401k Plan data: JACK F. JACOUB, M.D., INC. 401(K) PROFIT SHARING PLAN plan

JACK F. JACOUB, M.D., INC. 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan Name	JACK F. JACOUB, M.D., INC. 401(K) PROFIT SHARING PLAN
Plan identification number	001

JACK F. JACOUB, M.D., INC. 401(K) 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.
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.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
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

JACK F. JACOUB, M.D., INC. has sponsored the creation of one or more 401k plans.

Company Name: JACK F. JACOUB, M.D., INC.

Employer identification number (EIN): 262878401

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan JACK F. JACOUB, M.D., INC. 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2021-01-01 JJACOUB 2021-12-29 JJACOUB 2021-12-29
001 2020-01-01 JACK F. JACOUB 2021-05-13 JACK F. JACOUB 2021-05-13
001 2019-01-01 JACK F JACOUB 2020-07-28 JACK F JACOUB 2020-07-28
001 2018-01-01 JACK JACOUB 2019-06-24 JACK JACOUB 2019-06-24
001 2017-01-01 MICHELLE VERDUGO 2018-07-23
001 2016-01-01 JACK JACOUB 2017-07-28
001 2015-01-01 JACK F. JACOUB 2016-10-13 JACK F. JACOUB 2016-10-13
001 2014-01-01 JACK F. JACOUB 2015-10-06 JACK F. JACOUB 2015-10-06
001 2013-01-01 JACK F. JACOUB 2014-10-13 JACK F. JACOUB 2014-10-13
001 2012-01-01 JACK JACOUB 2013-07-18 JACK JACOUB 2013-07-18
001 2011-01-01 JACK F. JACOUB 2012-07-17 JACK F. JACOUB 2012-07-17

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2021-01-01	JJACOUB	2021-12-29	JJACOUB	2021-12-29
001	2020-01-01	JACK F. JACOUB	2021-05-13	JACK F. JACOUB	2021-05-13
001	2019-01-01	JACK F JACOUB	2020-07-28	JACK F JACOUB	2020-07-28
001	2018-01-01	JACK JACOUB	2019-06-24	JACK JACOUB	2019-06-24
001	2017-01-01	MICHELLE VERDUGO	2018-07-23
001	2016-01-01	JACK JACOUB	2017-07-28
001	2015-01-01	JACK F. JACOUB	2016-10-13	JACK F. JACOUB	2016-10-13
001	2014-01-01	JACK F. JACOUB	2015-10-06	JACK F. JACOUB	2015-10-06
001	2013-01-01	JACK F. JACOUB	2014-10-13	JACK F. JACOUB	2014-10-13
001	2012-01-01	JACK JACOUB	2013-07-18	JACK JACOUB	2013-07-18
001	2011-01-01	JACK F. JACOUB	2012-07-17	JACK F. JACOUB	2012-07-17

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Company Name:	JACK F. JACOUB, M.D., INC.
Employer identification number (EIN):	262878401
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)