401k Plan data: ACADEMIC CARDIOLOGY ASSOCIATES, P.C. 401(K) RETIREMENT PLAN plan

ACADEMIC CARDIOLOGY ASSOCIATES, P.C. 401(K) RETIREMENT PLAN 401k Plan overview

Plan Name	ACADEMIC CARDIOLOGY ASSOCIATES, P.C. 401(K) RETIREMENT PLAN
Plan identification number	002

ACADEMIC CARDIOLOGY ASSOCIATES, P.C. 401(K) RETIREMENT 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
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.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

ACADEMIC CARDIOLOGY ASSOCIATES, P.C. has sponsored the creation of one or more 401k plans.

Company Name: ACADEMIC CARDIOLOGY ASSOCIATES, P.C.

Employer identification number (EIN): 383091025

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

Additional information about ACADEMIC CARDIOLOGY ASSOCIATES, P.C.

Jurisdiction of Incorporation: Michigan Secretary of State

Incorporation Date: 0000-00-00

Company Identification Number: 483715

Legal Registered Office Address: 1701 SOUTH BLVD E #390 ROCHESTER HILLS

United States of America (USA)
48307

More information about ACADEMIC CARDIOLOGY ASSOCIATES, P.C.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ACADEMIC CARDIOLOGY ASSOCIATES, P.C. 401(K) RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2022-01-01
002 2021-01-01
002 2020-01-01
002 2019-01-01
002 2018-01-01
002 2017-01-01 MARTIN MCGOUGH 2018-05-09 MARTIN MCGOUGH 2018-05-09
002 2016-01-01 MARTIN MCGOUGH 2017-05-15 MARTIN MCGOUGH 2017-05-15
002 2015-01-01 MARTIN MCGOUGH 2016-06-02 MARTIN MCGOUGH 2016-06-02
002 2014-01-01 MARTIN F MCGOUGH 2015-07-01 MARTIN F MCGOUGH 2015-07-01
002 2013-01-01 MARTIN MCGOUGH 2014-04-30
002 2012-01-01 MARTIN F. MCGOUGH, M.D. 2014-04-29
002 2011-01-01 MARTIN F. MCGOUGH, M.D. 2012-05-10
002 2010-01-01 MARTIN F. MCGOUGH, M.D. 2011-07-26

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2022-01-01
002	2021-01-01
002	2020-01-01
002	2019-01-01
002	2018-01-01
002	2017-01-01	MARTIN MCGOUGH	2018-05-09	MARTIN MCGOUGH	2018-05-09
002	2016-01-01	MARTIN MCGOUGH	2017-05-15	MARTIN MCGOUGH	2017-05-15
002	2015-01-01	MARTIN MCGOUGH	2016-06-02	MARTIN MCGOUGH	2016-06-02
002	2014-01-01	MARTIN F MCGOUGH	2015-07-01	MARTIN F MCGOUGH	2015-07-01
002	2013-01-01	MARTIN MCGOUGH	2014-04-30
002	2012-01-01	MARTIN F. MCGOUGH, M.D.	2014-04-29
002	2011-01-01	MARTIN F. MCGOUGH, M.D.	2012-05-10
002	2010-01-01	MARTIN F. MCGOUGH, M.D.	2011-07-26

Plan Statistics for ACADEMIC CARDIOLOGY ASSOCIATES, P.C. 401(K) RETIREMENT PLAN

401k plan membership statisitcs for ACADEMIC CARDIOLOGY ASSOCIATES, P.C. 401(K) RETIREMENT PLAN

