401k Plan data: CAHABA VALLEY SURGICAL GROUP, P.C. PROFIT SHARING PLAN plan

CAHABA VALLEY SURGICAL GROUP, P.C. PROFIT SHARING PLAN 401k Plan overview

Plan Name	CAHABA VALLEY SURGICAL GROUP, P.C. PROFIT SHARING PLAN
Plan identification number	001

CAHABA VALLEY SURGICAL GROUP, P.C. 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.
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

CAHABA VALLEY SURGICAL GROUP, P.C. has sponsored the creation of one or more 401k plans.

Company Name: CAHABA VALLEY SURGICAL GROUP, P.C.

Employer identification number (EIN): 631132437

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CAHABA VALLEY SURGICAL GROUP, P.C. PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01 JEFF BONNER 2023-07-31
001 2021-01-01 REX ALAN SHERER 2022-09-20
001 2020-01-01 MYLES WALCOTT 2021-05-13
001 2019-01-01 MYLES WALCOTT 2020-08-11
001 2018-01-01 MYLES WALCOTT 2019-10-15
001 2017-01-01 MYLES WALCOTT 2018-09-25
001 2016-01-01 MYLES WALCOTT 2017-10-11
001 2015-01-01 MYLES WALCOTT 2016-07-28
001 2014-01-01 MYLES WALCOTT 2015-07-21
001 2013-01-01 MYLES WALCOTT
001 2012-01-01 MYLES WALCOTT
001 2011-01-01 MYLES WALCOTT
001 2010-01-01 REX SHERER 2011-10-04
001 2009-01-01 REX SHERER

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2022-01-01	JEFF BONNER	2023-07-31
001	2021-01-01	REX ALAN SHERER	2022-09-20
001	2020-01-01	MYLES WALCOTT	2021-05-13
001	2019-01-01	MYLES WALCOTT	2020-08-11
001	2018-01-01	MYLES WALCOTT	2019-10-15
001	2017-01-01	MYLES WALCOTT	2018-09-25
001	2016-01-01	MYLES WALCOTT	2017-10-11
001	2015-01-01	MYLES WALCOTT	2016-07-28
001	2014-01-01	MYLES WALCOTT	2015-07-21
001	2013-01-01	MYLES WALCOTT
001	2012-01-01	MYLES WALCOTT
001	2011-01-01	MYLES WALCOTT
001	2010-01-01	REX SHERER	2011-10-04
001	2009-01-01	REX SHERER

Plan Statistics for CAHABA VALLEY SURGICAL GROUP, P.C. PROFIT SHARING PLAN

401k plan membership statisitcs for CAHABA VALLEY SURGICAL GROUP, P.C. PROFIT SHARING PLAN

Measure Date Value
2013: CAHABA VALLEY SURGICAL GROUP, P.C. PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 15
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 11
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 4
Total of all active and inactive participants 2013-01-01 15
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 15
Number of participants with account balances 2013-01-01 15
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: CAHABA VALLEY SURGICAL GROUP, P.C. PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 13
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 9
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 4
Total of all active and inactive participants 2012-01-01 13
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 13
Number of participants with account balances 2012-01-01 13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: CAHABA VALLEY SURGICAL GROUP, P.C. PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 14
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 9
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 4
Total of all active and inactive participants 2011-01-01 13
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 13
Number of participants with account balances 2011-01-01 13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 1
2009: CAHABA VALLEY SURGICAL GROUP, P.C. PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 14
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 11
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 3
Total of all active and inactive participants 2009-01-01 14
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 14
Number of participants with account balances 2009-01-01 14
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2013: CAHABA VALLEY SURGICAL GROUP, P.C. PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	15
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	11
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	4
Total of all active and inactive participants	2013-01-01	15
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	15
Number of participants with account balances	2013-01-01	15
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: CAHABA VALLEY SURGICAL GROUP, P.C. PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	13
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	9
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	4
Total of all active and inactive participants	2012-01-01	13
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	13
Number of participants with account balances	2012-01-01	13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: CAHABA VALLEY SURGICAL GROUP, P.C. PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	14
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	9
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	4
Total of all active and inactive participants	2011-01-01	13
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	13
Number of participants with account balances	2011-01-01	13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	1
2009: CAHABA VALLEY SURGICAL GROUP, P.C. PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	14
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	11
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	3
Total of all active and inactive participants	2009-01-01	14
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	14
Number of participants with account balances	2009-01-01	14
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on CAHABA VALLEY SURGICAL GROUP, P.C. PROFIT SHARING PLAN

