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JEFFERS MANN & ARTMAN PEDIATRIC AND ADOLESCENT MEDICINE P.A. LONG TERM DISABILITY PLAN 401k Plan overview

Plan NameJEFFERS MANN & ARTMAN PEDIATRIC AND ADOLESCENT MEDICINE P.A. LONG TERM DISABILITY PLAN
Plan identification number 502

JEFFERS MANN & ARTMAN PEDIATRIC AND ADOLESCENT MEDICINE P.A. LONG TERM DISABILITY PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Long-term disability cover

401k Sponsoring company profile

JEFFERS, MANN AND ARTMAN PEDIATRIC AND ADOLESCENT MEDICINE P.A. has sponsored the creation of one or more 401k plans.

Company Name:JEFFERS, MANN AND ARTMAN PEDIATRIC AND ADOLESCENT MEDICINE P.A.
Employer identification number (EIN):562146753
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan JEFFERS MANN & ARTMAN PEDIATRIC AND ADOLESCENT MEDICINE P.A. LONG TERM DISABILITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022015-10-01MARY AHEARN
5022014-10-01MARY AHEARN

Plan Statistics for JEFFERS MANN & ARTMAN PEDIATRIC AND ADOLESCENT MEDICINE P.A. LONG TERM DISABILITY PLAN

401k plan membership statisitcs for JEFFERS MANN & ARTMAN PEDIATRIC AND ADOLESCENT MEDICINE P.A. LONG TERM DISABILITY PLAN

Measure Date Value
2015: JEFFERS MANN & ARTMAN PEDIATRIC AND ADOLESCENT MEDICINE P.A. LONG TERM DISABILITY PLAN 2015 401k membership
Total participants, beginning-of-year2015-10-01115
Total number of active participants reported on line 7a of the Form 55002015-10-010
Number of retired or separated participants receiving benefits2015-10-010
Number of other retired or separated participants entitled to future benefits2015-10-010
Total of all active and inactive participants2015-10-010
2014: JEFFERS MANN & ARTMAN PEDIATRIC AND ADOLESCENT MEDICINE P.A. LONG TERM DISABILITY PLAN 2014 401k membership
Total participants, beginning-of-year2014-10-01102
Total number of active participants reported on line 7a of the Form 55002014-10-01115
Number of retired or separated participants receiving benefits2014-10-010
Number of other retired or separated participants entitled to future benefits2014-10-010
Total of all active and inactive participants2014-10-01115

Form 5500 Responses for JEFFERS MANN & ARTMAN PEDIATRIC AND ADOLESCENT MEDICINE P.A. LONG TERM DISABILITY PLAN

2015: JEFFERS MANN & ARTMAN PEDIATRIC AND ADOLESCENT MEDICINE P.A. LONG TERM DISABILITY PLAN 2015 form 5500 responses
2015-10-01Type of plan entitySingle employer plan
2015-10-01Submission has been amendedNo
2015-10-01This submission is the final filingYes
2015-10-01This return/report is a short plan year return/report (less than 12 months)No
2015-10-01Plan is a collectively bargained planNo
2015-10-01Plan funding arrangement – InsuranceYes
2015-10-01Plan benefit arrangement – InsuranceYes
2014: JEFFERS MANN & ARTMAN PEDIATRIC AND ADOLESCENT MEDICINE P.A. LONG TERM DISABILITY PLAN 2014 form 5500 responses
2014-10-01Type of plan entitySingle employer plan
2014-10-01First time form 5500 has been submittedYes
2014-10-01Submission has been amendedNo
2014-10-01This submission is the final filingNo
2014-10-01This return/report is a short plan year return/report (less than 12 months)No
2014-10-01Plan is a collectively bargained planNo
2014-10-01Plan funding arrangement – InsuranceYes
2014-10-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number137153
Policy instance 1
Insurance contract or identification number137153
Number of Individuals Covered122
Insurance policy start date2015-10-01
Insurance policy end date2016-09-30
Total amount of commissions paid to insurance brokerUSD $4,352
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $47,036
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,352
Insurance broker organization code?3
Insurance broker nameCOBLE NICHOLSON AND ASSOCIATES LLC
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number137153
Policy instance 1
Insurance contract or identification number137153
Number of Individuals Covered115
Insurance policy start date2014-10-01
Insurance policy end date2015-09-30
Total amount of commissions paid to insurance brokerUSD $4,128
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
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 BrokerUSD $4,128
Insurance broker organization code?3
Insurance broker nameCOBLE NICHOLSON AND ASSOCIATES LLC

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