401k Plan data: MARK F. FARMUM, MD, A PROFESSIONAL CORPORATION CASH BALANCE PLAN plan

MARK F. FARMUM, MD, A PROFESSIONAL CORPORATION CASH BALANCE PLAN 401k Plan overview

Plan Name	MARK F. FARMUM, MD, A PROFESSIONAL CORPORATION CASH BALANCE PLAN
Plan identification number	003

MARK F. FARMUM, MD, A PROFESSIONAL CORPORATION CASH BALANCE PLAN Benefits

401k Plan Type

Defined Benefit Pension

Plan Features/Benefits

Benefits are primarily pay related
Benefits are primarily flat dollar (includes dollars per year of service)
Cash balance or similar plan - Plan has a "cash balance" formula. For this purpose, a "cash balance" formula is a benefit formula in a defined benefit plan by whatever name (for example, personal account plan, pension equity plan, life cycle plan, cash account plan, etc.) that rather than, or in addition to, expressing the accrued benefit as a life annuity commencing at normal retirement age, defines benefits for each employee in terms more common to a defined contribution plan such as a single sum distribution amount (for example, 10 percent of final average pay times years of service, or the amount of the employee's hypothetical account balance).

401k Sponsoring company profile

MARK FARNUM, MD., APC has sponsored the creation of one or more 401k plans.

Company Name: MARK FARNUM, MD., APC

Employer identification number (EIN): 953871400

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MARK F. FARMUM, MD, A PROFESSIONAL CORPORATION CASH BALANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
003 2019-02-01
003 2018-02-01
003 2017-02-01
003 2016-02-01
003 2015-02-01

Plan Statistics for MARK F. FARMUM, MD, A PROFESSIONAL CORPORATION CASH BALANCE PLAN

401k plan membership statisitcs for MARK F. FARMUM, MD, A PROFESSIONAL CORPORATION CASH BALANCE PLAN

