401k Plan data: PACIFIC EYE SURGEONS 401(K) PLAN plan

PACIFIC EYE SURGEONS 401(K) PLAN 401k Plan overview

Plan Name	PACIFIC EYE SURGEONS 401(K) PLAN
Plan identification number	001

PACIFIC EYE SURGEONS 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.
Participant-directed brokerage accounts provided as an investment option under the plan.
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

PACIFIC EYE SURGEONS, A CALIFORNIA PROFESSIONAL MEDICAL CORPORATION has sponsored the creation of one or more 401k plans.

Company Name: PACIFIC EYE SURGEONS, A CALIFORNIA PROFESSIONAL MEDICAL CORPORATION

Employer identification number (EIN): 201555344

NAIC Classification: 621320
NAIC Description: Offices of Optometrists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PACIFIC EYE SURGEONS 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2021-01-01 AHMAD A. AMIR, M.D. 2022-10-05
001 2020-01-01 AHMAD A. AMIR, M.D. 2021-10-07
001 2019-01-01 AHMAD A. AMIR, M.D. 2020-09-24
001 2018-01-01 AHMAD A. AMIR, M.D. 2019-09-20
001 2017-01-01
001 2016-01-01
001 2015-01-01
001 2014-01-01
001 2013-01-01 AHMAD A. AMIR, M.D.
001 2012-01-01 AHMAD A. AMIR, M.D.
001 2011-01-01 AHMAD A. AMIR, M.D.
001 2010-01-01 DOUGLAS S. HENDRY

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2021-01-01	AHMAD A. AMIR, M.D.	2022-10-05
001	2020-01-01	AHMAD A. AMIR, M.D.	2021-10-07
001	2019-01-01	AHMAD A. AMIR, M.D.	2020-09-24
001	2018-01-01	AHMAD A. AMIR, M.D.	2019-09-20
001	2017-01-01
001	2016-01-01
001	2015-01-01
001	2014-01-01
001	2013-01-01	AHMAD A. AMIR, M.D.
001	2012-01-01	AHMAD A. AMIR, M.D.
001	2011-01-01	AHMAD A. AMIR, M.D.
001	2010-01-01	DOUGLAS S. HENDRY

Plan Statistics for PACIFIC EYE SURGEONS 401(K) PLAN

401k plan membership statisitcs for PACIFIC EYE SURGEONS 401(K) PLAN

Measure Date Value
2021: PACIFIC EYE SURGEONS 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 88
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 0
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 0
Total of all active and inactive participants 2021-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 0
Number of participants with account balances 2021-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: PACIFIC EYE SURGEONS 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 94
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 75
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 13
Total of all active and inactive participants 2020-01-01 88
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 88
Number of participants with account balances 2020-01-01 79
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 7
2019: PACIFIC EYE SURGEONS 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 86
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 78
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 16
Total of all active and inactive participants 2019-01-01 94
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 94
Number of participants with account balances 2019-01-01 82
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 6
2018: PACIFIC EYE SURGEONS 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 84
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 76
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 6
Total of all active and inactive participants 2018-01-01 82
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 82
Number of participants with account balances 2018-01-01 74
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 6
2017: PACIFIC EYE SURGEONS 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 84
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 72
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 10
Total of all active and inactive participants 2017-01-01 82
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 82
Number of participants with account balances 2017-01-01 69
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 7
2016: PACIFIC EYE SURGEONS 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 77
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 69
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 13
Total of all active and inactive participants 2016-01-01 82
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 82
Number of participants with account balances 2016-01-01 75
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 6
2015: PACIFIC EYE SURGEONS 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 86
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 66
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 8
Total of all active and inactive participants 2015-01-01 74
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 74
Number of participants with account balances 2015-01-01 73
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 2
2014: PACIFIC EYE SURGEONS 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 86
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 63
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 19
Total of all active and inactive participants 2014-01-01 82
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 82
Number of participants with account balances 2014-01-01 82
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 9
2013: PACIFIC EYE SURGEONS 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 78
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 65
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 14
Total of all active and inactive participants 2013-01-01 79
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 79
Number of participants with account balances 2013-01-01 79
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 11
2012: PACIFIC EYE SURGEONS 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 74
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 62
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 9
Total of all active and inactive participants 2012-01-01 71
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 71
Number of participants with account balances 2012-01-01 71
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 8
2011: PACIFIC EYE SURGEONS 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 76
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 57
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 7
Total of all active and inactive participants 2011-01-01 64
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 64
Number of participants with account balances 2011-01-01 64
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 3
2010: PACIFIC EYE SURGEONS 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 63
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 53
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 20
Total of all active and inactive participants 2010-01-01 73
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 73
Number of participants with account balances 2010-01-01 73
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 6

