401k Plan data: SURGERY CLINIC OF COLUMBUS PLLC PROFIT SHARING PLAN plan

SURGERY CLINIC OF COLUMBUS PLLC PROFIT SHARING PLAN 401k Plan overview

Plan Name	SURGERY CLINIC OF COLUMBUS PLLC PROFIT SHARING PLAN
Plan identification number	001

SURGERY CLINIC OF COLUMBUS PLLC PROFIT SHARING PLAN Benefits

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

401k Sponsoring company profile

SURGERY CLINIC OF COLUMBUS PLLC has sponsored the creation of one or more 401k plans.

Company Name: SURGERY CLINIC OF COLUMBUS PLLC

Employer identification number (EIN): 640945438

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SURGERY CLINIC OF COLUMBUS PLLC 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 PAUL HAWKINS PAUL HAWKINS 2015-02-20
001 2012-01-01 THOMAS VINSON THOMAS VINSON 2013-10-11
001 2011-01-01 THOMAS VINSON
001 2009-01-01 THOMAS VINSON

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2013-01-01	PAUL HAWKINS	PAUL HAWKINS	2015-02-20
001	2012-01-01	THOMAS VINSON	THOMAS VINSON	2013-10-11
001	2011-01-01	THOMAS VINSON
001	2009-01-01	THOMAS VINSON

Plan Statistics for SURGERY CLINIC OF COLUMBUS PLLC PROFIT SHARING PLAN

401k plan membership statisitcs for SURGERY CLINIC OF COLUMBUS PLLC PROFIT SHARING PLAN

Measure Date Value
2013: SURGERY CLINIC OF COLUMBUS PLLC PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 1
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 0
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 0
Total of all active and inactive participants 2013-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 0
Number of participants with account balances 2013-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: SURGERY CLINIC OF COLUMBUS PLLC PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 5
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 1
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 0
Total of all active and inactive participants 2012-01-01 1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 1
Number of participants with account balances 2012-01-01 1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: SURGERY CLINIC OF COLUMBUS PLLC PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 5
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 5
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 0
Total of all active and inactive participants 2011-01-01 5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 5
Number of participants with account balances 2011-01-01 5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: SURGERY CLINIC OF COLUMBUS PLLC PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 6
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 5
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 0
Total of all active and inactive participants 2009-01-01 5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 5
Number of participants with account balances 2009-01-01 5

Measure	Date	Value
2013: SURGERY CLINIC OF COLUMBUS PLLC PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	1
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	0
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	0
Total of all active and inactive participants	2013-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	0
Number of participants with account balances	2013-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: SURGERY CLINIC OF COLUMBUS PLLC PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	5
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	1
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	0
Total of all active and inactive participants	2012-01-01	1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	1
Number of participants with account balances	2012-01-01	1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: SURGERY CLINIC OF COLUMBUS PLLC PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	5
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	5
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	0
Total of all active and inactive participants	2011-01-01	5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	5
Number of participants with account balances	2011-01-01	5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: SURGERY CLINIC OF COLUMBUS PLLC PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	6
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	5
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	0
Total of all active and inactive participants	2009-01-01	5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	5
Number of participants with account balances	2009-01-01	5

Financial Data on SURGERY CLINIC OF COLUMBUS PLLC PROFIT SHARING PLAN

Measure	Date	Value
2013 : SURGERY CLINIC OF COLUMBUS PLLC PROFIT SHARING PLAN 2013 401k financial data
Total income from all sources	2013-12-31	$39,930
Expenses. Total of all expenses incurred	2013-12-31	$1,420,235
Benefits paid (including direct rollovers)	2013-12-31	$1,420,235
Total plan assets at end of year	2013-12-31	$0
Total plan assets at beginning of year	2013-12-31	$1,380,305
Other income received	2013-12-31	$39,930
Net income (gross income less expenses)	2013-12-31	$-1,380,305
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$0
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$1,380,305
2012 : SURGERY CLINIC OF COLUMBUS PLLC PROFIT SHARING PLAN 2012 401k financial data
Transfers to/from the plan	2012-12-31	$-189,596
Total income from all sources	2012-12-31	$90,836
Expenses. Total of all expenses incurred	2012-12-31	$9,000
Total plan assets at end of year	2012-12-31	$1,380,305
Total plan assets at beginning of year	2012-12-31	$1,488,065
Value of fidelity bond covering the plan	2012-12-31	$350,000
Expenses. Other expenses not covered elsewhere	2012-12-31	$9,000
Other income received	2012-12-31	$90,836
Net income (gross income less expenses)	2012-12-31	$81,836
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$1,380,305
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$1,488,065
2011 : SURGERY CLINIC OF COLUMBUS PLLC PROFIT SHARING PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$-2,294
Expenses. Total of all expenses incurred	2011-12-31	$9,000
Total plan assets at end of year	2011-12-31	$1,488,065
Total plan assets at beginning of year	2011-12-31	$1,499,359
Value of fidelity bond covering the plan	2011-12-31	$350,000
Expenses. Other expenses not covered elsewhere	2011-12-31	$9,000
Other income received	2011-12-31	$-2,294
Net income (gross income less expenses)	2011-12-31	$-11,294
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$1,488,065
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$1,499,359
2010 : SURGERY CLINIC OF COLUMBUS PLLC PROFIT SHARING PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$121,718
Expenses. Total of all expenses incurred	2010-12-31	$4,050
Total plan assets at end of year	2010-12-31	$1,499,359
Total plan assets at beginning of year	2010-12-31	$1,381,691
Value of fidelity bond covering the plan	2010-12-31	$350,000
Expenses. Other expenses not covered elsewhere	2010-12-31	$4,050
Other income received	2010-12-31	$121,718
Net income (gross income less expenses)	2010-12-31	$117,668
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$1,499,359
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$1,381,691
Assets. Value of participant loans	2010-12-31	$2,098

Form 5500 Responses for SURGERY CLINIC OF COLUMBUS PLLC PROFIT SHARING PLAN

2013: SURGERY CLINIC OF COLUMBUS PLLC PROFIT SHARING PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	Yes
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 benefit arrangement – Insurance	Yes
2012: SURGERY CLINIC OF COLUMBUS PLLC PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: SURGERY CLINIC OF COLUMBUS PLLC PROFIT SHARING PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2009: SURGERY CLINIC OF COLUMBUS PLLC PROFIT SHARING PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

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Company Name:	SURGERY CLINIC OF COLUMBUS PLLC
Employer identification number (EIN):	640945438
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)