Measure Date Value
2019: MARK F. FARMUM, MD, A PROFESSIONAL CORPORATION CASH BALANCE PLAN 2019 401k membership
Market value of plan assets 2019-05-10 1,032,200
Acturial value of plan assets 2019-05-10 1,032,200
Funding target for retired participants and beneficiaries receiving payment 2019-05-10 0
Number of terminated vested participants 2019-05-10 0
Fundng target for terminated vested participants 2019-05-10 0
Active participant vested funding target 2019-05-10 1,034,717
Number of active participants 2019-05-10 4
Total funding liabilities for active participants 2019-05-10 1,034,717
Total participant count 2019-05-10 4
Total funding target for all participants 2019-05-10 1,034,717
Balance at beginning of prior year after applicable adjustments 2019-05-10 0
Prefunding balance at beginning of prior year after applicable adjustments 2019-05-10 0
Carryover balanced portion elected for use to offset prior years funding requirement 2019-05-10 0
Prefunding balanced used to offset prior years funding requirement 2019-05-10 0
Amount remaining of carryover balance 2019-05-10 0
Amount remaining of prefunding balance 2019-05-10 0
Present value of excess contributions 2019-05-10 271
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance 2019-05-10 271
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance 2019-05-10 0
Reductions in caryover balances due to elections or deemed elections 2019-05-10 0
Reductions in prefunding balances due to elections or deemed elections 2019-05-10 0
Balance of carryovers at beginning of current year 2019-05-10 0
Balance of prefunding at beginning of current year 2019-05-10 0
Total employer contributions 2019-05-10 53
Total employee contributions 2019-05-10 0
Contributions allocated toward unpaid minimum require contributions from prior years 2019-05-10 0
Contributions made to avoid restrictions adjusted to valuation date 2019-05-10 0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date 2019-05-10 53
Unpaid minimum required contributions for all prior years 2019-05-10 0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years 2019-05-10 0
Remaining amount of unpaid minimum required contributions 2019-05-10 0
Minimum required contributions for current year target normal cost 2019-05-10 0
Net shortfall amortization installment of oustanding balance 2019-05-10 2,517
Waiver amortization installment 2019-05-10 0
Total funding amount beforereflecting carryover/prefunding balances 2019-05-10 49
Carryover balance elected to use to offset funding requirement 2019-05-10 0
Prefunding balance elected to use to offset funding requirement 2019-05-10 0
Additional cash requirement 2019-05-10 49
Contributions allocatedtoward minimum required contributions for current year 2019-05-10 53
Unpaid minimum required contributions for current year 2019-05-10 0
Unpaid minimum required contributions for all years 2019-05-10 0
Market value of plan assets 2019-01-31 860,566
Acturial value of plan assets 2019-01-31 860,566
Funding target for retired participants and beneficiaries receiving payment 2019-01-31 0
Number of terminated vested participants 2019-01-31 0
Fundng target for terminated vested participants 2019-01-31 0
Active participant vested funding target 2019-01-31 783,809
Number of active participants 2019-01-31 4
Total funding liabilities for active participants 2019-01-31 783,809
Total participant count 2019-01-31 4
Total funding target for all participants 2019-01-31 783,809
Balance at beginning of prior year after applicable adjustments 2019-01-31 0
Prefunding balance at beginning of prior year after applicable adjustments 2019-01-31 0
Carryover balanced portion elected for use to offset prior years funding requirement 2019-01-31 0
Prefunding balanced used to offset prior years funding requirement 2019-01-31 0
Amount remaining of carryover balance 2019-01-31 0
Amount remaining of prefunding balance 2019-01-31 0
Present value of excess contributions 2019-01-31 350,586
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance 2019-01-31 350,586
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance 2019-01-31 0
Reductions in caryover balances due to elections or deemed elections 2019-01-31 0
Reductions in prefunding balances due to elections or deemed elections 2019-01-31 0
Balance of carryovers at beginning of current year 2019-01-31 0
Balance of prefunding at beginning of current year 2019-01-31 0
Total employer contributions 2019-01-31 171,815
Total employee contributions 2019-01-31 0
Contributions allocated toward unpaid minimum require contributions from prior years 2019-01-31 0
Contributions made to avoid restrictions adjusted to valuation date 2019-01-31 0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date 2019-01-31 171,634
Unpaid minimum required contributions for all prior years 2019-01-31 0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years 2019-01-31 0
Remaining amount of unpaid minimum required contributions 2019-01-31 0
Minimum required contributions for current year target normal cost 2019-01-31 248,120
Net shortfall amortization installment of oustanding balance 2019-01-31 0
Waiver amortization installment 2019-01-31 0
Total funding amount beforereflecting carryover/prefunding balances 2019-01-31 171,363
Carryover balance elected to use to offset funding requirement 2019-01-31 0
Prefunding balance elected to use to offset funding requirement 2019-01-31 0
Additional cash requirement 2019-01-31 171,363
Contributions allocatedtoward minimum required contributions for current year 2019-01-31 171,634
Unpaid minimum required contributions for current year 2019-01-31 0
Unpaid minimum required contributions for all years 2019-01-31 0
2018: MARK F. FARMUM, MD, A PROFESSIONAL CORPORATION CASH BALANCE PLAN 2018 401k membership
Market value of plan assets 2018-01-31 694,202
