401k Plan data: ELSTROM & HALL, S.C. DEFINED BENEFIT PENSION PLAN AND TRUST plan

ELSTROM & HALL, S.C. DEFINED BENEFIT PENSION PLAN AND TRUST 401k Plan overview

Plan Name	ELSTROM & HALL, S.C. DEFINED BENEFIT PENSION PLAN AND TRUST
Plan identification number	002

ELSTROM & HALL, S.C. DEFINED BENEFIT PENSION PLAN AND TRUST Benefits

401k Plan Type

Defined Benefit Pension

Plan Features/Benefits

Benefits are primarily pay related
Cash balance or similar plan - Plan has a "cash balance" formula. For this purpose, a "cash balance" formula is a benefit formula in a defined benefit plan by whatever name (for example, personal account plan, pension equity plan, life cycle plan, cash account plan, etc.) that rather than, or in addition to, expressing the accrued benefit as a life annuity commencing at normal retirement age, defines benefits for each employee in terms more common to a defined contribution plan such as a single sum distribution amount (for example, 10 percent of final average pay times years of service, or the amount of the employee's hypothetical account balance).
Frozen Plan - As of the last day of the plan year, the plan provides that no participant will get any new benefit accrual (whether because of service or compensation).
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

JOHN A. ELSTROM, M.D., P.C. has sponsored the creation of one or more 401k plans.

Company Name: JOHN A. ELSTROM, M.D., P.C.

Employer identification number (EIN): 362954907

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ELSTROM & HALL, S.C. DEFINED BENEFIT PENSION PLAN AND TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2016-03-01 ROBERT HALL, M.D. 2017-05-26
002 2015-03-01 ROBERT HALL, M.D. 2016-10-21
002 2014-03-01 ROBERT HALL, M.D. 2015-08-10
002 2013-03-01 ROBERT HALL, M.D. 2014-11-13
002 2012-03-01 ROBERT HALL, M.D. 2013-07-02
002 2011-03-01 ROBERT HALL, M.D. 2012-06-06
002 2010-03-01 JOHN A. ELSTROM 2011-11-30
002 2009-03-01 JOHN A ESLTROM MD
002 2009-03-01 JOHN A ESLTROM MD

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
002	2016-03-01	ROBERT HALL, M.D.	2017-05-26
002	2015-03-01	ROBERT HALL, M.D.	2016-10-21
002	2014-03-01	ROBERT HALL, M.D.	2015-08-10
002	2013-03-01	ROBERT HALL, M.D.	2014-11-13
002	2012-03-01	ROBERT HALL, M.D.	2013-07-02
002	2011-03-01	ROBERT HALL, M.D.	2012-06-06
002	2010-03-01	JOHN A. ELSTROM	2011-11-30
002	2009-03-01	JOHN A ESLTROM MD
002	2009-03-01	JOHN A ESLTROM MD

Plan Statistics for ELSTROM & HALL, S.C. DEFINED BENEFIT PENSION PLAN AND TRUST

401k plan membership statisitcs for ELSTROM & HALL, S.C. DEFINED BENEFIT PENSION PLAN AND TRUST

Measure Date Value
2016: ELSTROM & HALL, S.C. DEFINED BENEFIT PENSION PLAN AND TRUST 2016 401k membership
Market value of plan assets 2016-11-14 2,893,721
Acturial value of plan assets 2016-11-14 2,893,721
Funding target for retired participants and beneficiaries receiving payment 2016-11-14 0
Number of terminated vested participants 2016-11-14 2
Fundng target for terminated vested participants 2016-11-14 66,560
Active participant vested funding target 2016-11-14 2,509,048
Number of active participants 2016-11-14 10
Total funding liabilities for active participants 2016-11-14 2,509,048
Total participant count 2016-11-14 12
Total funding target for all participants 2016-11-14 2,575,608
Balance at beginning of prior year after applicable adjustments 2016-11-14 342,993
Prefunding balance at beginning of prior year after applicable adjustments 2016-11-14 0
Carryover balanced portion elected for use to offset prior years funding requirement 2016-11-14 0
Prefunding balanced used to offset prior years funding requirement 2016-11-14 0
Amount remaining of carryover balance 2016-11-14 342,993
Amount remaining of prefunding balance 2016-11-14 0
Present value of excess contributions 2016-11-14 0
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance 2016-11-14 0
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance 2016-11-14 0
Reductions in caryover balances due to elections or deemed elections 2016-11-14 0
Reductions in prefunding balances due to elections or deemed elections 2016-11-14 0
Balance of carryovers at beginning of current year 2016-11-14 315,313
Balance of prefunding at beginning of current year 2016-11-14 0
Total employer contributions 2016-11-14 0
Total employee contributions 2016-11-14 0
Contributions allocated toward unpaid minimum require contributions from prior years 2016-11-14 0
Contributions made to avoid restrictions adjusted to valuation date 2016-11-14 0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date 2016-11-14 0
Unpaid minimum required contributions for all prior years 2016-11-14 0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years 2016-11-14 0
Remaining amount of unpaid minimum required contributions 2016-11-14 0
Minimum required contributions for current year target normal cost 2016-11-14 13,828
Net shortfall amortization installment of oustanding balance 2016-11-14 0
Waiver amortization installment 2016-11-14 0
Total funding amount beforereflecting carryover/prefunding balances 2016-11-14 11,028
Carryover balance elected to use to offset funding requirement 2016-11-14 11,028
Prefunding balance elected to use to offset funding requirement 2016-11-14 0
Additional cash requirement 2016-11-14 0
Contributions allocatedtoward minimum required contributions for current year 2016-11-14 0
Unpaid minimum required contributions for current year 2016-11-14 0
Unpaid minimum required contributions for all years 2016-11-14 0
2009: ELSTROM & HALL, S.C. DEFINED BENEFIT PENSION PLAN AND TRUST 2009 401k membership
Total participants, beginning-of-year 2009-03-01 10
Total number of active participants reported on line 7a of the Form 5500 2009-03-01 11
Total of all active and inactive participants 2009-03-01 11
Total participants 2009-03-01 11

