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UROLOGIC SURGICAL CARE PLLC PLAN 401k Plan overview

Plan NameUROLOGIC SURGICAL CARE PLLC PLAN
Plan identification number 001

UROLOGIC SURGICAL CARE PLLC PLAN Benefits

401k Plan TypeDefined 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.
  • 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

UROLOGIC SURGICAL CARE LLC has sponsored the creation of one or more 401k plans.

Company Name:UROLOGIC SURGICAL CARE LLC
Employer identification number (EIN):342048365
NAIC Classification:621498
NAIC Description:All Other Outpatient Care Centers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan UROLOGIC SURGICAL CARE PLLC PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01JOHN ANSAY2023-06-14
0012021-01-01JASON GROTAS2022-07-07 JASON GROTAS2022-07-07
0012020-01-01JASON GROTAS2021-07-24 JASON GROTAS2021-07-24
0012019-01-01JASON GROTAS MD2020-07-28 JASON GROTAS MD2020-07-28
0012018-01-01JASON GROTAS2019-07-31 JASON GROTAS2019-07-31
0012017-01-01JASON GROTAS2018-07-16 JASON GROTAS2018-07-16
0012016-01-01JASON GROTAS2017-06-12 JASON GROTAS2017-06-12
0012015-01-01JASON GROTAS2016-06-09 JASON GROTAS2016-06-09
0012014-01-01JASON GROTAS
0012013-01-01JASON GROTAS MD JASON GROTAS MD2014-07-16
0012012-01-01JASON GROTAS MD JASON GROTAS MD2013-07-08
0012011-01-01JASON GROTAS MD
0012010-01-01JASON GROTAS MD

Plan Statistics for UROLOGIC SURGICAL CARE PLLC PLAN

401k plan membership statisitcs for UROLOGIC SURGICAL CARE PLLC PLAN

Measure Date Value
2014: UROLOGIC SURGICAL CARE PLLC PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-015
Total number of active participants reported on line 7a of the Form 55002014-01-015
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-015
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-015
Number of participants with account balances2014-01-015
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: UROLOGIC SURGICAL CARE PLLC PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-015
Total number of active participants reported on line 7a of the Form 55002013-01-015
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-015
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-015
Number of participants with account balances2013-01-015
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: UROLOGIC SURGICAL CARE PLLC PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-015
Total number of active participants reported on line 7a of the Form 55002012-01-015
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-015
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-015
Number of participants with account balances2012-01-015
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: UROLOGIC SURGICAL CARE PLLC PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-015
Total number of active participants reported on line 7a of the Form 55002011-01-015
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-015
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-015
Number of participants with account balances2011-01-015
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2010: UROLOGIC SURGICAL CARE PLLC PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-015
Total number of active participants reported on line 7a of the Form 55002010-01-014
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-010
Total of all active and inactive participants2010-01-014
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-014
Number of participants with account balances2010-01-012
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-010

