401k Plan data: AURELIO BENAVIDES, M.D., INC. 401K PLAN plan

AURELIO BENAVIDES, M.D., INC. 401K PLAN 401k Plan overview

Plan Name	AURELIO BENAVIDES, M.D., INC. 401K PLAN
Plan identification number	001

AURELIO BENAVIDES, M.D., INC. 401K 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
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.
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.
Life insurance

401k Sponsoring company profile

AURELIO BENAVIDES, M.D., INC. has sponsored the creation of one or more 401k plans.

Company Name: AURELIO BENAVIDES, M.D., INC.

Employer identification number (EIN): 550614548

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan AURELIO BENAVIDES, M.D., INC. 401K PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2019-01-01
001 2018-01-01
001 2017-01-01 AURELIO BENAVIDES, M.D.
001 2016-01-01 AURELIO BENAVIDES, M.D.
001 2015-01-01 AURELIO BENAVIDES, M.D.
001 2014-01-01 AURELIO BENAVIDES, M.D.
001 2013-01-01 AURELIO BENAVIDES, M.D.
001 2012-01-01 AURELIO BENAVIDES, M.D.
001 2011-01-01 AURELIO BENAVIDES, M.D.
001 2010-01-01 AURELIO BENAVIDES, M.D.
001 2009-01-01 AURELIO BENAVIDES, M.D.