Measure	Date	Value
2016: ELSTROM & HALL, S.C. DEFINED BENEFIT PENSION PLAN AND TRUST 2016 401k membership
Market value of plan assets	2016-11-14	2,893,721
Acturial value of plan assets	2016-11-14	2,893,721
Funding target for retired participants and beneficiaries receiving payment	2016-11-14	0
Number of terminated vested participants	2016-11-14	2
Fundng target for terminated vested participants	2016-11-14	66,560
Active participant vested funding target	2016-11-14	2,509,048
Number of active participants	2016-11-14	10
Total funding liabilities for active participants	2016-11-14	2,509,048
Total participant count	2016-11-14	12
Total funding target for all participants	2016-11-14	2,575,608
Balance at beginning of prior year after applicable adjustments	2016-11-14	342,993
Prefunding balance at beginning of prior year after applicable adjustments	2016-11-14	0
Carryover balanced portion elected for use to offset prior years funding requirement	2016-11-14	0
Prefunding balanced used to offset prior years funding requirement	2016-11-14	0
Amount remaining of carryover balance	2016-11-14	342,993
Amount remaining of prefunding balance	2016-11-14	0
Present value of excess contributions	2016-11-14	0
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance	2016-11-14	0
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance	2016-11-14	0
Reductions in caryover balances due to elections or deemed elections	2016-11-14	0
Reductions in prefunding balances due to elections or deemed elections	2016-11-14	0
Balance of carryovers at beginning of current year	2016-11-14	315,313
Balance of prefunding at beginning of current year	2016-11-14	0
Total employer contributions	2016-11-14	0
Total employee contributions	2016-11-14	0
Contributions allocated toward unpaid minimum require contributions from prior years	2016-11-14	0
Contributions made to avoid restrictions adjusted to valuation date	2016-11-14	0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date	2016-11-14	0
Unpaid minimum required contributions for all prior years	2016-11-14	0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years	2016-11-14	0
Remaining amount of unpaid minimum required contributions	2016-11-14	0
Minimum required contributions for current year target normal cost	2016-11-14	13,828
Net shortfall amortization installment of oustanding balance	2016-11-14	0
Waiver amortization installment	2016-11-14	0
Total funding amount beforereflecting carryover/prefunding balances	2016-11-14	11,028
Carryover balance elected to use to offset funding requirement	2016-11-14	11,028
Prefunding balance elected to use to offset funding requirement	2016-11-14	0
Additional cash requirement	2016-11-14	0
Contributions allocatedtoward minimum required contributions for current year	2016-11-14	0
Unpaid minimum required contributions for current year	2016-11-14	0
Unpaid minimum required contributions for all years	2016-11-14	0
2009: ELSTROM & HALL, S.C. DEFINED BENEFIT PENSION PLAN AND TRUST 2009 401k membership
Total participants, beginning-of-year	2009-03-01	10
Total number of active participants reported on line 7a of the Form 5500	2009-03-01	11
Total of all active and inactive participants	2009-03-01	11
Total participants	2009-03-01	11

Form 5500 Responses for ELSTROM & HALL, S.C. DEFINED BENEFIT PENSION PLAN AND TRUST

2009: ELSTROM & HALL, S.C. DEFINED BENEFIT PENSION PLAN AND TRUST 2009 form 5500 responses
2009-03-01	Type of plan entity	Single employer plan
2009-03-01	Plan funding arrangement – Trust	Yes
2009-03-01	Plan benefit arrangement - Trust	Yes

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Company Name:	JOHN A. ELSTROM, M.D., P.C.
Employer identification number (EIN):	362954907
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)