401k Plan data: UPSTATE SURGICAL GROUP, PC 401(K) & PROFIT SHARING PLAN plan

UPSTATE SURGICAL GROUP, PC 401(K) & PROFIT SHARING PLAN 401k Plan overview

Plan Name	UPSTATE SURGICAL GROUP, PC 401(K) & PROFIT SHARING PLAN
Plan identification number	001

UPSTATE SURGICAL GROUP, PC 401(K) & PROFIT SHARING PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Participant-directed brokerage accounts provided as an investment option under the plan.
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

UPSTATE SURGICAL GROUP, PC has sponsored the creation of one or more 401k plans.

Company Name: UPSTATE SURGICAL GROUP, PC

Employer identification number (EIN): 161430886

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan UPSTATE SURGICAL GROUP, PC 401(K) & PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2014-01-01 THOMAS F. CERTO
001 2014-01-01 THOMAS F. CERTO
001 2013-01-01 THOMAS F. CERTO
001 2012-01-01 THOMAS F. CERTO
001 2011-01-01 THOMAS F. CERTO
001 2010-01-01 THOMAS F CERTO, MD THOMAS F CERTO, MD 2011-05-09
001 2009-01-01 THOMAS F CERTO, MD THOMAS F CERTO, MD 2010-06-25

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2014-01-01	THOMAS F. CERTO
001	2014-01-01	THOMAS F. CERTO
001	2013-01-01	THOMAS F. CERTO
001	2012-01-01	THOMAS F. CERTO
001	2011-01-01	THOMAS F. CERTO
001	2010-01-01	THOMAS F CERTO, MD	THOMAS F CERTO, MD	2011-05-09
001	2009-01-01	THOMAS F CERTO, MD	THOMAS F CERTO, MD	2010-06-25

Plan Statistics for UPSTATE SURGICAL GROUP, PC 401(K) & PROFIT SHARING PLAN

401k plan membership statisitcs for UPSTATE SURGICAL GROUP, PC 401(K) & PROFIT SHARING PLAN

Measure Date Value
2014: UPSTATE SURGICAL GROUP, PC 401(K) & PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 29
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 0
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 0
Total of all active and inactive participants 2014-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 0
Number of participants with account balances 2014-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: UPSTATE SURGICAL GROUP, PC 401(K) & PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 40
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 4
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 25
Total of all active and inactive participants 2013-01-01 29
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 29
Number of participants with account balances 2013-01-01 29
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 1
2012: UPSTATE SURGICAL GROUP, PC 401(K) & PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 52
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 31
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 8
Total of all active and inactive participants 2012-01-01 39
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 39
Number of participants with account balances 2012-01-01 29
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 5
2011: UPSTATE SURGICAL GROUP, PC 401(K) & PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 41
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 38
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 14
Total of all active and inactive participants 2011-01-01 52
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 52
Number of participants with account balances 2011-01-01 39
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 3
2010: UPSTATE SURGICAL GROUP, PC 401(K) & PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 42
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 28
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 13
Total of all active and inactive participants 2010-01-01 41
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 41
Number of participants with account balances 2010-01-01 40
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 2
2009: UPSTATE SURGICAL GROUP, PC 401(K) & PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 38
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 28
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 12
Total of all active and inactive participants 2009-01-01 40
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 40
Number of participants with account balances 2009-01-01 40
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 2

Measure	Date	Value
2014: UPSTATE SURGICAL GROUP, PC 401(K) & PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	29
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	0
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	0
Total of all active and inactive participants	2014-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	0
Number of participants with account balances	2014-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: UPSTATE SURGICAL GROUP, PC 401(K) & PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	40
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	4
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	25
Total of all active and inactive participants	2013-01-01	29
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	29
Number of participants with account balances	2013-01-01	29
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	1
2012: UPSTATE SURGICAL GROUP, PC 401(K) & PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	52
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	31
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	8
Total of all active and inactive participants	2012-01-01	39
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	39
Number of participants with account balances	2012-01-01	29
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	5
2011: UPSTATE SURGICAL GROUP, PC 401(K) & PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	41
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	38
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	14
Total of all active and inactive participants	2011-01-01	52
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	52
Number of participants with account balances	2011-01-01	39
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	3
2010: UPSTATE SURGICAL GROUP, PC 401(K) & PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	42
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	28
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	13
Total of all active and inactive participants	2010-01-01	41
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	41
Number of participants with account balances	2010-01-01	40
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	2
2009: UPSTATE SURGICAL GROUP, PC 401(K) & PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	38
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	28
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	12
Total of all active and inactive participants	2009-01-01	40
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	40
Number of participants with account balances	2009-01-01	40
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	2

