. 401(K) CROSS-TESTED PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 17
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 4
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 10
Total of all active and inactive participants 2014-01-01 14
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 14
Number of participants with account balances 2014-01-01 14
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: COMPREHENSIVE PAIN MANAGEMENT OF THE FOX VALLEY, S.C. 401(K) CROSS-TESTED PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 14
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 12
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 3
Total of all active and inactive participants 2013-01-01 15
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 15
Number of participants with account balances 2013-01-01 15
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: COMPREHENSIVE PAIN MANAGEMENT OF THE FOX VALLEY, S.C. 401(K) CROSS-TESTED PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 16
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 10
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 4
Total of all active and inactive participants 2012-01-01 14
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 14
Number of participants with account balances 2012-01-01 14
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 1
2011: COMPREHENSIVE PAIN MANAGEMENT OF THE FOX VALLEY, S.C. 401(K) CROSS-TESTED PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 13
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 10
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 4
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 14
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: COMPREHENSIVE PAIN MANAGEMENT OF THE FOX VALLEY, S.C. 401(K) CROSS-TESTED PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 12
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 7
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 3
Total of all active and inactive participants 2009-01-01 10
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 10
Number of participants with account balances 2009-01-01 10
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 1

Measure	Date	Value
2014: COMPREHENSIVE PAIN MANAGEMENT OF THE FOX VALLEY, S.C. 401(K) CROSS-TESTED PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	17
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	4
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	10
Total of all active and inactive participants	2014-01-01	14
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	14
Number of participants with account balances	2014-01-01	14
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: COMPREHENSIVE PAIN MANAGEMENT OF THE FOX VALLEY, S.C. 401(K) CROSS-TESTED PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	14
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	12
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	3
Total of all active and inactive participants	2013-01-01	15
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	15
Number of participants with account balances	2013-01-01	15
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: COMPREHENSIVE PAIN MANAGEMENT OF THE FOX VALLEY, S.C. 401(K) CROSS-TESTED PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	16
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	10
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	4
Total of all active and inactive participants	2012-01-01	14
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	14
Number of participants with account balances	2012-01-01	14
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	1
2011: COMPREHENSIVE PAIN MANAGEMENT OF THE FOX VALLEY, S.C. 401(K) CROSS-TESTED PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	13
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	10
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	4
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	14
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: COMPREHENSIVE PAIN MANAGEMENT OF THE FOX VALLEY, S.C. 401(K) CROSS-TESTED PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	12
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	7
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	3
Total of all active and inactive participants	2009-01-01	10
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	10
Number of participants with account balances	2009-01-01	10
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	1

