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| Plan Name | EYE CLINIC OF AUSTIN 401(K) PSP |
| Plan identification number | 001 |
| 401k Plan Type | Defined Contribution Pension |
| Plan Features/Benefits |
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| Company Name: | THOMAS HENDERSON M.D., P.A. DBA EYE CLINIC OF AUSTIN |
| Employer identification number (EIN): | 742586972 |
| NAIC Classification: | 621111 |
| NAIC Description: | Offices of Physicians (except Mental Health Specialists) |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 001 | 2018-01-01 | JANICE HENDERSON | 2018-07-13 | ||
| 001 | 2017-01-01 | JANICE HENDERSON | 2018-04-25 | ||
| 001 | 2016-01-01 | JANICE HENDERSON | 2017-04-26 | ||
| 001 | 2015-01-01 | NATASHA PETITT | 2017-02-08 | ||
| 001 | 2015-01-01 | NATASHA PETITT | 2016-05-10 | ||
| 001 | 2014-01-01 | KRIS PELKY | 2015-06-09 | ||
| 001 | 2013-01-01 | CINDY VANOVER | 2014-04-08 | ||
| 001 | 2012-01-01 | CINDY VANOVER | 2013-02-15 | ||
| 001 | 2011-01-01 | THOMAS HENDERSON M.D. | 2012-06-07 | ||
| 001 | 2009-01-01 | CHERYL MCCLAIN |
| Measure | Date | Value |
|---|---|---|
| 2009: EYE CLINIC OF AUSTIN 401(K) PSP 2009 401k membership | ||
| Total participants, beginning-of-year | 2009-01-01 | 13 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 13 |
| 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 | 4 |
| Total of all active and inactive participants | 2009-01-01 | 17 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2009-01-01 | 0 |
| Total participants | 2009-01-01 | 17 |
| Number of participants with account balances | 2009-01-01 | 17 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2009-01-01 | 0 |
| Measure | Date | Value |
|---|---|---|
| 2010 : EYE CLINIC OF AUSTIN 401(K) PSP 2010 401k financial data | ||
| Transfers to/from the plan | 2010-12-31 | $0 |
| 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 | $102,889 |
| Expenses. Total of all expenses incurred | 2010-12-31 | $805 |
| Benefits paid (including direct rollovers) | 2010-12-31 | $805 |
| Total plan assets at end of year | 2010-12-31 | $225,290 |
| Total plan assets at beginning of year | 2010-12-31 | $123,206 |
| Value of fidelity bond covering the plan | 2010-12-31 | $200,000 |
| Total contributions received or receivable from participants | 2010-12-31 | $59,760 |
| Expenses. Other expenses not covered elsewhere | 2010-12-31 | $0 |
| Contributions received from other sources (not participants or employers) | 2010-12-31 | $0 |
| Other income received | 2010-12-31 | $20,711 |
| Noncash contributions received | 2010-12-31 | $0 |
| Net income (gross income less expenses) | 2010-12-31 | $102,084 |
| Net plan assets at end of year (total assets less liabilities) | 2010-12-31 | $225,290 |
| Net plan assets at beginning of year (total assets less liabilities) | 2010-12-31 | $123,206 |
| Total contributions received or receivable from employer(s) | 2010-12-31 | $22,418 |
| 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 | $0 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2010-12-31 | $0 |
| 2009 : EYE CLINIC OF AUSTIN 401(K) PSP 2009 401k financial data | ||
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2009-12-31 | $0 |
| 2009: EYE CLINIC OF AUSTIN 401(K) PSP 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 |
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 95364 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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