401k Plan data: WESTSIDE SURGICAL HOSPITAL LLC 401K PLAN plan

WESTSIDE SURGICAL HOSPITAL LLC 401K PLAN 401k Plan overview

Plan Name	WESTSIDE SURGICAL HOSPITAL LLC 401K PLAN
Plan identification number	001

WESTSIDE SURGICAL HOSPITAL LLC 401K 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.
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.
Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
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

WESTSIDE SURGICAL HOSPITAL, LLC has sponsored the creation of one or more 401k plans.

Company Name: WESTSIDE SURGICAL HOSPITAL, LLC

Employer identification number (EIN): 364722800

NAIC Classification: 622000
NAIC Description: Hospitals

Additional information about WESTSIDE SURGICAL HOSPITAL, LLC

Jurisdiction of Incorporation: Texas Secretary of State

Incorporation Date: 2011-12-05

Company Identification Number: 0801515461

Legal Registered Office Address: 5120 WOODWAY DR STE 7012 HOUSTON

United States of America (USA)
77056

More information about WESTSIDE SURGICAL HOSPITAL, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WESTSIDE SURGICAL HOSPITAL LLC 401K PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2015-01-01 HAJARAH N MABIKE
001 2015-01-01
001 2014-01-01 HAJARAH N MABIKE
001 2013-01-01 HAJARAH MABIKE 2014-06-24

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2015-01-01	HAJARAH N MABIKE
001	2015-01-01
001	2014-01-01	HAJARAH N MABIKE
001	2013-01-01	HAJARAH MABIKE	2014-06-24

Plan Statistics for WESTSIDE SURGICAL HOSPITAL LLC 401K PLAN

401k plan membership statisitcs for WESTSIDE SURGICAL HOSPITAL LLC 401K PLAN

Measure Date Value
2015: WESTSIDE SURGICAL HOSPITAL LLC 401K PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 228
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: WESTSIDE SURGICAL HOSPITAL LLC 401K PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 151
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 119
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 43
Total of all active and inactive participants 2014-01-01 162
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 162
Number of participants with account balances 2014-01-01 133
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0

Measure	Date	Value
2015: WESTSIDE SURGICAL HOSPITAL LLC 401K PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	228
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: WESTSIDE SURGICAL HOSPITAL LLC 401K PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	151
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	119
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	43
Total of all active and inactive participants	2014-01-01	162
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	162
Number of participants with account balances	2014-01-01	133
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0

