401k Plan data: WILLIAM J BLAHA MD INC 401K PROFIT SHARING PLAN plan

WILLIAM J BLAHA MD INC 401K PROFIT SHARING PLAN 401k Plan overview

Plan Name	WILLIAM J BLAHA MD INC 401K PROFIT SHARING PLAN
Plan identification number	001

WILLIAM J BLAHA MD INC 401K PROFIT SHARING PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Offset plan - Plan benefits are subject to offset for retirement benefits provided in another plan or arrangement of the employer.
Profit-sharing
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

WILLIAM J BLAHA MD INC has sponsored the creation of one or more 401k plans.

Company Name: WILLIAM J BLAHA MD INC

Employer identification number (EIN): 680034641

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

Additional information about WILLIAM J BLAHA MD INC

Jurisdiction of Incorporation: California Department of State

Incorporation Date:

Company Identification Number: C1259919

More information about WILLIAM J BLAHA MD INC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WILLIAM J BLAHA MD INC 401K PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2013-01-01
001 2012-01-01 WILLIAM J BLAHA WILLIAM J BLAHA 2013-05-08
001 2011-01-01 PENSION FILERS
001 2009-01-01 ASSOCIATED PENSION CONSULTANTS
001 2008-01-01

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2013-01-01
001	2012-01-01	WILLIAM J BLAHA	WILLIAM J BLAHA	2013-05-08
001	2011-01-01	PENSION FILERS
001	2009-01-01	ASSOCIATED PENSION CONSULTANTS
001	2008-01-01

Plan Statistics for WILLIAM J BLAHA MD INC 401K PROFIT SHARING PLAN

401k plan membership statisitcs for WILLIAM J BLAHA MD INC 401K PROFIT SHARING PLAN

Measure Date Value
2013: WILLIAM J BLAHA MD INC 401K PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 3
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 0
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 0
Total of all active and inactive participants 2013-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 0
Number of participants with account balances 2013-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: WILLIAM J BLAHA MD INC 401K PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 3
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 3
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 3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 3
Number of participants with account balances 2012-01-01 3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: WILLIAM J BLAHA MD INC 401K PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 3
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 3
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 0
Total of all active and inactive participants 2011-01-01 3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 3
Number of participants with account balances 2011-01-01 3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: WILLIAM J BLAHA MD INC 401K PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 3
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 3
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 3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 3
Number of participants with account balances 2009-01-01 3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2013: WILLIAM J BLAHA MD INC 401K PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	3
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	0
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	0
Total of all active and inactive participants	2013-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	0
Number of participants with account balances	2013-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: WILLIAM J BLAHA MD INC 401K PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	3
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	3
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	3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	3
Number of participants with account balances	2012-01-01	3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: WILLIAM J BLAHA MD INC 401K PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	3
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	3
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	0
Total of all active and inactive participants	2011-01-01	3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	3
Number of participants with account balances	2011-01-01	3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: WILLIAM J BLAHA MD INC 401K PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	3
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	3
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	3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	3
Number of participants with account balances	2009-01-01	3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on WILLIAM J BLAHA MD INC 401K PROFIT SHARING PLAN