Financial Data on COMPREHENSIVE PAIN MANAGEMENT OF THE FOX VALLEY, S.C. 401(K) CROSS-TESTED PROFIT SHARING PLAN

Measure	Date	Value
2014 : COMPREHENSIVE PAIN MANAGEMENT OF THE FOX VALLEY, S.C. 401(K) CROSS-TESTED PROFIT SHARING PLAN 2014 401k financial data
Total plan liabilities at end of year	2014-12-31	$0
Total plan liabilities at beginning of year	2014-12-31	$0
Total income from all sources	2014-12-31	$62,950
Expenses. Total of all expenses incurred	2014-12-31	$70,452
Benefits paid (including direct rollovers)	2014-12-31	$69,554
Total plan assets at end of year	2014-12-31	$169,549
Total plan assets at beginning of year	2014-12-31	$177,051
Value of fidelity bond covering the plan	2014-12-31	$16,955
Total contributions received or receivable from participants	2014-12-31	$33,510
Expenses. Other expenses not covered elsewhere	2014-12-31	$0
Contributions received from other sources (not participants or employers)	2014-12-31	$0
Other income received	2014-12-31	$7,299
Noncash contributions received	2014-12-31	$0
Net income (gross income less expenses)	2014-12-31	$-7,502
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$169,549
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$177,051
Total contributions received or receivable from employer(s)	2014-12-31	$22,141
Value of certain deemed distributions of participant loans	2014-12-31	$0
Value of corrective distributions	2014-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2014-12-31	$898
2013 : COMPREHENSIVE PAIN MANAGEMENT OF THE FOX VALLEY, S.C. 401(K) CROSS-TESTED PROFIT SHARING PLAN 2013 401k financial data
Total plan liabilities at end of year	2013-12-31	$0
Total plan liabilities at beginning of year	2013-12-31	$0
Total income from all sources	2013-12-31	$87,598
Expenses. Total of all expenses incurred	2013-12-31	$99,109
Benefits paid (including direct rollovers)	2013-12-31	$97,772
Total plan assets at end of year	2013-12-31	$177,051
Total plan assets at beginning of year	2013-12-31	$188,562
Value of fidelity bond covering the plan	2013-12-31	$17,705
Total contributions received or receivable from participants	2013-12-31	$37,640
Expenses. Other expenses not covered elsewhere	2013-12-31	$0
Contributions received from other sources (not participants or employers)	2013-12-31	$0
Other income received	2013-12-31	$29,614
Noncash contributions received	2013-12-31	$0
Net income (gross income less expenses)	2013-12-31	$-11,511
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$177,051
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$188,562
Total contributions received or receivable from employer(s)	2013-12-31	$20,344
Value of certain deemed distributions of participant loans	2013-12-31	$0
Value of corrective distributions	2013-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2013-12-31	$1,337
2012 : COMPREHENSIVE PAIN MANAGEMENT OF THE FOX VALLEY, S.C. 401(K) CROSS-TESTED PROFIT SHARING PLAN 2012 401k financial data
Total plan liabilities at end of year	2012-12-31	$0
Total plan liabilities at beginning of year	2012-12-31	$0
Total income from all sources	2012-12-31	$94,905
Expenses. Total of all expenses incurred	2012-12-31	$126,871
Benefits paid (including direct rollovers)	2012-12-31	$125,214
Total plan assets at end of year	2012-12-31	$188,562
Total plan assets at beginning of year	2012-12-31	$220,528
Value of fidelity bond covering the plan	2012-12-31	$18,856
Total contributions received or receivable from participants	2012-12-31	$50,169
Contributions received from other sources (not participants or employers)	2012-12-31	$0
Other income received	2012-12-31	$15,560
Noncash contributions received	2012-12-31	$0
Net income (gross income less expenses)	2012-12-31	$-31,966
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$188,562
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$220,528
Total contributions received or receivable from employer(s)	2012-12-31	$29,176
Expenses. Administrative service providers (salaries,fees and commissions)	2012-12-31	$1,657
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
2011 : COMPREHENSIVE PAIN MANAGEMENT OF THE FOX VALLEY, S.C. 401(K) CROSS-TESTED PROFIT SHARING PLAN 2011 401k financial data
Total plan liabilities at end of year	2011-12-31	$0
Total plan liabilities at beginning of year	2011-12-31	$0
Total income from all sources	2011-12-31	$51,007
Expenses. Total of all expenses incurred	2011-12-31	$1,124
Total plan assets at end of year	2011-12-31	$220,528
Total plan assets at beginning of year	2011-12-31	$170,645
Value of fidelity bond covering the plan	2011-12-31	$22,053
Total contributions received or receivable from participants	2011-12-31	$37,985
Expenses. Other expenses not covered elsewhere	2011-12-31	$0
Contributions received from other sources (not participants or employers)	2011-12-31	$0
Other income received	2011-12-31	$-6,794
Noncash contributions received	2011-12-31	$0
Net income (gross income less expenses)	2011-12-31	$49,883
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$220,528
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$170,645
Total contributions received or receivable from employer(s)	2011-12-31	$19,816
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$1,124
2010 : COMPREHENSIVE PAIN MANAGEMENT OF THE FOX VALLEY, S.C. 401(K) CROSS-TESTED PROFIT SHARING PLAN 2010 401k financial data
Total plan liabilities at end of year	2010-12-31	$0
Total plan liabilities at beginning of year	2010-12-31	$0
Total income from all sources	2010-12-31	$66,693
Expenses. Total of all expenses incurred	2010-12-31	$34,041
Benefits paid (including direct rollovers)	2010-12-31	$32,518
Total plan assets at end of year	2010-12-31	$170,645
Total plan assets at beginning of year	2010-12-31	$137,993
Value of fidelity bond covering the plan	2010-12-31	$10,000
Total contributions received or receivable from participants	2010-12-31	$34,587
Expenses. Other expenses not covered elsewhere	2010-12-31	$0
Other income received	2010-12-31	$12,688
Net income (gross income less expenses)	2010-12-31	$32,652
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$170,645
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$137,993
Total contributions received or receivable from employer(s)	2010-12-31	$19,418
Value of certain deemed distributions of participant loans	2010-12-31	$0
Value of corrective distributions	2010-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$1,523
2009 : COMPREHENSIVE PAIN MANAGEMENT OF THE FOX VALLEY, S.C. 401(K) CROSS-TESTED PROFIT SHARING PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for COMPREHENSIVE PAIN MANAGEMENT OF THE FOX VALLEY, S.C. 401(K) CROSS-TESTED PROFIT SHARING PLAN

2014: COMPREHENSIVE PAIN MANAGEMENT OF THE FOX VALLEY, S.C. 401(K) CROSS-TESTED PROFIT SHARING PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: COMPREHENSIVE PAIN MANAGEMENT OF THE FOX VALLEY, S.C. 401(K) CROSS-TESTED PROFIT SHARING PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: COMPREHENSIVE PAIN MANAGEMENT OF THE FOX VALLEY, S.C. 401(K) CROSS-TESTED PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
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 – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: COMPREHENSIVE PAIN MANAGEMENT OF THE FOX VALLEY, S.C. 401(K) CROSS-TESTED PROFIT SHARING 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 – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: COMPREHENSIVE PAIN MANAGEMENT OF THE FOX VALLEY, S.C. 401(K) CROSS-TESTED 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 – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

112942

Policy instance

Insurance contract or identification number	112942
Number of Individuals Covered	15
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $2,196
Total amount of fees paid to insurance company	USD $881
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 $2,196
Insurance broker organization code?	3
Amount paid for insurance broker fees	81
Additional information about fees paid to insurance broker	OTHER ALLOWANCE
Insurance broker name	SPURLOCK RUNYAN MILLER & ASSOCIATES

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Company Name:	COMPREHENSIVE PAIN MANAGEMENT OF THE FOX VALLEY, S.C.
Employer identification number (EIN):	205892243
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)