SAN JUAN MEDICAL CLINIC, INC. DEFINED BENEFIT PLAN AND TRUST 401k Plan overview

SAN JUAN MEDICAL CLINIC, INC. DEFINED BENEFIT PLAN AND TRUST Benefits

401k Sponsoring company profile

Company Name:	SAN JUAN MEDICAL CLINIC, INC.
Employer identification number (EIN):	204284489
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2022-01-01
002	2021-01-01
002	2020-01-01
002	2019-01-01
002	2018-01-01
002	2017-01-01
002	2016-01-01
002	2015-01-01
002	2014-01-01	ROMANY DEMIAN, M.D.	2015-06-29
002	2013-01-01	ROMANY DEMIAN, M.D.	2014-08-14
002	2012-01-01	ROMANY DEMIAN, M.D.	2013-10-07

Plan Statistics for SAN JUAN MEDICAL CLINIC, INC. DEFINED BENEFIT PLAN AND TRUST

Measure	Date	Value
2022: SAN JUAN MEDICAL CLINIC, INC. DEFINED BENEFIT PLAN AND TRUST 2022 401k membership
Market value of plan assets	2022-12-31	1,298,561
Acturial value of plan assets	2022-12-31	1,298,561
Funding target for retired participants and beneficiaries receiving payment	2022-12-31	0
Number of terminated vested participants	2022-12-31	2
Fundng target for terminated vested participants	2022-12-31	29
Active participant vested funding target	2022-12-31	1,421,561
Number of active participants	2022-12-31	3
Total funding liabilities for active participants	2022-12-31	1,421,692
Total participant count	2022-12-31	5
Total funding target for all participants	2022-12-31	1,421,721
Balance at beginning of prior year after applicable adjustments	2022-12-31	0
Prefunding balance at beginning of prior year after applicable adjustments	2022-12-31	244,300
Carryover balanced portion elected for use to offset prior years funding requirement	2022-12-31	0
Prefunding balanced used to offset prior years funding requirement	2022-12-31	1,249
Amount remaining of carryover balance	2022-12-31	0
Amount remaining of prefunding balance	2022-12-31	243,051
Present value of excess contributions	2022-12-31	0
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance	2022-12-31	0
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance	2022-12-31	0
Reductions in caryover balances due to elections or deemed elections	2022-12-31	0
Reductions in prefunding balances due to elections or deemed elections	2022-12-31	297,373
Balance of carryovers at beginning of current year	2022-12-31	0
Balance of prefunding at beginning of current year	2022-12-31	0
Total employer contributions	2022-12-31	180,400
Total employee contributions	2022-12-31	0
Contributions allocated toward unpaid minimum require contributions from prior years	2022-12-31	0
Contributions made to avoid restrictions adjusted to valuation date	2022-12-31	0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date	2022-12-31	178,959
Unpaid minimum required contributions for all prior years	2022-12-31	0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years	2022-12-31	0
Remaining amount of unpaid minimum required contributions	2022-12-31	0
Minimum required contributions for current year target normal cost	2022-12-31	115,416
Net shortfall amortization installment of oustanding balance	2022-12-31	123,160
Waiver amortization installment	2022-12-31	0
Total funding amount beforereflecting carryover/prefunding balances	2022-12-31	126,797
Carryover balance elected to use to offset funding requirement	2022-12-31	0
Prefunding balance elected to use to offset funding requirement	2022-12-31	0
Additional cash requirement	2022-12-31	126,797
Contributions allocatedtoward minimum required contributions for current year	2022-12-31	178,959
Unpaid minimum required contributions for current year	2022-12-31	0
Unpaid minimum required contributions for all years	2022-12-31	0
2021: SAN JUAN MEDICAL CLINIC, INC. DEFINED BENEFIT PLAN AND TRUST 2021 401k membership
Market value of plan assets	2021-12-31	1,655,012
Acturial value of plan assets	2021-12-31	1,655,012
Funding target for retired participants and beneficiaries receiving payment	2021-12-31	0
Number of terminated vested participants	2021-12-31	0
Fundng target for terminated vested participants	2021-12-31	0
Active participant vested funding target	2021-12-31	860,960
Number of active participants	2021-12-31	5
Total funding liabilities for active participants	2021-12-31	861,086
Total participant count	2021-12-31	5
Total funding target for all participants	2021-12-31	861,086
Balance at beginning of prior year after applicable adjustments	2021-12-31	0
