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TRI-VALLEY ORTHOPEDIC & SPORTS MEDICAL GROUP, INC. PROFIT SHARING PLAN 401k Plan overview

Plan NameTRI-VALLEY ORTHOPEDIC & SPORTS MEDICAL GROUP, INC. PROFIT SHARING PLAN
Plan identification number 002

TRI-VALLEY ORTHOPEDIC & SPORTS MEDICAL GROUP, INC. PROFIT SHARING PLAN Benefits

401k Plan TypeDefined 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.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Participant-directed brokerage accounts provided as an investment option under the plan.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • 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.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

TRI-VALLEY ORTHOPEDIC & SPORTS MEDICAL GROUP, INC. has sponsored the creation of one or more 401k plans.

Company Name:TRI-VALLEY ORTHOPEDIC & SPORTS MEDICAL GROUP, INC.
Employer identification number (EIN):943007844
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TRI-VALLEY ORTHOPEDIC & SPORTS MEDICAL GROUP, INC. PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022023-01-01ANN CHIOU-WILLIAMS2024-01-25
0022022-01-01ANN CHIOU-WILLIAMS2023-07-19
0022021-01-01ANN CHIOU-WILLIAMS2022-08-15
0022020-01-01ANN CHIOU-WILLIAMS2021-07-28
0022019-01-01ANN CHIOU-WILLIAMS2020-09-23
0022018-01-01
0022017-01-01ANN CHIOU-WILLIAMS
0022016-01-01ANN CHIOU-WILLIAMS
0022015-01-01ANN CHIOU-WILLIAMS
0022014-01-01CHRISTOPHER ZADEH2015-10-14
0022013-01-01CHRISTOPHER ZADEH2014-10-06
0022012-01-01ALEXANDRA BURGAR2013-09-26
0022011-01-01ALEXANDRA BURGAR2012-10-05
0022010-01-01ALEXANDRA BURGAR2011-07-25

Plan Statistics for TRI-VALLEY ORTHOPEDIC & SPORTS MEDICAL GROUP, INC. PROFIT SHARING PLAN

401k plan membership statisitcs for TRI-VALLEY ORTHOPEDIC & SPORTS MEDICAL GROUP, INC. PROFIT SHARING PLAN

Measure Date Value
2018: TRI-VALLEY ORTHOPEDIC & SPORTS MEDICAL GROUP, INC. PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0195
Total number of active participants reported on line 7a of the Form 55002018-01-0165
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-0117
Total of all active and inactive participants2018-01-0182
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-0182
Number of participants with account balances2018-01-0171
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: TRI-VALLEY ORTHOPEDIC & SPORTS MEDICAL GROUP, INC. PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01119
Total number of active participants reported on line 7a of the Form 55002017-01-0160
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-0135
Total of all active and inactive participants2017-01-0195
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-0195
Number of participants with account balances2017-01-0195
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: TRI-VALLEY ORTHOPEDIC & SPORTS MEDICAL GROUP, INC. PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01105
Total number of active participants reported on line 7a of the Form 55002016-01-0170
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-0148
Total of all active and inactive participants2016-01-01118
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-01118
Number of participants with account balances2016-01-01118
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-011
2015: TRI-VALLEY ORTHOPEDIC & SPORTS MEDICAL GROUP, INC. PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01121
Total number of active participants reported on line 7a of the Form 55002015-01-0193
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-0144
Total of all active and inactive participants2015-01-01137
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-01137
Number of participants with account balances2015-01-01137
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-012

