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LAKE CITY FAMILY MEDICINE, LLC 401(K) PLAN 401k Plan overview

Plan NameLAKE CITY FAMILY MEDICINE, LLC 401(K) PLAN
Plan identification number 001

LAKE CITY FAMILY MEDICINE, LLC 401(K) PLAN Benefits

401k Plan TypeDefined 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.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • 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

LAKE CITY FAMILY MEDICINE, LLC has sponsored the creation of one or more 401k plans.

Company Name:LAKE CITY FAMILY MEDICINE, LLC
Employer identification number (EIN):204336636
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LAKE CITY FAMILY MEDICINE, LLC 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01MORRIS BROWN2023-05-19 MORRIS BROWN2023-05-19
0012021-01-01MORRIS BROWN2022-12-15 MORRIS BROWN2022-12-15
0012020-01-01MORRIS BROWN2021-05-10
0012019-01-01MORRIS BROWN2020-06-02 MORRIS BROWN2020-06-02
0012018-01-01CARLOS LAMAS2019-06-04 CARLOS LAMAS2019-06-04
0012017-01-01MORRIS BROWN2018-07-26 MORRIS BROWN2018-07-26
0012016-01-01MORRIS BROWN2017-10-02 MORRIS BROWN2017-10-02
0012015-01-01MORRIS BROWN2016-07-28
0012014-01-01MORRIS BROWN
0012013-01-01MORRIS BROWN III MORRIS BROWN III2014-07-25
0012012-01-01MORRIS BROWN III MORRIS BROWN III2013-07-16
0012011-01-01MORRIS BROWN III
0012010-01-01MORRIS BROWN III2011-04-11

Plan Statistics for LAKE CITY FAMILY MEDICINE, LLC 401(K) PLAN

401k plan membership statisitcs for LAKE CITY FAMILY MEDICINE, LLC 401(K) PLAN

Measure Date Value
2014: LAKE CITY FAMILY MEDICINE, LLC 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-019
Total number of active participants reported on line 7a of the Form 55002014-01-017
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-012
Total of all active and inactive participants2014-01-019
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-019
Number of participants with account balances2014-01-019
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-011
2013: LAKE CITY FAMILY MEDICINE, LLC 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-018
Total number of active participants reported on line 7a of the Form 55002013-01-017
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-012
Total of all active and inactive participants2013-01-019
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-019
Number of participants with account balances2013-01-019
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-011
2012: LAKE CITY FAMILY MEDICINE, LLC 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-019
Total number of active participants reported on line 7a of the Form 55002012-01-017
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-013
Total of all active and inactive participants2012-01-0110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0110
Number of participants with account balances2012-01-017
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-011
2011: LAKE CITY FAMILY MEDICINE, LLC 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-019
Total number of active participants reported on line 7a of the Form 55002011-01-019
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-011
Total of all active and inactive participants2011-01-0110
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-0110
Number of participants with account balances2011-01-0110
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010