Measure	Date	Value
2021: PACIFIC EYE SURGEONS 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	88
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	0
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	0
Total of all active and inactive participants	2021-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	0
Number of participants with account balances	2021-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: PACIFIC EYE SURGEONS 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	94
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	75
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	13
Total of all active and inactive participants	2020-01-01	88
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	88
Number of participants with account balances	2020-01-01	79
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	7
2019: PACIFIC EYE SURGEONS 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	86
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	78
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	16
Total of all active and inactive participants	2019-01-01	94
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	94
Number of participants with account balances	2019-01-01	82
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	6
2018: PACIFIC EYE SURGEONS 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	84
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	76
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	6
Total of all active and inactive participants	2018-01-01	82
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	82
Number of participants with account balances	2018-01-01	74
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	6
2017: PACIFIC EYE SURGEONS 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	84
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	72
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	10
Total of all active and inactive participants	2017-01-01	82
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	82
Number of participants with account balances	2017-01-01	69
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	7
2016: PACIFIC EYE SURGEONS 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	77
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	69
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	13
Total of all active and inactive participants	2016-01-01	82
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	82
Number of participants with account balances	2016-01-01	75
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	6
2015: PACIFIC EYE SURGEONS 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	86
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	66
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	8
Total of all active and inactive participants	2015-01-01	74
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	74
Number of participants with account balances	2015-01-01	73
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	2
2014: PACIFIC EYE SURGEONS 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	86
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	63
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	19
Total of all active and inactive participants	2014-01-01	82
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	82
Number of participants with account balances	2014-01-01	82
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	9
2013: PACIFIC EYE SURGEONS 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	78
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	65
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	14
Total of all active and inactive participants	2013-01-01	79
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	79
Number of participants with account balances	2013-01-01	79
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	11
2012: PACIFIC EYE SURGEONS 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	74
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	62
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	9
Total of all active and inactive participants	2012-01-01	71
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	71
Number of participants with account balances	2012-01-01	71
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	8
2011: PACIFIC EYE SURGEONS 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	76
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	57
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	7
Total of all active and inactive participants	2011-01-01	64
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	64
Number of participants with account balances	2011-01-01	64
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	3
2010: PACIFIC EYE SURGEONS 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	63
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	53
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	20
Total of all active and inactive participants	2010-01-01	73
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	73
Number of participants with account balances	2010-01-01	73
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	6

