401k Plan data: SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING PLAN plan

SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan Name	SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING PLAN
Plan identification number	002

SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING 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.
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

SETHU V. MADHAVAN, M.D., INC. has sponsored the creation of one or more 401k plans.

Company Name: SETHU V. MADHAVAN, M.D., INC.

Employer identification number (EIN): 953963252

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2019-01-01 SETHU V. MADHAVAN, M.D. 2020-02-19
002 2018-01-01
002 2017-01-01
002 2016-01-01
002 2015-01-01
002 2014-01-01
002 2013-01-01
002 2012-01-01 SETHU V. MADHAVAN, M.D. SETHU V. MADHAVAN, M.D. 2013-06-19
002 2011-01-01 SETHU V. MADHAVAN, M.D. SETHU V. MADHAVAN, M.D. 2012-06-05
002 2010-01-01 SETHU V. MADHAVAN, M.D. SETHU V. MADHAVAN, M.D. 2011-10-10
002 2009-01-01 SETHU V. MADHAVAN, M.D. SETHU V. MADHAVAN, M.D. 2010-08-19

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2019-01-01	SETHU V. MADHAVAN, M.D.	2020-02-19
002	2018-01-01
002	2017-01-01
002	2016-01-01
002	2015-01-01
002	2014-01-01
002	2013-01-01
002	2012-01-01	SETHU V. MADHAVAN, M.D.		SETHU V. MADHAVAN, M.D.	2013-06-19
002	2011-01-01	SETHU V. MADHAVAN, M.D.		SETHU V. MADHAVAN, M.D.	2012-06-05
002	2010-01-01	SETHU V. MADHAVAN, M.D.		SETHU V. MADHAVAN, M.D.	2011-10-10
002	2009-01-01	SETHU V. MADHAVAN, M.D.		SETHU V. MADHAVAN, M.D.	2010-08-19

Plan Statistics for SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING PLAN

Measure Date Value
2019: SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 7
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 0
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 0
Total of all active and inactive participants 2019-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 0
Number of participants with account balances 2019-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 7
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 7
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 0
Total of all active and inactive participants 2018-01-01 7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 7
Number of participants with account balances 2018-01-01 7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 7
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 7
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 0
Total of all active and inactive participants 2017-01-01 7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 7
Number of participants with account balances 2017-01-01 7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 7
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 7
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 7
Number of participants with account balances 2016-01-01 7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 7
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 7
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 7
Number of participants with account balances 2015-01-01 7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 7
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 7
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 7
Number of participants with account balances 2014-01-01 7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 7
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 7
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 0
Total of all active and inactive participants 2013-01-01 7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 7
Number of participants with account balances 2013-01-01 7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 7
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 7
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 0
Total of all active and inactive participants 2012-01-01 7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 7
Number of participants with account balances 2012-01-01 7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 9
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 7
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 0
Total of all active and inactive participants 2011-01-01 7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 7
Number of participants with account balances 2011-01-01 7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 9
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 7
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 2
Total of all active and inactive participants 2010-01-01 9
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 9
Number of participants with account balances 2010-01-01 9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 1
2009: SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 11
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 8
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 1
Total of all active and inactive participants 2009-01-01 9
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 9
Number of participants with account balances 2009-01-01 9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2019: SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	7
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	0
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	0
Total of all active and inactive participants	2019-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	0
Number of participants with account balances	2019-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	7
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	7
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	0
Total of all active and inactive participants	2018-01-01	7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	7
Number of participants with account balances	2018-01-01	7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	7
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	7
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	0
Total of all active and inactive participants	2017-01-01	7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	7
Number of participants with account balances	2017-01-01	7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	7
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	7
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	7
Number of participants with account balances	2016-01-01	7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	7
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	7
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	7
Number of participants with account balances	2015-01-01	7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	7
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	7
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	7
Number of participants with account balances	2014-01-01	7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	7
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	7
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	0
Total of all active and inactive participants	2013-01-01	7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	7
Number of participants with account balances	2013-01-01	7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	7
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	7
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	0
Total of all active and inactive participants	2012-01-01	7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	7
Number of participants with account balances	2012-01-01	7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	9
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	7
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	0
Total of all active and inactive participants	2011-01-01	7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	7
Number of participants with account balances	2011-01-01	7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	9
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	7
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	2
Total of all active and inactive participants	2010-01-01	9
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	9
Number of participants with account balances	2010-01-01	9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	1
2009: SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	11
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	8
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	1
Total of all active and inactive participants	2009-01-01	9
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	9
Number of participants with account balances	2009-01-01	9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING PLAN