Financial Data on LAKE CITY FAMILY MEDICINE, LLC 401(K) PLAN

Measure Date Value
2014 : LAKE CITY FAMILY MEDICINE, LLC 401(K) PLAN 2014 401k financial data
Transfers to/from the plan2014-12-31$0
Total income from all sources2014-12-31$60,797
Expenses. Total of all expenses incurred2014-12-31$32,034
Benefits paid (including direct rollovers)2014-12-31$31,984
Total plan assets at end of year2014-12-31$641,708
Total plan assets at beginning of year2014-12-31$612,945
Value of fidelity bond covering the plan2014-12-31$150,000
Total contributions received or receivable from participants2014-12-31$29,609
Expenses. Other expenses not covered elsewhere2014-12-31$50
Contributions received from other sources (not participants or employers)2014-12-31$0
Other income received2014-12-31$15,351
Net income (gross income less expenses)2014-12-31$28,763
Net plan assets at end of year (total assets less liabilities)2014-12-31$641,708
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$612,945
Assets. Value of participant loans2014-12-31$39,211
Total contributions received or receivable from employer(s)2014-12-31$15,837
Value of certain deemed distributions of participant loans2014-12-31$0
Value of corrective distributions2014-12-31$0
Funding deficiency by the employer to the plan for this plan year2014-12-31$0
Minimum employer required contribution for this plan year2014-12-31$0
Amount contributed by the employer to the plan for this plan year2014-12-31$0
2013 : LAKE CITY FAMILY MEDICINE, LLC 401(K) PLAN 2013 401k financial data
Transfers to/from the plan2013-12-31$0
Total income from all sources2013-12-31$206,300
Expenses. Total of all expenses incurred2013-12-31$3,081
Benefits paid (including direct rollovers)2013-12-31$3,007
Total plan assets at end of year2013-12-31$612,945
Total plan assets at beginning of year2013-12-31$409,726
Value of fidelity bond covering the plan2013-12-31$150,000
Total contributions received or receivable from participants2013-12-31$23,401
Expenses. Other expenses not covered elsewhere2013-12-31$74
Contributions received from other sources (not participants or employers)2013-12-31$0
Other income received2013-12-31$107,727
Net income (gross income less expenses)2013-12-31$203,219
Net plan assets at end of year (total assets less liabilities)2013-12-31$612,945
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$409,726
Assets. Value of participant loans2013-12-31$49,942
Total contributions received or receivable from employer(s)2013-12-31$75,172
Value of certain deemed distributions of participant loans2013-12-31$0
Value of corrective distributions2013-12-31$0
Funding deficiency by the employer to the plan for this plan year2013-12-31$0
Minimum employer required contribution for this plan year2013-12-31$0
Amount contributed by the employer to the plan for this plan year2013-12-31$0
2012 : LAKE CITY FAMILY MEDICINE, LLC 401(K) PLAN 2012 401k financial data
Transfers to/from the plan2012-12-31$0
Total income from all sources2012-12-31$126,858
Expenses. Total of all expenses incurred2012-12-31$2,450
Benefits paid (including direct rollovers)2012-12-31$2,350
Total plan assets at end of year2012-12-31$409,726
Total plan assets at beginning of year2012-12-31$285,318
Value of fidelity bond covering the plan2012-12-31$150,000
Total contributions received or receivable from participants2012-12-31$19,212
Expenses. Other expenses not covered elsewhere2012-12-31$100
Contributions received from other sources (not participants or employers)2012-12-31$0
Other income received2012-12-31$48,537
Net income (gross income less expenses)2012-12-31$124,408
Net plan assets at end of year (total assets less liabilities)2012-12-31$409,726
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$285,318
Assets. Value of participant loans2012-12-31$54,774
Total contributions received or receivable from employer(s)2012-12-31$59,109
Value of certain deemed distributions of participant loans2012-12-31$0
Value of corrective distributions2012-12-31$0
Funding deficiency by the employer to the plan for this plan year2012-12-31$0
Minimum employer required contribution for this plan year2012-12-31$0
Amount contributed by the employer to the plan for this plan year2012-12-31$0
2011 : LAKE CITY FAMILY MEDICINE, LLC 401(K) PLAN 2011 401k financial data
Transfers to/from the plan2011-12-31$0
Total income from all sources2011-12-31$54,187
Expenses. Total of all expenses incurred2011-12-31$3,600
Benefits paid (including direct rollovers)2011-12-31$3,500
Total plan assets at end of year2011-12-31$285,318
Total plan assets at beginning of year2011-12-31$234,731
Value of fidelity bond covering the plan2011-12-31$150,000
Total contributions received or receivable from participants2011-12-31$25,098
Expenses. Other expenses not covered elsewhere2011-12-31$100
Contributions received from other sources (not participants or employers)2011-12-31$0
Other income received2011-12-31$-26,774
Net income (gross income less expenses)2011-12-31$50,587
Net plan assets at end of year (total assets less liabilities)2011-12-31$285,318
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$234,731
Assets. Value of participant loans2011-12-31$6,000
Total contributions received or receivable from employer(s)2011-12-31$55,863
Value of certain deemed distributions of participant loans2011-12-31$0
Value of corrective distributions2011-12-31$0
Funding deficiency by the employer to the plan for this plan year2011-12-31$0
Minimum employer required contribution for this plan year2011-12-31$0
Amount contributed by the employer to the plan for this plan year2011-12-31$0

Form 5500 Responses for LAKE CITY FAMILY MEDICINE, LLC 401(K) PLAN

2014: LAKE CITY FAMILY MEDICINE, LLC 401(K) PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: LAKE CITY FAMILY MEDICINE, LLC 401(K) PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: LAKE CITY FAMILY MEDICINE, LLC 401(K) PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: LAKE CITY FAMILY MEDICINE, LLC 401(K) PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-806264
Policy instance 1
Insurance contract or identification numberGA-806264
Number of Individuals Covered9
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $2,766
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,766
Insurance broker organization code?3
Insurance broker nameLPL FINANCIAL CORPORATION
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-806264
Policy instance 1
Insurance contract or identification numberGA-806264
Number of Individuals Covered9
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $1,884
Total amount of fees paid to insurance companyUSD $54
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,884
Insurance broker organization code?3
Amount paid for insurance broker fees54
Additional information about fees paid to insurance brokerSALES/MARKETING
Insurance broker nameLPL FINANCIAL LLC
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-806264
Policy instance 1
Insurance contract or identification numberGA-806264
Number of Individuals Covered7
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $1,305
Total amount of fees paid to insurance companyUSD $16
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $973
Insurance broker organization code?3
Amount paid for insurance broker fees16
Additional information about fees paid to insurance brokerSALES/MARKETING
Insurance broker nameLPL FINANCIAL LLC
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-806264
Policy instance 1
Insurance contract or identification numberGA-806264
Number of Individuals Covered10
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $1,297
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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