401k Plan data: EVERGREEN EYE CENTER PROFIT SHARING & 401(K) PLAN plan

EVERGREEN EYE CENTER PROFIT SHARING & 401(K) PLAN 401k Plan overview

Plan Name	EVERGREEN EYE CENTER PROFIT SHARING & 401(K) PLAN
Plan identification number	001

EVERGREEN EYE CENTER PROFIT SHARING & 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.
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.

401k Sponsoring company profile

EVERGREEN EYE CENTER, INC., P.S. has sponsored the creation of one or more 401k plans.

Company Name: EVERGREEN EYE CENTER, INC., P.S.

Employer identification number (EIN): 911628032

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

Additional information about EVERGREEN EYE CENTER, INC., P.S.

Jurisdiction of Incorporation: Washington Secretary of State Corporations Division

Incorporation Date: 1993-12-29

Company Identification Number: 601512780

Legal Registered Office Address: 33600 6TH AVE S SUITE 200

FEDERAL WAY
United States of America (USA)
980036743

More information about EVERGREEN EYE CENTER, INC., P.S.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EVERGREEN EYE CENTER PROFIT SHARING & 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2018-01-01
001 2017-01-01
001 2016-01-01 ZACHARY SMITH ZACHARY SMITH 2017-10-04
001 2015-01-01 ZACHARY SMITH
001 2014-01-01 ZACHARY M. SMITH ZACHARY M. SMITH 2015-10-15
001 2014-01-01 ZACHARY M. SMITH
001 2013-01-01 RICHARD A. BOUDREAU RICHARD A. BOUDREAU 2014-10-15
001 2012-01-01 RICHARD A. BOUDREAU RICHARD A. BOUDREAU 2013-10-09
001 2011-01-01 RICHARD A. BOUDREAU RICHARD A. BOUDREAU 2012-10-11
001 2010-01-01 RICHARD BOUDREAU
001 2009-01-01 RICHARD BOUDREAU

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2018-01-01
001	2017-01-01
001	2016-01-01	ZACHARY SMITH	ZACHARY SMITH	2017-10-04
001	2015-01-01	ZACHARY SMITH
001	2014-01-01	ZACHARY M. SMITH	ZACHARY M. SMITH	2015-10-15
001	2014-01-01	ZACHARY M. SMITH
001	2013-01-01	RICHARD A. BOUDREAU	RICHARD A. BOUDREAU	2014-10-15
001	2012-01-01	RICHARD A. BOUDREAU	RICHARD A. BOUDREAU	2013-10-09
001	2011-01-01	RICHARD A. BOUDREAU	RICHARD A. BOUDREAU	2012-10-11
001	2010-01-01	RICHARD BOUDREAU
001	2009-01-01	RICHARD BOUDREAU

Plan Statistics for EVERGREEN EYE CENTER PROFIT SHARING & 401(K) PLAN

401k plan membership statisitcs for EVERGREEN EYE CENTER PROFIT SHARING & 401(K) PLAN