Financial Data on PACIFIC EYE SURGEONS 401(K) PLAN

Measure	Date	Value
2021 : PACIFIC EYE SURGEONS 401(K) PLAN 2021 401k financial data
Total income from all sources	2021-12-31	$1,961,235
Expenses. Total of all expenses incurred	2021-12-31	$13,961,788
Benefits paid (including direct rollovers)	2021-12-31	$13,918,303
Total plan assets at end of year	2021-12-31	$0
Total plan assets at beginning of year	2021-12-31	$12,000,553
Value of fidelity bond covering the plan	2021-12-31	$841,500
Total contributions received or receivable from participants	2021-12-31	$275,928
Expenses. Other expenses not covered elsewhere	2021-12-31	$18,514
Contributions received from other sources (not participants or employers)	2021-12-31	$82,143
Other income received	2021-12-31	$1,408,572
Net income (gross income less expenses)	2021-12-31	$-12,000,553
Net plan assets at end of year (total assets less liabilities)	2021-12-31	$0
Net plan assets at beginning of year (total assets less liabilities)	2021-12-31	$12,000,553
Assets. Value of participant loans	2021-12-31	$0
Assets. Value of real-estate (other than employer real property)	2021-12-31	$0
Total contributions received or receivable from employer(s)	2021-12-31	$194,592
Expenses. Administrative service providers (salaries,fees and commissions)	2021-12-31	$24,971
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$870,000
2020 : PACIFIC EYE SURGEONS 401(K) PLAN 2020 401k financial data
Total income from all sources	2020-12-31	$1,897,767
Expenses. Total of all expenses incurred	2020-12-31	$179,630
Benefits paid (including direct rollovers)	2020-12-31	$154,983
Total plan assets at end of year	2020-12-31	$12,000,553
Total plan assets at beginning of year	2020-12-31	$10,282,416
Value of fidelity bond covering the plan	2020-12-31	$841,500
Total contributions received or receivable from participants	2020-12-31	$304,990
Contributions received from other sources (not participants or employers)	2020-12-31	$49,912
Other income received	2020-12-31	$1,108,804
Net income (gross income less expenses)	2020-12-31	$1,718,137
Net plan assets at end of year (total assets less liabilities)	2020-12-31	$12,000,553
Net plan assets at beginning of year (total assets less liabilities)	2020-12-31	$10,282,416
Assets. Value of participant loans	2020-12-31	$86,848
Assets. Value of real-estate (other than employer real property)	2020-12-31	$870,000
Total contributions received or receivable from employer(s)	2020-12-31	$434,061
Value of certain deemed distributions of participant loans	2020-12-31	$18,771
Expenses. Administrative service providers (salaries,fees and commissions)	2020-12-31	$5,876
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
2019 : PACIFIC EYE SURGEONS 401(K) PLAN 2019 401k financial data
Total income from all sources	2019-12-31	$2,278,846
Expenses. Total of all expenses incurred	2019-12-31	$210,324
Benefits paid (including direct rollovers)	2019-12-31	$187,560
Total plan assets at end of year	2019-12-31	$10,282,416
Total plan assets at beginning of year	2019-12-31	$8,213,894
Value of fidelity bond covering the plan	2019-12-31	$841,500
Total contributions received or receivable from participants	2019-12-31	$307,282
Expenses. Other expenses not covered elsewhere	2019-12-31	$6,410
Other income received	2019-12-31	$1,528,138
Net income (gross income less expenses)	2019-12-31	$2,068,522
Net plan assets at end of year (total assets less liabilities)	2019-12-31	$10,282,416
Net plan assets at beginning of year (total assets less liabilities)	2019-12-31	$8,213,894
Assets. Value of participant loans	2019-12-31	$140,885
Assets. Value of real-estate (other than employer real property)	2019-12-31	$810,000
Total contributions received or receivable from employer(s)	2019-12-31	$443,426
Expenses. Administrative service providers (salaries,fees and commissions)	2019-12-31	$16,354
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
2018 : PACIFIC EYE SURGEONS 401(K) PLAN 2018 401k financial data
Total income from all sources	2018-12-31	$376,862
Expenses. Total of all expenses incurred	2018-12-31	$333,275
Benefits paid (including direct rollovers)	2018-12-31	$313,823
Total plan assets at end of year	2018-12-31	$8,213,894
Total plan assets at beginning of year	2018-12-31	$8,170,307
Value of fidelity bond covering the plan	2018-12-31	$841,500
Total contributions received or receivable from participants	2018-12-31	$317,389
Expenses. Other expenses not covered elsewhere	2018-12-31	$4,130