Financial Data on AURELIO BENAVIDES, M.D., INC. 401K PLAN

Measure	Date	Value
2019 : AURELIO BENAVIDES, M.D., INC. 401K PLAN 2019 401k financial data
Transfers to/from the plan	2019-12-31	$0
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	$245,861
Expenses. Total of all expenses incurred	2019-12-31	$107,031
Benefits paid (including direct rollovers)	2019-12-31	$85,700
Total plan assets at end of year	2019-12-31	$1,201,693
Total plan assets at beginning of year	2019-12-31	$1,062,863
Value of fidelity bond covering the plan	2019-12-31	$250,000
Total contributions received or receivable from participants	2019-12-31	$0
Expenses. Other expenses not covered elsewhere	2019-12-31	$4,958
Contributions received from other sources (not participants or employers)	2019-12-31	$0
Other income received	2019-12-31	$245,861
Noncash contributions received	2019-12-31	$0
Net income (gross income less expenses)	2019-12-31	$138,830
Net plan assets at end of year (total assets less liabilities)	2019-12-31	$1,201,693
Net plan assets at beginning of year (total assets less liabilities)	2019-12-31	$1,062,863
Total contributions received or receivable from employer(s)	2019-12-31	$0
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	$16,373
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
2018 : AURELIO BENAVIDES, M.D., INC. 401K 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	$-28,241
Expenses. Total of all expenses incurred	2018-12-31	$118,036
Benefits paid (including direct rollovers)	2018-12-31	$81,000
Total plan assets at end of year	2018-12-31	$1,062,863
Total plan assets at beginning of year	2018-12-31	$1,209,140
Value of fidelity bond covering the plan	2018-12-31	$250,000
Total contributions received or receivable from participants	2018-12-31	$0
Expenses. Other expenses not covered elsewhere	2018-12-31	$4,958
Contributions received from other sources (not participants or employers)	2018-12-31	$0
Other income received	2018-12-31	$-28,241
Noncash contributions received	2018-12-31	$0
Net income (gross income less expenses)	2018-12-31	$-146,277
Net plan assets at end of year (total assets less liabilities)	2018-12-31	$1,062,863
Net plan assets at beginning of year (total assets less liabilities)	2018-12-31	$1,209,140
Total contributions received or receivable from employer(s)	2018-12-31	$0
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	$32,078
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
2017 : AURELIO BENAVIDES, M.D., INC. 401K PLAN 2017 401k financial data
Transfers to/from the plan	2017-12-31	$0
Total plan liabilities at end of year	2017-12-31	$0
Total plan liabilities at beginning of year	2017-12-31	$0
Total income from all sources	2017-12-31	$147,248
Expenses. Total of all expenses incurred	2017-12-31	$117,819
Benefits paid (including direct rollovers)	2017-12-31	$100,000
Total plan assets at end of year	2017-12-31	$1,209,140
Total plan assets at beginning of year	2017-12-31	$1,179,711
Value of fidelity bond covering the plan	2017-12-31	$250,000
Total contributions received or receivable from participants	2017-12-31	$0
Expenses. Other expenses not covered elsewhere	2017-12-31	$237
Contributions received from other sources (not participants or employers)	2017-12-31	$0
Other income received	2017-12-31	$147,248
Noncash contributions received	2017-12-31	$0
Net income (gross income less expenses)	2017-12-31	$29,429
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$1,209,140
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$1,179,711
Total contributions received or receivable from employer(s)	2017-12-31	$0
Value of certain deemed distributions of participant loans	2017-12-31	$0
Value of corrective distributions	2017-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2017-12-31	$17,582
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
2016 : AURELIO BENAVIDES, M.D., INC. 401K PLAN 2016 401k financial data
Transfers to/from the plan	2016-12-31	$0
Total plan liabilities at end of year	2016-12-31	$0
Total plan liabilities at beginning of year	2016-12-31	$0
Total income from all sources	2016-12-31	$91,118
Expenses. Total of all expenses incurred	2016-12-31	$91,829
Benefits paid (including direct rollovers)	2016-12-31	$75,000
Total plan assets at end of year	2016-12-31	$1,179,711
Total plan assets at beginning of year	2016-12-31	$1,180,422
Value of fidelity bond covering the plan	2016-12-31	$250,000
Total contributions received or receivable from participants	2016-12-31	$0
Expenses. Other expenses not covered elsewhere	2016-12-31	$533
Contributions received from other sources (not participants or employers)	2016-12-31	$0
Other income received	2016-12-31	$91,118
Noncash contributions received	2016-12-31	$0
Net income (gross income less expenses)	2016-12-31	$-711
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$1,179,711
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$1,180,422
Total contributions received or receivable from employer(s)	2016-12-31	$0
Value of certain deemed distributions of participant loans	2016-12-31	$0
Value of corrective distributions	2016-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2016-12-31	$16,296
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
2015 : AURELIO BENAVIDES, M.D., INC. 401K PLAN 2015 401k financial data
Transfers to/from the plan	2015-12-31	$0
Total plan liabilities at end of year	2015-12-31	$0
Total plan liabilities at beginning of year	2015-12-31	$0
Total income from all sources	2015-12-31	$27,211
Expenses. Total of all expenses incurred	2015-12-31	$76,465
Benefits paid (including direct rollovers)	2015-12-31	$63,000
Total plan assets at end of year	2015-12-31	$1,180,422
Total plan assets at beginning of year	2015-12-31	$1,229,676
Value of fidelity bond covering the plan	2015-12-31	$250,000
Total contributions received or receivable from participants	2015-12-31	$0
Expenses. Other expenses not covered elsewhere	2015-12-31	$141
Contributions received from other sources (not participants or employers)	2015-12-31	$0
Other income received	2015-12-31	$27,211
Noncash contributions received	2015-12-31	$0
Net income (gross income less expenses)	2015-12-31	$-49,254
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$1,180,422
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$1,229,676
Total contributions received or receivable from employer(s)	2015-12-31	$0
Value of certain deemed distributions of participant loans	2015-12-31	$0
Value of corrective distributions	2015-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2015-12-31	$13,324
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
2014 : AURELIO BENAVIDES, M.D., INC. 401K PLAN 2014 401k financial data
Transfers to/from the plan	2014-12-31	$0
Total plan liabilities at end of year	2014-12-31	$0