Financial Data on WESTSIDE SURGICAL HOSPITAL LLC 401K PLAN

Measure	Date	Value
2015 : WESTSIDE SURGICAL HOSPITAL LLC 401K PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total transfer of assets to this plan	2015-12-31	$0
Total transfer of assets from this plan	2015-12-31	$519,942
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$398,968
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$76,097
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$60,986
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$411,881
Value of total assets at end of year	2015-12-31	$0
Value of total assets at beginning of year	2015-12-31	$197,071
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$15,111
Total interest from all sources	2015-12-31	$480
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$882
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$882
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$20,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$217,502
Participant contributions at beginning of year	2015-12-31	$9,855
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$109,574
Other income not declared elsewhere	2015-12-31	$5,014
Administrative expenses (other) incurred	2015-12-31	$15,111
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$322,871
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$197,071
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$178,237
Interest on participant loans	2015-12-31	$480
Value of interest in common/collective trusts at beginning of year	2015-12-31	$8,979
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-19,235
Net investment gain or loss from common/collective trusts	2015-12-31	$-54
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$84,805
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$60,986
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	CALVETTI FERGUSON
Accountancy firm EIN	2015-12-31	134255527
Total unrealized appreciation/depreciation of assets	2015-12-14	$0
Total transfer of assets to this plan	2015-12-14	$0
Total transfer of assets from this plan	2015-12-14	$519,942
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-14	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-14	$0
Total income from all sources (including contributions)	2015-12-14	$398,968
Total loss/gain on sale of assets	2015-12-14	$0
Total of all expenses incurred	2015-12-14	$76,097
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-14	$60,986
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-14	$411,881
Value of total assets at end of year	2015-12-14	$0
Value of total assets at beginning of year	2015-12-14	$197,071
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-14	$15,111
Total interest from all sources	2015-12-14	$480
Total dividends received (eg from common stock, registered investment company shares)	2015-12-14	$882
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-14	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-14	$882
Was this plan covered by a fidelity bond	2015-12-14	Yes
Value of fidelity bond cover	2015-12-14	$20,000
If this is an individual account plan, was there a blackout period	2015-12-14	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-14	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-14	No
Contributions received from participants	2015-12-14	$217,502
Participant contributions at beginning of year	2015-12-14	$9,855
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-14	$109,574
Other income not declared elsewhere	2015-12-14	$5,014
Administrative expenses (other) incurred	2015-12-14	$15,111
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-14	No
Value of net income/loss	2015-12-14	$322,871
Value of net assets at end of year (total assets less liabilities)	2015-12-14	$0
Value of net assets at beginning of year (total assets less liabilities)	2015-12-14	$197,071
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-14	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-14	No
Were any leases to which the plan was party in default or uncollectible	2015-12-14	No
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-14	$178,237
Interest on participant loans	2015-12-14	$480
Value of interest in common/collective trusts at beginning of year	2015-12-14	$8,979
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-14	$-19,235
Net investment gain or loss from common/collective trusts	2015-12-14	$-54
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-14	No
Was there a failure to transmit to the plan any participant contributions	2015-12-14	No
Has the plan failed to provide any benefit when due under the plan	2015-12-14	No
Contributions received in cash from employer	2015-12-14	$84,805
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-14	$60,986
Did the plan have assets held for investment	2015-12-14	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-14	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-14	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-14	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-14	Disclaimer
Accountancy firm name	2015-12-14	CALVETTI FERGUSON
Accountancy firm EIN	2015-12-14	134255527
2014 : WESTSIDE SURGICAL HOSPITAL LLC 401K PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total transfer of assets to this plan	2014-12-31	$0
Total transfer of assets from this plan	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$186,506
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$61,364
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$58,942
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$176,977
Value of total assets at end of year	2014-12-31	$197,071
Value of total assets at beginning of year	2014-12-31	$71,929
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$2,422
Total interest from all sources	2014-12-31	$97
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$3,923
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$3,923
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$8,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$176,977
Participant contributions at end of year	2014-12-31	$9,855
Participant contributions at beginning of year	2014-12-31	$1,186
Administrative expenses (other) incurred	2014-12-31	$2,422
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$125,142
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$197,071
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$71,929
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$178,237
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$68,301
Interest on participant loans	2014-12-31	$97
Value of interest in common/collective trusts at end of year	2014-12-31	$8,979
Value of interest in common/collective trusts at beginning of year	2014-12-31	$2,442
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$5,107
Net investment gain or loss from common/collective trusts	2014-12-31	$402
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$58,942
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	CALVETTI FERGUSON
Accountancy firm EIN	2014-12-31	134255527

Form 5500 Responses for WESTSIDE SURGICAL HOSPITAL LLC 401K PLAN

2015: WESTSIDE SURGICAL HOSPITAL LLC 401K 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)	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: WESTSIDE SURGICAL HOSPITAL LLC 401K 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

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Company Name:	WESTSIDE SURGICAL HOSPITAL, LLC
Employer identification number (EIN):	364722800
NAIC Classification:	622000
NAIC Description:	Hospitals

Jurisdiction of Incorporation:	Texas Secretary of State
Incorporation Date:	2011-12-05
Company Identification Number:	0801515461
Legal Registered Office Address:	5120 WOODWAY DR STE 7012 HOUSTON United States of America (USA) 77056