Financial Data on UROLOGIC SURGICAL CARE PLLC PLAN

Measure Date Value
2014 : UROLOGIC SURGICAL CARE PLLC PLAN 2014 401k financial data
Transfers to/from the plan2014-12-31$0
Total income from all sources2014-12-31$102,796
Expenses. Total of all expenses incurred2014-12-31$48
Benefits paid (including direct rollovers)2014-12-31$0
Total plan assets at end of year2014-12-31$509,620
Total plan assets at beginning of year2014-12-31$406,872
Total contributions received or receivable from participants2014-12-31$56,551
Expenses. Other expenses not covered elsewhere2014-12-31$48
Contributions received from other sources (not participants or employers)2014-12-31$0
Other income received2014-12-31$8,665
Net income (gross income less expenses)2014-12-31$102,748
Net plan assets at end of year (total assets less liabilities)2014-12-31$509,620
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$406,872
Assets. Value of participant loans2014-12-31$74,100
Total contributions received or receivable from employer(s)2014-12-31$37,580
Value of certain deemed distributions of participant loans2014-12-31$0
Value of corrective distributions2014-12-31$0
2013 : UROLOGIC SURGICAL CARE PLLC PLAN 2013 401k financial data
Transfers to/from the plan2013-12-31$0
Total income from all sources2013-12-31$101,721
Expenses. Total of all expenses incurred2013-12-31$24
Benefits paid (including direct rollovers)2013-12-31$0
Total plan assets at end of year2013-12-31$406,872
Total plan assets at beginning of year2013-12-31$305,175
Total contributions received or receivable from participants2013-12-31$24,646
Expenses. Other expenses not covered elsewhere2013-12-31$24
Contributions received from other sources (not participants or employers)2013-12-31$0
Other income received2013-12-31$47,199
Net income (gross income less expenses)2013-12-31$101,697
Net plan assets at end of year (total assets less liabilities)2013-12-31$406,872
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$305,175
Assets. Value of participant loans2013-12-31$93,055
Total contributions received or receivable from employer(s)2013-12-31$29,876
Value of certain deemed distributions of participant loans2013-12-31$0
Value of corrective distributions2013-12-31$0
2012 : UROLOGIC SURGICAL CARE PLLC PLAN 2012 401k financial data
Transfers to/from the plan2012-12-31$0
Total income from all sources2012-12-31$95,329
Expenses. Total of all expenses incurred2012-12-31$0
Benefits paid (including direct rollovers)2012-12-31$0
Total plan assets at end of year2012-12-31$305,175
Total plan assets at beginning of year2012-12-31$209,846
Total contributions received or receivable from participants2012-12-31$36,994
Expenses. Other expenses not covered elsewhere2012-12-31$0
Contributions received from other sources (not participants or employers)2012-12-31$0
Other income received2012-12-31$30,124
Net income (gross income less expenses)2012-12-31$95,329
Net plan assets at end of year (total assets less liabilities)2012-12-31$305,175
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$209,846
Assets. Value of participant loans2012-12-31$0
Total contributions received or receivable from employer(s)2012-12-31$28,211
Value of certain deemed distributions of participant loans2012-12-31$0
Value of corrective distributions2012-12-31$0
2011 : UROLOGIC SURGICAL CARE PLLC PLAN 2011 401k financial data
Transfers to/from the plan2011-12-31$0
Total income from all sources2011-12-31$56,207
Expenses. Total of all expenses incurred2011-12-31$0
Benefits paid (including direct rollovers)2011-12-31$0
Total plan assets at end of year2011-12-31$209,846
Total plan assets at beginning of year2011-12-31$153,639
Total contributions received or receivable from participants2011-12-31$41,224
Expenses. Other expenses not covered elsewhere2011-12-31$0
Contributions received from other sources (not participants or employers)2011-12-31$0
Other income received2011-12-31$-10,962
Net income (gross income less expenses)2011-12-31$56,207
Net plan assets at end of year (total assets less liabilities)2011-12-31$209,846
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$153,639
Assets. Value of participant loans2011-12-31$0
Total contributions received or receivable from employer(s)2011-12-31$25,945
Value of certain deemed distributions of participant loans2011-12-31$0
Value of corrective distributions2011-12-31$0
2010 : UROLOGIC SURGICAL CARE PLLC PLAN 2010 401k financial data
Total income from all sources2010-12-31$76,461
Expenses. Total of all expenses incurred2010-12-31$0
Benefits paid (including direct rollovers)2010-12-31$0
Total plan assets at end of year2010-12-31$153,639
Total plan assets at beginning of year2010-12-31$77,178
Total contributions received or receivable from participants2010-12-31$52,000
Expenses. Other expenses not covered elsewhere2010-12-31$0
Contributions received from other sources (not participants or employers)2010-12-31$0
Other income received2010-12-31$8,461
Net income (gross income less expenses)2010-12-31$76,461
Net plan assets at end of year (total assets less liabilities)2010-12-31$153,639
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$77,178
Assets. Value of participant loans2010-12-31$0
Total contributions received or receivable from employer(s)2010-12-31$16,000
Value of certain deemed distributions of participant loans2010-12-31$0
Value of corrective distributions2010-12-31$0

Form 5500 Responses for UROLOGIC SURGICAL CARE PLLC PLAN

2014: UROLOGIC SURGICAL CARE PLLC PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: UROLOGIC SURGICAL CARE PLLC PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: UROLOGIC SURGICAL CARE PLLC PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: UROLOGIC SURGICAL CARE PLLC PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: UROLOGIC SURGICAL CARE PLLC PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedYes
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-823629
Policy instance 1
Insurance contract or identification numberGA-823629
Number of Individuals Covered5
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $1,411
Total amount of fees paid to insurance companyUSD $141
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,411
Insurance broker organization code?3
Amount paid for insurance broker fees141
Additional information about fees paid to insurance brokerSALES/MARKETING
Insurance broker nameMERRILL LYNCH, PIERCE, FENNER &
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-823629
Policy instance 1
Insurance contract or identification numberGA-823629
Number of Individuals Covered5
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $1,292
Total amount of fees paid to insurance companyUSD $129
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,292
Insurance broker organization code?3
Amount paid for insurance broker fees129
Additional information about fees paid to insurance brokerSALES/MARKETING
Insurance broker nameMERRILL LYNCH PIERCE FENNER SMITH I
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-823629
Policy instance 1
Insurance contract or identification numberGA-823629
Number of Individuals Covered5
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $961
Total amount of fees paid to insurance companyUSD $96
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $961
Insurance broker organization code?3
Amount paid for insurance broker fees96
Additional information about fees paid to insurance brokerSALES/MARKETING
Insurance broker nameMERRILL LYNCH PIERCE FENNER SMITH I
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-823629
Policy instance 1
Insurance contract or identification numberGA-823629
Number of Individuals Covered5
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $610
Total amount of fees paid to insurance companyUSD $86
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-823629
Policy instance 1
Insurance contract or identification numberGA-823629
Number of Individuals Covered2
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $1,517
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,517
Insurance broker organization code?3
Insurance broker nameMERRILL LYNCH LIFE AGENCY

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