Total plan liabilities at beginning of year	2014-12-31	$0
Total income from all sources	2014-12-31	$80,682
Expenses. Total of all expenses incurred	2014-12-31	$59,443
Benefits paid (including direct rollovers)	2014-12-31	$43,931
Total plan assets at end of year	2014-12-31	$1,229,676
Total plan assets at beginning of year	2014-12-31	$1,208,437
Value of fidelity bond covering the plan	2014-12-31	$250,000
Total contributions received or receivable from participants	2014-12-31	$0
Expenses. Other expenses not covered elsewhere	2014-12-31	$1,560
Contributions received from other sources (not participants or employers)	2014-12-31	$0
Other income received	2014-12-31	$80,682
Noncash contributions received	2014-12-31	$0
Net income (gross income less expenses)	2014-12-31	$21,239
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$1,229,676
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$1,208,437
Total contributions received or receivable from employer(s)	2014-12-31	$0
Value of certain deemed distributions of participant loans	2014-12-31	$0
Value of corrective distributions	2014-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2014-12-31	$13,952
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
2013 : AURELIO BENAVIDES, M.D., INC. 401K PLAN 2013 401k financial data
Transfers to/from the plan	2013-12-31	$0
Total plan liabilities at end of year	2013-12-31	$0
Total plan liabilities at beginning of year	2013-12-31	$0
Total income from all sources	2013-12-31	$-12,610
Expenses. Total of all expenses incurred	2013-12-31	$167,412
Benefits paid (including direct rollovers)	2013-12-31	$152,426
Total plan assets at end of year	2013-12-31	$1,208,437
Total plan assets at beginning of year	2013-12-31	$1,388,459
Value of fidelity bond covering the plan	2013-12-31	$250,000
Total contributions received or receivable from participants	2013-12-31	$0
Expenses. Other expenses not covered elsewhere	2013-12-31	$507
Contributions received from other sources (not participants or employers)	2013-12-31	$0
Other income received	2013-12-31	$-12,610
Noncash contributions received	2013-12-31	$0
Net income (gross income less expenses)	2013-12-31	$-180,022
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$1,208,437
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$1,388,459
Total contributions received or receivable from employer(s)	2013-12-31	$0
Value of certain deemed distributions of participant loans	2013-12-31	$0
Value of corrective distributions	2013-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2013-12-31	$14,479
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
2012 : AURELIO BENAVIDES, M.D., INC. 401K PLAN 2012 401k financial data
Transfers to/from the plan	2012-12-31	$0
Total plan liabilities at end of year	2012-12-31	$0
Total plan liabilities at beginning of year	2012-12-31	$0
Total income from all sources	2012-12-31	$190,568
Expenses. Total of all expenses incurred	2012-12-31	$82,852
Benefits paid (including direct rollovers)	2012-12-31	$50,030
Total plan assets at end of year	2012-12-31	$1,388,459
Total plan assets at beginning of year	2012-12-31	$1,280,743
Value of fidelity bond covering the plan	2012-12-31	$250,000
Total contributions received or receivable from participants	2012-12-31	$11,000
Expenses. Other expenses not covered elsewhere	2012-12-31	$4,857
Contributions received from other sources (not participants or employers)	2012-12-31	$0
Other income received	2012-12-31	$168,568
Noncash contributions received	2012-12-31	$0
Net income (gross income less expenses)	2012-12-31	$107,716
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$1,388,459
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$1,280,743
Total contributions received or receivable from employer(s)	2012-12-31	$11,000
Value of certain deemed distributions of participant loans	2012-12-31	$0
Value of corrective distributions	2012-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2012-12-31	$27,965
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
2011 : AURELIO BENAVIDES, M.D., INC. 401K PLAN 2011 401k financial data
Transfers to/from the plan	2011-12-31	$0
Total plan liabilities at end of year	2011-12-31	$0
Total plan liabilities at beginning of year	2011-12-31	$0
Total income from all sources	2011-12-31	$110,516
Expenses. Total of all expenses incurred	2011-12-31	$108,816
Benefits paid (including direct rollovers)	2011-12-31	$95,649
Total plan assets at end of year	2011-12-31	$1,280,743
Total plan assets at beginning of year	2011-12-31	$1,279,043
Value of fidelity bond covering the plan	2011-12-31	$250,000
Total contributions received or receivable from participants	2011-12-31	$17,764
Expenses. Other expenses not covered elsewhere	2011-12-31	$901
Contributions received from other sources (not participants or employers)	2011-12-31	$0
Other income received	2011-12-31	$89,246
Noncash contributions received	2011-12-31	$0
Net income (gross income less expenses)	2011-12-31	$1,700
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$1,280,743
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$1,279,043
Assets. Value of participant loans	2011-12-31	$0
Total contributions received or receivable from employer(s)	2011-12-31	$3,506
Value of certain deemed distributions of participant loans	2011-12-31	$0
Value of corrective distributions	2011-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$12,266
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
2010 : AURELIO BENAVIDES, M.D., INC. 401K PLAN 2010 401k financial data
Transfers to/from the plan	2010-12-31	$0
Total plan liabilities at end of year	2010-12-31	$0
Total plan liabilities at beginning of year	2010-12-31	$0
Total income from all sources	2010-12-31	$113,283
Expenses. Total of all expenses incurred	2010-12-31	$12,833
Benefits paid (including direct rollovers)	2010-12-31	$0
Total plan assets at end of year	2010-12-31	$1,279,043
Total plan assets at beginning of year	2010-12-31	$1,178,593
Value of fidelity bond covering the plan	2010-12-31	$250,000
Total contributions received or receivable from participants	2010-12-31	$22,000
Expenses. Other expenses not covered elsewhere	2010-12-31	$1,254
Contributions received from other sources (not participants or employers)	2010-12-31	$0
Other income received	2010-12-31	$66,283
Noncash contributions received	2010-12-31	$0
Net income (gross income less expenses)	2010-12-31	$100,450
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$1,279,043
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$1,178,593
Assets. Value of participant loans	2010-12-31	$5,417
Total contributions received or receivable from employer(s)	2010-12-31	$25,000
Value of certain deemed distributions of participant loans	2010-12-31	$0
Value of corrective distributions	2010-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$11,579