Other income received	2018-12-31	$-357,018
Net income (gross income less expenses)	2018-12-31	$43,587
Net plan assets at end of year (total assets less liabilities)	2018-12-31	$8,213,894
Net plan assets at beginning of year (total assets less liabilities)	2018-12-31	$8,170,307
Assets. Value of participant loans	2018-12-31	$120,277
Assets. Value of real-estate (other than employer real property)	2018-12-31	$810,000
Total contributions received or receivable from employer(s)	2018-12-31	$416,491
Expenses. Administrative service providers (salaries,fees and commissions)	2018-12-31	$15,322
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
2017 : PACIFIC EYE SURGEONS 401(K) PLAN 2017 401k financial data
Total income from all sources	2017-12-31	$1,808,748
Expenses. Total of all expenses incurred	2017-12-31	$1,105,635
Benefits paid (including direct rollovers)	2017-12-31	$1,087,814
Total plan assets at end of year	2017-12-31	$8,170,307
Total plan assets at beginning of year	2017-12-31	$7,467,194
Value of fidelity bond covering the plan	2017-12-31	$841,500
Total contributions received or receivable from participants	2017-12-31	$316,624
Expenses. Other expenses not covered elsewhere	2017-12-31	$3,940
Other income received	2017-12-31	$1,104,355
Net income (gross income less expenses)	2017-12-31	$703,113
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$8,170,307
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$7,467,194
Assets. Value of participant loans	2017-12-31	$95,788
Assets. Value of real-estate (other than employer real property)	2017-12-31	$810,000
Total contributions received or receivable from employer(s)	2017-12-31	$387,769
Expenses. Administrative service providers (salaries,fees and commissions)	2017-12-31	$13,881
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
2016 : PACIFIC EYE SURGEONS 401(K) PLAN 2016 401k financial data
Total plan liabilities at beginning of year	2016-12-31	$0
Total income from all sources	2016-12-31	$1,290,928
Expenses. Total of all expenses incurred	2016-12-31	$373,158
Benefits paid (including direct rollovers)	2016-12-31	$358,493
Total plan assets at end of year	2016-12-31	$7,467,194
Total plan assets at beginning of year	2016-12-31	$6,549,424
Value of fidelity bond covering the plan	2016-12-31	$841,500
Total contributions received or receivable from participants	2016-12-31	$336,215
Expenses. Other expenses not covered elsewhere	2016-12-31	$3,100
Contributions received from other sources (not participants or employers)	2016-12-31	$256,547
Other income received	2016-12-31	$293,499
Net income (gross income less expenses)	2016-12-31	$917,770
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$7,467,194
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$6,549,424
Assets. Value of participant loans	2016-12-31	$74,542
Assets. Value of real-estate (other than employer real property)	2016-12-31	$841,500
Total contributions received or receivable from employer(s)	2016-12-31	$404,667
Expenses. Administrative service providers (salaries,fees and commissions)	2016-12-31	$11,565
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
2015 : PACIFIC EYE SURGEONS 401(K) PLAN 2015 401k financial data
Total plan liabilities at end of year	2015-12-31	$0
Total plan liabilities at beginning of year	2015-12-31	$44,720
Total income from all sources	2015-12-31	$721,542
Expenses. Total of all expenses incurred	2015-12-31	$772,202
Benefits paid (including direct rollovers)	2015-12-31	$761,824
Total plan assets at end of year	2015-12-31	$6,549,424
Total plan assets at beginning of year	2015-12-31	$6,644,804
Value of fidelity bond covering the plan	2015-12-31	$841,500
Total contributions received or receivable from participants	2015-12-31	$298,703
Expenses. Other expenses not covered elsewhere	2015-12-31	$8,181
Contributions received from other sources (not participants or employers)	2015-12-31	$1,131
Other income received	2015-12-31	$1,708
Net income (gross income less expenses)	2015-12-31	$-50,660
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$6,549,424
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$6,600,084
Assets. Value of participant loans	2015-12-31	$34,707
Assets. Value of real-estate (other than employer real property)	2015-12-31	$841,500
Total contributions received or receivable from employer(s)	2015-12-31	$420,000
Expenses. Administrative service providers (salaries,fees and commissions)	2015-12-31	$2,197
