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PREMIER FAMILY MEDICINE PROFIT SHARING PLAN 401k Plan overview

Plan NamePREMIER FAMILY MEDICINE PROFIT SHARING PLAN
Plan identification number 001

PREMIER FAMILY MEDICINE PROFIT SHARING PLAN 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.
  • 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

PREMIER FAMILY MEDICINE has sponsored the creation of one or more 401k plans.

Company Name:PREMIER FAMILY MEDICINE
Employer identification number (EIN):841136316
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Additional information about PREMIER FAMILY MEDICINE

Jurisdiction of Incorporation: Colorado Department of State
Incorporation Date: 1990-03-09
Company Identification Number: 19901014509
Legal Registered Office Address: 2960 N. Circle Dr. Suite 200

Colorado Springs
United States of America (USA)
80909

More information about PREMIER FAMILY MEDICINE

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PREMIER FAMILY MEDICINE PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01C DAVID BIRD2023-06-05
0012021-01-01TERI POKORNY2022-06-22
0012020-01-01TERI POKORNY2022-04-06
0012020-01-01TERI POKORNY2022-07-19
0012019-01-01TERI POKORNY2020-10-15
0012018-01-01TERI POKORNY2019-10-16
0012017-01-01TERI POKORNY2018-07-31
0012016-01-01TERI POKORNY2017-10-16
0012015-01-01C DAVID BIRD MD2016-10-12 C DAVID BIRD MD2016-10-12
0012014-01-01ASHLEY WIECHMANN ASHLEY WIECHMANN2015-10-13
0012013-01-01
0012012-01-01ASHLEY WIECHMANN ASHLEY WIECHMANN2013-11-27
0012011-01-01ARLENE ZIMMERMAN
0012009-01-01ARLENE ZIMMERMAN
0012009-01-01ARLENE ZIMMERMAN

Plan Statistics for PREMIER FAMILY MEDICINE PROFIT SHARING PLAN

401k plan membership statisitcs for PREMIER FAMILY MEDICINE PROFIT SHARING PLAN

Measure Date Value
2014: PREMIER FAMILY MEDICINE PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0133
Total number of active participants reported on line 7a of the Form 55002014-01-0127
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-0114
Total of all active and inactive participants2014-01-0141
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0141
Number of participants with account balances2014-01-0135
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-011
2013: PREMIER FAMILY MEDICINE PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0132
Total number of active participants reported on line 7a of the Form 55002013-01-0121
Number of retired or separated participants receiving benefits2013-01-011
Number of other retired or separated participants entitled to future benefits2013-01-0112
Total of all active and inactive participants2013-01-0134
Total participants2013-01-0134
Number of participants with account balances2013-01-0128
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-011
2012: PREMIER FAMILY MEDICINE PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0134
Total number of active participants reported on line 7a of the Form 55002012-01-0124
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-019
Total of all active and inactive participants2012-01-0133
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0133
Number of participants with account balances2012-01-0124
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: PREMIER FAMILY MEDICINE PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0145
Total number of active participants reported on line 7a of the Form 55002011-01-0126
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-019
Total of all active and inactive participants2011-01-0135
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-0135
Number of participants with account balances2011-01-0135
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2009: PREMIER FAMILY MEDICINE PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-0123
Total number of active participants reported on line 7a of the Form 55002009-01-0121
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-019
Total of all active and inactive participants2009-01-0130
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-0130
Number of participants with account balances2009-01-0130
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on PREMIER FAMILY MEDICINE PROFIT SHARING PLAN

