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FORM 5500 DATA

Douglas A. Thom Clinic, Inc. Retirement Plan

Overview

Plan Information

  • Plan Year01/01/2018 — 12/31/2018
  • Date of Plan01/01/2001
  • Net Assets as of 12/31/2018 $21,857,159
  • Plan Number2
  • Plan Type Single Employer
  • Is the plan collectively bargained? No
  • Did the plan file for an extension of time or the DFVC Program?Yes
  • Plan Funding ArrangementInsurance Trust
  • Plan Benefit ArrangementInsurance Trust

Participant Information as of 12/31/2018

  • Active (Eligible) Participants870
  • Retired or separated participants receiving benefits4
  • Other retired or separated participants entitled to future benefits237
  • Subtotal1,111
  • Deceased participants whose beneficiaries are receiving or are entitled to receive benefits0
  • Total1,111
  • Total number of participants as of 01/01/20181,100
  • Number of participants with account balances771
  • Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested0

Expenses

  • Total Benefit Payments$0
  • Corrective Distributions$0
  • Administrative Service Providers$0
  • Other Expenses$0
  • Total Expenses$0
  • Total Transfers$0

Sponsor Information

  • Address251 West Central Street Suite 22
  • CityNatick
  • StateMA
  • Zip01760-3758
  • Telephone(508) 655-5222
  • EIN04-2104268
  • Industry Code624100
  • Named AdministratorGretchen Rowe Owens

Audit Information

  • Audit StatusAudited
  • AuditorRsm Us, LLP
  • Auditor EIN42-0714325
  • Audit Opinion Disclaimer
  • Audit TypeLimited Scope Audit

Benefits Provided Under the Plan

Code Benefit Description
2F ERISA section 404(c) Plan This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
2G 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.
2L Code section 403(b)(1) arrangement A 403(b) plan, also known as a tax-sheltered annuity (TSA) plan, is a retirement plan for certain employees of public schools, employees of certain tax-exempt organizations, and certain ministers.
2M Code section 403(b)(7) accounts A 403(b)(7) plan is a tax-deferred retirement plan often available to employees of public schools or non-profit organizations.
2T Participant-directed Account Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.

Questions and Answers

Question Answer Amount
During the plan year did the employer fail to transmit to the plan any participant contributions within the time period described in 29 CFT 2510.3-102? No
Were any loans by the plan or fixed income obligations due the plan in default as of the close of plan year or classified during the year as uncollectible? Disregard participant loans secured by participant's account balance. No
Were any leases to which the plan was a party in default or classified during the year as uncollectible? No
Were there any nonexempt transactions with any party-in-interest? No
Was this plan covered by a fidelity bond? Yes $500,000
Did the plan have a loss, whether or not reimbursed by the plan's fidelity bond, that was caused by fraud or dishonesty? No
Did the plan hold any assets whose current value was neither readily determinable on an established market nor set by an independent third party appraiser? No
Did the plan receive any noncash contributions whose value was neither readily determinable on an established market nor set by an independent third party appraiser? No
Did the plan have assets held for investment? Yes
Were any plan transactions or series of transactions in excess of 5% of the current value of plan assets? No
Were all the plan assets either distributed to participants or beneficiaries, transferred to another plan, or brought under the control of the PBGC? No
Has the plan failed to provide any benefit when due under the plan? No
If this is an individual account plan, was there a blackout period? No
If there was a blackout period, have you either provided the required notice or one of the exceptions to providing the notice applied under 29 CFR 2520.101-3? No

Financials

Income and Expense Statement

Income $962,247
Contributions $2,016,745
Cash Contributions $2,016,745
Cash from Employers $192,742
Cash from Participants $1,742,231
Others (including rollovers) $81,772
Noncash Contributions $0
Total Earnings on Investments $-1,118,988
Total Interest $66,099
Interest-Bearing Cash $0
U.S. Government Securities $0
Corporate Debt Instruments $0
Loans (other than to participants) $0
Participant Loans $5,157
Interest from Other Investments $60,942
Total Dividends $1,136,297
Preferred Stock $0
Common Stock $0
Rents $0
Net gain (loss) on sale of assets $0
Aggregate Proceeds $0
Aggregate Carrying Amount $0
Total Unrealized Appreciation (depreciation) of assets $0
Real Estate $0
Other $0
Net investment gain (loss) from common/collective trusts $0
Net investment gain (loss) from pooled separate accounts $0
Net investment gain (loss) from master trust investment accounts $0
Net investment gain (loss) from 103-12 investment entities $0
Net investment gain (loss) from registered investment companies $-2,321,384
Other Income $64,490
Expenses $937,250
Total Benefit Payments $864,482
Directly to participants or beneficiaries, including direct rollovers $864,482
To insurance carriers for the provision of benefits $0
Other Benefit Payment Fees $0
Corrective Distributions $0
Certain deemed distributions of participant loans $0
Interest expense $0
Total Administrative Expenses $72,768
Professional Fees $0
Contract Administrator Fees $400
Investment Advisory and management fees $72,368
Other Administrative Fees $0
Net Income $24,997
Transfers of Assets to this Plan $0
Transfers of Assets from this Plan $0