Form 5500 Responses for AURELIO BENAVIDES, M.D., INC. 401K PLAN

2019: AURELIO BENAVIDES, M.D., INC. 401K 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: AURELIO BENAVIDES, M.D., INC. 401K 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
2017: AURELIO BENAVIDES, M.D., INC. 401K PLAN 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 – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: AURELIO BENAVIDES, M.D., INC. 401K PLAN 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 – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: AURELIO BENAVIDES, M.D., INC. 401K PLAN 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 – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: AURELIO BENAVIDES, M.D., INC. 401K PLAN 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 – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: AURELIO BENAVIDES, M.D., INC. 401K PLAN 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 – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: AURELIO BENAVIDES, M.D., INC. 401K PLAN 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 – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: AURELIO BENAVIDES, M.D., INC. 401K PLAN 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
2010: AURELIO BENAVIDES, M.D., INC. 401K 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: AURELIO BENAVIDES, M.D., INC. 401K 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 – 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

PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68136 )
Policy contract number	BOO160783
Policy instance	1
PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68136 )
Policy contract number	BOO160783
Policy instance	1
PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68136 )
Policy contract number	BOO160783
Policy instance	1
PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68136 )
Policy contract number	BOO160783
Policy instance	1
PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68136 )
Policy contract number	BOO160783
Policy instance	1
NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66680 )
Policy contract number	0155040
Policy instance	1
PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68136 )
Policy contract number	BOO160783
Policy instance	2
NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66680 )
Policy contract number	0155040
Policy instance	1
PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68136 )
Policy contract number	BOO160783
Policy instance	2
NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66680 )
Policy contract number	0155040
Policy instance	1
PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68136 )
Policy contract number	BOO160783
Policy instance	2
PROTECTIVE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68136 )
Policy contract number	BOO160783
Policy instance	3
NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66680 )
Policy contract number	0155040
Policy instance	1
PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )
Policy contract number	1A22781250
Policy instance	2

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Company Name:	AURELIO BENAVIDES, M.D., INC.
Employer identification number (EIN):	550614548
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)