Measure Date Value
2022: ACADEMIC CARDIOLOGY ASSOCIATES, P.C. 401(K) RETIREMENT PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 44
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 30
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 9
Total of all active and inactive participants 2022-01-01 39
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 39
Number of participants with account balances 2022-01-01 35
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: ACADEMIC CARDIOLOGY ASSOCIATES, P.C. 401(K) RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 42
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 34
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 10
Total of all active and inactive participants 2021-01-01 44
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 44
Number of participants with account balances 2021-01-01 38
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: ACADEMIC CARDIOLOGY ASSOCIATES, P.C. 401(K) RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 39
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 32
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 10
Total of all active and inactive participants 2020-01-01 42
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 42
Number of participants with account balances 2020-01-01 36
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 1
2019: ACADEMIC CARDIOLOGY ASSOCIATES, P.C. 401(K) RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 35
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 29
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 10
Total of all active and inactive participants 2019-01-01 39
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 39
Number of participants with account balances 2019-01-01 35
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 3
2018: ACADEMIC CARDIOLOGY ASSOCIATES, P.C. 401(K) RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 36
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 26
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 9
Total of all active and inactive participants 2018-01-01 35
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 35
Number of participants with account balances 2018-01-01 33
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0

Measure	Date	Value
2022: ACADEMIC CARDIOLOGY ASSOCIATES, P.C. 401(K) RETIREMENT PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	44
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	30
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	9
Total of all active and inactive participants	2022-01-01	39
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	39
Number of participants with account balances	2022-01-01	35
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: ACADEMIC CARDIOLOGY ASSOCIATES, P.C. 401(K) RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	42
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	34
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	10
Total of all active and inactive participants	2021-01-01	44
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	44
Number of participants with account balances	2021-01-01	38
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: ACADEMIC CARDIOLOGY ASSOCIATES, P.C. 401(K) RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	39
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	32
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	10
Total of all active and inactive participants	2020-01-01	42
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	42
Number of participants with account balances	2020-01-01	36
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	1
2019: ACADEMIC CARDIOLOGY ASSOCIATES, P.C. 401(K) RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	35
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	29
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	10
Total of all active and inactive participants	2019-01-01	39
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	39
Number of participants with account balances	2019-01-01	35
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	3
2018: ACADEMIC CARDIOLOGY ASSOCIATES, P.C. 401(K) RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	36
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	26
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	9
Total of all active and inactive participants	2018-01-01	35
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	35
Number of participants with account balances	2018-01-01	33
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0

