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KEYSTONE PLASTIC & RECONSTRUCTIVE SURGERY 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan NameKEYSTONE PLASTIC & RECONSTRUCTIVE SURGERY 401(K) PROFIT SHARING PLAN
Plan identification number 001

KEYSTONE PLASTIC & RECONSTRUCTIVE SURGERY 401(K) PROFIT SHARING PLAN Benefits

401k Plan TypeDefined 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.
  • Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
  • 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.

401k Sponsoring company profile

KEYSTONE PLASTIC & RECONSTRUCTIVE SURGERY has sponsored the creation of one or more 401k plans.

Company Name:KEYSTONE PLASTIC & RECONSTRUCTIVE SURGERY
Employer identification number (EIN):760514609
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan KEYSTONE PLASTIC & RECONSTRUCTIVE SURGERY 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012024-01-01THOMAS SHANNON
0012023-01-01
0012023-01-01THOMAS SHANNON
0012022-01-01
0012022-01-01THOMAS SHANNON
0012021-01-01THOMAS SHANNON2022-10-12
0012020-01-01
0012019-01-01THOMAS O SHANNON2020-10-12
0012019-01-01THOMAS O SHANNON2021-02-01
0012018-01-01THOMAS O SHANNON2020-10-12
0012017-01-01
0012016-01-01
0012015-01-01
0012014-01-01THOMAS SHANNON
0012013-01-01THOMAS SHANNON
0012012-01-01THOMAS SHANNON, M.D
0012011-01-01THOMAS SHANNON, MD2012-10-03
0012010-01-01THOMAS SHANNON2012-05-21 THOMAS SHANNON2012-05-21

