401k Plan data: THE SAVANNAH PEDIATRICS, P.C. 401(K) PROFIT SHARING PLAN plan

THE SAVANNAH PEDIATRICS, P.C. 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan Name	THE SAVANNAH PEDIATRICS, P.C. 401(K) PROFIT SHARING PLAN
Plan identification number	002

THE SAVANNAH PEDIATRICS, P.C. 401(K) 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.
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

THE SAVANNAH PEDIATRICS, P.C. has sponsored the creation of one or more 401k plans.

Company Name: THE SAVANNAH PEDIATRICS, P.C.

Employer identification number (EIN): 581108800

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE SAVANNAH PEDIATRICS, P.C. 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2020-01-01 KRISTINA ADAMS 2020-11-12
002 2019-01-01 KRISTINA ADAMS 2020-10-15
002 2018-01-01 KRISTINA ADAMS 2019-10-07
002 2017-01-01 KRISTINA ADAMS 2018-09-18
002 2016-01-01 KRISTINA ADAMS 2017-10-09
002 2015-01-01 KRISTINA ADAMS 2016-09-26
002 2014-01-01 KRISTINA ADAMS 2015-10-07
002 2013-01-01 KRISTINA ADAMS 2014-09-25
002 2012-01-01 KRISTINA M. ADAMS KRISTINA M. ADAMS 2013-09-11
002 2011-01-01 KRISTINA M. ADAMS
002 2010-01-01 KRISTINA M. ADAMS
002 2009-01-01 KRISTINA ADAMS

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2020-01-01	KRISTINA ADAMS	2020-11-12
002	2019-01-01	KRISTINA ADAMS	2020-10-15
002	2018-01-01	KRISTINA ADAMS	2019-10-07
002	2017-01-01	KRISTINA ADAMS	2018-09-18
002	2016-01-01	KRISTINA ADAMS	2017-10-09
002	2015-01-01	KRISTINA ADAMS	2016-09-26
002	2014-01-01	KRISTINA ADAMS	2015-10-07
002	2013-01-01	KRISTINA ADAMS	2014-09-25
002	2012-01-01	KRISTINA M. ADAMS		KRISTINA M. ADAMS	2013-09-11
002	2011-01-01	KRISTINA M. ADAMS
002	2010-01-01	KRISTINA M. ADAMS
002	2009-01-01	KRISTINA ADAMS

Plan Statistics for THE SAVANNAH PEDIATRICS, P.C. 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for THE SAVANNAH PEDIATRICS, P.C. 401(K) PROFIT SHARING PLAN

Measure Date Value
2012: THE SAVANNAH PEDIATRICS, P.C. 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 31
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 17
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 12
Total of all active and inactive participants 2012-01-01 29
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 29
Number of participants with account balances 2012-01-01 29
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 3
2011: THE SAVANNAH PEDIATRICS, P.C. 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 28
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 23
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 8
Total of all active and inactive participants 2011-01-01 31
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 31
Number of participants with account balances 2011-01-01 29
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 1
2010: THE SAVANNAH PEDIATRICS, P.C. 401(K) PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 28
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 21
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 7
Total of all active and inactive participants 2010-01-01 28
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 28
Number of participants with account balances 2010-01-01 26
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: THE SAVANNAH PEDIATRICS, P.C. 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 40
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 22
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 6
Total of all active and inactive participants 2009-01-01 28
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 28
Number of participants with account balances 2009-01-01 23
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 1

Measure	Date	Value
2012: THE SAVANNAH PEDIATRICS, P.C. 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	31
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	17
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	12
Total of all active and inactive participants	2012-01-01	29
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	29
Number of participants with account balances	2012-01-01	29
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	3
2011: THE SAVANNAH PEDIATRICS, P.C. 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	28
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	23
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	8
Total of all active and inactive participants	2011-01-01	31
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	31
Number of participants with account balances	2011-01-01	29
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	1
2010: THE SAVANNAH PEDIATRICS, P.C. 401(K) PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	28
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	21
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	7
Total of all active and inactive participants	2010-01-01	28
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	28
Number of participants with account balances	2010-01-01	26
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: THE SAVANNAH PEDIATRICS, P.C. 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	40
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	22
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	6
Total of all active and inactive participants	2009-01-01	28
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	28
Number of participants with account balances	2009-01-01	23
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	1

