401k Plan data: DAKOTA PLAINS SURGICAL CENTER LLP 401(K) PROFIT SHARING PLAN plan

DAKOTA PLAINS SURGICAL CENTER LLP 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan Name	DAKOTA PLAINS SURGICAL CENTER LLP 401(K) PROFIT SHARING PLAN
Plan identification number	002

DAKOTA PLAINS SURGICAL CENTER LLP 401(K) PROFIT SHARING 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.
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.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

DAKOTA PLAINS SURGICAL CENTER LLP has sponsored the creation of one or more 401k plans.

Company Name: DAKOTA PLAINS SURGICAL CENTER LLP

Employer identification number (EIN): 460446046

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DAKOTA PLAINS SURGICAL CENTER LLP 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2015-01-01 PATTY KLINE PATTY KLINE 2016-10-05
002 2014-01-01 PATTY KLINE PATTY KLINE 2015-10-13

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2015-01-01	PATTY KLINE		PATTY KLINE	2016-10-05
002	2014-01-01	PATTY KLINE		PATTY KLINE	2015-10-13

Plan Statistics for DAKOTA PLAINS SURGICAL CENTER LLP 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for DAKOTA PLAINS SURGICAL CENTER LLP 401(K) PROFIT SHARING PLAN

Measure Date Value
2015: DAKOTA PLAINS SURGICAL CENTER LLP 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 131
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: DAKOTA PLAINS SURGICAL CENTER LLP 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 141
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 55
Number of retired or separated participants receiving benefits 2014-01-01 50
Number of other retired or separated participants entitled to future benefits 2014-01-01 26
Total of all active and inactive participants 2014-01-01 131
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 131
Number of participants with account balances 2014-01-01 127
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: DAKOTA PLAINS SURGICAL CENTER LLP 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	131
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: DAKOTA PLAINS SURGICAL CENTER LLP 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	141
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	55
Number of retired or separated participants receiving benefits	2014-01-01	50
Number of other retired or separated participants entitled to future benefits	2014-01-01	26
Total of all active and inactive participants	2014-01-01	131
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	131
Number of participants with account balances	2014-01-01	127
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0

Financial Data on DAKOTA PLAINS SURGICAL CENTER LLP 401(K) PROFIT SHARING PLAN

Measure	Date	Value
2015 : DAKOTA PLAINS SURGICAL CENTER LLP 401(K) PROFIT SHARING PLAN 2015 401k financial data
Total income from all sources (including contributions)	2015-12-31	$123,663
Total of all expenses incurred	2015-12-31	$3,213,004
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$3,205,713
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$144,317
Value of total assets at end of year	2015-12-31	$0
Value of total assets at beginning of year	2015-12-31	$3,089,341
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$7,291
Total interest from all sources	2015-12-31	$737
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$2,945
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2015-12-31	$0
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$2,945
Administrative expenses professional fees incurred	2015-12-31	$7,291
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$600,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$105,035
Participant contributions at end of year	2015-12-31	$0
Participant contributions at beginning of year	2015-12-31	$27,851
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$333
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	$-3,089,341
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	$3,089,341
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 end of year	2015-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$654,566
Interest on participant loans	2015-12-31	$737
Value of interest in common/collective trusts at end of year	2015-12-31	$0
Value of interest in common/collective trusts at beginning of year	2015-12-31	$2,164,194
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-24,336
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	$38,949
Employer contributions (assets) at end of year	2015-12-31	$0
Employer contributions (assets) at beginning of year	2015-12-31	$242,730
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$3,205,713
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	EIDE BAILLY, LLP
Accountancy firm EIN	2015-12-31	450250958
2014 : DAKOTA PLAINS SURGICAL CENTER LLP 401(K) PROFIT SHARING PLAN 2014 401k financial data
Total income from all sources (including contributions)	2014-12-31	$915,185
Total of all expenses incurred	2014-12-31	$8,908,432
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$8,893,783
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$624,105
Value of total assets at end of year	2014-12-31	$3,089,341
Value of total assets at beginning of year	2014-12-31	$11,082,588
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$14,649
Total interest from all sources	2014-12-31	$2,823
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$11,483
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	$11,483
Administrative expenses professional fees incurred	2014-12-31	$0
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$600,000
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	$193,511
Participant contributions at end of year	2014-12-31	$27,851
Participant contributions at beginning of year	2014-12-31	$239,117
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$118,422
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	$-7,993,247
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$3,089,341
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$11,082,588
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
Investment advisory and management fees	2014-12-31	$14,649
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$654,566
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$1,951,387
Interest on participant loans	2014-12-31	$2,823
Value of interest in common/collective trusts at end of year	2014-12-31	$2,164,194
Value of interest in common/collective trusts at beginning of year	2014-12-31	$8,573,579
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$276,774
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
Contributions received in cash from employer	2014-12-31	$312,172
Employer contributions (assets) at end of year	2014-12-31	$242,730
Employer contributions (assets) at beginning of year	2014-12-31	$318,505
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$8,893,783
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	EIDE BAILLY, LLP
Accountancy firm EIN	2014-12-31	450250958

Form 5500 Responses for DAKOTA PLAINS SURGICAL CENTER LLP 401(K) PROFIT SHARING PLAN

2015: DAKOTA PLAINS SURGICAL CENTER LLP 401(K) PROFIT SHARING PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	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: DAKOTA PLAINS SURGICAL CENTER LLP 401(K) PROFIT SHARING PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	DAKOTA PLAINS SURGICAL CENTER LLP
Employer identification number (EIN):	460446046
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)