401k Plan data: R. SCOTT CAIRNS MD PC PROFIT SHARING PLAN plan

R. SCOTT CAIRNS MD PC PROFIT SHARING PLAN 401k Plan overview

Plan Name	R. SCOTT CAIRNS MD PC PROFIT SHARING PLAN
Plan identification number	002

R. SCOTT CAIRNS MD PC PROFIT SHARING PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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.
Participant-directed brokerage accounts provided as an investment option under the plan.
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

R. SCOTT CAIRNS, M.D., P.C. has sponsored the creation of one or more 401k plans.

Company Name: R. SCOTT CAIRNS, M.D., P.C.

Employer identification number (EIN): 421028283

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan R. SCOTT CAIRNS MD PC PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2012-01-01 R SCOTT CAIRNS
002 2011-01-01 R SCOTT CAIRNS
002 2010-01-01 R SCOTT CAIRNS
002 2009-01-01 R SCOTT CAIRNS

Plan id#	Filing Submission Date	Name of Administrator
002	2012-01-01	R SCOTT CAIRNS
002	2011-01-01	R SCOTT CAIRNS
002	2010-01-01	R SCOTT CAIRNS
002	2009-01-01	R SCOTT CAIRNS

Plan Statistics for R. SCOTT CAIRNS MD PC PROFIT SHARING PLAN

401k plan membership statisitcs for R. SCOTT CAIRNS MD PC PROFIT SHARING PLAN

Measure Date Value
2012: R. SCOTT CAIRNS MD PC PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 1
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 0
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 0
Total of all active and inactive participants 2012-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 0
Number of participants with account balances 2012-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: R. SCOTT CAIRNS MD PC PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 5
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 0
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 1
Total of all active and inactive participants 2011-01-01 1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 1
Number of participants with account balances 2011-01-01 1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: R. SCOTT CAIRNS MD PC PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 8
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 0
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 5
Total of all active and inactive participants 2010-01-01 5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 5
Number of participants with account balances 2010-01-01 5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: R. SCOTT CAIRNS MD PC 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 8
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 0
Total of all active and inactive participants 2009-01-01 8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 8
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
2012: R. SCOTT CAIRNS MD PC PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	1
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	0
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	0
Total of all active and inactive participants	2012-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	0
Number of participants with account balances	2012-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: R. SCOTT CAIRNS MD PC PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	5
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	0
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	1
Total of all active and inactive participants	2011-01-01	1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	1
Number of participants with account balances	2011-01-01	1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: R. SCOTT CAIRNS MD PC PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	8
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	0
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	5
Total of all active and inactive participants	2010-01-01	5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	5
Number of participants with account balances	2010-01-01	5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: R. SCOTT CAIRNS MD PC 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	8
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	0
Total of all active and inactive participants	2009-01-01	8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	8
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

Financial Data on R. SCOTT CAIRNS MD PC PROFIT SHARING PLAN

Measure	Date	Value
2012 : R. SCOTT CAIRNS MD PC PROFIT SHARING PLAN 2012 401k financial data
Total income from all sources	2012-03-01	$12,465
Expenses. Total of all expenses incurred	2012-03-01	$162,167
Benefits paid (including direct rollovers)	2012-03-01	$162,102
Total plan assets at end of year	2012-03-01	$0
Total plan assets at beginning of year	2012-03-01	$149,702
Value of fidelity bond covering the plan	2012-03-01	$25,000
Other income received	2012-03-01	$12,465
Net income (gross income less expenses)	2012-03-01	$-149,702
Net plan assets at end of year (total assets less liabilities)	2012-03-01	$0
Net plan assets at beginning of year (total assets less liabilities)	2012-03-01	$149,702
Expenses. Administrative service providers (salaries,fees and commissions)	2012-03-01	$65
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-03-01	$0
2011 : R. SCOTT CAIRNS MD PC PROFIT SHARING PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$62,821
Expenses. Total of all expenses incurred	2011-12-31	$4,256,611
Benefits paid (including direct rollovers)	2011-12-31	$4,256,371
Total plan assets at end of year	2011-12-31	$149,702
Total plan assets at beginning of year	2011-12-31	$4,343,492
Value of fidelity bond covering the plan	2011-12-31	$25,000
Other income received	2011-12-31	$62,821
Net income (gross income less expenses)	2011-12-31	$-4,193,790
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$149,702
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$4,343,492
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$240
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Total income from all sources	2011-03-22	$60,416
Expenses. Total of all expenses incurred	2011-03-22	$4,403,908
Benefits paid (including direct rollovers)	2011-03-22	$4,402,798
Total plan assets at end of year	2011-03-22	$0
Total plan assets at beginning of year	2011-03-22	$4,343,492
Value of fidelity bond covering the plan	2011-03-22	$25,000
Other income received	2011-03-22	$60,416
Net income (gross income less expenses)	2011-03-22	$-4,343,492
Net plan assets at end of year (total assets less liabilities)	2011-03-22	$0
Net plan assets at beginning of year (total assets less liabilities)	2011-03-22	$4,343,492
Expenses. Administrative service providers (salaries,fees and commissions)	2011-03-22	$1,110
2010 : R. SCOTT CAIRNS MD PC PROFIT SHARING PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$445,148
Expenses. Total of all expenses incurred	2010-12-31	$256,035
Benefits paid (including direct rollovers)	2010-12-31	$230,024
Total plan assets at end of year	2010-12-31	$4,343,492
Total plan assets at beginning of year	2010-12-31	$4,154,379
Value of fidelity bond covering the plan	2010-12-31	$25,000
Total contributions received or receivable from participants	2010-12-31	$16,930
Other income received	2010-12-31	$428,218
Net income (gross income less expenses)	2010-12-31	$189,113
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$4,343,492
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$4,154,379
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$26,011
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
2009 : R. SCOTT CAIRNS MD PC 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 R. SCOTT CAIRNS MD PC PROFIT SHARING PLAN

2012: R. SCOTT CAIRNS MD PC PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	Yes
2012-01-01	This submission is the final filing	Yes
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: R. SCOTT CAIRNS MD PC PROFIT SHARING PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	Yes
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 – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: R. SCOTT CAIRNS MD PC 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: R. SCOTT CAIRNS MD PC 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

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Company Name:	R. SCOTT CAIRNS, M.D., P.C.
Employer identification number (EIN):	421028283
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)