Financial Data on THE SAVANNAH PEDIATRICS, P.C. 401(K) PROFIT SHARING PLAN

Measure	Date	Value
2012 : THE SAVANNAH PEDIATRICS, P.C. 401(K) PROFIT SHARING PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$221,369
Expenses. Total of all expenses incurred	2012-12-31	$936,251
Benefits paid (including direct rollovers)	2012-12-31	$934,597
Total plan assets at end of year	2012-12-31	$1,064,258
Total plan assets at beginning of year	2012-12-31	$1,779,140
Value of fidelity bond covering the plan	2012-12-31	$100,000
Total contributions received or receivable from participants	2012-12-31	$37,485
Contributions received from other sources (not participants or employers)	2012-12-31	$0
Other income received	2012-12-31	$150,683
Net income (gross income less expenses)	2012-12-31	$-714,882
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$1,064,258
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$1,779,140
Total contributions received or receivable from employer(s)	2012-12-31	$33,201
Value of certain deemed distributions of participant loans	2012-12-31	$0
Value of corrective distributions	2012-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2012-12-31	$1,654
2011 : THE SAVANNAH PEDIATRICS, P.C. 401(K) PROFIT SHARING PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$96,530
Expenses. Total of all expenses incurred	2011-12-31	$79,477
Benefits paid (including direct rollovers)	2011-12-31	$78,008
Total plan assets at end of year	2011-12-31	$1,779,140
Total plan assets at beginning of year	2011-12-31	$1,762,087
Value of fidelity bond covering the plan	2011-12-31	$100,000
Total contributions received or receivable from participants	2011-12-31	$43,843
Contributions received from other sources (not participants or employers)	2011-12-31	$0
Other income received	2011-12-31	$14,060
Net income (gross income less expenses)	2011-12-31	$17,053
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$1,779,140
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$1,762,087
Total contributions received or receivable from employer(s)	2011-12-31	$38,627
Value of certain deemed distributions of participant loans	2011-12-31	$0
Value of corrective distributions	2011-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$1,469
2010 : THE SAVANNAH PEDIATRICS, P.C. 401(K) PROFIT SHARING PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$263,481
Expenses. Total of all expenses incurred	2010-12-31	$58,800
Benefits paid (including direct rollovers)	2010-12-31	$57,154
Total plan assets at end of year	2010-12-31	$1,762,087
Total plan assets at beginning of year	2010-12-31	$1,557,406
Value of fidelity bond covering the plan	2010-12-31	$100,000
Total contributions received or receivable from participants	2010-12-31	$55,796
Contributions received from other sources (not participants or employers)	2010-12-31	$0
Other income received	2010-12-31	$172,281
Net income (gross income less expenses)	2010-12-31	$204,681
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$1,762,087
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$1,557,406
Total contributions received or receivable from employer(s)	2010-12-31	$35,404
Value of certain deemed distributions of participant loans	2010-12-31	$0
Value of corrective distributions	2010-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$1,646

Form 5500 Responses for THE SAVANNAH PEDIATRICS, P.C. 401(K) PROFIT SHARING PLAN

2012: THE SAVANNAH PEDIATRICS, P.C. 401(K) PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: THE SAVANNAH PEDIATRICS, P.C. 401(K) PROFIT SHARING PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
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 – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: THE SAVANNAH PEDIATRICS, P.C. 401(K) 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 – Trust	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: THE SAVANNAH PEDIATRICS, P.C. 401(K) 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 – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	THE SAVANNAH PEDIATRICS, P.C.
Employer identification number (EIN):	581108800
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)