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| Plan Name | LIFE & AD&D PLAN |
| Plan identification number | 504 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | PHYSICIANS GROUP, LLC |
| Employer identification number (EIN): | 271593025 |
| NAIC Classification: | 621111 |
| NAIC Description: | Offices of Physicians (except Mental Health Specialists) |
Additional information about PHYSICIANS GROUP, LLC
| Jurisdiction of Incorporation: | Ohio Secretary of State Business Services Division |
| Incorporation Date: | 2007-05-25 |
| Company Identification Number: | 1702801 |
| Legal Registered Office Address: |
5542 AIRPORT HWY - TOLEDO United States of America (USA) 43615 |
More information about PHYSICIANS GROUP, LLC
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 504 | 2012-07-01 | VINCENT PAYNE | |||
| 504 | 2011-07-01 | BRENDA SIBERT | BRENDA SIBERT | 2012-11-27 |
| Measure | Date | Value |
|---|---|---|
| 2012: LIFE & AD&D PLAN 2012 401k membership | ||
| Total participants, beginning-of-year | 2012-07-01 | 232 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-07-01 | 0 |
| Number of retired or separated participants receiving benefits | 2012-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2012-07-01 | 0 |
| Total of all active and inactive participants | 2012-07-01 | 0 |
| 2011: LIFE & AD&D PLAN 2011 401k membership | ||
| Total participants, beginning-of-year | 2011-07-01 | 0 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-07-01 | 232 |
| Total of all active and inactive participants | 2011-07-01 | 232 |
| 2012: LIFE & AD&D PLAN 2012 form 5500 responses | ||
|---|---|---|
| 2012-07-01 | Type of plan entity | Single employer plan |
| 2012-07-01 | Submission has been amended | No |
| 2012-07-01 | This submission is the final filing | Yes |
| 2012-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-07-01 | Plan is a collectively bargained plan | No |
| 2012-07-01 | Plan funding arrangement – Insurance | Yes |
| 2012-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: LIFE & AD&D PLAN 2011 form 5500 responses | ||
| 2011-07-01 | Type of plan entity | Single employer plan |
| 2011-07-01 | First time form 5500 has been submitted | Yes |
| 2011-07-01 | Plan funding arrangement – Insurance | Yes |
| 2011-07-01 | Plan benefit arrangement – Insurance | Yes |
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