Financial Data on TRI-VALLEY ORTHOPEDIC & SPORTS MEDICAL GROUP, INC. PROFIT SHARING PLAN

Measure Date Value
2018 : TRI-VALLEY ORTHOPEDIC & SPORTS MEDICAL GROUP, INC. PROFIT SHARING PLAN 2018 401k financial data
Transfers to/from the plan2018-12-31$0
Total plan liabilities at end of year2018-12-31$0
Total plan liabilities at beginning of year2018-12-31$0
Total income from all sources2018-12-31$140,232
Expenses. Total of all expenses incurred2018-12-31$230,560
Benefits paid (including direct rollovers)2018-12-31$220,145
Total plan assets at end of year2018-12-31$7,068,343
Total plan assets at beginning of year2018-12-31$7,158,671
Value of fidelity bond covering the plan2018-12-31$500,000
Total contributions received or receivable from participants2018-12-31$337,002
Expenses. Other expenses not covered elsewhere2018-12-31$0
Contributions received from other sources (not participants or employers)2018-12-31$0
Other income received2018-12-31$-339,035
Noncash contributions received2018-12-31$0
Net income (gross income less expenses)2018-12-31$-90,328
Net plan assets at end of year (total assets less liabilities)2018-12-31$7,068,343
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$7,158,671
Total contributions received or receivable from employer(s)2018-12-31$142,265
Value of certain deemed distributions of participant loans2018-12-31$0
Value of corrective distributions2018-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$10,415
2017 : TRI-VALLEY ORTHOPEDIC & SPORTS MEDICAL GROUP, INC. PROFIT SHARING PLAN 2017 401k financial data
Total income from all sources (including contributions)2017-12-31$1,305,176
Total of all expenses incurred2017-12-31$339,856
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$323,433
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$396,272
Value of total assets at end of year2017-12-31$7,158,675
Value of total assets at beginning of year2017-12-31$6,193,355
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$16,423
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$43,483
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2017-12-31$43,483
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$500,000
If this is an individual account plan, was there a blackout period2017-12-31No
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$249,380
Assets. Other investments not covered elsewhere at end of year2017-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2017-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Income. Non cash contributions2017-12-31$0
Value of net income/loss2017-12-31$965,320
Value of net assets at end of year (total assets less liabilities)2017-12-31$7,158,675
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$6,193,355
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$2,109,416
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$2,142,510
Value of interest in pooled separate accounts at end of year2017-12-31$4,234,348
Value of interest in pooled separate accounts at beginning of year2017-12-31$3,223,881
Value of interest in common/collective trusts at end of year2017-12-31$336,972
Value of interest in common/collective trusts at beginning of year2017-12-31$280,299
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-12-31$284,459
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-12-31$306,536
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-12-31$306,536
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-12-31$312,882
Net investment gain/loss from pooled separate accounts2017-12-31$552,539
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$146,892
Employer contributions (assets) at end of year2017-12-31$146,893
Employer contributions (assets) at beginning of year2017-12-31$193,168
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$323,433
Asset. Corporate debt instrument debt (other) at end of year2017-12-31$46,587
Asset. Corporate debt instrument debt (other) at beginning of year2017-12-31$46,961
Contract administrator fees2017-12-31$16,423
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31LOUIE & WONG LLP
Accountancy firm EIN2017-12-31912007579
2016 : TRI-VALLEY ORTHOPEDIC & SPORTS MEDICAL GROUP, INC. PROFIT SHARING PLAN 2016 401k financial data
Total income from all sources (including contributions)2016-12-31$847,111
Total of all expenses incurred2016-12-31$630,278
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$622,311
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$468,926
Value of total assets at end of year2016-12-31$6,193,355
Value of total assets at beginning of year2016-12-31$5,976,522
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$7,967
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$45,811
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2016-12-31$45,811
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$500,000
If this is an individual account plan, was there a blackout period2016-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$275,758
Assets. Other investments not covered elsewhere at end of year2016-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2016-12-31$368,787
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$216,833
Value of net assets at end of year (total assets less liabilities)2016-12-31$6,193,355
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$5,976,522
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-31$2,142,510
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$5,037,050
Value of interest in pooled separate accounts at end of year2016-12-31$3,223,881
Value of interest in pooled separate accounts at beginning of year2016-12-31$0
Value of interest in common/collective trusts at end of year2016-12-31$280,299
Value of interest in common/collective trusts at beginning of year2016-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$306,536
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$300,075
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$300,075
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-12-31$11,077
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-12-31$97,414
Net investment gain/loss from pooled separate accounts2016-12-31$234,960
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$193,168
Employer contributions (assets) at end of year2016-12-31$193,168
Employer contributions (assets) at beginning of year2016-12-31$212,335
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$622,311
Asset. Corporate debt instrument debt (other) at end of year2016-12-31$46,961
Asset. Corporate debt instrument debt (other) at beginning of year2016-12-31$47,198
Contract administrator fees2016-12-31$7,967
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31LOUIE & WONG LLP
Accountancy firm EIN2016-12-31912007579
2015 : TRI-VALLEY ORTHOPEDIC & SPORTS MEDICAL GROUP, INC. PROFIT SHARING PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total income from all sources (including contributions)2015-12-31$527,525
Total loss/gain on sale of assets2015-12-31$-2,209
Total of all expenses incurred2015-12-31$495,764
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$485,535
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$599,980
Value of total assets at end of year2015-12-31$5,976,522
Value of total assets at beginning of year2015-12-31$5,944,761
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$10,229
Total interest from all sources2015-12-31$2,284
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$109,311
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2015-12-31$101,599
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$500,000
If this is an individual account plan, was there a blackout period2015-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$288,453
Assets. Other investments not covered elsewhere at end of year2015-12-31$368,787
Assets. Other investments not covered elsewhere at beginning of year2015-12-31$439,006
Income. Received or receivable in cash from other sources (including rollovers)2015-12-31$99,192
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$31,761
Value of net assets at end of year (total assets less liabilities)2015-12-31$5,976,522
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$5,944,761
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Investment advisory and management fees2015-12-31$8,954
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$5,037,050
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$4,969,176
Interest earned on other investments2015-12-31$517
Income. Interest from corporate debt instruments2015-12-31$1,730
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-12-31$300,075
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-12-31$292,662
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-12-31$292,662
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2015-12-31$37
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-12-31$11,077
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-12-31$9,481
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$-129,345
Net investment gain/loss from pooled separate accounts2015-12-31$-52,496
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$212,335
Employer contributions (assets) at end of year2015-12-31$212,335
Employer contributions (assets) at beginning of year2015-12-31$187,073
Income. Dividends from common stock2015-12-31$7,712
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$485,535
Asset. Corporate debt instrument debt (other) at end of year2015-12-31$47,198
Asset. Corporate debt instrument debt (other) at beginning of year2015-12-31$47,363
Contract administrator fees2015-12-31$1,275
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Aggregate proceeds on sale of assets2015-12-31$1,943,533
Aggregate carrying amount (costs) on sale of assets2015-12-31$1,945,742
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31LOUIE & WONG LLP
Accountancy firm EIN2015-12-31912007579