Measure Date Value
2018: EVERGREEN EYE CENTER PROFIT SHARING & 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 144
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 100
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 74
Total of all active and inactive participants 2018-01-01 174
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 174
Number of participants with account balances 2018-01-01 150
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2016: EVERGREEN EYE CENTER PROFIT SHARING & 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 97
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 57
Number of retired or separated participants receiving benefits 2016-01-01 16
Number of other retired or separated participants entitled to future benefits 2016-01-01 22
Total of all active and inactive participants 2016-01-01 95
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 95
Number of participants with account balances 2016-01-01 83
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: EVERGREEN EYE CENTER PROFIT SHARING & 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 88
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 9
Number of other retired or separated participants entitled to future benefits 2015-01-01 16
Total of all active and inactive participants 2015-01-01 91
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 91
Number of participants with account balances 2015-01-01 90
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: EVERGREEN EYE CENTER PROFIT SHARING & 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 90
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 65
Number of retired or separated participants receiving benefits 2014-01-01 4
Number of other retired or separated participants entitled to future benefits 2014-01-01 7
Total of all active and inactive participants 2014-01-01 76
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 76
Number of participants with account balances 2014-01-01 68
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: EVERGREEN EYE CENTER PROFIT SHARING & 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 61
Number of retired or separated participants receiving benefits 2013-01-01 6
Number of other retired or separated participants entitled to future benefits 2013-01-01 12
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 0
2012: EVERGREEN EYE CENTER PROFIT SHARING & 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 83
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 60
Number of retired or separated participants receiving benefits 2012-01-01 3
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 72
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 72
Number of participants with account balances 2012-01-01 72
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: EVERGREEN EYE CENTER PROFIT SHARING & 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 81
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 17
Total of all active and inactive participants 2011-01-01 74
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 74
Number of participants with account balances 2011-01-01 74
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: EVERGREEN EYE CENTER PROFIT SHARING & 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 62
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 59
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 79
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 79
Number of participants with account balances 2010-01-01 77
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: EVERGREEN EYE CENTER PROFIT SHARING & 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 57
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 44
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 18
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 0
Total participants 2009-01-01 62
Number of participants with account balances 2009-01-01 60
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2018: EVERGREEN EYE CENTER PROFIT SHARING & 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	144
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	100
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	74
Total of all active and inactive participants	2018-01-01	174
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	174
Number of participants with account balances	2018-01-01	150
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2016: EVERGREEN EYE CENTER PROFIT SHARING & 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	97
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	57
Number of retired or separated participants receiving benefits	2016-01-01	16
Number of other retired or separated participants entitled to future benefits	2016-01-01	22
Total of all active and inactive participants	2016-01-01	95
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	95
Number of participants with account balances	2016-01-01	83
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: EVERGREEN EYE CENTER PROFIT SHARING & 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	88
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	9
Number of other retired or separated participants entitled to future benefits	2015-01-01	16
Total of all active and inactive participants	2015-01-01	91
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	91
Number of participants with account balances	2015-01-01	90
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: EVERGREEN EYE CENTER PROFIT SHARING & 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	90
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	65
Number of retired or separated participants receiving benefits	2014-01-01	4
Number of other retired or separated participants entitled to future benefits	2014-01-01	7
Total of all active and inactive participants	2014-01-01	76
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	76
Number of participants with account balances	2014-01-01	68
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: EVERGREEN EYE CENTER PROFIT SHARING & 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	61
Number of retired or separated participants receiving benefits	2013-01-01	6
Number of other retired or separated participants entitled to future benefits	2013-01-01	12
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	0
2012: EVERGREEN EYE CENTER PROFIT SHARING & 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	83
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	60
Number of retired or separated participants receiving benefits	2012-01-01	3
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	72
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	72
Number of participants with account balances	2012-01-01	72
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: EVERGREEN EYE CENTER PROFIT SHARING & 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	81
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	17
Total of all active and inactive participants	2011-01-01	74
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	74
Number of participants with account balances	2011-01-01	74
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: EVERGREEN EYE CENTER PROFIT SHARING & 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	62
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	59
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	79
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	79
Number of participants with account balances	2010-01-01	77
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: EVERGREEN EYE CENTER PROFIT SHARING & 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	57
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	44
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	18
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	0
Total participants	2009-01-01	62
Number of participants with account balances	2009-01-01	60
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on EVERGREEN EYE CENTER PROFIT SHARING & 401(K) PLAN

