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| Plan Name | MICHAEL D. BAUM, M.D., P.A. PROFIT SHARING PLAN |
| Plan identification number | 001 |
| 401k Plan Type | Defined Contribution Pension |
| Plan Features/Benefits |
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| Company Name: | MICHAEL D. BAUM, M.D., P.A. |
| Employer identification number (EIN): | 521426371 |
| NAIC Classification: | 621111 |
| NAIC Description: | Offices of Physicians (except Mental Health Specialists) |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 001 | 2014-01-01 | MICHAEL D. BAUM | 2014-12-29 | MICHAEL D. BAUM | 2014-12-29 |
| 001 | 2013-01-01 | MICHAEL D. BAUM | 2014-07-01 | MICHAEL D. BAUM | 2014-07-01 |
| 001 | 2012-01-01 | MICHAEL D. BAUM | 2013-09-10 | MICHAEL D. BAUM | 2013-09-10 |
| 001 | 2011-01-01 | MICHAEL D. BAUM | 2012-09-18 | MICHAEL D. BAUM | 2012-09-18 |
| 001 | 2010-01-01 | MICHAEL D. BAUM, M.D. | MICHAEL D. BAUM, M.D. | 2011-05-23 | |
| 001 | 2009-01-01 | MICHAEL D. BAUM, M.D. | MICHAEL D. BAUM, M.D. | 2010-08-10 |
| Measure | Date | Value |
|---|---|---|
| 2010: MICHAEL D. BAUM, M.D., P.A. PROFIT SHARING PLAN 2010 401k membership | ||
| Total participants, beginning-of-year | 2010-01-01 | 5 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 5 |
| Number of retired or separated participants receiving benefits | 2010-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2010-01-01 | 0 |
| Total of all active and inactive participants | 2010-01-01 | 5 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2010-01-01 | 0 |
| Total participants | 2010-01-01 | 5 |
| Number of participants with account balances | 2010-01-01 | 5 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2010-01-01 | 0 |
| 2009: MICHAEL D. BAUM, M.D., P.A. PROFIT SHARING PLAN 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 | 5 |
| Number of retired or separated participants receiving benefits | 2009-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2009-01-01 | 0 |
| Total of all active and inactive participants | 2009-01-01 | 5 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2009-01-01 | 0 |
| Total participants | 2009-01-01 | 5 |
| Number of participants with account balances | 2009-01-01 | 5 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2009-01-01 | 0 |
| Measure | Date | Value |
|---|---|---|
| 2010 : MICHAEL D. BAUM, M.D., P.A. PROFIT SHARING PLAN 2010 401k financial data | ||
| Total income from all sources | 2010-12-31 | $144,013 |
| Expenses. Total of all expenses incurred | 2010-12-31 | $78 |
| Total plan assets at end of year | 2010-12-31 | $1,875,462 |
| Total plan assets at beginning of year | 2010-12-31 | $1,731,527 |
| Value of fidelity bond covering the plan | 2010-12-31 | $275,000 |
| Expenses. Other expenses not covered elsewhere | 2010-12-31 | $78 |
| Other income received | 2010-12-31 | $88,018 |
| Net income (gross income less expenses) | 2010-12-31 | $143,935 |
| Net plan assets at end of year (total assets less liabilities) | 2010-12-31 | $1,875,462 |
| Net plan assets at beginning of year (total assets less liabilities) | 2010-12-31 | $1,731,527 |
| Total contributions received or receivable from employer(s) | 2010-12-31 | $55,995 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2010-12-31 | $0 |
| 2010: MICHAEL D. BAUM, M.D., P.A. PROFIT SHARING PLAN 2010 form 5500 responses | ||
|---|---|---|
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | Submission has been amended | No |
| 2010-01-01 | This submission is the final filing | No |
| 2010-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2010-01-01 | Plan is a collectively bargained plan | No |
| 2010-01-01 | Plan funding arrangement – Insurance | Yes |
| 2010-01-01 | Plan funding arrangement – Trust | Yes |
| 2010-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2010-01-01 | Plan benefit arrangement - Trust | Yes |
| 2009: MICHAEL D. BAUM, M.D., P.A. PROFIT SHARING PLAN 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 |
| RIVERSOURCE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65005 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 4189156 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
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