Prefunding balance at beginning of prior year after applicable adjustments	2021-12-31	231,385
Carryover balanced portion elected for use to offset prior years funding requirement	2021-12-31	0
Prefunding balanced used to offset prior years funding requirement	2021-12-31	0
Amount remaining of carryover balance	2021-12-31	0
Amount remaining of prefunding balance	2021-12-31	231,385
Present value of excess contributions	2021-12-31	99,236
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance	2021-12-31	99,236
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance	2021-12-31	99,236
Reductions in caryover balances due to elections or deemed elections	2021-12-31	0
Reductions in prefunding balances due to elections or deemed elections	2021-12-31	157,611
Balance of carryovers at beginning of current year	2021-12-31	0
Balance of prefunding at beginning of current year	2021-12-31	244,300
Total employer contributions	2021-12-31	115,000
Total employee contributions	2021-12-31	0
Contributions allocated toward unpaid minimum require contributions from prior years	2021-12-31	0
Contributions made to avoid restrictions adjusted to valuation date	2021-12-31	0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date	2021-12-31	114,191
Unpaid minimum required contributions for all prior years	2021-12-31	0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years	2021-12-31	0
Remaining amount of unpaid minimum required contributions	2021-12-31	0
Minimum required contributions for current year target normal cost	2021-12-31	653,400
Net shortfall amortization installment of oustanding balance	2021-12-31	0
Waiver amortization installment	2021-12-31	0
Total funding amount beforereflecting carryover/prefunding balances	2021-12-31	115,500
Carryover balance elected to use to offset funding requirement	2021-12-31	0
Prefunding balance elected to use to offset funding requirement	2021-12-31	1,309
Additional cash requirement	2021-12-31	114,191
Contributions allocatedtoward minimum required contributions for current year	2021-12-31	114,191
Unpaid minimum required contributions for current year	2021-12-31	0
Unpaid minimum required contributions for all years	2021-12-31	0
2020: SAN JUAN MEDICAL CLINIC, INC. DEFINED BENEFIT PLAN AND TRUST 2020 401k membership
Market value of plan assets	2020-12-31	1,255,422
Acturial value of plan assets	2020-12-31	1,255,422
Funding target for retired participants and beneficiaries receiving payment	2020-12-31	0
Number of terminated vested participants	2020-12-31	0
Fundng target for terminated vested participants	2020-12-31	0
Active participant vested funding target	2020-12-31	755,793
Number of active participants	2020-12-31	3
Total funding liabilities for active participants	2020-12-31	755,945
Total participant count	2020-12-31	3
Total funding target for all participants	2020-12-31	755,945
Balance at beginning of prior year after applicable adjustments	2020-12-31	0
Prefunding balance at beginning of prior year after applicable adjustments	2020-12-31	93,063
Carryover balanced portion elected for use to offset prior years funding requirement	2020-12-31	0
Prefunding balanced used to offset prior years funding requirement	2020-12-31	0
Amount remaining of carryover balance	2020-12-31	0
Amount remaining of prefunding balance	2020-12-31	93,063
Present value of excess contributions	2020-12-31	113,781
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance	2020-12-31	113,781
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance	2020-12-31	113,781
Reductions in caryover balances due to elections or deemed elections	2020-12-31	0
Reductions in prefunding balances due to elections or deemed elections	2020-12-31	0
Balance of carryovers at beginning of current year	2020-12-31	0
Balance of prefunding at beginning of current year	2020-12-31	231,385
Total employer contributions	2020-12-31	100,000
Total employee contributions	2020-12-31	0
Contributions allocated toward unpaid minimum require contributions from prior years	2020-12-31	0
Contributions made to avoid restrictions adjusted to valuation date	2020-12-31	0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date	2020-12-31	99,236
Unpaid minimum required contributions for all prior years	2020-12-31	0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years	2020-12-31	0
Remaining amount of unpaid minimum required contributions	2020-12-31	0