Financial Data on ACADEMIC CARDIOLOGY ASSOCIATES, P.C. 401(K) RETIREMENT PLAN

Measure	Date	Value
2022 : ACADEMIC CARDIOLOGY ASSOCIATES, P.C. 401(K) RETIREMENT PLAN 2022 401k financial data
Transfers to/from the plan	2022-12-31	$0
Total plan liabilities at end of year	2022-12-31	$0
Total plan liabilities at beginning of year	2022-12-31	$0
Total income from all sources	2022-12-31	$-562,497
Expenses. Total of all expenses incurred	2022-12-31	$916,367
Benefits paid (including direct rollovers)	2022-12-31	$876,513
Total plan assets at end of year	2022-12-31	$4,395,475
Total plan assets at beginning of year	2022-12-31	$5,874,339
Value of fidelity bond covering the plan	2022-12-31	$500,000
Assets. Value of tangible personal property	2022-12-31	$0
Total contributions received or receivable from participants	2022-12-31	$204,135
Assets. Value of loans (other than to participants)	2022-12-31	$0
Expenses. Other expenses not covered elsewhere	2022-12-31	$0
Contributions received from other sources (not participants or employers)	2022-12-31	$61,238
Other income received	2022-12-31	$-906,791
Noncash contributions received	2022-12-31	$0
Net income (gross income less expenses)	2022-12-31	$-1,478,864
Net plan assets at end of year (total assets less liabilities)	2022-12-31	$4,395,475
Net plan assets at beginning of year (total assets less liabilities)	2022-12-31	$5,874,339
Assets. Value of participant loans	2022-12-31	$3,843
Assets. Value of assets in partnership/joint-venture interests	2022-12-31	$0
Assets. Value of real-estate (other than employer real property)	2022-12-31	$0
Assets. Value of employer securities	2022-12-31	$0
Assets. Value of employer real property	2022-12-31	$0
Total contributions received or receivable from employer(s)	2022-12-31	$78,921
Value of certain deemed distributions of participant loans	2022-12-31	$0
Value of corrective distributions	2022-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2022-12-31	$39,854
2021 : ACADEMIC CARDIOLOGY ASSOCIATES, P.C. 401(K) RETIREMENT PLAN 2021 401k financial data
Transfers to/from the plan	2021-12-31	$0
Total plan liabilities at end of year	2021-12-31	$0
Total plan liabilities at beginning of year	2021-12-31	$0
Total income from all sources	2021-12-31	$956,924
Expenses. Total of all expenses incurred	2021-12-31	$95,797
Benefits paid (including direct rollovers)	2021-12-31	$54,464
Total plan assets at end of year	2021-12-31	$5,874,339
Total plan assets at beginning of year	2021-12-31	$5,013,212
Value of fidelity bond covering the plan	2021-12-31	$500,000
Assets. Value of tangible personal property	2021-12-31	$0
Total contributions received or receivable from participants	2021-12-31	$188,341
Assets. Value of loans (other than to participants)	2021-12-31	$0
Expenses. Other expenses not covered elsewhere	2021-12-31	$0
Contributions received from other sources (not participants or employers)	2021-12-31	$0
Other income received	2021-12-31	$686,649
Noncash contributions received	2021-12-31	$0
Net income (gross income less expenses)	2021-12-31	$861,127
Net plan assets at end of year (total assets less liabilities)	2021-12-31	$5,874,339
Net plan assets at beginning of year (total assets less liabilities)	2021-12-31	$5,013,212
Assets. Value of participant loans	2021-12-31	$7,000
Assets. Value of assets in partnership/joint-venture interests	2021-12-31	$0
Assets. Value of real-estate (other than employer real property)	2021-12-31	$0
Assets. Value of employer securities	2021-12-31	$0
Assets. Value of employer real property	2021-12-31	$0
Total contributions received or receivable from employer(s)	2021-12-31	$81,934
Value of certain deemed distributions of participant loans	2021-12-31	$0
Value of corrective distributions	2021-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2021-12-31	$41,333
2020 : ACADEMIC CARDIOLOGY ASSOCIATES, P.C. 401(K) RETIREMENT PLAN 2020 401k financial data
Transfers to/from the plan	2020-12-31	$0
Total plan liabilities at end of year	2020-12-31	$0
Total plan liabilities at beginning of year	2020-12-31	$0
Total income from all sources	2020-12-31	$776,076
Expenses. Total of all expenses incurred	2020-12-31	$33,310
Benefits paid (including direct rollovers)	2020-12-31	$1,742
Total plan assets at end of year	2020-12-31	$5,013,212
Total plan assets at beginning of year	2020-12-31	$4,270,446
Value of fidelity bond covering the plan	2020-12-31	$500,000
Total contributions received or receivable from participants	2020-12-31	$136,301
Expenses. Other expenses not covered elsewhere	2020-12-31	$0
Contributions received from other sources (not participants or employers)	2020-12-31	$0
Other income received	2020-12-31	$589,591
Noncash contributions received	2020-12-31	$0
Net income (gross income less expenses)	2020-12-31	$742,766
Net plan assets at end of year (total assets less liabilities)	2020-12-31	$5,013,212
Net plan assets at beginning of year (total assets less liabilities)	2020-12-31	$4,270,446
Assets. Value of participant loans	2020-12-31	$3,729
Total contributions received or receivable from employer(s)	2020-12-31	$50,184
Value of certain deemed distributions of participant loans	2020-12-31	$0
Value of corrective distributions	2020-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2020-12-31	$31,568
2019 : ACADEMIC CARDIOLOGY ASSOCIATES, P.C. 401(K) RETIREMENT PLAN 2019 401k financial data
Transfers to/from the plan	2019-12-31	$175,406
Total plan liabilities at end of year	2019-12-31	$0
Total plan liabilities at beginning of year	2019-12-31	$0
Total income from all sources	2019-12-31	$758,341
Expenses. Total of all expenses incurred	2019-12-31	$114,528
Benefits paid (including direct rollovers)	2019-12-31	$88,792
Total plan assets at end of year	2019-12-31	$4,270,446
Total plan assets at beginning of year	2019-12-31	$3,451,227
Value of fidelity bond covering the plan	2019-12-31	$500,000
Total contributions received or receivable from participants	2019-12-31	$112,365
Expenses. Other expenses not covered elsewhere	2019-12-31	$0
Contributions received from other sources (not participants or employers)	2019-12-31	$3,804
Other income received	2019-12-31	$561,591
Noncash contributions received	2019-12-31	$0
Net income (gross income less expenses)	2019-12-31	$643,813
Net plan assets at end of year (total assets less liabilities)	2019-12-31	$4,270,446
Net plan assets at beginning of year (total assets less liabilities)	2019-12-31	$3,451,227
Assets. Value of participant loans	2019-12-31	$4,798
Total contributions received or receivable from employer(s)	2019-12-31	$80,581
Value of certain deemed distributions of participant loans	2019-12-31	$0
Value of corrective distributions	2019-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2019-12-31	$25,736
2018 : ACADEMIC CARDIOLOGY ASSOCIATES, P.C. 401(K) RETIREMENT PLAN 2018 401k financial data
Transfers to/from the plan	2018-12-31	$0
Total plan liabilities at end of year	2018-12-31	$0
Total plan liabilities at beginning of year	2018-12-31	$0
Total income from all sources	2018-12-31	$1,203
Expenses. Total of all expenses incurred	2018-12-31	$28,761
Benefits paid (including direct rollovers)	2018-12-31	$27,758
Total plan assets at end of year	2018-12-31	$3,451,227
Total plan assets at beginning of year	2018-12-31	$3,478,785
Value of fidelity bond covering the plan	2018-12-31	$500,000
Total contributions received or receivable from participants	2018-12-31	$69,414
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	$-111,811
Noncash contributions received	2018-12-31	$0
Net income (gross income less expenses)	2018-12-31	$-27,558
Net plan assets at end of year (total assets less liabilities)	2018-12-31	$3,451,227
Net plan assets at beginning of year (total assets less liabilities)	2018-12-31	$3,478,785
Assets. Value of participant loans	2018-12-31	$27,031
Total contributions received or receivable from employer(s)	2018-12-31	$43,600
Value of certain deemed distributions of participant loans	2018-12-31	$0
Value of corrective distributions	2018-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2018-12-31	$1,003

