401k Plan data: EMPLOYEES PROFIT SHARING PLAN AND TRUST NORTHLAND MID AMERICA ORTHOPAEDIC GROUP, INC plan

EMPLOYEES PROFIT SHARING PLAN AND TRUST NORTHLAND MID AMERICA ORTHOPAEDIC GROUP, INC 401k Plan overview

Plan Name	EMPLOYEES PROFIT SHARING PLAN AND TRUST NORTHLAND MID AMERICA ORTHOPAEDIC GROUP, INC
Plan identification number	001

EMPLOYEES PROFIT SHARING PLAN AND TRUST NORTHLAND MID AMERICA ORTHOPAEDIC GROUP, INC Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
Partial participant-directed account plan - Participants have the opportunity to direct the investment of a portion of 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.

401k Sponsoring company profile

NORTHLAND MID AMERICA ORTHOPAEDIC GROUP, INC has sponsored the creation of one or more 401k plans.

Company Name: NORTHLAND MID AMERICA ORTHOPAEDIC GROUP, INC

Employer identification number (EIN): 430830657

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEES PROFIT SHARING PLAN AND TRUST NORTHLAND MID AMERICA ORTHOPAEDIC GROUP, INC

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2012-01-01 RANDALL D ROUSH MD
001 2011-01-01 RANDALL D ROUSH MD
001 2009-01-01 RANDALL D ROUSH MD

Plan id#	Filing Submission Date	Name of Administrator
001	2012-01-01	RANDALL D ROUSH MD
001	2011-01-01	RANDALL D ROUSH MD
001	2009-01-01	RANDALL D ROUSH MD

Plan Statistics for EMPLOYEES PROFIT SHARING PLAN AND TRUST NORTHLAND MID AMERICA ORTHOPAEDIC GROUP, INC

401k plan membership statisitcs for EMPLOYEES PROFIT SHARING PLAN AND TRUST NORTHLAND MID AMERICA ORTHOPAEDIC GROUP, INC

Measure Date Value
2012: EMPLOYEES PROFIT SHARING PLAN AND TRUST NORTHLAND MID AMERICA ORTHOPAEDIC GROUP, INC 2012 401k membership
Total participants, beginning-of-year 2012-01-01 7
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 0
Total of all active and inactive participants 2012-01-01 0
Total participants 2012-01-01 0
Number of participants with account balances 2012-01-01 0
2011: EMPLOYEES PROFIT SHARING PLAN AND TRUST NORTHLAND MID AMERICA ORTHOPAEDIC GROUP, INC 2011 401k membership
Total participants, beginning-of-year 2011-01-01 43
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 7
Total of all active and inactive participants 2011-01-01 7
Total participants 2011-01-01 7
Number of participants with account balances 2011-01-01 7
2009: EMPLOYEES PROFIT SHARING PLAN AND TRUST NORTHLAND MID AMERICA ORTHOPAEDIC GROUP, INC 2009 401k membership
Total participants, beginning-of-year 2009-01-01 47
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 43
Total of all active and inactive participants 2009-01-01 43
Total participants 2009-01-01 43
Number of participants with account balances 2009-01-01 43

Measure	Date	Value
2012: EMPLOYEES PROFIT SHARING PLAN AND TRUST NORTHLAND MID AMERICA ORTHOPAEDIC GROUP, INC 2012 401k membership
Total participants, beginning-of-year	2012-01-01	7
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	0
Total of all active and inactive participants	2012-01-01	0
Total participants	2012-01-01	0
Number of participants with account balances	2012-01-01	0
2011: EMPLOYEES PROFIT SHARING PLAN AND TRUST NORTHLAND MID AMERICA ORTHOPAEDIC GROUP, INC 2011 401k membership
Total participants, beginning-of-year	2011-01-01	43
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	7
Total of all active and inactive participants	2011-01-01	7
Total participants	2011-01-01	7
Number of participants with account balances	2011-01-01	7
2009: EMPLOYEES PROFIT SHARING PLAN AND TRUST NORTHLAND MID AMERICA ORTHOPAEDIC GROUP, INC 2009 401k membership
Total participants, beginning-of-year	2009-01-01	47
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	43
Total of all active and inactive participants	2009-01-01	43
Total participants	2009-01-01	43
Number of participants with account balances	2009-01-01	43

Financial Data on EMPLOYEES PROFIT SHARING PLAN AND TRUST NORTHLAND MID AMERICA ORTHOPAEDIC GROUP, INC

Measure	Date	Value
2012 : EMPLOYEES PROFIT SHARING PLAN AND TRUST NORTHLAND MID AMERICA ORTHOPAEDIC GROUP, INC 2012 401k financial data
Total income from all sources	2012-12-31	$221,943
Expenses. Total of all expenses incurred	2012-12-31	$5,936,524
Benefits paid (including direct rollovers)	2012-12-31	$5,936,524
Total plan assets at end of year	2012-12-31	$0
Total plan assets at beginning of year	2012-12-31	$5,714,581
Other income received	2012-12-31	$221,943
Net income (gross income less expenses)	2012-12-31	$-5,714,581
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$0
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$5,714,581
2011 : EMPLOYEES PROFIT SHARING PLAN AND TRUST NORTHLAND MID AMERICA ORTHOPAEDIC GROUP, INC 2011 401k financial data
Total income from all sources	2011-12-31	$62,339
Expenses. Total of all expenses incurred	2011-12-31	$2,992,120
Benefits paid (including direct rollovers)	2011-12-31	$2,992,120
Total plan assets at end of year	2011-12-31	$5,714,581
Total plan assets at beginning of year	2011-12-31	$8,644,362
Value of fidelity bond covering the plan	2011-12-31	$1,000,000
Other income received	2011-12-31	$-182,661
Net income (gross income less expenses)	2011-12-31	$-2,929,781
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$5,714,581
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$8,644,362
Total contributions received or receivable from employer(s)	2011-12-31	$245,000
2010 : EMPLOYEES PROFIT SHARING PLAN AND TRUST NORTHLAND MID AMERICA ORTHOPAEDIC GROUP, INC 2010 401k financial data
Total income from all sources	2010-12-31	$1,488,220
Total plan assets at end of year	2010-12-31	$8,644,362
Total plan assets at beginning of year	2010-12-31	$7,156,142
Value of fidelity bond covering the plan	2010-12-31	$1,000,000
Total contributions received or receivable from participants	2010-12-31	$191,687
Other income received	2010-12-31	$975,847
Net income (gross income less expenses)	2010-12-31	$1,488,220
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$8,644,362
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$7,156,142
Total contributions received or receivable from employer(s)	2010-12-31	$320,686

Form 5500 Responses for EMPLOYEES PROFIT SHARING PLAN AND TRUST NORTHLAND MID AMERICA ORTHOPAEDIC GROUP, INC

2012: EMPLOYEES PROFIT SHARING PLAN AND TRUST NORTHLAND MID AMERICA ORTHOPAEDIC GROUP, INC 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	This submission is the final filing	Yes
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: EMPLOYEES PROFIT SHARING PLAN AND TRUST NORTHLAND MID AMERICA ORTHOPAEDIC GROUP, INC 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
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
2009: EMPLOYEES PROFIT SHARING PLAN AND TRUST NORTHLAND MID AMERICA ORTHOPAEDIC GROUP, INC 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	This submission is the final filing	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:	NORTHLAND MID AMERICA ORTHOPAEDIC GROUP, INC
Employer identification number (EIN):	430830657
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)