Acturial value of plan assets 2018-01-31 694,202
Funding target for retired participants and beneficiaries receiving payment 2018-01-31 0
Number of terminated vested participants 2018-01-31 0
Fundng target for terminated vested participants 2018-01-31 0
Active participant vested funding target 2018-01-31 497,102
Number of active participants 2018-01-31 4
Total funding liabilities for active participants 2018-01-31 497,102
Total participant count 2018-01-31 4
Total funding target for all participants 2018-01-31 497,102
Balance at beginning of prior year after applicable adjustments 2018-01-31 0
Prefunding balance at beginning of prior year after applicable adjustments 2018-01-31 0
Carryover balanced portion elected for use to offset prior years funding requirement 2018-01-31 0
Prefunding balanced used to offset prior years funding requirement 2018-01-31 0
Amount remaining of carryover balance 2018-01-31 0
Amount remaining of prefunding balance 2018-01-31 0
Present value of excess contributions 2018-01-31 21,892
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance 2018-01-31 21,892
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance 2018-01-31 0
Reductions in caryover balances due to elections or deemed elections 2018-01-31 0
Reductions in prefunding balances due to elections or deemed elections 2018-01-31 0
Balance of carryovers at beginning of current year 2018-01-31 0
Balance of prefunding at beginning of current year 2018-01-31 0
Total employer contributions 2018-01-31 350,000
Total employee contributions 2018-01-31 0
Contributions allocated toward unpaid minimum require contributions from prior years 2018-01-31 0
Contributions made to avoid restrictions adjusted to valuation date 2018-01-31 0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date 2018-01-31 350,586
Unpaid minimum required contributions for all prior years 2018-01-31 0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years 2018-01-31 0
Remaining amount of unpaid minimum required contributions 2018-01-31 0
Minimum required contributions for current year target normal cost 2018-01-31 252,693
Net shortfall amortization installment of oustanding balance 2018-01-31 0
Waiver amortization installment 2018-01-31 0
Total funding amount beforereflecting carryover/prefunding balances 2018-01-31 0
Carryover balance elected to use to offset funding requirement 2018-01-31 0
Prefunding balance elected to use to offset funding requirement 2018-01-31 0
Additional cash requirement 2018-01-31 0
Contributions allocatedtoward minimum required contributions for current year 2018-01-31 350,586
Unpaid minimum required contributions for current year 2018-01-31 0
Unpaid minimum required contributions for all years 2018-01-31 0
2017: MARK F. FARMUM, MD, A PROFESSIONAL CORPORATION CASH BALANCE PLAN 2017 401k membership
Market value of plan assets 2017-01-31 242,190
Acturial value of plan assets 2017-01-31 242,190
Funding target for retired participants and beneficiaries receiving payment 2017-01-31 0
Number of terminated vested participants 2017-01-31 0
Fundng target for terminated vested participants 2017-01-31 0
Active participant vested funding target 2017-01-31 0
Number of active participants 2017-01-31 4
Total funding liabilities for active participants 2017-01-31 224,755
Total participant count 2017-01-31 4
Total funding target for all participants 2017-01-31 224,755
Balance at beginning of prior year after applicable adjustments 2017-01-31 0
Prefunding balance at beginning of prior year after applicable adjustments 2017-01-31 0
Carryover balanced portion elected for use to offset prior years funding requirement 2017-01-31 0
Prefunding balanced used to offset prior years funding requirement 2017-01-31 0
Amount remaining of carryover balance 2017-01-31 0
Amount remaining of prefunding balance 2017-01-31 0
Present value of excess contributions 2017-01-31 37,475
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance 2017-01-31 37,480
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance 2017-01-31 0
Reductions in caryover balances due to elections or deemed elections 2017-01-31 0
Reductions in prefunding balances due to elections or deemed elections 2017-01-31 0
Balance of carryovers at beginning of current year 2017-01-31 0
Balance of prefunding at beginning of current year 2017-01-31 0
Total employer contributions 2017-01-31 252,069
Total employee contributions 2017-01-31 0
Contributions allocated toward unpaid minimum require contributions from prior years 2017-01-31 0
Contributions made to avoid restrictions adjusted to valuation date 2017-01-31 0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date 2017-01-31 252,748
Liquidity shortfalls end of Q1 2017-01-31 0
Liquidity shortfalls end of Q2 2017-01-31 0
Liquidity shortfalls end of Q3 2017-01-31 0
Liquidity shortfalls end of Q4 2017-01-31 0
Unpaid minimum required contributions for all prior years 2017-01-31 0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years 2017-01-31 0
Remaining amount of unpaid minimum required contributions 2017-01-31 0
Minimum required contributions for current year target normal cost 2017-01-31 248,291
Net shortfall amortization installment of oustanding balance 2017-01-31 0
Waiver amortization installment 2017-01-31 0
Total funding amount beforereflecting carryover/prefunding balances 2017-01-31 230,856
Carryover balance elected to use to offset funding requirement 2017-01-31 0
Prefunding balance elected to use to offset funding requirement 2017-01-31 0
Additional cash requirement 2017-01-31 230,856
Contributions allocatedtoward minimum required contributions for current year 2017-01-31 252,748
Unpaid minimum required contributions for current year 2017-01-31 0
Unpaid minimum required contributions for all years 2017-01-31 0

