401k Plan data: JAY WEISKOPF MD plan

JAY WEISKOPF MD 401k Plan overview

Plan Name	JAY WEISKOPF MD
Plan identification number	001

JAY WEISKOPF MD Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
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.
Plan covering Self-Employed individuals.
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

JAY WEISKOPF MD has sponsored the creation of one or more 401k plans.

Company Name: JAY WEISKOPF MD

Employer identification number (EIN): 251471357

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan JAY WEISKOPF MD

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2012-01-01 CHRIS KAMINSKI CPA 2013-07-22
001 2011-01-01 CHRIS KAMINSKI CPA
001 2009-01-01 JAY WEISKOPF MD

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2012-01-01	CHRIS KAMINSKI CPA	2013-07-22
001	2011-01-01	CHRIS KAMINSKI CPA
001	2009-01-01	JAY WEISKOPF MD

Plan Statistics for JAY WEISKOPF MD

401k plan membership statisitcs for JAY WEISKOPF MD

Measure Date Value
2011: JAY WEISKOPF MD 2011 401k membership
Total participants, beginning-of-year 2011-01-01 5
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 2
Number of retired or separated participants receiving benefits 2011-01-01 3
Total of all active and inactive participants 2011-01-01 5
Total participants 2011-01-01 5
Number of participants with account balances 2011-01-01 2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: JAY WEISKOPF MD 2009 401k membership
Total participants, beginning-of-year 2009-01-01 5
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 2
Number of other retired or separated participants entitled to future benefits 2009-01-01 3
Total of all active and inactive participants 2009-01-01 5
Total participants 2009-01-01 5
Number of participants with account balances 2009-01-01 5

Measure	Date	Value
2011: JAY WEISKOPF MD 2011 401k membership
Total participants, beginning-of-year	2011-01-01	5
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	2
Number of retired or separated participants receiving benefits	2011-01-01	3
Total of all active and inactive participants	2011-01-01	5
Total participants	2011-01-01	5
Number of participants with account balances	2011-01-01	2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: JAY WEISKOPF MD 2009 401k membership
Total participants, beginning-of-year	2009-01-01	5
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	2
Number of other retired or separated participants entitled to future benefits	2009-01-01	3
Total of all active and inactive participants	2009-01-01	5
Total participants	2009-01-01	5
Number of participants with account balances	2009-01-01	5

Financial Data on JAY WEISKOPF MD

Measure	Date	Value
2011 : JAY WEISKOPF MD 2011 401k financial data
Total income from all sources	2011-12-31	$137,379
Expenses. Total of all expenses incurred	2011-12-31	$114,916
Benefits paid (including direct rollovers)	2011-12-31	$114,916
Total plan assets at end of year	2011-12-31	$1,200,732
Total plan assets at beginning of year	2011-12-31	$1,178,269
Value of fidelity bond covering the plan	2011-12-31	$110,000
Total contributions received or receivable from participants	2011-12-31	$23,000
Other income received	2011-12-31	$114,379
Net income (gross income less expenses)	2011-12-31	$22,463
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$1,200,732
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$1,178,269
2010 : JAY WEISKOPF MD 2010 401k financial data
Total income from all sources	2010-12-31	$123,271
Expenses. Total of all expenses incurred	2010-12-31	$2,390
Benefits paid (including direct rollovers)	2010-12-31	$2,390
Total plan assets at end of year	2010-12-31	$1,178,269
Total plan assets at beginning of year	2010-12-31	$1,057,388
Value of fidelity bond covering the plan	2010-12-31	$110,000
Contributions received from other sources (not participants or employers)	2010-12-31	$123,271
Net income (gross income less expenses)	2010-12-31	$120,881
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$1,178,269
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$1,057,388

Form 5500 Responses for JAY WEISKOPF MD

2011: JAY WEISKOPF MD 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 – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: JAY WEISKOPF MD 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	This submission is the final filing	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )

Policy contract number

28591

Policy instance

Insurance contract or identification number	28591
Number of Individuals Covered	2
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	Yes
Life Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )

Policy contract number

28591

Policy instance

Insurance contract or identification number	28591
Number of Individuals Covered	2
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	JAY WEISKOPF MD
Employer identification number (EIN):	251471357
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)