401k Plan data: LASER & DERMATOLOGIC SURGERY CENTER, INC. 401K PROFIT SHARING PLAN plan

LASER & DERMATOLOGIC SURGERY CENTER, INC. 401K PROFIT SHARING PLAN 401k Plan overview

Plan Name	LASER & DERMATOLOGIC SURGERY CENTER, INC. 401K PROFIT SHARING PLAN
Plan identification number	004

LASER & DERMATOLOGIC SURGERY CENTER, INC. 401K 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.
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.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

LASER & DERMATOLOGIC SURGERY CENTER, INC. has sponsored the creation of one or more 401k plans.

Company Name: LASER & DERMATOLOGIC SURGERY CENTER, INC.

Employer identification number (EIN): 431842885

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LASER & DERMATOLOGIC SURGERY CENTER, INC. 401K PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
004 2016-01-01 GEORGE HRUZA 2017-04-25
004 2015-01-01 GEORGE HRUZA 2016-05-09
004 2014-01-01 GEORGE HRUZA 2015-07-28
004 2013-01-01 GEORGE HRUZA 2014-07-01
004 2012-01-01 GEORGE HRUZA 2013-07-15
004 2011-01-01 GEORGE HRUZA 2012-05-27
004 2010-01-01 GEORGE HRUZA 2011-10-12

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
004	2016-01-01	GEORGE HRUZA	2017-04-25
004	2015-01-01	GEORGE HRUZA	2016-05-09
004	2014-01-01	GEORGE HRUZA	2015-07-28
004	2013-01-01	GEORGE HRUZA	2014-07-01
004	2012-01-01	GEORGE HRUZA	2013-07-15
004	2011-01-01	GEORGE HRUZA	2012-05-27
004	2010-01-01	GEORGE HRUZA	2011-10-12

Financial Data on LASER & DERMATOLOGIC SURGERY CENTER, INC. 401K PROFIT SHARING PLAN

Measure	Date	Value
2008 : LASER & DERMATOLOGIC SURGERY CENTER, INC. 401K PROFIT SHARING PLAN 2008 401k financial data
Total income from all sources	2008-12-31	$641,304
Expenses. Total of all expenses incurred	2008-12-31	$14,082
Benefits paid (including direct rollovers)	2008-12-31	$14,082
Total plan assets at end of year	2008-12-31	$1,125,110
Total plan assets at beginning of year	2008-12-31	$497,888
Value of fidelity bond covering the plan	2008-12-31	$15,000
Total contributions received or receivable from participants	2008-12-31	$50,691
Contributions received from other sources (not participants or employers)	2008-12-31	$742,705
Other income received	2008-12-31	$-194,812
Net income (gross income less expenses)	2008-12-31	$627,222
Net plan assets at end of year (total assets less liabilities)	2008-12-31	$1,125,110
Net plan assets at beginning of year (total assets less liabilities)	2008-12-31	$497,888
Assets. Value of participant loans	2008-12-31	$30,915
Total contributions received or receivable from employer(s)	2008-12-31	$42,720

Insurance Providers Used on plan

ING LIFE INSRUANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

F6XD

Policy instance

Insurance contract or identification number	F6XD
Number of Individuals Covered	11
Insurance policy start date	2008-01-01
Insurance policy end date	2008-12-31
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	Yes
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Insurance broker organization code?	3
Insurance broker name	JANET L. HEITZIG

Potentially related plans

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Company Name:	LASER & DERMATOLOGIC SURGERY CENTER, INC.
Employer identification number (EIN):	431842885
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)