Financial Data on UPSTATE SURGICAL GROUP, PC 401(K) & PROFIT SHARING PLAN

Measure	Date	Value
2014 : UPSTATE SURGICAL GROUP, PC 401(K) & PROFIT SHARING PLAN 2014 401k financial data
Total income from all sources	2014-12-31	$66,587
Expenses. Total of all expenses incurred	2014-12-31	$3,657,922
Benefits paid (including direct rollovers)	2014-12-31	$3,636,157
Total plan assets at beginning of year	2014-12-31	$3,591,335
Value of fidelity bond covering the plan	2014-12-31	$300,000
Total contributions received or receivable from participants	2014-12-31	$5,482
Other income received	2014-12-31	$24,984
Net income (gross income less expenses)	2014-12-31	$-3,591,335
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$0
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$3,591,335
Assets. Value of participant loans	2014-12-31	$0
Total contributions received or receivable from employer(s)	2014-12-31	$36,121
Expenses. Administrative service providers (salaries,fees and commissions)	2014-12-31	$21,765
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
2013 : UPSTATE SURGICAL GROUP, PC 401(K) & PROFIT SHARING PLAN 2013 401k financial data
Total income from all sources	2013-12-31	$552,649
Expenses. Total of all expenses incurred	2013-12-31	$474,991
Benefits paid (including direct rollovers)	2013-12-31	$444,963
Total plan assets at end of year	2013-12-31	$3,591,335
Total plan assets at beginning of year	2013-12-31	$3,513,677
Value of fidelity bond covering the plan	2013-12-31	$300,000
Total contributions received or receivable from participants	2013-12-31	$67,307
Other income received	2013-12-31	$368,079
Net income (gross income less expenses)	2013-12-31	$77,658
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$3,591,335
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$3,513,677
Assets. Value of participant loans	2013-12-31	$23,663
Total contributions received or receivable from employer(s)	2013-12-31	$117,263
Expenses. Administrative service providers (salaries,fees and commissions)	2013-12-31	$30,028
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
2012 : UPSTATE SURGICAL GROUP, PC 401(K) & PROFIT SHARING PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$713,185
Expenses. Total of all expenses incurred	2012-12-31	$45,703
Benefits paid (including direct rollovers)	2012-12-31	$36,575
Total plan assets at end of year	2012-12-31	$3,513,677
Total plan assets at beginning of year	2012-12-31	$2,846,195
Value of fidelity bond covering the plan	2012-12-31	$300,000
Total contributions received or receivable from participants	2012-12-31	$89,820
Other income received	2012-12-31	$415,189
Net income (gross income less expenses)	2012-12-31	$667,482
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$3,513,677
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$2,846,195
Assets. Value of participant loans	2012-12-31	$30,951
Total contributions received or receivable from employer(s)	2012-12-31	$208,176
Expenses. Administrative service providers (salaries,fees and commissions)	2012-12-31	$9,128
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
2011 : UPSTATE SURGICAL GROUP, PC 401(K) & PROFIT SHARING PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$158,737
Expenses. Total of all expenses incurred	2011-12-31	$66,457
Benefits paid (including direct rollovers)	2011-12-31	$53,721
Total plan assets at end of year	2011-12-31	$2,846,195
Total plan assets at beginning of year	2011-12-31	$2,753,915
Value of fidelity bond covering the plan	2011-12-31	$300,000
Total contributions received or receivable from participants	2011-12-31	$87,654
Other income received	2011-12-31	$-70,109
Net income (gross income less expenses)	2011-12-31	$92,280
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$2,846,195
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$2,753,915
Assets. Value of participant loans	2011-12-31	$19,220
Total contributions received or receivable from employer(s)	2011-12-31	$141,192
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$12,736
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
2010 : UPSTATE SURGICAL GROUP, PC 401(K) & PROFIT SHARING PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$583,105
Expenses. Total of all expenses incurred	2010-12-31	$888,763
Benefits paid (including direct rollovers)	2010-12-31	$887,975
Total plan assets at end of year	2010-12-31	$2,753,915
Total plan assets at beginning of year	2010-12-31	$3,059,573
Value of fidelity bond covering the plan	2010-12-31	$150,000
Total contributions received or receivable from participants	2010-12-31	$67,762
Expenses. Other expenses not covered elsewhere	2010-12-31	$788
Contributions received from other sources (not participants or employers)	2010-12-31	$15,847
Other income received	2010-12-31	$299,907
Net income (gross income less expenses)	2010-12-31	$-305,658
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$2,753,915
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$3,059,573
Assets. Value of participant loans	2010-12-31	$21,729
Total contributions received or receivable from employer(s)	2010-12-31	$199,589

Form 5500 Responses for UPSTATE SURGICAL GROUP, PC 401(K) & PROFIT SHARING PLAN

2014: UPSTATE SURGICAL GROUP, PC 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	Yes
2014-01-01	This submission is the final filing	Yes
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: UPSTATE SURGICAL GROUP, PC 401(K) & PROFIT SHARING 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: UPSTATE SURGICAL GROUP, PC 401(K) & PROFIT SHARING 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: UPSTATE SURGICAL GROUP, PC 401(K) & PROFIT SHARING 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: UPSTATE SURGICAL GROUP, PC 401(K) & PROFIT SHARING 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: UPSTATE SURGICAL GROUP, PC 401(K) & PROFIT SHARING 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:	UPSTATE SURGICAL GROUP, PC
Employer identification number (EIN):	161430886
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)