Financial Data on KEYSTONE PLASTIC & RECONSTRUCTIVE SURGERY 401(K) PROFIT SHARING PLAN

Measure Date Value
2023 : KEYSTONE PLASTIC & RECONSTRUCTIVE SURGERY 401(K) PROFIT SHARING PLAN 2023 401k financial data
Total income from all sources2023-12-31$52,642
Expenses. Total of all expenses incurred2023-12-31$5,881
Benefits paid (including direct rollovers)2023-12-31$58
Total plan assets at end of year2023-12-31$484,241
Total plan assets at beginning of year2023-12-31$437,480
Value of fidelity bond covering the plan2023-12-31$160,000
Assets. Value of tangible personal property2023-12-31$158,843
Total contributions received or receivable from participants2023-12-31$0
Contributions received from other sources (not participants or employers)2023-12-31$0
Other income received2023-12-31$52,642
Net income (gross income less expenses)2023-12-31$46,761
Net plan assets at end of year (total assets less liabilities)2023-12-31$484,241
Net plan assets at beginning of year (total assets less liabilities)2023-12-31$437,480
Total contributions received or receivable from employer(s)2023-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2023-12-31$5,823
2022 : KEYSTONE PLASTIC & RECONSTRUCTIVE SURGERY 401(K) PROFIT SHARING PLAN 2022 401k financial data
Total income from all sources2022-12-31$-86,460
Expenses. Total of all expenses incurred2022-12-31$309,159
Benefits paid (including direct rollovers)2022-12-31$300,020
Total plan assets at end of year2022-12-31$437,480
Total plan assets at beginning of year2022-12-31$833,099
Value of fidelity bond covering the plan2022-12-31$160,000
Assets. Value of tangible personal property2022-12-31$144,089
Total contributions received or receivable from participants2022-12-31$0
Contributions received from other sources (not participants or employers)2022-12-31$0
Other income received2022-12-31$-86,460
Net income (gross income less expenses)2022-12-31$-395,619
Net plan assets at end of year (total assets less liabilities)2022-12-31$437,480
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$833,099
Total contributions received or receivable from employer(s)2022-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2022-12-31$9,139
2020 : KEYSTONE PLASTIC & RECONSTRUCTIVE SURGERY 401(K) PROFIT SHARING PLAN 2020 401k financial data
Total income from all sources2020-12-31$85,804
Expenses. Total of all expenses incurred2020-12-31$6,656
Benefits paid (including direct rollovers)2020-12-31$0
Total plan assets at end of year2020-12-31$764,676
Total plan assets at beginning of year2020-12-31$685,528
Value of fidelity bond covering the plan2020-12-31$149,599
Assets. Value of tangible personal property2020-12-31$149,599
Total contributions received or receivable from participants2020-12-31$1,019
Contributions received from other sources (not participants or employers)2020-12-31$0
Other income received2020-12-31$84,785
Net income (gross income less expenses)2020-12-31$79,148
Net plan assets at end of year (total assets less liabilities)2020-12-31$764,676
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$685,528
Total contributions received or receivable from employer(s)2020-12-31$0
Value of certain deemed distributions of participant loans2020-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$6,656
2019 : KEYSTONE PLASTIC & RECONSTRUCTIVE SURGERY 401(K) PROFIT SHARING PLAN 2019 401k financial data
Transfers to/from the plan2019-12-31$0
Total plan liabilities at end of year2019-12-31$0
Total plan liabilities at beginning of year2019-12-31$0
Total income from all sources2019-12-31$18,213
Expenses. Total of all expenses incurred2019-12-31$0
Benefits paid (including direct rollovers)2019-12-31$0
Total plan assets at end of year2019-12-31$626,965
Total plan assets at beginning of year2019-12-31$608,752
Value of fidelity bond covering the plan2019-12-31$60,875
Assets. Value of tangible personal property2019-12-31$102,576
Total contributions received or receivable from participants2019-12-31$0
Expenses. Other expenses not covered elsewhere2019-12-31$0
Contributions received from other sources (not participants or employers)2019-12-31$0
Other income received2019-12-31$18,213
Noncash contributions received2019-12-31$0
Net income (gross income less expenses)2019-12-31$18,213
Net plan assets at end of year (total assets less liabilities)2019-12-31$626,965
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$608,752
Total contributions received or receivable from employer(s)2019-12-31$0
Value of certain deemed distributions of participant loans2019-12-31$0
Value of corrective distributions2019-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$0
2018 : KEYSTONE PLASTIC & RECONSTRUCTIVE SURGERY 401(K) PROFIT SHARING PLAN 2018 401k financial data
Transfers to/from the plan2018-12-31$0
Total plan liabilities at end of year2018-12-31$0
Total plan liabilities at beginning of year2018-12-31$0
Total income from all sources2018-12-31$-28,391
Expenses. Total of all expenses incurred2018-12-31$9,498
Benefits paid (including direct rollovers)2018-12-31$6,543
Total plan assets at end of year2018-12-31$608,752
Total plan assets at beginning of year2018-12-31$646,641
Value of fidelity bond covering the plan2018-12-31$40,000
Assets. Value of tangible personal property2018-12-31$102,576
Total contributions received or receivable from participants2018-12-31$3,924
Expenses. Other expenses not covered elsewhere2018-12-31$0
Contributions received from other sources (not participants or employers)2018-12-31$0
Other income received2018-12-31$-32,315
Noncash contributions received2018-12-31$0
Net income (gross income less expenses)2018-12-31$-37,889
Net plan assets at end of year (total assets less liabilities)2018-12-31$608,752
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$646,641
Total contributions received or receivable from employer(s)2018-12-31$0
Value of certain deemed distributions of participant loans2018-12-31$0
Value of corrective distributions2018-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$2,955
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
2017 : KEYSTONE PLASTIC & RECONSTRUCTIVE SURGERY 401(K) PROFIT SHARING PLAN 2017 401k financial data
Total plan liabilities at end of year2017-12-31$0
Total plan liabilities at beginning of year2017-12-31$0
Total income from all sources2017-12-31$99,726
Expenses. Total of all expenses incurred2017-12-31$3,618
Benefits paid (including direct rollovers)2017-12-31$877
Total plan assets at end of year2017-12-31$646,641
Total plan assets at beginning of year2017-12-31$550,533
Value of fidelity bond covering the plan2017-12-31$40,000
Assets. Value of tangible personal property2017-12-31$109,578
Total contributions received or receivable from participants2017-12-31$3,465
Expenses. Other expenses not covered elsewhere2017-12-31$0
Contributions received from other sources (not participants or employers)2017-12-31$0
Other income received2017-12-31$96,261
Noncash contributions received2017-12-31$0
Net income (gross income less expenses)2017-12-31$96,108
Net plan assets at end of year (total assets less liabilities)2017-12-31$646,641
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$550,533
Total contributions received or receivable from employer(s)2017-12-31$0