Form 5500 Responses for ACADEMIC CARDIOLOGY ASSOCIATES, P.C. 401(K) RETIREMENT PLAN

2022: ACADEMIC CARDIOLOGY ASSOCIATES, P.C. 401(K) RETIREMENT PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	This submission is the final filing	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: ACADEMIC CARDIOLOGY ASSOCIATES, P.C. 401(K) RETIREMENT PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	This submission is the final filing	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: ACADEMIC CARDIOLOGY ASSOCIATES, P.C. 401(K) RETIREMENT PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: ACADEMIC CARDIOLOGY ASSOCIATES, P.C. 401(K) RETIREMENT PLAN 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	No
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 – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: ACADEMIC CARDIOLOGY ASSOCIATES, P.C. 401(K) RETIREMENT PLAN 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 – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )

Policy contract number

000

Policy instance

Insurance contract or identification number	000
Number of Individuals Covered	0
Insurance policy start date	2020-01-01
Insurance policy end date	2020-11-05
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contracts With Unallocated Funds Deposit Administration	0
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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

MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )

Policy contract number

000

Policy instance

Insurance contract or identification number	000
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
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?	0
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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

MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )

Policy contract number

000

Policy instance

Insurance contract or identification number	000
Number of Individuals Covered	22
Insurance policy start date	2018-01-01
Insurance policy end date	2018-11-05
Total amount of commissions paid to insurance broker	USD $7,493
Are there contracts with allocated funds for individual policies?	0
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Broker	USD $7,493
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

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Company Name:	ACADEMIC CARDIOLOGY ASSOCIATES, P.C.
Employer identification number (EIN):	383091025
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)

Jurisdiction of Incorporation:	Michigan Secretary of State
Incorporation Date:	0000-00-00
Company Identification Number:	483715
Legal Registered Office Address:	1701 SOUTH BLVD E #390 ROCHESTER HILLS United States of America (USA) 48307