Measure	Date	Value
2019: MARK F. FARMUM, MD, A PROFESSIONAL CORPORATION CASH BALANCE PLAN 2019 401k membership
Market value of plan assets	2019-05-10	1,032,200
Acturial value of plan assets	2019-05-10	1,032,200
Funding target for retired participants and beneficiaries receiving payment	2019-05-10	0
Number of terminated vested participants	2019-05-10	0
Fundng target for terminated vested participants	2019-05-10	0
Active participant vested funding target	2019-05-10	1,034,717
Number of active participants	2019-05-10	4
Total funding liabilities for active participants	2019-05-10	1,034,717
Total participant count	2019-05-10	4
Total funding target for all participants	2019-05-10	1,034,717
Balance at beginning of prior year after applicable adjustments	2019-05-10	0
Prefunding balance at beginning of prior year after applicable adjustments	2019-05-10	0
Carryover balanced portion elected for use to offset prior years funding requirement	2019-05-10	0
Prefunding balanced used to offset prior years funding requirement	2019-05-10	0
Amount remaining of carryover balance	2019-05-10	0
Amount remaining of prefunding balance	2019-05-10	0
Present value of excess contributions	2019-05-10	271
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance	2019-05-10	271
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance	2019-05-10	0
Reductions in caryover balances due to elections or deemed elections	2019-05-10	0
Reductions in prefunding balances due to elections or deemed elections	2019-05-10	0
Balance of carryovers at beginning of current year	2019-05-10	0
Balance of prefunding at beginning of current year	2019-05-10	0
Total employer contributions	2019-05-10	53
Total employee contributions	2019-05-10	0
Contributions allocated toward unpaid minimum require contributions from prior years	2019-05-10	0
Contributions made to avoid restrictions adjusted to valuation date	2019-05-10	0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date	2019-05-10	53
Unpaid minimum required contributions for all prior years	2019-05-10	0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years	2019-05-10	0
Remaining amount of unpaid minimum required contributions	2019-05-10	0
Minimum required contributions for current year target normal cost	2019-05-10	0
Net shortfall amortization installment of oustanding balance	2019-05-10	2,517
Waiver amortization installment	2019-05-10	0
Total funding amount beforereflecting carryover/prefunding balances	2019-05-10	49
Carryover balance elected to use to offset funding requirement	2019-05-10	0
Prefunding balance elected to use to offset funding requirement	2019-05-10	0
Additional cash requirement	2019-05-10	49
Contributions allocatedtoward minimum required contributions for current year	2019-05-10	53
Unpaid minimum required contributions for current year	2019-05-10	0
Unpaid minimum required contributions for all years	2019-05-10	0
Market value of plan assets	2019-01-31	860,566
Acturial value of plan assets	2019-01-31	860,566
Funding target for retired participants and beneficiaries receiving payment	2019-01-31	0
Number of terminated vested participants	2019-01-31	0
Fundng target for terminated vested participants	2019-01-31	0
Active participant vested funding target	2019-01-31	783,809
Number of active participants	2019-01-31	4
Total funding liabilities for active participants	2019-01-31	783,809
Total participant count	2019-01-31	4
Total funding target for all participants	2019-01-31	783,809
Balance at beginning of prior year after applicable adjustments	2019-01-31	0
Prefunding balance at beginning of prior year after applicable adjustments	2019-01-31	0
Carryover balanced portion elected for use to offset prior years funding requirement	2019-01-31	0
Prefunding balanced used to offset prior years funding requirement	2019-01-31	0
Amount remaining of carryover balance	2019-01-31	0
Amount remaining of prefunding balance	2019-01-31	0
Present value of excess contributions	2019-01-31	350,586
