401k Plan data: JOHN E GOFF MD PC PROFIT SHARING PLAN plan

JOHN E GOFF MD PC PROFIT SHARING PLAN 401k Plan overview

Plan Name	JOHN E GOFF MD PC PROFIT SHARING PLAN
Plan identification number	001

JOHN E GOFF MD PC PROFIT SHARING PLAN Benefits

401k Plan Type	Defined Contribution Pension
Plan Features/Benefits	Profit-sharing Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

JOHN E GOFF MD PC has sponsored the creation of one or more 401k plans.

Company Name: JOHN E GOFF MD PC

Employer identification number (EIN): 431179422

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan JOHN E GOFF MD PC PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2015-01-01 JOHN E GOFF MD JOHN E GOFF MD 2016-05-27
001 2014-01-01 JOHN E GOFF MD JOHN E GOFF MD 2015-09-15
001 2013-01-01 JOHN E GOFF MD JOHN E GOFF MD 2014-06-04
001 2012-01-01 JOHN E GOFF MD JOHN E GOFF MD 2013-08-01

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2015-01-01	JOHN E GOFF MD	JOHN E GOFF MD	2016-05-27
001	2014-01-01	JOHN E GOFF MD	JOHN E GOFF MD	2015-09-15
001	2013-01-01	JOHN E GOFF MD	JOHN E GOFF MD	2014-06-04
001	2012-01-01	JOHN E GOFF MD	JOHN E GOFF MD	2013-08-01

Plan Statistics for JOHN E GOFF MD PC PROFIT SHARING PLAN

401k plan membership statisitcs for JOHN E GOFF MD PC PROFIT SHARING PLAN

Measure Date Value
2015: JOHN E GOFF MD PC PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 7
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 6
Number of retired or separated participants receiving benefits 2015-01-01 1
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 7
Number of participants with account balances 2015-01-01 6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: JOHN E GOFF MD PC PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 7
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 7
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 0
Total of all active and inactive participants 2014-01-01 7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 7
Number of participants with account balances 2014-01-01 7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: JOHN E GOFF MD PC PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 7
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 7
Total of all active and inactive participants 2013-01-01 7
Total participants 2013-01-01 7
Number of participants with account balances 2013-01-01 7
2012: JOHN E GOFF MD PC PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 6
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 7
Total of all active and inactive participants 2012-01-01 7
Total participants 2012-01-01 7
Number of participants with account balances 2012-01-01 6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 1

Measure	Date	Value
2015: JOHN E GOFF MD PC PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	7
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	6
Number of retired or separated participants receiving benefits	2015-01-01	1
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	7
Number of participants with account balances	2015-01-01	6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: JOHN E GOFF MD PC PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	7
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	7
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	0
Total of all active and inactive participants	2014-01-01	7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	7
Number of participants with account balances	2014-01-01	7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: JOHN E GOFF MD PC PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	7
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	7
Total of all active and inactive participants	2013-01-01	7
Total participants	2013-01-01	7
Number of participants with account balances	2013-01-01	7
2012: JOHN E GOFF MD PC PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	6
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	7
Total of all active and inactive participants	2012-01-01	7
Total participants	2012-01-01	7
Number of participants with account balances	2012-01-01	6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	1

