401k Plan data: BACK, SEIGEL AND GOLDSTEIN, M.D., P.A. RETIREMENT TRUST plan

BACK, SEIGEL AND GOLDSTEIN, M.D., P.A. RETIREMENT TRUST 401k Plan overview

Plan Name	BACK, SEIGEL AND GOLDSTEIN, M.D., P.A. RETIREMENT TRUST
Plan identification number	001

BACK, SEIGEL AND GOLDSTEIN, M.D., P.A. RETIREMENT TRUST Benefits

401k Plan Type

Defined 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.
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

BACK, SEIGEL AND GOLDSTEIN, M.D., P.A. has sponsored the creation of one or more 401k plans.

Company Name: BACK, SEIGEL AND GOLDSTEIN, M.D., P.A.

Employer identification number (EIN): 221932249

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BACK, SEIGEL AND GOLDSTEIN, M.D., P.A. RETIREMENT TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2019-01-01 STEVEN A. GOLDSTEIN 2019-12-24 STEVEN A. GOLDSTEIN 2019-12-24
001 2018-01-01
001 2017-01-01
001 2016-01-01
001 2015-01-01
001 2014-01-01
001 2013-01-01
001 2012-01-01 STEVEN A. GOLDSTEIN STEVEN A. GOLDSTEIN 2013-03-19
001 2011-01-01 STEVEN A. GOLDSTEIN STEVEN A. GOLDSTEIN 2012-04-19
001 2009-01-01 STEVEN A. GOLDSTEIN STEVEN A. GOLDSTEIN 2010-08-05

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2019-01-01	STEVEN A. GOLDSTEIN	2019-12-24	STEVEN A. GOLDSTEIN	2019-12-24
001	2018-01-01
001	2017-01-01
001	2016-01-01
001	2015-01-01
001	2014-01-01
001	2013-01-01
001	2012-01-01	STEVEN A. GOLDSTEIN		STEVEN A. GOLDSTEIN	2013-03-19
001	2011-01-01	STEVEN A. GOLDSTEIN		STEVEN A. GOLDSTEIN	2012-04-19
001	2009-01-01	STEVEN A. GOLDSTEIN		STEVEN A. GOLDSTEIN	2010-08-05

