401k Plan data: PALOMAR MEDICAL GROUP, INC. 401(K) PLAN plan

PALOMAR MEDICAL GROUP, INC. 401(K) PLAN 401k Plan overview

Plan Name	PALOMAR MEDICAL GROUP, INC. 401(K) PLAN
Plan identification number	001

PALOMAR MEDICAL GROUP, INC. 401(K) 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
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.
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

PALOMAR MEDICAL GROUP, INC. has sponsored the creation of one or more 401k plans.

Company Name: PALOMAR MEDICAL GROUP, INC.

Employer identification number (EIN): 952634338

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PALOMAR MEDICAL GROUP, INC. 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2016-01-01 OSMAN KHAWAR 2016-12-27 OSMAN KHAWAR 2016-12-27
001 2015-01-01 OSMAN KHAWAR 2016-06-06 OSMAN KHAWAR 2016-06-06
001 2014-01-01 OSMAN KHAWAR 2015-09-17 OSMAN KHAWAR 2015-09-17
001 2013-01-01 OSMAN KHAWAR 2014-09-02 OSMAN KHAWAR 2014-09-02
001 2012-01-01 EMMET LEE 2013-09-04 EMMET LEE 2013-09-04
001 2011-01-01 EMMET LEE EMMET LEE 2012-10-15
001 2010-01-01 EMMET LEE

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2016-01-01	OSMAN KHAWAR	2016-12-27	OSMAN KHAWAR	2016-12-27
001	2015-01-01	OSMAN KHAWAR	2016-06-06	OSMAN KHAWAR	2016-06-06
001	2014-01-01	OSMAN KHAWAR	2015-09-17	OSMAN KHAWAR	2015-09-17
001	2013-01-01	OSMAN KHAWAR	2014-09-02	OSMAN KHAWAR	2014-09-02
001	2012-01-01	EMMET LEE	2013-09-04	EMMET LEE	2013-09-04
001	2011-01-01	EMMET LEE		EMMET LEE	2012-10-15
001	2010-01-01	EMMET LEE

Plan Statistics for PALOMAR MEDICAL GROUP, INC. 401(K) PLAN

401k plan membership statisitcs for PALOMAR MEDICAL GROUP, INC. 401(K) PLAN

Measure Date Value
2011: PALOMAR MEDICAL GROUP, INC. 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 43
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 32
Number of other retired or separated participants entitled to future benefits 2011-01-01 15
Total of all active and inactive participants 2011-01-01 47
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 47
Number of participants with account balances 2011-01-01 40
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: PALOMAR MEDICAL GROUP, INC. 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 44
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 28
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 15
Total of all active and inactive participants 2010-01-01 43
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 43
Number of participants with account balances 2010-01-01 43
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 1

Measure	Date	Value
2011: PALOMAR MEDICAL GROUP, INC. 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	43
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	32
Number of other retired or separated participants entitled to future benefits	2011-01-01	15
Total of all active and inactive participants	2011-01-01	47
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	47
Number of participants with account balances	2011-01-01	40
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: PALOMAR MEDICAL GROUP, INC. 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	44
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	28
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	15
Total of all active and inactive participants	2010-01-01	43
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	43
Number of participants with account balances	2010-01-01	43
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	1

Financial Data on PALOMAR MEDICAL GROUP, INC. 401(K) PLAN

Measure	Date	Value
2011 : PALOMAR MEDICAL GROUP, INC. 401(K) PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$-2,365,374
Expenses. Total of all expenses incurred	2011-12-31	$29,918
Benefits paid (including direct rollovers)	2011-12-31	$25,161
Total plan assets at end of year	2011-12-31	$5,522,426
Total plan assets at beginning of year	2011-12-31	$7,917,718
Value of fidelity bond covering the plan	2011-12-31	$500,000
Total contributions received or receivable from participants	2011-12-31	$162,394
Contributions received from other sources (not participants or employers)	2011-12-31	$30,230
Other income received	2011-12-31	$-2,773,670
Net income (gross income less expenses)	2011-12-31	$-2,395,292
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$5,522,426
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$7,917,718
Total contributions received or receivable from employer(s)	2011-12-31	$215,672
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$4,757
2010 : PALOMAR MEDICAL GROUP, INC. 401(K) 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	$1,327,956
Expenses. Total of all expenses incurred	2010-12-31	$33,872
Benefits paid (including direct rollovers)	2010-12-31	$229
Total plan assets at end of year	2010-12-31	$7,917,718
Total plan assets at beginning of year	2010-12-31	$6,623,634
Value of fidelity bond covering the plan	2010-12-31	$500,000
Total contributions received or receivable from participants	2010-12-31	$97,575
Expenses. Other expenses not covered elsewhere	2010-12-31	$0
Contributions received from other sources (not participants or employers)	2010-12-31	$9,083
Other income received	2010-12-31	$977,374
Noncash contributions received	2010-12-31	$0
Net income (gross income less expenses)	2010-12-31	$1,294,084
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$7,917,718
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$6,623,634
Assets. Value of assets in partnership/joint-venture interests	2010-12-31	$11,000
Total contributions received or receivable from employer(s)	2010-12-31	$243,924
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	$33,643
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0

Form 5500 Responses for PALOMAR MEDICAL GROUP, INC. 401(K) PLAN

2011: PALOMAR MEDICAL GROUP, INC. 401(K) 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: PALOMAR MEDICAL GROUP, INC. 401(K) PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

65838

Policy instance

Insurance contract or identification number	65838
Number of Individuals Covered	0
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

64948

Policy instance

Insurance contract or identification number	64948
Number of Individuals Covered	43
Insurance policy start date	2010-01-01
Insurance policy end date	2010-05-31
Total amount of commissions paid to insurance broker	USD $21,235
Total amount of fees paid to insurance company	USD $2,108
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,830
Insurance broker organization code?	3
Amount paid for insurance broker fees	2108
Additional information about fees paid to insurance broker	TPA COMPENSATION
Insurance broker name	POLYCOMP ADMINISTRATIVE SERVICES

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Company Name:	PALOMAR MEDICAL GROUP, INC.
Employer identification number (EIN):	952634338
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)