Measure	Date	Value
2019 : SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING PLAN 2019 401k financial data
Total plan liabilities at end of year	2019-07-31	$0
Total plan liabilities at beginning of year	2019-07-31	$0
Total income from all sources	2019-07-31	$36,270
Expenses. Total of all expenses incurred	2019-07-31	$436,225
Benefits paid (including direct rollovers)	2019-07-31	$435,130
Total plan assets at end of year	2019-07-31	$0
Total plan assets at beginning of year	2019-07-31	$399,955
Value of fidelity bond covering the plan	2019-07-31	$280,000
Total contributions received or receivable from participants	2019-07-31	$1,500
Expenses. Other expenses not covered elsewhere	2019-07-31	$1,095
Contributions received from other sources (not participants or employers)	2019-07-31	$0
Other income received	2019-07-31	$34,770
Noncash contributions received	2019-07-31	$0
Net income (gross income less expenses)	2019-07-31	$-399,955
Net plan assets at end of year (total assets less liabilities)	2019-07-31	$0
Net plan assets at beginning of year (total assets less liabilities)	2019-07-31	$399,955
Assets. Value of participant loans	2019-07-31	$0
Assets. Value of real-estate (other than employer real property)	2019-07-31	$0
Total contributions received or receivable from employer(s)	2019-07-31	$0
Value of certain deemed distributions of participant loans	2019-07-31	$0
Value of corrective distributions	2019-07-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2019-07-31	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-07-31	$0
2018 : SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING PLAN 2018 401k financial data
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	$-50,136
Expenses. Total of all expenses incurred	2018-12-31	$2,144
Benefits paid (including direct rollovers)	2018-12-31	$0
Total plan assets at end of year	2018-12-31	$399,955
Total plan assets at beginning of year	2018-12-31	$452,235
Value of fidelity bond covering the plan	2018-12-31	$280,000
Total contributions received or receivable from participants	2018-12-31	$2,080
Expenses. Other expenses not covered elsewhere	2018-12-31	$0
Contributions received from other sources (not participants or employers)	2018-12-31	$0
Other income received	2018-12-31	$-52,216
Noncash contributions received	2018-12-31	$0
Net income (gross income less expenses)	2018-12-31	$-52,280
Net plan assets at end of year (total assets less liabilities)	2018-12-31	$399,955
Net plan assets at beginning of year (total assets less liabilities)	2018-12-31	$452,235
Assets. Value of participant loans	2018-12-31	$4,307
Assets. Value of real-estate (other than employer real property)	2018-12-31	$35,700
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	$2,144
2017 : SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING 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	$482,469
Expenses. Total of all expenses incurred	2017-12-31	$2,927,961
Benefits paid (including direct rollovers)	2017-12-31	$2,915,518
Total plan assets at end of year	2017-12-31	$452,234
Total plan assets at beginning of year	2017-12-31	$2,897,726
Value of fidelity bond covering the plan	2017-12-31	$280,000
Total contributions received or receivable from participants	2017-12-31	$8,080
Expenses. Other expenses not covered elsewhere	2017-12-31	$12,443
Contributions received from other sources (not participants or employers)	2017-12-31	$0
Other income received	2017-12-31	$414,312
Noncash contributions received	2017-12-31	$0
Net income (gross income less expenses)	2017-12-31	$-2,445,492
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$452,234
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$2,897,726
Assets. Value of participant loans	2017-12-31	$6,541
Assets. Value of real-estate (other than employer real property)	2017-12-31	$63,530
Total contributions received or receivable from employer(s)	2017-12-31	$60,077
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	$0
2016 : SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING 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	$181,039
Expenses. Total of all expenses incurred	2016-12-31	$25,975
Benefits paid (including direct rollovers)	2016-12-31	$0
Total plan assets at end of year	2016-12-31	$2,897,726
Total plan assets at beginning of year	2016-12-31	$2,742,662
Value of fidelity bond covering the plan	2016-12-31	$280,000
Total contributions received or receivable from participants	2016-12-31	$8,160
Expenses. Other expenses not covered elsewhere	2016-12-31	$25,805
Contributions received from other sources (not participants or employers)	2016-12-31	$0
Other income received	2016-12-31	$113,609
Noncash contributions received	2016-12-31	$0
Net income (gross income less expenses)	2016-12-31	$155,064
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$2,897,726
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$2,742,662
Assets. Value of participant loans	2016-12-31	$10,490
Assets. Value of real-estate (other than employer real property)	2016-12-31	$62,284
Total contributions received or receivable from employer(s)	2016-12-31	$59,270
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	$170
2015 : SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING 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	$54,834
Expenses. Total of all expenses incurred	2015-12-31	$25,875
Benefits paid (including direct rollovers)	2015-12-31	$0
Total plan assets at end of year	2015-12-31	$2,742,662
Total plan assets at beginning of year	2015-12-31	$2,713,703
Value of fidelity bond covering the plan	2015-12-31	$280,000
Total contributions received or receivable from participants	2015-12-31	$8,080
Expenses. Other expenses not covered elsewhere	2015-12-31	$25,875
Contributions received from other sources (not participants or employers)	2015-12-31	$0
Other income received	2015-12-31	$-11,917
Noncash contributions received	2015-12-31	$0
Net income (gross income less expenses)	2015-12-31	$28,959
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$2,742,662
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$2,713,703
Assets. Value of participant loans	2015-12-31	$1,903