Financial Data on BACK, SEIGEL AND GOLDSTEIN, M.D., P.A. RETIREMENT TRUST

Measure	Date	Value
2019 : BACK, SEIGEL AND GOLDSTEIN, M.D., P.A. RETIREMENT TRUST 2019 401k financial data
Total income from all sources	2019-12-31	$419,948
Expenses. Total of all expenses incurred	2019-12-31	$2,674,225
Benefits paid (including direct rollovers)	2019-12-31	$2,666,401
Total plan assets at end of year	2019-12-31	$0
Total plan assets at beginning of year	2019-12-31	$2,254,277
Value of fidelity bond covering the plan	2019-12-31	$200,000
Total contributions received or receivable from participants	2019-12-31	$48,853
Expenses. Other expenses not covered elsewhere	2019-12-31	$0
Contributions received from other sources (not participants or employers)	2019-12-31	$0
Other income received	2019-12-31	$364,411
Net income (gross income less expenses)	2019-12-31	$-2,254,277
Net plan assets at end of year (total assets less liabilities)	2019-12-31	$0
Net plan assets at beginning of year (total assets less liabilities)	2019-12-31	$2,254,277
Assets. Value of participant loans	2019-12-31	$0
Total contributions received or receivable from employer(s)	2019-12-31	$6,684
Expenses. Administrative service providers (salaries,fees and commissions)	2019-12-31	$7,824
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
2018 : BACK, SEIGEL AND GOLDSTEIN, M.D., P.A. RETIREMENT TRUST 2018 401k financial data
Total income from all sources	2018-12-31	$-68,973
Expenses. Total of all expenses incurred	2018-12-31	$50,792
Benefits paid (including direct rollovers)	2018-12-31	$48,106
Total plan assets at end of year	2018-12-31	$2,254,277
Total plan assets at beginning of year	2018-12-31	$2,374,042
Value of fidelity bond covering the plan	2018-12-31	$200,000
Total contributions received or receivable from participants	2018-12-31	$69,922
Expenses. Other expenses not covered elsewhere	2018-12-31	$0
Contributions received from other sources (not participants or employers)	2018-12-31	$0
Other income received	2018-12-31	$-146,818
Net income (gross income less expenses)	2018-12-31	$-119,765
Net plan assets at end of year (total assets less liabilities)	2018-12-31	$2,254,277
Net plan assets at beginning of year (total assets less liabilities)	2018-12-31	$2,374,042
Assets. Value of participant loans	2018-12-31	$13,672
Total contributions received or receivable from employer(s)	2018-12-31	$7,923
Expenses. Administrative service providers (salaries,fees and commissions)	2018-12-31	$2,686
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
2017 : BACK, SEIGEL AND GOLDSTEIN, M.D., P.A. RETIREMENT TRUST 2017 401k financial data
Total income from all sources	2017-12-31	$374,926
Expenses. Total of all expenses incurred	2017-12-31	$18,297
Benefits paid (including direct rollovers)	2017-12-31	$15,732
Total plan assets at end of year	2017-12-31	$2,374,042
Total plan assets at beginning of year	2017-12-31	$2,017,413
Value of fidelity bond covering the plan	2017-12-31	$200,000
Total contributions received or receivable from participants	2017-12-31	$73,427
Expenses. Other expenses not covered elsewhere	2017-12-31	$0
Contributions received from other sources (not participants or employers)	2017-12-31	$0
Other income received	2017-12-31	$290,973
Net income (gross income less expenses)	2017-12-31	$356,629
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$2,374,042
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$2,017,413
Assets. Value of participant loans	2017-12-31	$17,476
Total contributions received or receivable from employer(s)	2017-12-31	$10,526
Expenses. Administrative service providers (salaries,fees and commissions)	2017-12-31	$2,565
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
2016 : BACK, SEIGEL AND GOLDSTEIN, M.D., P.A. RETIREMENT TRUST 2016 401k financial data
Total income from all sources	2016-12-31	$184,644
Expenses. Total of all expenses incurred	2016-12-31	$2,210
Total plan assets at end of year	2016-12-31	$2,017,413
Total plan assets at beginning of year	2016-12-31	$1,834,979
Value of fidelity bond covering the plan	2016-12-31	$200,000
Total contributions received or receivable from participants	2016-12-31	$69,697
Expenses. Other expenses not covered elsewhere	2016-12-31	$0
Contributions received from other sources (not participants or employers)	2016-12-31	$0
Other income received	2016-12-31	$102,271
Net income (gross income less expenses)	2016-12-31	$182,434
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$2,017,413
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$1,834,979
Assets. Value of participant loans	2016-12-31	$3,706
Total contributions received or receivable from employer(s)	2016-12-31	$12,676
Expenses. Administrative service providers (salaries,fees and commissions)	2016-12-31	$2,210
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
2015 : BACK, SEIGEL AND GOLDSTEIN, M.D., P.A. RETIREMENT TRUST 2015 401k financial data
Total income from all sources	2015-12-31	$46,564
Expenses. Total of all expenses incurred	2015-12-31	$2,013
Total plan assets at end of year	2015-12-31	$1,834,979
Total plan assets at beginning of year	2015-12-31	$1,790,428
Value of fidelity bond covering the plan	2015-12-31	$200,000
Total contributions received or receivable from participants	2015-12-31	$63,896
Expenses. Other expenses not covered elsewhere	2015-12-31	$0
Contributions received from other sources (not participants or employers)	2015-12-31	$0
Other income received	2015-12-31	$-30,882
Net income (gross income less expenses)	2015-12-31	$44,551
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$1,834,979
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$1,790,428
Assets. Value of participant loans	2015-12-31	$10,693
Total contributions received or receivable from employer(s)	2015-12-31	$13,550
Expenses. Administrative service providers (salaries,fees and commissions)	2015-12-31	$2,013
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
2014 : BACK, SEIGEL AND GOLDSTEIN, M.D., P.A. RETIREMENT TRUST 2014 401k financial data
Total income from all sources	2014-12-31	$154,034
Expenses. Total of all expenses incurred	2014-12-31	$2,515
Benefits paid (including direct rollovers)	2014-12-31	$756
Total plan assets at end of year	2014-12-31	$1,790,428
Total plan assets at beginning of year	2014-12-31	$1,638,909
Value of fidelity bond covering the plan	2014-12-31	$200,000
Total contributions received or receivable from participants	2014-12-31	$57,936
Expenses. Other expenses not covered elsewhere	2014-12-31	$0
Contributions received from other sources (not participants or employers)	2014-12-31	$0
Other income received	2014-12-31	$83,423
Net income (gross income less expenses)	2014-12-31	$151,519
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$1,790,428
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$1,638,909
Assets. Value of participant loans	2014-12-31	$18,130
Total contributions received or receivable from employer(s)	2014-12-31	$12,675
Expenses. Administrative service providers (salaries,fees and commissions)	2014-12-31	$1,759
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
2013 : BACK, SEIGEL AND GOLDSTEIN, M.D., P.A. RETIREMENT TRUST 2013 401k financial data
Total income from all sources	2013-12-31	$292,697
Expenses. Total of all expenses incurred	2013-12-31	$1,601
Total plan assets at end of year	2013-12-31	$1,638,909
Total plan assets at beginning of year	2013-12-31	$1,347,813
Value of fidelity bond covering the plan	2013-12-31	$200,000
Total contributions received or receivable from participants	2013-12-31	$71,053
Expenses. Other expenses not covered elsewhere	2013-12-31	$1,601
Contributions received from other sources (not participants or employers)	2013-12-31	$0
Other income received	2013-12-31	$208,982
Net income (gross income less expenses)	2013-12-31	$291,096
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$1,638,909
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$1,347,813
Assets. Value of participant loans	2013-12-31	$25,204
Total contributions received or receivable from employer(s)	2013-12-31	$12,662
Expenses. Administrative service providers (salaries,fees and commissions)	2013-12-31	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
2012 : BACK, SEIGEL AND GOLDSTEIN, M.D., P.A. RETIREMENT TRUST 2012 401k financial data
Total income from all sources	2012-12-31	$228,064
Expenses. Total of all expenses incurred	2012-12-31	$0
Total plan assets at end of year	2012-12-31	$1,347,813
Total plan assets at beginning of year	2012-12-31	$1,119,749
Value of fidelity bond covering the plan	2012-12-31	$200,000
Total contributions received or receivable from participants	2012-12-31	$60,461
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	$155,452
Net income (gross income less expenses)	2012-12-31	$228,064
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$1,347,813
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$1,119,749
Assets. Value of participant loans	2012-12-31	$0
Total contributions received or receivable from employer(s)	2012-12-31	$12,151
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 : BACK, SEIGEL AND GOLDSTEIN, M.D., P.A. RETIREMENT TRUST 2011 401k financial data
Total income from all sources	2011-12-31	$29,020
Expenses. Total of all expenses incurred	2011-12-31	$11,737
Total plan assets at end of year	2011-12-31	$1,119,749
Total plan assets at beginning of year	2011-12-31	$1,102,466
Value of fidelity bond covering the plan	2011-12-31	$200,000
Total contributions received or receivable from participants	2011-12-31	$48,017
Expenses. Other expenses not covered elsewhere	2011-12-31	$11,737
Contributions received from other sources (not participants or employers)	2011-12-31	$0
Other income received	2011-12-31	$-28,549
Net income (gross income less expenses)	2011-12-31	$17,283
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$1,119,749
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$1,102,466
Assets. Value of participant loans	2011-12-31	$40,542
Total contributions received or receivable from employer(s)	2011-12-31	$9,552
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
2010 : BACK, SEIGEL AND GOLDSTEIN, M.D., P.A. RETIREMENT TRUST 2010 401k financial data
Total income from all sources	2010-12-31	$136,145
Expenses. Total of all expenses incurred	2010-12-31	$6,319
Total plan assets at end of year	2010-12-31	$1,102,466
Total plan assets at beginning of year	2010-12-31	$972,640
Value of fidelity bond covering the plan	2010-12-31	$200,000
Total contributions received or receivable from participants	2010-12-31	$1,980
Expenses. Other expenses not covered elsewhere	2010-12-31	$6,319
Contributions received from other sources (not participants or employers)	2010-12-31	$0
Other income received	2010-12-31	$134,165
Net income (gross income less expenses)	2010-12-31	$129,826
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$1,102,466
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$972,640
Assets. Value of participant loans	2010-12-31	$55,961
Total contributions received or receivable from employer(s)	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 : BACK, SEIGEL AND GOLDSTEIN, M.D., P.A. RETIREMENT TRUST 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