Measure	Date	Value
2013 : WILLIAM J BLAHA MD INC 401K PROFIT SHARING PLAN 2013 401k financial data
Total plan liabilities at end of year	2013-10-02	$0
Total plan liabilities at beginning of year	2013-10-02	$0
Total income from all sources	2013-10-02	$25,685
Expenses. Total of all expenses incurred	2013-10-02	$1,051,325
Benefits paid (including direct rollovers)	2013-10-02	$1,041,158
Total plan assets at end of year	2013-10-02	$0
Total plan assets at beginning of year	2013-10-02	$1,025,640
Value of fidelity bond covering the plan	2013-10-02	$100,000
Other income received	2013-10-02	$24,342
Net income (gross income less expenses)	2013-10-02	$-1,025,640
Net plan assets at end of year (total assets less liabilities)	2013-10-02	$0
Net plan assets at beginning of year (total assets less liabilities)	2013-10-02	$1,025,640
Assets. Value of participant loans	2013-10-02	$0
Assets. Value of real-estate (other than employer real property)	2013-10-02	$0
Total contributions received or receivable from employer(s)	2013-10-02	$1,343
Expenses. Administrative service providers (salaries,fees and commissions)	2013-10-02	$10,167
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-10-02	$0
2012 : WILLIAM J BLAHA MD INC 401K PROFIT SHARING PLAN 2012 401k financial data
Total plan liabilities at end of year	2012-12-31	$0
Total plan liabilities at beginning of year	2012-12-31	$0
Total income from all sources	2012-12-31	$87,185
Expenses. Total of all expenses incurred	2012-12-31	$13,640
Total plan assets at end of year	2012-12-31	$1,025,640
Total plan assets at beginning of year	2012-12-31	$952,095
Value of fidelity bond covering the plan	2012-12-31	$100,000
Total contributions received or receivable from participants	2012-12-31	$22,500
Expenses. Other expenses not covered elsewhere	2012-12-31	$1,305
Other income received	2012-12-31	$55,685
Net income (gross income less expenses)	2012-12-31	$73,545
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$1,025,640
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$952,095
Assets. Value of participant loans	2012-12-31	$888
Assets. Value of real-estate (other than employer real property)	2012-12-31	$48,900
Total contributions received or receivable from employer(s)	2012-12-31	$9,000
Expenses. Administrative service providers (salaries,fees and commissions)	2012-12-31	$12,335
2011 : WILLIAM J BLAHA MD INC 401K PROFIT SHARING PLAN 2011 401k financial data
Total plan liabilities at beginning of year	2011-12-31	$0
Total income from all sources	2011-12-31	$23,563
Expenses. Total of all expenses incurred	2011-12-31	$11,458
Total plan assets at end of year	2011-12-31	$952,095
Total plan assets at beginning of year	2011-12-31	$939,990
Value of fidelity bond covering the plan	2011-12-31	$100,000
Total contributions received or receivable from participants	2011-12-31	$22,000
Expenses. Other expenses not covered elsewhere	2011-12-31	$460
Other income received	2011-12-31	$-16,337
Net income (gross income less expenses)	2011-12-31	$12,105
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$952,095
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$939,990
Assets. Value of participant loans	2011-12-31	$7,913
Assets. Value of real-estate (other than employer real property)	2011-12-31	$53,500
Total contributions received or receivable from employer(s)	2011-12-31	$17,900
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$10,998
2010 : WILLIAM J BLAHA MD INC 401K PROFIT SHARING PLAN 2010 401k financial data
Total plan liabilities at end of year	2010-12-31	$0
Total plan liabilities at beginning of year	2010-12-31	$0
Total income from all sources	2010-12-31	$80,651
Expenses. Total of all expenses incurred	2010-12-31	$10,961
Total plan assets at end of year	2010-12-31	$939,990
Total plan assets at beginning of year	2010-12-31	$870,300
Value of fidelity bond covering the plan	2010-12-31	$100,000
Total contributions received or receivable from participants	2010-12-31	$20,500
Expenses. Other expenses not covered elsewhere	2010-12-31	$1,217
Other income received	2010-12-31	$42,251
Net income (gross income less expenses)	2010-12-31	$69,690
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$939,990
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$870,300
Assets. Value of participant loans	2010-12-31	$14,367
Assets. Value of real-estate (other than employer real property)	2010-12-31	$52,500
Total contributions received or receivable from employer(s)	2010-12-31	$17,900
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$9,744

Form 5500 Responses for WILLIAM J BLAHA MD INC 401K PROFIT SHARING PLAN

2013: WILLIAM J BLAHA MD INC 401K PROFIT SHARING PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	Yes
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2013-01-01	Plan is a collectively bargained plan	No
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: WILLIAM J BLAHA MD INC 401K 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 – 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: WILLIAM J BLAHA MD INC 401K 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 – 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: WILLIAM J BLAHA MD INC 401K 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
2008: WILLIAM J BLAHA MD INC 401K PROFIT SHARING PLAN 2008 form 5500 responses
2008-01-01	Type of plan entity	Single employer plan
2008-01-01	Submission has been amended	Yes
2008-01-01	This submission is the final filing	No
2008-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2008-01-01	Plan is a collectively bargained plan	No

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Company Name:	WILLIAM J BLAHA MD INC
Employer identification number (EIN):	680034641
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)

Jurisdiction of Incorporation:	California Department of State
Incorporation Date:
Company Identification Number:	C1259919