401k Plan data: DOMINION URGENT CARE PROFIT SHARING PLAN plan

DOMINION URGENT CARE PROFIT SHARING PLAN 401k Plan overview

Plan Name	DOMINION URGENT CARE PROFIT SHARING PLAN
Plan identification number	002

DOMINION URGENT CARE PROFIT SHARING PLAN Benefits

401k Plan Type	Defined Contribution Pension
Plan Features/Benefits	Profit-sharing 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

DOMINION URGENT CARE has sponsored the creation of one or more 401k plans.

Company Name: DOMINION URGENT CARE

Employer identification number (EIN): 542027077

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DOMINION URGENT CARE PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2019-01-01
002 2018-01-01
002 2017-01-01
002 2017-01-01
002 2016-01-01
002 2015-01-01
002 2014-01-01

Plan Statistics for DOMINION URGENT CARE PROFIT SHARING PLAN

401k plan membership statisitcs for DOMINION URGENT CARE PROFIT SHARING PLAN

Measure Date Value
2017: DOMINION URGENT CARE PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 6
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 5
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 0
Total of all active and inactive participants 2017-01-01 5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 5
Number of participants with account balances 2017-01-01 5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: DOMINION URGENT CARE PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 4
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 4
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 4
Number of participants with account balances 2016-01-01 4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: DOMINION URGENT CARE PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 6
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 6
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 6
Number of participants with account balances 2015-01-01 6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: DOMINION URGENT CARE PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 6
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 6
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 6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 6
Number of participants with account balances 2014-01-01 6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0

Measure	Date	Value
2017: DOMINION URGENT CARE PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	6
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	5
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	0
Total of all active and inactive participants	2017-01-01	5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	5
Number of participants with account balances	2017-01-01	5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: DOMINION URGENT CARE PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	4
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	4
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	4
Number of participants with account balances	2016-01-01	4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: DOMINION URGENT CARE PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	6
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	6
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	6
Number of participants with account balances	2015-01-01	6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: DOMINION URGENT CARE PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	6
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	6
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	6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	6
Number of participants with account balances	2014-01-01	6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0

Financial Data on DOMINION URGENT CARE PROFIT SHARING PLAN

Measure	Date	Value
2017 : DOMINION URGENT CARE PROFIT SHARING PLAN 2017 401k financial data
Transfers to/from the plan	2017-12-31	$0
Total plan liabilities at end of year	2017-12-31	$0
Total plan liabilities at beginning of year	2017-12-31	$0
Total income from all sources	2017-12-31	$6,884
Expenses. Total of all expenses incurred	2017-12-31	$3,879
Benefits paid (including direct rollovers)	2017-12-31	$3,879
Total plan assets at end of year	2017-12-31	$17,215
Total plan assets at beginning of year	2017-12-31	$14,210
Value of fidelity bond covering the plan	2017-12-31	$50,000
Total contributions received or receivable from participants	2017-12-31	$0
Expenses. Other expenses not covered elsewhere	2017-12-31	$0
Contributions received from other sources (not participants or employers)	2017-12-31	$0
Other income received	2017-12-31	$985
Noncash contributions received	2017-12-31	$0
Net income (gross income less expenses)	2017-12-31	$3,005
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$17,215
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$14,210
Total contributions received or receivable from employer(s)	2017-12-31	$5,899
Value of certain deemed distributions of participant loans	2017-12-31	$0
Value of corrective distributions	2017-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2017-12-31	$0
2016 : DOMINION URGENT CARE PROFIT SHARING PLAN 2016 401k financial data
Transfers to/from the plan	2016-12-31	$0
Total plan liabilities at beginning of year	2016-12-31	$0
Total income from all sources	2016-12-31	$8,158
Expenses. Total of all expenses incurred	2016-12-31	$0
Benefits paid (including direct rollovers)	2016-12-31	$0
Total plan assets at end of year	2016-12-31	$14,210
Total plan assets at beginning of year	2016-12-31	$6,052
Value of fidelity bond covering the plan	2016-12-31	$50,000
Total contributions received or receivable from participants	2016-12-31	$0
Expenses. Other expenses not covered elsewhere	2016-12-31	$0
Contributions received from other sources (not participants or employers)	2016-12-31	$0
Other income received	2016-12-31	$84
Noncash contributions received	2016-12-31	$0
Net income (gross income less expenses)	2016-12-31	$8,158
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$14,210
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$6,052
Total contributions received or receivable from employer(s)	2016-12-31	$8,074
Value of certain deemed distributions of participant loans	2016-12-31	$0
Value of corrective distributions	2016-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2016-12-31	$0
2015 : DOMINION URGENT CARE PROFIT SHARING PLAN 2015 401k financial data
Transfers to/from the plan	2015-12-31	$0
Total plan liabilities at end of year	2015-12-31	$0
Total plan liabilities at beginning of year	2015-12-31	$0
Total income from all sources	2015-12-31	$-630
Expenses. Total of all expenses incurred	2015-12-31	$0
Benefits paid (including direct rollovers)	2015-12-31	$0
Total plan assets at end of year	2015-12-31	$6,052
Total plan assets at beginning of year	2015-12-31	$6,682
Value of fidelity bond covering the plan	2015-12-31	$50,000
Total contributions received or receivable from participants	2015-12-31	$0
Expenses. Other expenses not covered elsewhere	2015-12-31	$0
Contributions received from other sources (not participants or employers)	2015-12-31	$0
Other income received	2015-12-31	$-630
Noncash contributions received	2015-12-31	$0
Net income (gross income less expenses)	2015-12-31	$-630
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$6,052
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$6,682
Total contributions received or receivable from employer(s)	2015-12-31	$0
Value of certain deemed distributions of participant loans	2015-12-31	$0
Value of corrective distributions	2015-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2015-12-31	$0
2014 : DOMINION URGENT CARE PROFIT SHARING PLAN 2014 401k financial data
Transfers to/from the plan	2014-12-31	$0
Total plan liabilities at end of year	2014-12-31	$0
Total plan liabilities at beginning of year	2014-12-31	$0
Total income from all sources	2014-12-31	$6,682
Expenses. Total of all expenses incurred	2014-12-31	$0
Benefits paid (including direct rollovers)	2014-12-31	$0
Total plan assets at end of year	2014-12-31	$6,682
Total plan assets at beginning of year	2014-12-31	$0
Value of fidelity bond covering the plan	2014-12-31	$50,000
Total contributions received or receivable from participants	2014-12-31	$0
Expenses. Other expenses not covered elsewhere	2014-12-31	$0
Contributions received from other sources (not participants or employers)	2014-12-31	$0
Other income received	2014-12-31	$0
Noncash contributions received	2014-12-31	$0
Net income (gross income less expenses)	2014-12-31	$6,682
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$6,682
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$0
Total contributions received or receivable from employer(s)	2014-12-31	$6,682
Value of certain deemed distributions of participant loans	2014-12-31	$0
Value of corrective distributions	2014-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2014-12-31	$0

Form 5500 Responses for DOMINION URGENT CARE PROFIT SHARING PLAN

2017: DOMINION URGENT CARE PROFIT SHARING PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: DOMINION URGENT CARE PROFIT SHARING 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: DOMINION URGENT CARE PROFIT SHARING PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	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: DOMINION URGENT CARE PROFIT SHARING PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	DOMINION URGENT CARE
Employer identification number (EIN):	542027077
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2019-01-01
002	2018-01-01
002	2017-01-01
002	2017-01-01
002	2016-01-01
002	2015-01-01
002	2014-01-01