Minimum required contributions for current year target normal cost	2020-12-31	94,875
Net shortfall amortization installment of oustanding balance	2020-12-31	0
Waiver amortization installment	2020-12-31	0
Total funding amount beforereflecting carryover/prefunding balances	2020-12-31	0
Additional cash requirement	2020-12-31	0
Contributions allocatedtoward minimum required contributions for current year	2020-12-31	99,236
Unpaid minimum required contributions for current year	2020-12-31	0
Unpaid minimum required contributions for all years	2020-12-31	0
2019: SAN JUAN MEDICAL CLINIC, INC. DEFINED BENEFIT PLAN AND TRUST 2019 401k membership
Market value of plan assets	2019-12-31	849,588
Acturial value of plan assets	2019-12-31	849,588
Funding target for retired participants and beneficiaries receiving payment	2019-12-31	0
Number of terminated vested participants	2019-12-31	0
Fundng target for terminated vested participants	2019-12-31	0
Active participant vested funding target	2019-12-31	619,330
Number of active participants	2019-12-31	2
Total funding liabilities for active participants	2019-12-31	619,502
Total participant count	2019-12-31	2
Total funding target for all participants	2019-12-31	619,502
Balance at beginning of prior year after applicable adjustments	2019-12-31	0
Prefunding balance at beginning of prior year after applicable adjustments	2019-12-31	47,623
Carryover balanced portion elected for use to offset prior years funding requirement	2019-12-31	0
Prefunding balanced used to offset prior years funding requirement	2019-12-31	0
Amount remaining of carryover balance	2019-12-31	0
Amount remaining of prefunding balance	2019-12-31	47,623
Present value of excess contributions	2019-12-31	48,031
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance	2019-12-31	48,031
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance	2019-12-31	48,031
Reductions in caryover balances due to elections or deemed elections	2019-12-31	0
Reductions in prefunding balances due to elections or deemed elections	2019-12-31	0
Balance of carryovers at beginning of current year	2019-12-31	0
Balance of prefunding at beginning of current year	2019-12-31	93,063
Total employer contributions	2019-12-31	114,878
Total employee contributions	2019-12-31	0
Contributions allocated toward unpaid minimum require contributions from prior years	2019-12-31	0
Contributions made to avoid restrictions adjusted to valuation date	2019-12-31	0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date	2019-12-31	113,781
Unpaid minimum required contributions for all prior years	2019-12-31	0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years	2019-12-31	0
Remaining amount of unpaid minimum required contributions	2019-12-31	0
Minimum required contributions for current year target normal cost	2019-12-31	88,679
Net shortfall amortization installment of oustanding balance	2019-12-31	0
Waiver amortization installment	2019-12-31	0
Total funding amount beforereflecting carryover/prefunding balances	2019-12-31	0
Carryover balance elected to use to offset funding requirement	2019-12-31	0
Prefunding balance elected to use to offset funding requirement	2019-12-31	0
Additional cash requirement	2019-12-31	0
Contributions allocatedtoward minimum required contributions for current year	2019-12-31	113,781
Unpaid minimum required contributions for current year	2019-12-31	0
Unpaid minimum required contributions for all years	2019-12-31	0
2018: SAN JUAN MEDICAL CLINIC, INC. DEFINED BENEFIT PLAN AND TRUST 2018 401k membership
Market value of plan assets	2018-12-31	540,807
Acturial value of plan assets	2018-12-31	540,807
Funding target for retired participants and beneficiaries receiving payment	2018-12-31	0
Number of terminated vested participants	2018-12-31	0
Fundng target for terminated vested participants	2018-12-31	0
Active participant vested funding target	2018-12-31	485,224
Number of active participants	2018-12-31	2
Total funding liabilities for active participants	2018-12-31	485,330
Total participant count	2018-12-31	2
Total funding target for all participants	2018-12-31	485,330
Balance at beginning of prior year after applicable adjustments	2018-12-31	0
Prefunding balance at beginning of prior year after applicable adjustments	2018-12-31	75,500