Form 5500 Responses for TRI-VALLEY ORTHOPEDIC & SPORTS MEDICAL GROUP, INC. PROFIT SHARING PLAN

2018: TRI-VALLEY ORTHOPEDIC & SPORTS MEDICAL GROUP, INC. PROFIT SHARING PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement - TrustYes
2017: TRI-VALLEY ORTHOPEDIC & SPORTS MEDICAL GROUP, INC. PROFIT SHARING PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement - TrustYes
2016: TRI-VALLEY ORTHOPEDIC & SPORTS MEDICAL GROUP, INC. PROFIT SHARING PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement - TrustYes
2015: TRI-VALLEY ORTHOPEDIC & SPORTS MEDICAL GROUP, INC. PROFIT SHARING PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number343051-000
Policy instance 1
Insurance contract or identification number343051-000
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $16,211
Total amount of fees paid to insurance companyUSD $3,257
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Commission paid to Insurance BrokerUSD $11,348
Amount paid for insurance broker fees0
Insurance broker organization code?3
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number343051-000
Policy instance 1
Insurance contract or identification number343051-000
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $7,564
Total amount of fees paid to insurance companyUSD $4,011
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Commission paid to Insurance BrokerUSD $5,200
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameMORGAN STANLEY INSURANCE SERVICES I
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number95659
Policy instance 1
Insurance contract or identification number95659
Number of Individuals Covered138
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $13,016
Total amount of fees paid to insurance companyUSD $2,926
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 BrokerUSD $13,016
Amount paid for insurance broker fees1634
Additional information about fees paid to insurance brokerTPA COMPENSATION
Insurance broker organization code?3
Insurance broker nameMHM RETIREMENT PLAN SOLUTIONS

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