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CHADRON MEDICAL CLINIC, PC 401(K) PROFIT SHARING PLAN & TRUST 401k Plan overview

Plan NameCHADRON MEDICAL CLINIC, PC 401(K) PROFIT SHARING PLAN & TRUST
Plan identification number 002

CHADRON MEDICAL CLINIC, PC 401(K) PROFIT SHARING PLAN & TRUST 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.
  • Participant-directed brokerage accounts provided as an investment option under the plan.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Plan not intended to be qualified - A plan not intended to be qualified under Code sections 401, 403, or 408.
  • 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) received services of leased employees, as defined in Code section 414(n), during the plan year.

401k Sponsoring company profile

CHADRON MEDICAL CLINIC, PC has sponsored the creation of one or more 401k plans.

Company Name:CHADRON MEDICAL CLINIC, PC
Employer identification number (EIN):470549024
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CHADRON MEDICAL CLINIC, PC 401(K) PROFIT SHARING PLAN & TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022022-01-01VICTORIA BARRAZA2023-01-30
0022021-01-01VICTORIA BARRAZA2022-09-19
0022020-01-01TERESA LANDRETH2021-05-04
0022019-01-01TERESA LANDRETH2020-06-17
0022018-01-01TERESA LANDRETH2019-05-13
0022017-01-01TERESA J. LANDRETH2018-05-17 TERESA J. LANDRETH2018-05-17
0022016-01-01TERESA J. LANDRETH2017-05-30
0022015-01-01TERESA LANDRETH2016-05-31
0022014-01-01TERESA J LANDRETH2015-06-19 TERESA J LANDRETH2015-06-19
0022013-01-01TERESA LANDRETH2014-09-11
0022012-01-01JERRY MCLAIN
0022011-01-01JERRY MCLAIN
0022009-01-01JERRY MCLAIN

Plan Statistics for CHADRON MEDICAL CLINIC, PC 401(K) PROFIT SHARING PLAN & TRUST

401k plan membership statisitcs for CHADRON MEDICAL CLINIC, PC 401(K) PROFIT SHARING PLAN & TRUST

Measure Date Value
2012: CHADRON MEDICAL CLINIC, PC 401(K) PROFIT SHARING PLAN & TRUST 2012 401k membership
Total participants, beginning-of-year2012-01-0123
Total number of active participants reported on line 7a of the Form 55002012-01-0118
Number of retired or separated participants receiving benefits2012-01-014
Total of all active and inactive participants2012-01-0122
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-011
Total participants2012-01-0123
2011: CHADRON MEDICAL CLINIC, PC 401(K) PROFIT SHARING PLAN & TRUST 2011 401k membership
Total participants, beginning-of-year2011-01-0120
Total number of active participants reported on line 7a of the Form 55002011-01-0119
Number of retired or separated participants receiving benefits2011-01-013
Total of all active and inactive participants2011-01-0122
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-011
Total participants2011-01-0123
2009: CHADRON MEDICAL CLINIC, PC 401(K) PROFIT SHARING PLAN & TRUST 2009 401k membership
Total participants, beginning-of-year2009-01-0119
Total number of active participants reported on line 7a of the Form 55002009-01-0118
Number of retired or separated participants receiving benefits2009-01-011
Total of all active and inactive participants2009-01-0119
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-011
Total participants2009-01-0120
Number of participants with account balances2009-01-0120

Financial Data on CHADRON MEDICAL CLINIC, PC 401(K) PROFIT SHARING PLAN & TRUST

Measure Date Value
2012 : CHADRON MEDICAL CLINIC, PC 401(K) PROFIT SHARING PLAN & TRUST 2012 401k financial data
Total income from all sources2012-12-31$568,785
Expenses. Total of all expenses incurred2012-12-31$8,529
Benefits paid (including direct rollovers)2012-12-31$7,303
Total plan assets at end of year2012-12-31$2,624,189
Total plan assets at beginning of year2012-12-31$2,063,933
Total contributions received or receivable from participants2012-12-31$141,798
Expenses. Other expenses not covered elsewhere2012-12-31$0
Other income received2012-12-31$371,574
Net income (gross income less expenses)2012-12-31$560,256
Net plan assets at end of year (total assets less liabilities)2012-12-31$2,624,189
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$2,063,933
Total contributions received or receivable from employer(s)2012-12-31$55,413
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$1,226
2011 : CHADRON MEDICAL CLINIC, PC 401(K) PROFIT SHARING PLAN & TRUST 2011 401k financial data
Total income from all sources2011-12-31$56,687
Expenses. Total of all expenses incurred2011-12-31$7,855
Benefits paid (including direct rollovers)2011-12-31$5,588
Total plan assets at end of year2011-12-31$2,063,933
Total plan assets at beginning of year2011-12-31$2,015,101
Total contributions received or receivable from participants2011-12-31$108,670
Other income received2011-12-31$-99,566
Net income (gross income less expenses)2011-12-31$48,832
Net plan assets at end of year (total assets less liabilities)2011-12-31$2,063,933
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$2,015,101
Total contributions received or receivable from employer(s)2011-12-31$47,583
Expenses. Administrative service providers (salaries,fees and commissions)2011-12-31$2,267
2010 : CHADRON MEDICAL CLINIC, PC 401(K) PROFIT SHARING PLAN & TRUST 2010 401k financial data
Total income from all sources2010-12-31$405,225
Expenses. Total of all expenses incurred2010-12-31$126,465
Benefits paid (including direct rollovers)2010-12-31$124,721
Total plan assets at end of year2010-12-31$2,015,101
Total plan assets at beginning of year2010-12-31$1,736,341
Total contributions received or receivable from participants2010-12-31$115,514
Other income received2010-12-31$239,589
Net income (gross income less expenses)2010-12-31$278,760
Net plan assets at end of year (total assets less liabilities)2010-12-31$2,015,101
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$1,736,341
Total contributions received or receivable from employer(s)2010-12-31$50,122
Expenses. Administrative service providers (salaries,fees and commissions)2010-12-31$1,744

Form 5500 Responses for CHADRON MEDICAL CLINIC, PC 401(K) PROFIT SHARING PLAN & TRUST

2012: CHADRON MEDICAL CLINIC, PC 401(K) PROFIT SHARING PLAN & TRUST 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: CHADRON MEDICAL CLINIC, PC 401(K) PROFIT SHARING PLAN & TRUST 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2009: CHADRON MEDICAL CLINIC, PC 401(K) PROFIT SHARING PLAN & TRUST 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01This submission is the final filingNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

C.M. LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93432 )
Policy contract number60334220
Policy instance 1
Insurance contract or identification number60334220
Number of Individuals Covered3
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $48
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $24
Insurance broker organization code?3
Insurance broker nameKEITH A DERAS
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number011219803
Policy instance 2
Insurance contract or identification number011219803
Number of Individuals Covered1
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $8
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4
Insurance broker organization code?3
Insurance broker nameKEITH A DERAS
C.M. LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93432 )
Policy contract number60334220
Policy instance 1
Insurance contract or identification number60334220
Number of Individuals Covered3
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $46
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number011219803
Policy instance 2
Insurance contract or identification number011219803
Number of Individuals Covered1
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $12
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
C.M. LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93432 )
Policy contract number60334220
Policy instance 1
Insurance contract or identification number60334220
Number of Individuals Covered3
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $44
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22
Insurance broker organization code?3
Insurance broker nameKEITH A DERAS

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