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
2014 : PACIFIC EYE SURGEONS 401(K) PLAN 2014 401k financial data
Transfers to/from the plan	2014-12-31	$0
Total plan liabilities at end of year	2014-12-31	$44,720
Total plan liabilities at beginning of year	2014-12-31	$53,441
Total income from all sources	2014-12-31	$1,090,086
Expenses. Total of all expenses incurred	2014-12-31	$187,263
Benefits paid (including direct rollovers)	2014-12-31	$159,969
Total plan assets at end of year	2014-12-31	$6,644,804
Total plan assets at beginning of year	2014-12-31	$5,750,702
Value of fidelity bond covering the plan	2014-12-31	$765,000
Total contributions received or receivable from participants	2014-12-31	$272,925
Expenses. Other expenses not covered elsewhere	2014-12-31	$27,294
Contributions received from other sources (not participants or employers)	2014-12-31	$0
Other income received	2014-12-31	$413,070
Noncash contributions received	2014-12-31	$0
Net income (gross income less expenses)	2014-12-31	$902,823
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$6,600,084
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$5,697,261
Assets. Value of participant loans	2014-12-31	$49,799
Assets. Value of real-estate (other than employer real property)	2014-12-31	$841,500
Total contributions received or receivable from employer(s)	2014-12-31	$404,091
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
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
2013 : PACIFIC EYE SURGEONS 401(K) PLAN 2013 401k financial data
Transfers to/from the plan	2013-12-31	$0
Total plan liabilities at end of year	2013-12-31	$53,441
Total plan liabilities at beginning of year	2013-12-31	$66,006
Total income from all sources	2013-12-31	$945,334
Expenses. Total of all expenses incurred	2013-12-31	$19,841
Benefits paid (including direct rollovers)	2013-12-31	$3,032
Total plan assets at end of year	2013-12-31	$5,750,702
Total plan assets at beginning of year	2013-12-31	$4,837,774
Value of fidelity bond covering the plan	2013-12-31	$765,000
Total contributions received or receivable from participants	2013-12-31	$266,800
Expenses. Other expenses not covered elsewhere	2013-12-31	$16,809
Contributions received from other sources (not participants or employers)	2013-12-31	$0
Other income received	2013-12-31	$287,921
Noncash contributions received	2013-12-31	$0
Net income (gross income less expenses)	2013-12-31	$925,493
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$5,697,261
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$4,771,768
Assets. Value of participant loans	2013-12-31	$49,645
Assets. Value of real-estate (other than employer real property)	2013-12-31	$765,000
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2013-12-31	$9,316
Total contributions received or receivable from employer(s)	2013-12-31	$390,613
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
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
2012 : PACIFIC EYE SURGEONS 401(K) PLAN 2012 401k financial data
Transfers to/from the plan	2012-12-31	$0
Total plan liabilities at end of year	2012-12-31	$66,006
Total plan liabilities at beginning of year	2012-12-31	$82,596
Total income from all sources	2012-12-31	$1,353,156
Expenses. Total of all expenses incurred	2012-12-31	$147,566
Benefits paid (including direct rollovers)	2012-12-31	$133,143
Total plan assets at end of year	2012-12-31	$4,837,774
Total plan assets at beginning of year	2012-12-31	$3,648,774
Value of fidelity bond covering the plan	2012-12-31	$765,000
Total contributions received or receivable from participants	2012-12-31	$246,327
Expenses. Other expenses not covered elsewhere	2012-12-31	$14,423
Contributions received from other sources (not participants or employers)	2012-12-31	$984
Other income received	2012-12-31	$740,240
Noncash contributions received	2012-12-31	$0
Net income (gross income less expenses)	2012-12-31	$1,205,590
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$4,771,768
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$3,566,178
Assets. Value of participant loans	2012-12-31	$68,000
Assets. Value of real-estate (other than employer real property)	2012-12-31	$765,000
Total contributions received or receivable from employer(s)	2012-12-31	$365,605
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	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$33,007