Assets. Value of real-estate (other than employer real property)	2015-12-31	$61,349
Total contributions received or receivable from employer(s)	2015-12-31	$58,671
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	$0
2014 : SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING 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	$269,143
Expenses. Total of all expenses incurred	2014-12-31	$25,734
Benefits paid (including direct rollovers)	2014-12-31	$0
Total plan assets at end of year	2014-12-31	$2,713,703
Total plan assets at beginning of year	2014-12-31	$2,470,294
Value of fidelity bond covering the plan	2014-12-31	$250,000
Total contributions received or receivable from participants	2014-12-31	$7,580
Expenses. Other expenses not covered elsewhere	2014-12-31	$25,734
Contributions received from other sources (not participants or employers)	2014-12-31	$0
Other income received	2014-12-31	$203,794
Noncash contributions received	2014-12-31	$0
Net income (gross income less expenses)	2014-12-31	$243,409
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$2,713,703
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$2,470,294
Assets. Value of participant loans	2014-12-31	$4,517
Assets. Value of real-estate (other than employer real property)	2014-12-31	$60,147
Total contributions received or receivable from employer(s)	2014-12-31	$57,769
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	$0
2013 : SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING 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	$398,219
Expenses. Total of all expenses incurred	2013-12-31	$24,533
Benefits paid (including direct rollovers)	2013-12-31	$0
Total plan assets at end of year	2013-12-31	$2,470,294
Total plan assets at beginning of year	2013-12-31	$2,096,608
Value of fidelity bond covering the plan	2013-12-31	$210,000
Total contributions received or receivable from participants	2013-12-31	$7,580
Expenses. Other expenses not covered elsewhere	2013-12-31	$24,533
Contributions received from other sources (not participants or employers)	2013-12-31	$0
Other income received	2013-12-31	$333,875
Noncash contributions received	2013-12-31	$0
Net income (gross income less expenses)	2013-12-31	$373,686
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$2,470,294
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$2,096,608
Assets. Value of participant loans	2013-12-31	$7,405
Assets. Value of real-estate (other than employer real property)	2013-12-31	$59,875
Total contributions received or receivable from employer(s)	2013-12-31	$56,764
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	$0
2012 : SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING 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	$293,304
Expenses. Total of all expenses incurred	2012-12-31	$22,617
Benefits paid (including direct rollovers)	2012-12-31	$0
Total plan assets at end of year	2012-12-31	$2,096,608
Total plan assets at beginning of year	2012-12-31	$1,825,921
Value of fidelity bond covering the plan	2012-12-31	$190,000
Total contributions received or receivable from participants	2012-12-31	$7,580
Expenses. Other expenses not covered elsewhere	2012-12-31	$22,467
Contributions received from other sources (not participants or employers)	2012-12-31	$0
Other income received	2012-12-31	$229,913
Noncash contributions received	2012-12-31	$0
Net income (gross income less expenses)	2012-12-31	$270,687
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$2,096,608
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$1,825,921
Assets. Value of participant loans	2012-12-31	$10,175
Assets. Value of real-estate (other than employer real property)	2012-12-31	$58,701
Total contributions received or receivable from employer(s)	2012-12-31	$55,811
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	$150
2011 : SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING 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	$-10,061
Expenses. Total of all expenses incurred	2011-12-31	$23,159
Benefits paid (including direct rollovers)	2011-12-31	$591
Total plan assets at end of year	2011-12-31	$1,825,921
Total plan assets at beginning of year	2011-12-31	$1,859,141
Value of fidelity bond covering the plan	2011-12-31	$190,000
Total contributions received or receivable from participants	2011-12-31	$17,645
Expenses. Other expenses not covered elsewhere	2011-12-31	$22,568
Contributions received from other sources (not participants or employers)	2011-12-31	$0
Other income received	2011-12-31	$-81,551
Noncash contributions received	2011-12-31	$0
Net income (gross income less expenses)	2011-12-31	$-33,220
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$1,825,921
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$1,859,141
Assets. Value of real-estate (other than employer real property)	2011-12-31	$57,550
Total contributions received or receivable from employer(s)	2011-12-31	$53,845
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	$0
2010 : SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING 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	$283,108
Expenses. Total of all expenses incurred	2010-12-31	$20,857
Benefits paid (including direct rollovers)	2010-12-31	$0
Total plan assets at end of year	2010-12-31	$1,859,141
Total plan assets at beginning of year	2010-12-31	$1,596,890
Value of fidelity bond covering the plan	2010-12-31	$160,000
Total contributions received or receivable from participants	2010-12-31	$18,210
Expenses. Other expenses not covered elsewhere	2010-12-31	$20,857
Contributions received from other sources (not participants or employers)	2010-12-31	$0
Other income received	2010-12-31	$210,649
Noncash contributions received	2010-12-31	$0
Net income (gross income less expenses)	2010-12-31	$262,251
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$1,859,141
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$1,596,890
Assets. Value of assets in partnership/joint-venture interests	2010-12-31	$90
Assets. Value of real-estate (other than employer real property)	2010-12-31	$73,895
Total contributions received or receivable from employer(s)	2010-12-31	$54,249
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	$0