Measure	Date	Value
2013 : CAHABA VALLEY SURGICAL GROUP, P.C. PROFIT SHARING PLAN 2013 401k financial data
Total income from all sources	2013-12-31	$421,139
Expenses. Total of all expenses incurred	2013-12-31	$749,241
Benefits paid (including direct rollovers)	2013-12-31	$749,166
Total plan assets at end of year	2013-12-31	$1,852,375
Total plan assets at beginning of year	2013-12-31	$2,180,477
Value of fidelity bond covering the plan	2013-12-31	$200,000
Total contributions received or receivable from participants	2013-12-31	$27,550
Other income received	2013-12-31	$346,105
Net income (gross income less expenses)	2013-12-31	$-328,102
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$1,852,375
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$2,180,477
Assets. Value of assets in partnership/joint-venture interests	2013-12-31	$0
Total contributions received or receivable from employer(s)	2013-12-31	$47,484
Expenses. Administrative service providers (salaries,fees and commissions)	2013-12-31	$75
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
2012 : CAHABA VALLEY SURGICAL GROUP, P.C. PROFIT SHARING PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$277,545
Expenses. Total of all expenses incurred	2012-12-31	$477
Benefits paid (including direct rollovers)	2012-12-31	$477
Total plan assets at end of year	2012-12-31	$2,180,477
Total plan assets at beginning of year	2012-12-31	$1,903,409
Value of fidelity bond covering the plan	2012-12-31	$200,000
Total contributions received or receivable from participants	2012-12-31	$28,155
Other income received	2012-12-31	$204,198
Net income (gross income less expenses)	2012-12-31	$277,068
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$2,180,477
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$1,903,409
Assets. Value of assets in partnership/joint-venture interests	2012-12-31	$64,000
Total contributions received or receivable from employer(s)	2012-12-31	$45,192
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
2011 : CAHABA VALLEY SURGICAL GROUP, P.C. PROFIT SHARING PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$100,907
Expenses. Total of all expenses incurred	2011-12-31	$3,401
Benefits paid (including direct rollovers)	2011-12-31	$3,401
Total plan assets at end of year	2011-12-31	$1,903,409
Total plan assets at beginning of year	2011-12-31	$1,805,903
Value of fidelity bond covering the plan	2011-12-31	$200,000
Total contributions received or receivable from participants	2011-12-31	$29,170
Other income received	2011-12-31	$31,491
Net income (gross income less expenses)	2011-12-31	$97,506
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$1,903,409
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$1,805,903
Assets. Value of assets in partnership/joint-venture interests	2011-12-31	$76,400
Total contributions received or receivable from employer(s)	2011-12-31	$40,246
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0

Form 5500 Responses for CAHABA VALLEY SURGICAL GROUP, P.C. PROFIT SHARING PLAN

2013: CAHABA VALLEY SURGICAL GROUP, P.C. PROFIT SHARING PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Mulitple 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 – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: CAHABA VALLEY SURGICAL GROUP, P.C. 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 – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: CAHABA VALLEY SURGICAL GROUP, P.C. 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 – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: CAHABA VALLEY SURGICAL GROUP, P.C. 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

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-824068

Policy instance

Insurance contract or identification number	GA-824068
Number of Individuals Covered	9
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $1,930
Total amount of fees paid to insurance company	USD $241
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Broker	USD $1,494
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	COMMISSIONS
Insurance broker organization code?	3
Insurance broker name	PLANTECH, LLP

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-824068

Policy instance

Insurance contract or identification number	GA-824068
Number of Individuals Covered	10
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $1,602
Total amount of fees paid to insurance company	USD $200
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Broker	USD $1,602
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	COMMISSIONS
Insurance broker organization code?	7
Insurance broker name	PLANTECH, LLP

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-824068

Policy instance

Insurance contract or identification number	GA-824068
Number of Individuals Covered	10
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $1,422
Total amount of fees paid to insurance company	USD $178
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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

Potentially related plans

CAHABA VALLEY DEVELOPMENT 401(K) PLAN [EIN = 810628150]

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Company Name:	CAHABA VALLEY SURGICAL GROUP, P.C.
Employer identification number (EIN):	631132437
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)