Financial Data on JOHN E GOFF MD PC PROFIT SHARING PLAN

Measure	Date	Value
2015 : JOHN E GOFF MD PC PROFIT SHARING PLAN 2015 401k financial data
Total plan liabilities at end of year	2015-12-31	$100
Total plan liabilities at beginning of year	2015-12-31	$100
Total income from all sources	2015-12-31	$-71,405
Expenses. Total of all expenses incurred	2015-12-31	$1,054
Benefits paid (including direct rollovers)	2015-12-31	$884
Total plan assets at end of year	2015-12-31	$2,331,221
Total plan assets at beginning of year	2015-12-31	$2,403,680
Value of fidelity bond covering the plan	2015-12-31	$250,000
Other income received	2015-12-31	$-71,405
Net income (gross income less expenses)	2015-12-31	$-72,459
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$2,331,121
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$2,403,580
Expenses. Administrative service providers (salaries,fees and commissions)	2015-12-31	$170
2014 : JOHN E GOFF MD PC PROFIT SHARING PLAN 2014 401k financial data
Total plan liabilities at end of year	2014-12-31	$100
Total plan liabilities at beginning of year	2014-12-31	$100
Total income from all sources	2014-12-31	$275,628
Expenses. Total of all expenses incurred	2014-12-31	$227
Total plan assets at end of year	2014-12-31	$2,403,680
Total plan assets at beginning of year	2014-12-31	$2,128,279
Value of fidelity bond covering the plan	2014-12-31	$250,000
Other income received	2014-12-31	$225,628
Net income (gross income less expenses)	2014-12-31	$275,401
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$2,403,580
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$2,128,179
Total contributions received or receivable from employer(s)	2014-12-31	$50,000
Expenses. Administrative service providers (salaries,fees and commissions)	2014-12-31	$227
2013 : JOHN E GOFF MD PC PROFIT SHARING PLAN 2013 401k financial data
Total plan liabilities at end of year	2013-12-31	$100
Total plan liabilities at beginning of year	2013-12-31	$100
Total income from all sources	2013-12-31	$419,702
Expenses. Total of all expenses incurred	2013-12-31	$350
Total plan assets at end of year	2013-12-31	$2,128,079
Total plan assets at beginning of year	2013-12-31	$1,708,727
Value of fidelity bond covering the plan	2013-12-31	$155,000
Other income received	2013-12-31	$369,702
Net income (gross income less expenses)	2013-12-31	$419,352
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$2,127,979
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$1,708,627
Total contributions received or receivable from employer(s)	2013-12-31	$50,000
Expenses. Administrative service providers (salaries,fees and commissions)	2013-12-31	$350
2012 : JOHN E GOFF MD PC PROFIT SHARING PLAN 2012 401k financial data
Total plan liabilities at end of year	2012-12-31	$100
Total income from all sources	2012-12-31	$205,294
Expenses. Total of all expenses incurred	2012-12-31	$9,274
Benefits paid (including direct rollovers)	2012-12-31	$8,908
Total plan assets at end of year	2012-12-31	$1,708,727
Total plan assets at beginning of year	2012-12-31	$1,512,607
Value of fidelity bond covering the plan	2012-12-31	$195,000
Other income received	2012-12-31	$133,675
Net income (gross income less expenses)	2012-12-31	$196,020
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$1,708,627
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$1,512,607
Total contributions received or receivable from employer(s)	2012-12-31	$71,619
Expenses. Administrative service providers (salaries,fees and commissions)	2012-12-31	$366

Form 5500 Responses for JOHN E GOFF MD PC PROFIT SHARING PLAN

2015: JOHN E GOFF MD PC PROFIT SHARING PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: JOHN E GOFF MD PC PROFIT SHARING PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
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: JOHN E GOFF MD PC PROFIT SHARING PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: JOHN E GOFF MD PC PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
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

Insurance Providers Used on plan

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 79065 )

Policy contract number

078000086254

Policy instance

Insurance contract or identification number	078000086254
Number of Individuals Covered	1
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Insurance broker name	BERSTEIN/WHEELER

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 79065 )

Policy contract number

078000086254

Policy instance

Insurance contract or identification number	078000086254
Number of Individuals Covered	1
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Insurance broker name	BERSTEIN/WHEELER

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 79065 )

Policy contract number

078000086254

Policy instance

Insurance contract or identification number	078000086254
Number of Individuals Covered	1
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Insurance broker name	CONSTANCE BERSTEIN

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 79065 )

Policy contract number

078000086254

Policy instance

Insurance contract or identification number	078000086254
Number of Individuals Covered	1
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $3,138
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,138
Insurance broker name	CONSTANCE BERSTEIN

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Company Name:	JOHN E GOFF MD PC
Employer identification number (EIN):	431179422
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)