Value of certain deemed distributions of participant loans2017-12-31$0
Value of corrective distributions2017-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$2,741
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
2016 : KEYSTONE PLASTIC & RECONSTRUCTIVE SURGERY 401(K) PROFIT SHARING PLAN 2016 401k financial data
Transfers to/from the plan2016-12-31$0
Total plan liabilities at end of year2016-12-31$0
Total plan liabilities at beginning of year2016-12-31$0
Total income from all sources2016-12-31$76,052
Expenses. Total of all expenses incurred2016-12-31$14,356
Benefits paid (including direct rollovers)2016-12-31$12,507
Total plan assets at end of year2016-12-31$550,533
Total plan assets at beginning of year2016-12-31$488,837
Value of fidelity bond covering the plan2016-12-31$40,000
Assets. Value of tangible personal property2016-12-31$92,072
Total contributions received or receivable from participants2016-12-31$3,334
Expenses. Other expenses not covered elsewhere2016-12-31$0
Contributions received from other sources (not participants or employers)2016-12-31$0
Other income received2016-12-31$42,718
Net income (gross income less expenses)2016-12-31$61,696
Net plan assets at end of year (total assets less liabilities)2016-12-31$550,533
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$488,837
Total contributions received or receivable from employer(s)2016-12-31$30,000
Value of certain deemed distributions of participant loans2016-12-31$0
Value of corrective distributions2016-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$1,849
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
2015 : KEYSTONE PLASTIC & RECONSTRUCTIVE SURGERY 401(K) PROFIT SHARING PLAN 2015 401k financial data
Transfers to/from the plan2015-12-31$0
Total plan liabilities at end of year2015-12-31$0
Total plan liabilities at beginning of year2015-12-31$0
Total income from all sources2015-12-31$-1,016
Expenses. Total of all expenses incurred2015-12-31$1,726
Benefits paid (including direct rollovers)2015-12-31$59
Total plan assets at end of year2015-12-31$488,837
Total plan assets at beginning of year2015-12-31$491,579
Value of fidelity bond covering the plan2015-12-31$40,000
Assets. Value of tangible personal property2015-12-31$84,824
Total contributions received or receivable from participants2015-12-31$4,216
Expenses. Other expenses not covered elsewhere2015-12-31$0
Contributions received from other sources (not participants or employers)2015-12-31$0
Other income received2015-12-31$-12,277
Noncash contributions received2015-12-31$0
Net income (gross income less expenses)2015-12-31$-2,742
Net plan assets at end of year (total assets less liabilities)2015-12-31$488,837
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$491,579
Total contributions received or receivable from employer(s)2015-12-31$7,045
Value of certain deemed distributions of participant loans2015-12-31$0
Value of corrective distributions2015-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$1,667
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
2014 : KEYSTONE PLASTIC & RECONSTRUCTIVE SURGERY 401(K) PROFIT SHARING PLAN 2014 401k financial data
Transfers to/from the plan2014-12-31$0
Total plan liabilities at end of year2014-12-31$0
Total plan liabilities at beginning of year2014-12-31$0
Total income from all sources2014-12-31$78,864
Expenses. Total of all expenses incurred2014-12-31$6,152
Benefits paid (including direct rollovers)2014-12-31$4,132
Total plan assets at end of year2014-12-31$491,579
Total plan assets at beginning of year2014-12-31$418,867
Value of fidelity bond covering the plan2014-12-31$40,000
Assets. Value of tangible personal property2014-12-31$96,408
Total contributions received or receivable from participants2014-12-31$17,738
Expenses. Other expenses not covered elsewhere2014-12-31$0
Contributions received from other sources (not participants or employers)2014-12-31$0
Other income received2014-12-31$17,571
Noncash contributions received2014-12-31$0
Net income (gross income less expenses)2014-12-31$72,712
Net plan assets at end of year (total assets less liabilities)2014-12-31$491,579
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$418,867
Total contributions received or receivable from employer(s)2014-12-31$43,555
Value of certain deemed distributions of participant loans2014-12-31$0
Value of corrective distributions2014-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$2,020
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
2013 : KEYSTONE PLASTIC & RECONSTRUCTIVE SURGERY 401(K) PROFIT SHARING PLAN 2013 401k financial data
Transfers to/from the plan2013-12-31$0
Total plan liabilities at end of year2013-12-31$0
Total plan liabilities at beginning of year2013-12-31$0
Total income from all sources2013-12-31$50,379
Expenses. Total of all expenses incurred2013-12-31$24,860
Benefits paid (including direct rollovers)2013-12-31$23,176
Total plan assets at end of year2013-12-31$418,867
Total plan assets at beginning of year2013-12-31$393,348
Value of fidelity bond covering the plan2013-12-31$40,000
Assets. Value of tangible personal property2013-12-31$97,076
Total contributions received or receivable from participants2013-12-31$18,835
Expenses. Other expenses not covered elsewhere2013-12-31$1,684
Contributions received from other sources (not participants or employers)2013-12-31$0
Other income received2013-12-31$31,544
Noncash contributions received2013-12-31$0
Net income (gross income less expenses)2013-12-31$25,519
Net plan assets at end of year (total assets less liabilities)2013-12-31$418,867
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$393,348
Assets. Value of employer securities2013-12-31$97,076
Total contributions received or receivable from employer(s)2013-12-31$0
Value of certain deemed distributions of participant loans2013-12-31$0
Value of corrective distributions2013-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
2012 : KEYSTONE PLASTIC & RECONSTRUCTIVE SURGERY 401(K) PROFIT SHARING PLAN 2012 401k financial data
Transfers to/from the plan2012-12-31$0
Total plan liabilities at end of year2012-12-31$0
Total plan liabilities at beginning of year2012-12-31$0
Total income from all sources2012-12-31$104,731
Expenses. Total of all expenses incurred2012-12-31$3,652
Benefits paid (including direct rollovers)2012-12-31$3,011
Total plan assets at end of year2012-12-31$393,348
Total plan assets at beginning of year2012-12-31$292,269
Total contributions received or receivable from participants2012-12-31$25,284
Expenses. Other expenses not covered elsewhere2012-12-31$228
Contributions received from other sources (not participants or employers)2012-12-31$0
Other income received2012-12-31$16,391
Noncash contributions received2012-12-31$0
Net income (gross income less expenses)2012-12-31$101,079
Net plan assets at end of year (total assets less liabilities)2012-12-31$393,348
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$292,269
Assets. Value of employer securities2012-12-31$100,512
Total contributions received or receivable from employer(s)2012-12-31$63,056
Value of certain deemed distributions of participant loans2012-12-31$0
Value of corrective distributions2012-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$413
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0