Measure	Date	Value
2018 : EVERGREEN EYE CENTER PROFIT SHARING & 401(K) PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total transfer of assets to this plan	2018-12-31	$0
Total transfer of assets from this plan	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$33,750
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$330,494
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$228,790
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$228,290
Expenses. Certain deemed distributions of participant loans	2018-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$498,724
Value of total assets at end of year	2018-12-31	$2,897,680
Value of total assets at beginning of year	2018-12-31	$2,762,226
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$500
Total interest from all sources	2018-12-31	$471
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$172,979
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2018-12-31	$172,979
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$294,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$231,763
Participant contributions at end of year	2018-12-31	$7,237
Participant contributions at beginning of year	2018-12-31	$10,661
Participant contributions at end of year	2018-12-31	$14,879
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2018-12-31	$33,750
Administrative expenses (other) incurred	2018-12-31	$500
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$101,704
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$2,863,930
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$2,762,226
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$2,731,242
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$2,751,565
Interest on participant loans	2018-12-31	$471
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-341,680
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$266,961
Employer contributions (assets) at end of year	2018-12-31	$144,322
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$228,290
Did the plan have assets held for investment	2018-12-31	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	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	VWC, P.S.
Accountancy firm EIN	2018-12-31	911007261
2016 : EVERGREEN EYE CENTER PROFIT SHARING & 401(K) PLAN 2016 401k financial data
Total income from all sources	2016-12-31	$338,694
Expenses. Total of all expenses incurred	2016-12-31	$965,656
Benefits paid (including direct rollovers)	2016-12-31	$952,449
Total plan assets at end of year	2016-12-31	$3,315,161
Total plan assets at beginning of year	2016-12-31	$3,942,123
Value of fidelity bond covering the plan	2016-12-31	$905,000
Total contributions received or receivable from participants	2016-12-31	$160,099
Assets. Value of loans (other than to participants)	2016-12-31	$800,000
Other income received	2016-12-31	$118,495
Net income (gross income less expenses)	2016-12-31	$-626,962
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$3,315,161
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$3,942,123
Assets. Value of participant loans	2016-12-31	$14,870
Assets. Value of assets in partnership/joint-venture interests	2016-12-31	$190,000
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	2016-12-31	$153,936
Total contributions received or receivable from employer(s)	2016-12-31	$60,100
Value of certain deemed distributions of participant loans	2016-12-31	$13,207
2015 : EVERGREEN EYE CENTER PROFIT SHARING & 401(K) PLAN 2015 401k financial data
Total income from all sources	2015-12-31	$211,353
Expenses. Total of all expenses incurred	2015-12-31	$193,287
Benefits paid (including direct rollovers)	2015-12-31	$173,769
Total plan assets at end of year	2015-12-31	$3,942,123
Total plan assets at beginning of year	2015-12-31	$3,924,057
Value of fidelity bond covering the plan	2015-12-31	$905,000
Total contributions received or receivable from participants	2015-12-31	$191,386
Assets. Value of loans (other than to participants)	2015-12-31	$800,000
Other income received	2015-12-31	$-71,019
Net income (gross income less expenses)	2015-12-31	$18,066
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$3,942,123
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$3,924,057
Assets. Value of participant loans	2015-12-31	$40,210
Assets. Value of assets in partnership/joint-venture interests	2015-12-31	$190,000
Total contributions received or receivable from employer(s)	2015-12-31	$90,986
Value of certain deemed distributions of participant loans	2015-12-31	$4,213
Expenses. Administrative service providers (salaries,fees and commissions)	2015-12-31	$15,305
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
2014 : EVERGREEN EYE CENTER PROFIT SHARING & 401(K) PLAN 2014 401k financial data
Total income from all sources	2014-12-31	$547,014
Expenses. Total of all expenses incurred	2014-12-31	$207,612
Benefits paid (including direct rollovers)	2014-12-31	$181,498
Total plan assets at end of year	2014-12-31	$3,938,813
Total plan assets at beginning of year	2014-12-31	$3,599,411
Value of fidelity bond covering the plan	2014-12-31	$400,000
Total contributions received or receivable from participants	2014-12-31	$214,684
Contributions received from other sources (not participants or employers)	2014-12-31	$0
Other income received	2014-12-31	$195,211
Noncash contributions received	2014-12-31	$0
Net income (gross income less expenses)	2014-12-31	$339,402
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$3,938,813
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$3,599,411
Assets. Value of participant loans	2014-12-31	$89,478
Assets. Value of assets in partnership/joint-venture interests	2014-12-31	$190,000
Total contributions received or receivable from employer(s)	2014-12-31	$137,119
Value of certain deemed distributions of participant loans	2014-12-31	$11,442
Expenses. Administrative service providers (salaries,fees and commissions)	2014-12-31	$14,672
2013 : EVERGREEN EYE CENTER PROFIT SHARING & 401(K) PLAN 2013 401k financial data
Total plan liabilities at beginning of year	2013-12-31	$0
Total income from all sources	2013-12-31	$698,346
Expenses. Total of all expenses incurred	2013-12-31	$174,328
Benefits paid (including direct rollovers)	2013-12-31	$130,530
Total plan assets at end of year	2013-12-31	$3,599,411
Total plan assets at beginning of year	2013-12-31	$3,075,393
Value of fidelity bond covering the plan	2013-12-31	$400,000