Form 5500 Responses for SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING PLAN

2019: SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING 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	Yes
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING 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 – Trust	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING 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 - Trust	Yes
2016: SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING 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 - Trust	Yes
2015: SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING 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 - Trust	Yes
2014: SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING 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 - Trust	Yes
2013: SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING 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 - Trust	Yes
2012: SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING 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 - Trust	Yes
2011: SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING 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 - Trust	Yes
2010: SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING 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 - Trust	Yes
2009: SETHU V. MADHAVAN, M.D., INC. 401(K) PROFIT SHARING 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 - 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

101368

Policy instance

Insurance contract or identification number	101368
Number of Individuals Covered	0
Insurance policy start date	2019-01-01
Insurance policy end date	2019-07-31
Total amount of commissions paid to insurance broker	USD $1,143
Total amount of fees paid to insurance company	USD $84
Are there contracts with allocated funds for individual policies?	0
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Broker	USD $1,143
Insurance broker organization code?	4
Amount paid for insurance broker fees	84
Additional information about fees paid to insurance broker	TPA COMPENSATION

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

Policy contract number

101368

Policy instance

Insurance contract or identification number	101368
Number of Individuals Covered	6
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $1,939
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Broker	USD $1,939
Insurance broker organization code?	4

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

Policy contract number

101368

Policy instance

Insurance contract or identification number	101368
Number of Individuals Covered	6
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $1,718
Total amount of fees paid to insurance company	USD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $1,718
Insurance broker organization code?	4
Insurance broker name	AMERIPRISE FINANCIAL SERVICES INC.

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

Policy contract number

101368

Policy instance

Insurance contract or identification number	101368
Number of Individuals Covered	6
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $1,482
Total amount of fees paid to insurance company	USD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,482
Insurance broker organization code?	4
Insurance broker name	AMERIPRISE FINANCIAL SERVICES INC.

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

Policy contract number

101368

Policy instance

Insurance contract or identification number	101368
Number of Individuals Covered	6
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $1,380
Total amount of fees paid to insurance company	USD $64
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,380
Amount paid for insurance broker fees	53
Insurance broker organization code?	4
Additional information about fees paid to insurance broker	ADMINISTRATION FEES
Insurance broker name	PRB ADMINISTRATORS INC.

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

Policy contract number

101368

Policy instance

Insurance contract or identification number	101368
Number of Individuals Covered	6
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $1,178
Total amount of fees paid to insurance company	USD $313
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,178
Amount paid for insurance broker fees	190
Insurance broker organization code?	4
Insurance broker name	PRB ADMINISTRATORS INC.

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

Policy contract number

101368

Policy instance

Insurance contract or identification number	101368
Number of Individuals Covered	6
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $1,453
Total amount of fees paid to insurance company	USD $316
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,058
Amount paid for insurance broker fees	166
Additional information about fees paid to insurance broker	OTHER ALLOWANCE
Insurance broker organization code?	4
Insurance broker name	PRB ADMINISTRATORS INC.

UNION CENTRAL LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 80837 )

Policy contract number

712241

Policy instance

Insurance contract or identification number	712241
Number of Individuals Covered	0
Insurance policy start date	2011-01-01
Insurance policy end date	2011-05-02
Total amount of commissions paid to insurance broker	USD $321
Total amount of fees paid to insurance company	USD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

101368

Policy instance

Insurance contract or identification number	101368
Number of Individuals Covered	6
Insurance policy start date	2011-04-29
Insurance policy end date	2011-12-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

UNION CENTRAL LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 80837 )

Policy contract number

712241

Policy instance

Insurance contract or identification number	712241
Number of Individuals Covered	9
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $946
Total amount of fees paid to insurance company	USD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	SETHU V. MADHAVAN, M.D., INC.
Employer identification number (EIN):	953963252
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)