Form 5500 Responses for KEYSTONE PLASTIC & RECONSTRUCTIVE SURGERY 401(K) PROFIT SHARING PLAN

2023: KEYSTONE PLASTIC & RECONSTRUCTIVE SURGERY 401(K) PROFIT SHARING PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Plan funding arrangement – TrustYes
2023-01-01Plan benefit arrangement - TrustYes
2022: KEYSTONE PLASTIC & RECONSTRUCTIVE SURGERY 401(K) PROFIT SHARING PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement - TrustYes
2020: KEYSTONE PLASTIC & RECONSTRUCTIVE SURGERY 401(K) PROFIT SHARING PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: KEYSTONE PLASTIC & RECONSTRUCTIVE SURGERY 401(K) PROFIT SHARING PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: KEYSTONE PLASTIC & RECONSTRUCTIVE SURGERY 401(K) PROFIT SHARING PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: KEYSTONE PLASTIC & RECONSTRUCTIVE SURGERY 401(K) PROFIT SHARING PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: KEYSTONE PLASTIC & RECONSTRUCTIVE SURGERY 401(K) PROFIT SHARING PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: KEYSTONE PLASTIC & RECONSTRUCTIVE SURGERY 401(K) PROFIT SHARING PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: KEYSTONE PLASTIC & RECONSTRUCTIVE SURGERY 401(K) PROFIT SHARING PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: KEYSTONE PLASTIC & RECONSTRUCTIVE SURGERY 401(K) PROFIT SHARING PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedYes
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: KEYSTONE PLASTIC & RECONSTRUCTIVE SURGERY 401(K) PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedYes
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number810510
Policy instance 1
Insurance contract or identification number810510
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $154
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number810510
Policy instance 1
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number665961
Policy instance 1
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 78778 )
Policy contract number632782
Policy instance 1
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberE665961
Policy instance 2
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 78778 )
Policy contract number632782
Policy instance 1
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 78778 )
Policy contract number632782
Policy instance 2
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number106859
Policy instance 1
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number106859
Policy instance 1
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number106859
Policy instance 1
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number106859
Policy instance 1

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