2011 : PACIFIC EYE SURGEONS 401(K) PLAN 2011 401k financial data
Transfers to/from the plan	2011-12-31	$0
Total plan liabilities at end of year	2011-12-31	$82,596
Total plan liabilities at beginning of year	2011-12-31	$1,170
Total income from all sources	2011-12-31	$1,069,295
Expenses. Total of all expenses incurred	2011-12-31	$76,270
Benefits paid (including direct rollovers)	2011-12-31	$63,155
Total plan assets at end of year	2011-12-31	$3,648,774
Total plan assets at beginning of year	2011-12-31	$2,574,323
Value of fidelity bond covering the plan	2011-12-31	$375,000
Total contributions received or receivable from participants	2011-12-31	$220,347
Expenses. Other expenses not covered elsewhere	2011-12-31	$13,115
Contributions received from other sources (not participants or employers)	2011-12-31	$689,452
Other income received	2011-12-31	$-188,116
Noncash contributions received	2011-12-31	$0
Net income (gross income less expenses)	2011-12-31	$993,025
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$3,566,178
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$2,573,153
Assets. Value of participant loans	2011-12-31	$76,299
Assets. Value of real-estate (other than employer real property)	2011-12-31	$765,000
Total contributions received or receivable from employer(s)	2011-12-31	$347,612
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
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$5,851
2010 : PACIFIC EYE SURGEONS 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	$1,170
Total income from all sources	2010-12-31	$304,932
Expenses. Total of all expenses incurred	2010-12-31	$50,535
Benefits paid (including direct rollovers)	2010-12-31	$50,335
Total plan assets at end of year	2010-12-31	$2,574,323
Total plan assets at beginning of year	2010-12-31	$2,318,756
Value of fidelity bond covering the plan	2010-12-31	$60,000
Total contributions received or receivable from participants	2010-12-31	$182,597
Expenses. Other expenses not covered elsewhere	2010-12-31	$200
Contributions received from other sources (not participants or employers)	2010-12-31	$0
Other income received	2010-12-31	$-222,975
Noncash contributions received	2010-12-31	$0
Net income (gross income less expenses)	2010-12-31	$254,397
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$2,573,153
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$2,318,756
Assets. Value of participant loans	2010-12-31	$112,497
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2010-12-31	$4,404
Total contributions received or receivable from employer(s)	2010-12-31	$345,310
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
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 PACIFIC EYE SURGEONS 401(K) PLAN

2021: PACIFIC EYE SURGEONS 401(K) PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	Yes
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: PACIFIC EYE SURGEONS 401(K) PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: PACIFIC EYE SURGEONS 401(K) 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	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
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: PACIFIC EYE SURGEONS 401(K) 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: PACIFIC EYE SURGEONS 401(K) 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 – Trust	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: PACIFIC EYE SURGEONS 401(K) 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 – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: PACIFIC EYE SURGEONS 401(K) 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 – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: PACIFIC EYE SURGEONS 401(K) PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: PACIFIC EYE SURGEONS 401(K) 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 – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: PACIFIC EYE SURGEONS 401(K) 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 – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: PACIFIC EYE SURGEONS 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 – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: PACIFIC EYE SURGEONS 401(K) 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 – Trust	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	PACIFIC EYE SURGEONS, A CALIFORNIA PROFESSIONAL MEDICAL CORPORATION
Employer identification number (EIN):	201555344
NAIC Classification:	621320
NAIC Description:	Offices of Optometrists