Asset and Liability Statement

12/31/2018 12/31/2017 Change YOY
Total Assets $21,857,159 $21,832,162 0.11%
Total noninterest-bearing cash $0 $0 0.0%
Receivables $0 $0 0.0%
Employer Contributions $0 $0 0.0%
Participant Contributions $0 $0 0.0%
Other Contributions $0 $0 0.0%
General Investments $0 $0 0.0%
Interest-bearing cash $0 $0 0.0%
U.S. Government Securities $0 $0 0.0%
Corporate Debt Instruments $0 $0 0.0%
Preferred $0 $0 0.0%
All Other $0 $0 0.0%
Corporate Stocks $0 $0 0.0%
Preferred $0 $0 0.0%
Common $0 $0 0.0%
Partnership/joint venture interests $0 $0 0.0%
Real estate (other than employer real property) $0 $0 0.0%
Loans (other than to participants) $0 $0 0.0%
Participants Loans $110,092 $78,121 40.92%
Value of interest in common/collective trusts $0 $0 0.0%
Value of interest in pooled separate accounts $0 $0 0.0%
Value of interest in master trust investment accounts $0 $0 0.0%
Value of interest in 103-12 investment entities $0 $0 0.0%
Value of interest in registered investment companies $18,429,024 $19,013,899 -3.08%
Value of funds held in insurance co. general account $3,318,043 $2,740,142 21.09%
Other Investments $0 $0 0.0%
Employer-related Investments $0 $0 0.0%
Employer Securities $0 $0 0.0%
Employer Real Property $0 $0 0.0%
Buildings and other property used in plan operation $0 $0 0.0%
Total Liabilities $0 $0 0.0%
Benefit Claims Payable (1) $0 $0 0.0%
Operating Payables (1) $0 $0 0.0%
Acquisition Indebtedness (1) $0 $0 0.0%
Other liabilities (1) $0 $0 0.0%
Net Assets $21,857,159 $21,832,162 0.11%

Service Providers

Persons Receiving Only Eligible Indirect Compensation

There is no information on eligible indirect compensation for this plan.

Other Service Providers Receiving Direct or Indirect Compensation

Name Nature of Service Relationship to Plan Sponsor Direct Compensation Paid by Plan Indirect Compensation Paid by Plan Total Compensation
Rbc Wealth Management Investment advisory (plan) Advisor $56,638 $0 $56,638
Rms Us LLP Accounting (including auditing) Auditor $15,730 $0 $15,730
Lincoln National Corporation Contract Administrator Service Provider $400 $0 $400
Total $72,768 $0 $72,768

Indirect Compensation

There are no service providers with indirect compensation listed for this plan.

Service Providers Who Fail or Refuse to Provide Information

There are no service providers who failed or refused to provide information.

Termination Information on Accountants and Enrolled Actuaries

There is no termination information for this plan.

Investments

Investments

No investments information available for this plan.

Insurance Information

Insurance Information

Insurance Carrier Summary Persons Covered
Lincoln National Life Insurance Company 523
EIN 35-0472300
Industry Code 65676
Contract Number 892943-007
Contract Year 01/01/2018 — 12/31/2018
Value in General Account at Year End $0
Value in Separate Accounts at Year End $0
Insurance Fees and Commissions $0
Persons Receiving Commissions and Fees There are no brokers listed for this plan.
Allocated Funds
Type of Contract Unspecified
Basis of premium rates
Premiums paid to carrier $0
Premiums due but unpaid at the end of the year $0
If the carrier, service, or other organization incurred any specific costs in connection with the acquisition or retention of the contract or policy, enter amount $0
Specify the nature of the costs
Unallocated Funds
Type of Contract STABLE VALUE
Balance at the end of the previous year $2,726,800
Additions $748,630
Contributions Deposited during the year $239,583
Dividends and credits $0
Interest credited during the year $60,448
Transferred from separate account $378,539
Other $70,060
Total of Balance and Additions $3,475,430
Deductions $171,130
Disbursed from fund to pay benefits or purchase annuities during the year $53,225
Administration charge made by carrier $152
Transferred to Separate Account $36,710
Other $81,043
Balance at the end of the current year $3,304,300
Lincoln National Life Insurance Company 2
EIN 35-0472300
Industry Code 65676
Contract Number 891935+001
Contract Year 01/01/2018 — 12/31/2018
Value in General Account at Year End $0
Value in Separate Accounts at Year End $0
Insurance Fees and Commissions $34
Persons Receiving Commissions and Fees
Agent/Broker Organization Code Commissions Paid Fees Paid Purpose of Fees Paid
Rbc Capital Markets LLC 60 S 6th St Ms-P21 Minneapolis, MN 55402 Agent or Broker other than Insurance $34 $0
Allocated Funds
Type of Contract Unspecified
Basis of premium rates
Premiums paid to carrier $0
Premiums due but unpaid at the end of the year $0
If the carrier, service, or other organization incurred any specific costs in connection with the acquisition or retention of the contract or policy, enter amount $0
Specify the nature of the costs
Unallocated Funds
Type of Contract GROUP VARIABLE ANNUITY W/ GUAR FUND
Balance at the end of the previous year $13,342
Additions $3,622
Contributions Deposited during the year $0
Dividends and credits $0
Interest credited during the year $494
Transferred from separate account $0
Other $3,128
Total of Balance and Additions $16,964
Deductions $3,221
Disbursed from fund to pay benefits or purchase annuities during the year $0
Administration charge made by carrier $0
Transferred to Separate Account $0
Other $3,221
Balance at the end of the current year $13,743