401k Plan data: PACIFIC FAMILY MEDICAL CENTER, L.L.C. 401(K) PROFIT SHARING PLAN plan

PACIFIC FAMILY MEDICAL CENTER, L.L.C. 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan Name	PACIFIC FAMILY MEDICAL CENTER, L.L.C. 401(K) PROFIT SHARING PLAN
Plan identification number	001

PACIFIC FAMILY MEDICAL CENTER, L.L.C. 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
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.
Plan covering Self-Employed individuals.

401k Sponsoring company profile

PACIFIC FAMILY MEDICAL CENTER, L.L.C. has sponsored the creation of one or more 401k plans.

Company Name: PACIFIC FAMILY MEDICAL CENTER, L.L.C.

Employer identification number (EIN): 562291437

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PACIFIC FAMILY MEDICAL CENTER, L.L.C. 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2013-01-01 MICHELLE A. RASMUSSEN, M.D 2014-10-14
001 2012-01-01 MICHELLE A. RASMUSSEN, M.D. 2013-10-14
001 2011-01-01 MICHELLE A. RASMUSSEN, M.D. 2012-10-15 MICHELLE A. RASMUSSEN, M.D. 2012-10-15
001 2010-01-01 MICHELLE A. RASMUSSEN, M.D. 2011-10-17 MICHELLE A. RASMUSSEN, M.D. 2011-10-17
001 2007-01-01 MICHELLE A. RASMUSSEN, M.D. MICHELLE A. RASMUSSEN, M.D. 2010-10-04

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2013-01-01	MICHELLE A. RASMUSSEN, M.D	2014-10-14
001	2012-01-01	MICHELLE A. RASMUSSEN, M.D.	2013-10-14
001	2011-01-01	MICHELLE A. RASMUSSEN, M.D.	2012-10-15	MICHELLE A. RASMUSSEN, M.D.	2012-10-15
001	2010-01-01	MICHELLE A. RASMUSSEN, M.D.	2011-10-17	MICHELLE A. RASMUSSEN, M.D.	2011-10-17
001	2007-01-01	MICHELLE A. RASMUSSEN, M.D.		MICHELLE A. RASMUSSEN, M.D.	2010-10-04

Plan Statistics for PACIFIC FAMILY MEDICAL CENTER, L.L.C. 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for PACIFIC FAMILY MEDICAL CENTER, L.L.C. 401(K) PROFIT SHARING PLAN

Measure Date Value
2007: PACIFIC FAMILY MEDICAL CENTER, L.L.C. 401(K) PROFIT SHARING PLAN 2007 401k membership
Total participants, beginning-of-year 2007-01-01 4
Total number of active participants reported on line 7a of the Form 5500 2007-01-01 7
Number of retired or separated participants receiving benefits 2007-01-01 0
Number of other retired or separated participants entitled to future benefits 2007-01-01 1
Total of all active and inactive participants 2007-01-01 8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2007-01-01 0
Total participants 2007-01-01 8
Number of participants with account balances 2007-01-01 8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2007-01-01 0

Measure	Date	Value
2007: PACIFIC FAMILY MEDICAL CENTER, L.L.C. 401(K) PROFIT SHARING PLAN 2007 401k membership
Total participants, beginning-of-year	2007-01-01	4
Total number of active participants reported on line 7a of the Form 5500	2007-01-01	7
Number of retired or separated participants receiving benefits	2007-01-01	0
Number of other retired or separated participants entitled to future benefits	2007-01-01	1
Total of all active and inactive participants	2007-01-01	8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2007-01-01	0
Total participants	2007-01-01	8
Number of participants with account balances	2007-01-01	8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2007-01-01	0

Form 5500 Responses for PACIFIC FAMILY MEDICAL CENTER, L.L.C. 401(K) PROFIT SHARING PLAN

2007: PACIFIC FAMILY MEDICAL CENTER, L.L.C. 401(K) PROFIT SHARING PLAN 2007 form 5500 responses
2007-01-01	Type of plan entity	Single employer plan
2007-01-01	Submission has been amended	No
2007-01-01	This submission is the final filing	No
2007-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2007-01-01	Plan is a collectively bargained plan	No
2007-01-01	Plan funding arrangement – Trust	Yes
2007-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	PACIFIC FAMILY MEDICAL CENTER, L.L.C.
Employer identification number (EIN):	562291437
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)