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance	2019-01-31	350,586
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance	2019-01-31	0
Reductions in caryover balances due to elections or deemed elections	2019-01-31	0
Reductions in prefunding balances due to elections or deemed elections	2019-01-31	0
Balance of carryovers at beginning of current year	2019-01-31	0
Balance of prefunding at beginning of current year	2019-01-31	0
Total employer contributions	2019-01-31	171,815
Total employee contributions	2019-01-31	0
Contributions allocated toward unpaid minimum require contributions from prior years	2019-01-31	0
Contributions made to avoid restrictions adjusted to valuation date	2019-01-31	0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date	2019-01-31	171,634
Unpaid minimum required contributions for all prior years	2019-01-31	0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years	2019-01-31	0
Remaining amount of unpaid minimum required contributions	2019-01-31	0
Minimum required contributions for current year target normal cost	2019-01-31	248,120
Net shortfall amortization installment of oustanding balance	2019-01-31	0
Waiver amortization installment	2019-01-31	0
Total funding amount beforereflecting carryover/prefunding balances	2019-01-31	171,363
Carryover balance elected to use to offset funding requirement	2019-01-31	0
Prefunding balance elected to use to offset funding requirement	2019-01-31	0
Additional cash requirement	2019-01-31	171,363
Contributions allocatedtoward minimum required contributions for current year	2019-01-31	171,634
Unpaid minimum required contributions for current year	2019-01-31	0
Unpaid minimum required contributions for all years	2019-01-31	0
2018: MARK F. FARMUM, MD, A PROFESSIONAL CORPORATION CASH BALANCE PLAN 2018 401k membership
Market value of plan assets	2018-01-31	694,202
Acturial value of plan assets	2018-01-31	694,202
Funding target for retired participants and beneficiaries receiving payment	2018-01-31	0
Number of terminated vested participants	2018-01-31	0
Fundng target for terminated vested participants	2018-01-31	0
Active participant vested funding target	2018-01-31	497,102
Number of active participants	2018-01-31	4
Total funding liabilities for active participants	2018-01-31	497,102
Total participant count	2018-01-31	4
Total funding target for all participants	2018-01-31	497,102
Balance at beginning of prior year after applicable adjustments	2018-01-31	0
Prefunding balance at beginning of prior year after applicable adjustments	2018-01-31	0
Carryover balanced portion elected for use to offset prior years funding requirement	2018-01-31	0
Prefunding balanced used to offset prior years funding requirement	2018-01-31	0
Amount remaining of carryover balance	2018-01-31	0
Amount remaining of prefunding balance	2018-01-31	0
Present value of excess contributions	2018-01-31	21,892
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance	2018-01-31	21,892
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance	2018-01-31	0
Reductions in caryover balances due to elections or deemed elections	2018-01-31	0
Reductions in prefunding balances due to elections or deemed elections	2018-01-31	0
Balance of carryovers at beginning of current year	2018-01-31	0
Balance of prefunding at beginning of current year	2018-01-31	0
Total employer contributions	2018-01-31	350,000
Total employee contributions	2018-01-31	0
Contributions allocated toward unpaid minimum require contributions from prior years	2018-01-31	0
Contributions made to avoid restrictions adjusted to valuation date	2018-01-31	0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date	2018-01-31	350,586
Unpaid minimum required contributions for all prior years	2018-01-31	0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years	2018-01-31	0
Remaining amount of unpaid minimum required contributions	2018-01-31	0
Minimum required contributions for current year target normal cost	2018-01-31	252,693
