401k Plan data: PROVIDENCE MEDICAL GROUP 401(K) PLAN plan

PROVIDENCE MEDICAL GROUP 401(K) PLAN 401k Plan overview

Plan Name	PROVIDENCE MEDICAL GROUP 401(K) PLAN
Plan identification number	002

PROVIDENCE MEDICAL GROUP 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
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.
Plan covering Self-Employed individuals.
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

PROVIDENCE MEDICAL GROUP has sponsored the creation of one or more 401k plans.

Company Name: PROVIDENCE MEDICAL GROUP

Employer identification number (EIN): 330679962

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PROVIDENCE MEDICAL GROUP 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2015-01-01 PHONG NGUYEN
002 2014-01-01 PHONG NGUYEN
002 2013-01-01 PHONG NGUYEN
002 2012-01-01 PHONG NGUYEN
002 2011-01-01 PHONG NGUYEN
002 2009-01-01 PHONG NGUYEN

Plan id#	Filing Submission Date	Name of Administrator
002	2015-01-01	PHONG NGUYEN
002	2014-01-01	PHONG NGUYEN
002	2013-01-01	PHONG NGUYEN
002	2012-01-01	PHONG NGUYEN
002	2011-01-01	PHONG NGUYEN
002	2009-01-01	PHONG NGUYEN

Plan Statistics for PROVIDENCE MEDICAL GROUP 401(K) PLAN

401k plan membership statisitcs for PROVIDENCE MEDICAL GROUP 401(K) PLAN

Measure Date Value
2015: PROVIDENCE MEDICAL GROUP 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 113
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 0
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 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 0
Number of participants with account balances 2015-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: PROVIDENCE MEDICAL GROUP 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 81
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 97
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 15
Total of all active and inactive participants 2014-01-01 112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 1
Total participants 2014-01-01 113
Number of participants with account balances 2014-01-01 84
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: PROVIDENCE MEDICAL GROUP 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 77
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 69
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 11
Total of all active and inactive participants 2013-01-01 80
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 1
Total participants 2013-01-01 81
Number of participants with account balances 2013-01-01 72
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: PROVIDENCE MEDICAL GROUP 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 66
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 66
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 10
Total of all active and inactive participants 2012-01-01 76
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 1
Total participants 2012-01-01 77
Number of participants with account balances 2012-01-01 70
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: PROVIDENCE MEDICAL GROUP 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 62
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 58
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 65
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 1
Total participants 2011-01-01 66
Number of participants with account balances 2011-01-01 66
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: PROVIDENCE MEDICAL GROUP 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 52
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 52
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 10
Total of all active and inactive participants 2009-01-01 62
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 1
Total participants 2009-01-01 63
Number of participants with account balances 2009-01-01 56
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2015: PROVIDENCE MEDICAL GROUP 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	113
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	0
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	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	0
Number of participants with account balances	2015-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: PROVIDENCE MEDICAL GROUP 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	81
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	97
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	15
Total of all active and inactive participants	2014-01-01	112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	1
Total participants	2014-01-01	113
Number of participants with account balances	2014-01-01	84
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: PROVIDENCE MEDICAL GROUP 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	77
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	69
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	11
Total of all active and inactive participants	2013-01-01	80
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	1
Total participants	2013-01-01	81
Number of participants with account balances	2013-01-01	72
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: PROVIDENCE MEDICAL GROUP 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	66
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	66
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	10
Total of all active and inactive participants	2012-01-01	76
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	1
Total participants	2012-01-01	77
Number of participants with account balances	2012-01-01	70
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: PROVIDENCE MEDICAL GROUP 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	62
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	58
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	65
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	1
Total participants	2011-01-01	66
Number of participants with account balances	2011-01-01	66
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: PROVIDENCE MEDICAL GROUP 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	52
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	52
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	10
Total of all active and inactive participants	2009-01-01	62
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	1
Total participants	2009-01-01	63
Number of participants with account balances	2009-01-01	56
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on PROVIDENCE MEDICAL GROUP 401(K) PLAN