Total contributions received or receivable from participants	2013-12-31	$165,103
Assets. Value of loans (other than to participants)	2013-12-31	$660,000
Contributions received from other sources (not participants or employers)	2013-12-31	$18,501
Other income received	2013-12-31	$397,132
Net income (gross income less expenses)	2013-12-31	$524,018
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$3,599,411
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$3,075,393
Assets. Value of participant loans	2013-12-31	$66,503
Assets. Value of assets in partnership/joint-venture interests	2013-12-31	$190,000
Total contributions received or receivable from employer(s)	2013-12-31	$117,610
Value of certain deemed distributions of participant loans	2013-12-31	$25,941
Expenses. Administrative service providers (salaries,fees and commissions)	2013-12-31	$17,857
2012 : EVERGREEN EYE CENTER PROFIT SHARING & 401(K) PLAN 2012 401k financial data
Total plan liabilities at end of year	2012-12-31	$0
Total plan liabilities at beginning of year	2012-12-31	$0
Total income from all sources	2012-12-31	$625,650
Expenses. Total of all expenses incurred	2012-12-31	$75,509
Benefits paid (including direct rollovers)	2012-12-31	$62,474
Total plan assets at end of year	2012-12-31	$3,075,393
Total plan assets at beginning of year	2012-12-31	$2,525,252
Value of fidelity bond covering the plan	2012-12-31	$400,000
Total contributions received or receivable from participants	2012-12-31	$174,469
Assets. Value of loans (other than to participants)	2012-12-31	$200,000
Other income received	2012-12-31	$299,061
Net income (gross income less expenses)	2012-12-31	$550,141
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$3,075,393
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$2,525,252
Assets. Value of participant loans	2012-12-31	$98,472
Assets. Value of assets in partnership/joint-venture interests	2012-12-31	$190,000
Assets. Value of real-estate (other than employer real property)	2012-12-31	$178,000
Total contributions received or receivable from employer(s)	2012-12-31	$152,120
Expenses. Administrative service providers (salaries,fees and commissions)	2012-12-31	$13,035
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
2011 : EVERGREEN EYE CENTER PROFIT SHARING & 401(K) PLAN 2011 401k financial data
Total plan liabilities at end of year	2011-12-31	$0
Total plan liabilities at beginning of year	2011-12-31	$0
Total income from all sources	2011-12-31	$197,717
Expenses. Total of all expenses incurred	2011-12-31	$118,633
Benefits paid (including direct rollovers)	2011-12-31	$107,640
Total plan assets at end of year	2011-12-31	$2,525,252
Total plan assets at beginning of year	2011-12-31	$2,446,168
Value of fidelity bond covering the plan	2011-12-31	$400,000
Total contributions received or receivable from participants	2011-12-31	$164,101
Expenses. Other expenses not covered elsewhere	2011-12-31	$948
Contributions received from other sources (not participants or employers)	2011-12-31	$20,731
Other income received	2011-12-31	$-132,032
Net income (gross income less expenses)	2011-12-31	$79,084
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$2,525,252
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$2,446,168
Assets. Value of participant loans	2011-12-31	$40,609
Assets. Value of assets in partnership/joint-venture interests	2011-12-31	$190,000
Assets. Value of real-estate (other than employer real property)	2011-12-31	$187,000
Total contributions received or receivable from employer(s)	2011-12-31	$144,917
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$10,045
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
2010 : EVERGREEN EYE CENTER PROFIT SHARING & 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	$0
Total plan liabilities at beginning of year	2010-12-31	$0
Total income from all sources	2010-12-31	$391,778
Expenses. Total of all expenses incurred	2010-12-31	$9,306
Benefits paid (including direct rollovers)	2010-12-31	$9,306
Total plan assets at end of year	2010-12-31	$2,446,168
Total plan assets at beginning of year	2010-12-31	$2,063,696
Value of fidelity bond covering the plan	2010-12-31	$210,000
Total contributions received or receivable from participants	2010-12-31	$157,042
Expenses. Other expenses not covered elsewhere	2010-12-31	$0
Contributions received from other sources (not participants or employers)	2010-12-31	$712
Other income received	2010-12-31	$139,162
Noncash contributions received	2010-12-31	$0
Net income (gross income less expenses)	2010-12-31	$382,472
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$2,446,168
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$2,063,696
Assets. Value of participant loans	2010-12-31	$69,035
Assets. Value of real-estate (other than employer real property)	2010-12-31	$187,000
Total contributions received or receivable from employer(s)	2010-12-31	$94,862
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
2009 : EVERGREEN EYE CENTER PROFIT SHARING & 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 EVERGREEN EYE CENTER PROFIT SHARING & 401(K) PLAN

2018: EVERGREEN EYE CENTER PROFIT SHARING & 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
2016: EVERGREEN EYE CENTER PROFIT SHARING & 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: EVERGREEN EYE CENTER PROFIT SHARING & 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: EVERGREEN EYE CENTER PROFIT SHARING & 401(K) PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	Yes
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: EVERGREEN EYE CENTER PROFIT SHARING & 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: EVERGREEN EYE CENTER PROFIT SHARING & 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: EVERGREEN EYE CENTER PROFIT SHARING & 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: EVERGREEN EYE CENTER PROFIT SHARING & 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
2009: EVERGREEN EYE CENTER PROFIT SHARING & 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 is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	EVERGREEN EYE CENTER, INC., P.S.
Employer identification number (EIN):	911628032
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)

Jurisdiction of Incorporation:	Washington Secretary of State Corporations Division
Incorporation Date:	1993-12-29
Company Identification Number:	601512780
Legal Registered Office Address:	33600 6TH AVE S SUITE 200 FEDERAL WAY United States of America (USA) 980036743