Form 5500 Responses for BACK, SEIGEL AND GOLDSTEIN, M.D., P.A. RETIREMENT TRUST

2019: BACK, SEIGEL AND GOLDSTEIN, M.D., P.A. RETIREMENT TRUST 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	Yes
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: BACK, SEIGEL AND GOLDSTEIN, M.D., P.A. RETIREMENT TRUST 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: BACK, SEIGEL AND GOLDSTEIN, M.D., P.A. RETIREMENT TRUST 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: BACK, SEIGEL AND GOLDSTEIN, M.D., P.A. RETIREMENT TRUST 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: BACK, SEIGEL AND GOLDSTEIN, M.D., P.A. RETIREMENT TRUST 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: BACK, SEIGEL AND GOLDSTEIN, M.D., P.A. RETIREMENT TRUST 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: BACK, SEIGEL AND GOLDSTEIN, M.D., P.A. RETIREMENT TRUST 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	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
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 - Trust	Yes
2012: BACK, SEIGEL AND GOLDSTEIN, M.D., P.A. RETIREMENT TRUST 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 - Trust	Yes
2011: BACK, SEIGEL AND GOLDSTEIN, M.D., P.A. RETIREMENT TRUST 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 - Trust	Yes
2009: BACK, SEIGEL AND GOLDSTEIN, M.D., P.A. RETIREMENT TRUST 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

Insurance Providers Used on plan

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number	456669 613953
Policy instance	1
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number	456669 613953
Policy instance	1
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number	456669 613953
Policy instance	1

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Company Name:	BACK, SEIGEL AND GOLDSTEIN, M.D., P.A.
Employer identification number (EIN):	221932249
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)