Measure Date Value
2014 : PREMIER FAMILY MEDICINE PROFIT SHARING PLAN 2014 401k financial data
Total income from all sources2014-12-31$100,788
Expenses. Total of all expenses incurred2014-12-31$18,752
Benefits paid (including direct rollovers)2014-12-31$18,543
Total plan assets at end of year2014-12-31$1,367,173
Total plan assets at beginning of year2014-12-31$1,285,137
Value of fidelity bond covering the plan2014-12-31$250,000
Total contributions received or receivable from participants2014-12-31$49,328
Expenses. Other expenses not covered elsewhere2014-12-31$209
Contributions received from other sources (not participants or employers)2014-12-31$0
Other income received2014-12-31$28,180
Net income (gross income less expenses)2014-12-31$82,036
Net plan assets at end of year (total assets less liabilities)2014-12-31$1,367,173
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$1,285,137
Assets. Value of participant loans2014-12-31$9,441
Total contributions received or receivable from employer(s)2014-12-31$23,280
Value of certain deemed distributions of participant loans2014-12-31$0
Value of corrective distributions2014-12-31$0
Funding deficiency by the employer to the plan for this plan year2014-12-31$0
Minimum employer required contribution for this plan year2014-12-31$0
Amount contributed by the employer to the plan for this plan year2014-12-31$0
2013 : PREMIER FAMILY MEDICINE PROFIT SHARING PLAN 2013 401k financial data
Total income from all sources2013-12-31$209,953
Expenses. Total of all expenses incurred2013-12-31$49,576
Benefits paid (including direct rollovers)2013-12-31$49,544
Total plan assets at end of year2013-12-31$1,285,137
Total plan assets at beginning of year2013-12-31$1,124,760
Value of fidelity bond covering the plan2013-12-31$105,000
Total contributions received or receivable from participants2013-12-31$27,962
Contributions received from other sources (not participants or employers)2013-12-31$0
Other income received2013-12-31$166,309
Net income (gross income less expenses)2013-12-31$160,377
Net plan assets at end of year (total assets less liabilities)2013-12-31$1,285,137
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$1,124,760
Assets. Value of participant loans2013-12-31$4,025
Total contributions received or receivable from employer(s)2013-12-31$15,682
Expenses. Administrative service providers (salaries,fees and commissions)2013-12-31$32
2012 : PREMIER FAMILY MEDICINE PROFIT SHARING PLAN 2012 401k financial data
Transfers to/from the plan2012-12-31$0
Total income from all sources2012-12-31$205,435
Expenses. Total of all expenses incurred2012-12-31$90,503
Benefits paid (including direct rollovers)2012-12-31$90,471
Total plan assets at end of year2012-12-31$1,124,760
Total plan assets at beginning of year2012-12-31$1,009,828
Value of fidelity bond covering the plan2012-12-31$105,000
Total contributions received or receivable from participants2012-12-31$46,584
Expenses. Other expenses not covered elsewhere2012-12-31$32
Contributions received from other sources (not participants or employers)2012-12-31$0
Other income received2012-12-31$135,055
Net income (gross income less expenses)2012-12-31$114,932
Net plan assets at end of year (total assets less liabilities)2012-12-31$1,124,760
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$1,009,828
Assets. Value of participant loans2012-12-31$6,655
Total contributions received or receivable from employer(s)2012-12-31$23,796
Value of certain deemed distributions of participant loans2012-12-31$0
Value of corrective distributions2012-12-31$0
Funding deficiency by the employer to the plan for this plan year2012-12-31$0
Minimum employer required contribution for this plan year2012-12-31$0
Amount contributed by the employer to the plan for this plan year2012-12-31$0
2011 : PREMIER FAMILY MEDICINE PROFIT SHARING PLAN 2011 401k financial data
Transfers to/from the plan2011-12-31$0
Total income from all sources2011-12-31$58,854
Expenses. Total of all expenses incurred2011-12-31$44,303
Benefits paid (including direct rollovers)2011-12-31$44,127
Total plan assets at end of year2011-12-31$1,009,828
Total plan assets at beginning of year2011-12-31$995,277
Value of fidelity bond covering the plan2011-12-31$105,000
Total contributions received or receivable from participants2011-12-31$70,374
Expenses. Other expenses not covered elsewhere2011-12-31$176
Contributions received from other sources (not participants or employers)2011-12-31$0
Other income received2011-12-31$-43,843
Net income (gross income less expenses)2011-12-31$14,551
Net plan assets at end of year (total assets less liabilities)2011-12-31$1,009,828
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$995,277
Assets. Value of participant loans2011-12-31$14,712
Total contributions received or receivable from employer(s)2011-12-31$32,323
Value of certain deemed distributions of participant loans2011-12-31$0
Value of corrective distributions2011-12-31$0
Funding deficiency by the employer to the plan for this plan year2011-12-31$0
Minimum employer required contribution for this plan year2011-12-31$0
Amount contributed by the employer to the plan for this plan year2011-12-31$0
2010 : PREMIER FAMILY MEDICINE PROFIT SHARING PLAN 2010 401k financial data
Transfers to/from the plan2010-12-31$0
Total income from all sources2010-12-31$211,422
Expenses. Total of all expenses incurred2010-12-31$32,164
Benefits paid (including direct rollovers)2010-12-31$32,136
Total plan assets at end of year2010-12-31$995,277
Total plan assets at beginning of year2010-12-31$816,019
Value of fidelity bond covering the plan2010-12-31$105,000
Total contributions received or receivable from participants2010-12-31$79,885
Expenses. Other expenses not covered elsewhere2010-12-31$28
Contributions received from other sources (not participants or employers)2010-12-31$0
Other income received2010-12-31$102,715
Net income (gross income less expenses)2010-12-31$179,258
Net plan assets at end of year (total assets less liabilities)2010-12-31$995,277
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$816,019
Assets. Value of participant loans2010-12-31$16,157
Total contributions received or receivable from employer(s)2010-12-31$28,822
Value of certain deemed distributions of participant loans2010-12-31$0
Value of corrective distributions2010-12-31$0
Funding deficiency by the employer to the plan for this plan year2010-12-31$0
Minimum employer required contribution for this plan year2010-12-31$0
Amount contributed by the employer to the plan for this plan year2010-12-31$0
2009 : PREMIER FAMILY MEDICINE PROFIT SHARING PLAN 2009 401k financial data
Funding deficiency by the employer to the plan for this plan year2009-12-31$0
Minimum employer required contribution for this plan year2009-12-31$0
Amount contributed by the employer to the plan for this plan year2009-12-31$0

