401k Plan data: W. K. BORGSMILLER, MD, INC. 401K PLAN plan

W. K. BORGSMILLER, MD, INC. 401K PLAN 401k Plan overview

Plan Name	W. K. BORGSMILLER, MD, INC. 401K PLAN
Plan identification number	001

W. K. BORGSMILLER, MD, INC. 401K 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
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.
Participant-directed brokerage accounts provided as an investment option under the plan.
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 K. BORGSMILLER, MD, INC. has sponsored the creation of one or more 401k plans.

Company Name: WILLIAM K. BORGSMILLER, MD, INC.

Employer identification number (EIN): 942626022

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan W. K. BORGSMILLER, MD, INC. 401K PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2012-01-01 MARY BORGSMILLER
001 2011-01-01 MARY BORGSMILLER
001 2010-01-01 MARY BORGSMILLER
001 2009-01-01 MARY BORGSMILLER

Plan id#	Filing Submission Date	Name of Administrator
001	2012-01-01	MARY BORGSMILLER
001	2011-01-01	MARY BORGSMILLER
001	2010-01-01	MARY BORGSMILLER
001	2009-01-01	MARY BORGSMILLER

Plan Statistics for W. K. BORGSMILLER, MD, INC. 401K PLAN

401k plan membership statisitcs for W. K. BORGSMILLER, MD, INC. 401K PLAN

Measure Date Value
2012: W. K. BORGSMILLER, MD, INC. 401K PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 4
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 1
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 1
Total of all active and inactive participants 2012-01-01 2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 2
Number of participants with account balances 2012-01-01 2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: W. K. BORGSMILLER, MD, INC. 401K PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 4
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 4
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 4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 4
Number of participants with account balances 2011-01-01 4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: W. K. BORGSMILLER, MD, INC. 401K PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 4
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 4
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 0
Total of all active and inactive participants 2010-01-01 4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 4
Number of participants with account balances 2010-01-01 4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: W. K. BORGSMILLER, MD, INC. 401K PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 4
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 4
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 4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 4
Number of participants with account balances 2009-01-01 4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2012: W. K. BORGSMILLER, MD, INC. 401K PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	4
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	1
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	1
Total of all active and inactive participants	2012-01-01	2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	2
Number of participants with account balances	2012-01-01	2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: W. K. BORGSMILLER, MD, INC. 401K PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	4
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	4
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	4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	4
Number of participants with account balances	2011-01-01	4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: W. K. BORGSMILLER, MD, INC. 401K PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	4
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	4
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	0
Total of all active and inactive participants	2010-01-01	4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	4
Number of participants with account balances	2010-01-01	4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: W. K. BORGSMILLER, MD, INC. 401K PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	4
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	4
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	4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	4
Number of participants with account balances	2009-01-01	4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on W. K. BORGSMILLER, MD, INC. 401K PLAN

Measure	Date	Value
2012 : W. K. BORGSMILLER, MD, INC. 401K PLAN 2012 401k financial data
Transfers to/from the plan	2012-12-31	$0
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	$66,323
Expenses. Total of all expenses incurred	2012-12-31	$54,293
Benefits paid (including direct rollovers)	2012-12-31	$54,293
Total plan assets at end of year	2012-12-31	$2,108,030
Total plan assets at beginning of year	2012-12-31	$2,096,000
Value of fidelity bond covering the plan	2012-12-31	$195,000
Assets. Value of tangible personal property	2012-12-31	$28,408
Total contributions received or receivable from participants	2012-12-31	$1,941
Expenses. Other expenses not covered elsewhere	2012-12-31	$0
Contributions received from other sources (not participants or employers)	2012-12-31	$0
Other income received	2012-12-31	$63,620
Noncash contributions received	2012-12-31	$0
Net income (gross income less expenses)	2012-12-31	$12,030
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$2,108,030
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$2,096,000
Assets. Value of participant loans	2012-12-31	$23,872
Total contributions received or receivable from employer(s)	2012-12-31	$762
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	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
2011 : W. K. BORGSMILLER, MD, INC. 401K PLAN 2011 401k financial data
Transfers to/from the plan	2011-12-31	$0
Total plan liabilities at end of year	2011-12-31	$0
Total plan liabilities at beginning of year	2011-12-31	$0
Total income from all sources	2011-12-31	$-37,096
Expenses. Total of all expenses incurred	2011-12-31	$0
Benefits paid (including direct rollovers)	2011-12-31	$0
Total plan assets at end of year	2011-12-31	$2,096,000
Total plan assets at beginning of year	2011-12-31	$2,133,096
Value of fidelity bond covering the plan	2011-12-31	$195,000
Assets. Value of tangible personal property	2011-12-31	$28,972
Total contributions received or receivable from participants	2011-12-31	$37,777
Expenses. Other expenses not covered elsewhere	2011-12-31	$0
Contributions received from other sources (not participants or employers)	2011-12-31	$0
Other income received	2011-12-31	$-103,664
Noncash contributions received	2011-12-31	$0
Net income (gross income less expenses)	2011-12-31	$-37,096
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$2,096,000
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$2,133,096
Total contributions received or receivable from employer(s)	2011-12-31	$28,791
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	$0
2010 : W. K. BORGSMILLER, MD, INC. 401K PLAN 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	$61,348
Expenses. Total of all expenses incurred	2010-12-31	$0
Benefits paid (including direct rollovers)	2010-12-31	$0
Total plan assets at end of year	2010-12-31	$2,133,096
Total plan assets at beginning of year	2010-12-31	$2,071,748
Value of fidelity bond covering the plan	2010-12-31	$195,000
Assets. Value of tangible personal property	2010-12-31	$34,138
Total contributions received or receivable from participants	2010-12-31	$38,815
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	$-10,226
Noncash contributions received	2010-12-31	$0
Net income (gross income less expenses)	2010-12-31	$61,348
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$2,133,096
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$2,071,748
Assets. Value of assets in partnership/joint-venture interests	2010-12-31	$7,026
Total contributions received or receivable from employer(s)	2010-12-31	$32,759
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

Form 5500 Responses for W. K. BORGSMILLER, MD, INC. 401K PLAN

2012: W. K. BORGSMILLER, MD, INC. 401K 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: W. K. BORGSMILLER, MD, INC. 401K 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: W. K. BORGSMILLER, MD, INC. 401K 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: W. K. BORGSMILLER, MD, INC. 401K 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:	WILLIAM K. BORGSMILLER, MD, INC.
Employer identification number (EIN):	942626022
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)