Measure	Date	Value
2015 : PROVIDENCE MEDICAL GROUP 401(K) PLAN 2015 401k financial data
Transfers to/from the plan	2015-06-26	$0
Total plan liabilities at end of year	2015-06-26	$0
Total plan liabilities at beginning of year	2015-06-26	$0
Total income from all sources	2015-06-26	$1,008,602
Expenses. Total of all expenses incurred	2015-06-26	$13,370,713
Benefits paid (including direct rollovers)	2015-06-26	$13,360,318
Total plan assets at end of year	2015-06-26	$0
Total plan assets at beginning of year	2015-06-26	$12,362,111
Value of fidelity bond covering the plan	2015-06-26	$500,000
Total contributions received or receivable from participants	2015-06-26	$0
Expenses. Other expenses not covered elsewhere	2015-06-26	$0
Contributions received from other sources (not participants or employers)	2015-06-26	$0
Other income received	2015-06-26	$392,607
Noncash contributions received	2015-06-26	$0
Net income (gross income less expenses)	2015-06-26	$-12,362,111
Net plan assets at end of year (total assets less liabilities)	2015-06-26	$0
Net plan assets at beginning of year (total assets less liabilities)	2015-06-26	$12,362,111
Total contributions received or receivable from employer(s)	2015-06-26	$615,995
Value of certain deemed distributions of participant loans	2015-06-26	$0
Value of corrective distributions	2015-06-26	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2015-06-26	$10,395
2014 : PROVIDENCE MEDICAL GROUP 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	$0
Total plan liabilities at beginning of year	2014-12-31	$0
Total income from all sources	2014-12-31	$2,532,265
Expenses. Total of all expenses incurred	2014-12-31	$307,015
Benefits paid (including direct rollovers)	2014-12-31	$286,825
Total plan assets at end of year	2014-12-31	$12,362,111
Total plan assets at beginning of year	2014-12-31	$10,136,861
Value of fidelity bond covering the plan	2014-12-31	$500,000
Total contributions received or receivable from participants	2014-12-31	$917,804
Expenses. Other expenses not covered elsewhere	2014-12-31	$0
Contributions received from other sources (not participants or employers)	2014-12-31	$0
Other income received	2014-12-31	$790,235
Noncash contributions received	2014-12-31	$0
Net income (gross income less expenses)	2014-12-31	$2,225,250
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$12,362,111
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$10,136,861
Total contributions received or receivable from employer(s)	2014-12-31	$824,226
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	$20,190
2013 : PROVIDENCE MEDICAL GROUP 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	$0
Total income from all sources	2013-12-31	$3,327,396
Expenses. Total of all expenses incurred	2013-12-31	$610,708
Benefits paid (including direct rollovers)	2013-12-31	$606,247
Total plan assets at end of year	2013-12-31	$10,136,861
Total plan assets at beginning of year	2013-12-31	$7,420,173
Value of fidelity bond covering the plan	2013-12-31	$500,000
Total contributions received or receivable from participants	2013-12-31	$884,022
Expenses. Other expenses not covered elsewhere	2013-12-31	$0
Contributions received from other sources (not participants or employers)	2013-12-31	$100,610
Other income received	2013-12-31	$1,607,905
Noncash contributions received	2013-12-31	$0
Net income (gross income less expenses)	2013-12-31	$2,716,688
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$10,136,861
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$7,420,173
Total contributions received or receivable from employer(s)	2013-12-31	$734,859
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	$4,461
2012 : PROVIDENCE MEDICAL GROUP 401(K) PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$2,000,583
Expenses. Total of all expenses incurred	2012-12-31	$274,729
Benefits paid (including direct rollovers)	2012-12-31	$270,000
Total plan assets at end of year	2012-12-31	$7,420,173
Total plan assets at beginning of year	2012-12-31	$5,694,319
Value of fidelity bond covering the plan	2012-12-31	$500,000
Total contributions received or receivable from participants	2012-12-31	$804,607
Contributions received from other sources (not participants or employers)	2012-12-31	$15,312
Other income received	2012-12-31	$816,417
Net income (gross income less expenses)	2012-12-31	$1,725,854
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$7,420,173
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$5,694,319
Total contributions received or receivable from employer(s)	2012-12-31	$364,247
Value of corrective distributions	2012-12-31	$1,509
Expenses. Administrative service providers (salaries,fees and commissions)	2012-12-31	$3,220
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
2011 : PROVIDENCE MEDICAL GROUP 401(K) PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$816,336
Expenses. Total of all expenses incurred	2011-12-31	$108,945
Benefits paid (including direct rollovers)	2011-12-31	$105,981
Total plan assets at end of year	2011-12-31	$5,694,319
Total plan assets at beginning of year	2011-12-31	$4,986,928
Total contributions received or receivable from participants	2011-12-31	$714,039
Contributions received from other sources (not participants or employers)	2011-12-31	$9,625
Other income received	2011-12-31	$-207,936
Net income (gross income less expenses)	2011-12-31	$707,391
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$5,694,319
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$4,986,928
Total contributions received or receivable from employer(s)	2011-12-31	$300,608
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$2,964
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
2010 : PROVIDENCE MEDICAL GROUP 401(K) PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$1,566,355
Expenses. Total of all expenses incurred	2010-12-31	$133,120
Benefits paid (including direct rollovers)	2010-12-31	$130,449
Total plan assets at end of year	2010-12-31	$4,986,928
Total plan assets at beginning of year	2010-12-31	$3,553,693
Total contributions received or receivable from participants	2010-12-31	$595,341
Contributions received from other sources (not participants or employers)	2010-12-31	$111,071
Other income received	2010-12-31	$588,203
Net income (gross income less expenses)	2010-12-31	$1,433,235
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$4,986,928
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$3,553,693
Total contributions received or receivable from employer(s)	2010-12-31	$271,740
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$2,671
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
2009 : PROVIDENCE MEDICAL GROUP 401(K) PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for PROVIDENCE MEDICAL GROUP 401(K) PLAN

2015: PROVIDENCE MEDICAL GROUP 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	Yes
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
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: PROVIDENCE MEDICAL GROUP 401(K) 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 – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: PROVIDENCE MEDICAL GROUP 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: PROVIDENCE MEDICAL GROUP 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 funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: PROVIDENCE MEDICAL GROUP 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 funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: PROVIDENCE MEDICAL GROUP 401(K) 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 funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	PROVIDENCE MEDICAL GROUP
Employer identification number (EIN):	330679962
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)