Form 5500 Responses for PREMIER FAMILY MEDICINE PROFIT SHARING PLAN

2014: PREMIER FAMILY MEDICINE 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
2013: PREMIER FAMILY MEDICINE PROFIT SHARING PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: PREMIER FAMILY MEDICINE PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
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
2011: PREMIER FAMILY MEDICINE PROFIT SHARING PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2009: PREMIER FAMILY MEDICINE PROFIT SHARING PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-829567
Policy instance 1
Insurance contract or identification numberGA-829567
Number of Individuals Covered35
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $3,280
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?Yes
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 BenefitNo
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 $3,280
Insurance broker organization code?3
Insurance broker nameEDWARD D JONES & CO L P.
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-811824
Policy instance 1
Insurance contract or identification numberGA-811824
Number of Individuals Covered28
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $4,920
Total amount of fees paid to insurance companyUSD $0
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 $4,920
Insurance broker organization code?3
Insurance broker nameEDWARD D JONES & CO
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-811824
Policy instance 1
Insurance contract or identification numberGA-811824
Number of Individuals Covered24
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $4,567
Total amount of fees paid to insurance companyUSD $1,061
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?Yes
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 BenefitNo
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 $4,567
Insurance broker organization code?3
Amount paid for insurance broker fees1061
Additional information about fees paid to insurance brokerSALES/MARKETING
Insurance broker nameEDWARD D JONES & CO
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-811824
Policy instance 1
Insurance contract or identification numberGA-811824
Number of Individuals Covered35
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $4,456
Total amount of fees paid to insurance companyUSD $1,011
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?Yes
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 BenefitNo
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
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-811824
Policy instance 1
Insurance contract or identification numberGA-811824
Number of Individuals Covered35
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $2,694
Total amount of fees paid to insurance companyUSD $625
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?Yes
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 BenefitNo
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

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