Net shortfall amortization installment of oustanding balance	2018-01-31	0
Waiver amortization installment	2018-01-31	0
Total funding amount beforereflecting carryover/prefunding balances	2018-01-31	0
Carryover balance elected to use to offset funding requirement	2018-01-31	0
Prefunding balance elected to use to offset funding requirement	2018-01-31	0
Additional cash requirement	2018-01-31	0
Contributions allocatedtoward minimum required contributions for current year	2018-01-31	350,586
Unpaid minimum required contributions for current year	2018-01-31	0
Unpaid minimum required contributions for all years	2018-01-31	0
2017: MARK F. FARMUM, MD, A PROFESSIONAL CORPORATION CASH BALANCE PLAN 2017 401k membership
Market value of plan assets	2017-01-31	242,190
Acturial value of plan assets	2017-01-31	242,190
Funding target for retired participants and beneficiaries receiving payment	2017-01-31	0
Number of terminated vested participants	2017-01-31	0
Fundng target for terminated vested participants	2017-01-31	0
Active participant vested funding target	2017-01-31	0
Number of active participants	2017-01-31	4
Total funding liabilities for active participants	2017-01-31	224,755
Total participant count	2017-01-31	4
Total funding target for all participants	2017-01-31	224,755
Balance at beginning of prior year after applicable adjustments	2017-01-31	0
Prefunding balance at beginning of prior year after applicable adjustments	2017-01-31	0
Carryover balanced portion elected for use to offset prior years funding requirement	2017-01-31	0
Prefunding balanced used to offset prior years funding requirement	2017-01-31	0
Amount remaining of carryover balance	2017-01-31	0
Amount remaining of prefunding balance	2017-01-31	0
Present value of excess contributions	2017-01-31	37,475
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance	2017-01-31	37,480
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance	2017-01-31	0
Reductions in caryover balances due to elections or deemed elections	2017-01-31	0
Reductions in prefunding balances due to elections or deemed elections	2017-01-31	0
Balance of carryovers at beginning of current year	2017-01-31	0
Balance of prefunding at beginning of current year	2017-01-31	0
Total employer contributions	2017-01-31	252,069
Total employee contributions	2017-01-31	0
Contributions allocated toward unpaid minimum require contributions from prior years	2017-01-31	0
Contributions made to avoid restrictions adjusted to valuation date	2017-01-31	0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date	2017-01-31	252,748
Liquidity shortfalls end of Q1	2017-01-31	0
Liquidity shortfalls end of Q2	2017-01-31	0
Liquidity shortfalls end of Q3	2017-01-31	0
Liquidity shortfalls end of Q4	2017-01-31	0
Unpaid minimum required contributions for all prior years	2017-01-31	0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years	2017-01-31	0
Remaining amount of unpaid minimum required contributions	2017-01-31	0
Minimum required contributions for current year target normal cost	2017-01-31	248,291
Net shortfall amortization installment of oustanding balance	2017-01-31	0
Waiver amortization installment	2017-01-31	0
Total funding amount beforereflecting carryover/prefunding balances	2017-01-31	230,856
Carryover balance elected to use to offset funding requirement	2017-01-31	0
Prefunding balance elected to use to offset funding requirement	2017-01-31	0
Additional cash requirement	2017-01-31	230,856
Contributions allocatedtoward minimum required contributions for current year	2017-01-31	252,748
Unpaid minimum required contributions for current year	2017-01-31	0
Unpaid minimum required contributions for all years	2017-01-31	0

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Company Name:	MARK FARNUM, MD., APC
Employer identification number (EIN):	953871400
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
003	2019-02-01
003	2018-02-01
003	2017-02-01
003	2016-02-01
003	2015-02-01