Carryover balanced portion elected for use to offset prior years funding requirement	2018-12-31	0
Prefunding balanced used to offset prior years funding requirement	2018-12-31	0
Amount remaining of carryover balance	2018-12-31	0
Amount remaining of prefunding balance	2018-12-31	75,500
Present value of excess contributions	2018-12-31	52,991
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance	2018-12-31	52,991
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance	2018-12-31	52,991
Reductions in caryover balances due to elections or deemed elections	2018-12-31	0
Reductions in prefunding balances due to elections or deemed elections	2018-12-31	92,616
Balance of carryovers at beginning of current year	2018-12-31	0
Balance of prefunding at beginning of current year	2018-12-31	47,623
Total employer contributions	2018-12-31	136,017
Total employee contributions	2018-12-31	0
Contributions allocated toward unpaid minimum require contributions from prior years	2018-12-31	0
Contributions made to avoid restrictions adjusted to valuation date	2018-12-31	0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date	2018-12-31	134,847
Unpaid minimum required contributions for all prior years	2018-12-31	0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years	2018-12-31	0
Remaining amount of unpaid minimum required contributions	2018-12-31	0
Minimum required contributions for current year target normal cost	2018-12-31	92,003
Net shortfall amortization installment of oustanding balance	2018-12-31	0
Waiver amortization installment	2018-12-31	0
Total funding amount beforereflecting carryover/prefunding balances	2018-12-31	86,816
Carryover balance elected to use to offset funding requirement	2018-12-31	0
Prefunding balance elected to use to offset funding requirement	2018-12-31	0
Additional cash requirement	2018-12-31	86,816
Contributions allocatedtoward minimum required contributions for current year	2018-12-31	134,847
Unpaid minimum required contributions for current year	2018-12-31	0
Unpaid minimum required contributions for all years	2018-12-31	0
2017: SAN JUAN MEDICAL CLINIC, INC. DEFINED BENEFIT PLAN AND TRUST 2017 401k membership
Market value of plan assets	2017-12-31	445,084
Acturial value of plan assets	2017-12-31	445,084
Funding target for retired participants and beneficiaries receiving payment	2017-12-31	0
Number of terminated vested participants	2017-12-31	0
Fundng target for terminated vested participants	2017-12-31	0
Active participant vested funding target	2017-12-31	337,630
Number of active participants	2017-12-31	2
Total funding liabilities for active participants	2017-12-31	337,630
Total participant count	2017-12-31	2
Total funding target for all participants	2017-12-31	337,630
Balance at beginning of prior year after applicable adjustments	2017-12-31	0
Prefunding balance at beginning of prior year after applicable adjustments	2017-12-31	46,330
Carryover balanced portion elected for use to offset prior years funding requirement	2017-12-31	0
Prefunding balanced used to offset prior years funding requirement	2017-12-31	0
Amount remaining of carryover balance	2017-12-31	0
Amount remaining of prefunding balance	2017-12-31	46,330
Present value of excess contributions	2017-12-31	29,063
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance	2017-12-31	29,063
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance	2017-12-31	29,063
Reductions in caryover balances due to elections or deemed elections	2017-12-31	0
Reductions in prefunding balances due to elections or deemed elections	2017-12-31	0
Balance of carryovers at beginning of current year	2017-12-31	0
Balance of prefunding at beginning of current year	2017-12-31	75,500
Total employer contributions	2017-12-31	125,643
Total employee contributions	2017-12-31	0
Contributions allocated toward unpaid minimum require contributions from prior years	2017-12-31	0
Contributions made to avoid restrictions adjusted to valuation date	2017-12-31	0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date	2017-12-31	124,447
Unpaid minimum required contributions for all prior years	2017-12-31	0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years	2017-12-31	0
Remaining amount of unpaid minimum required contributions	2017-12-31	0
Minimum required contributions for current year target normal cost	2017-12-31	99,023
Net shortfall amortization installment of oustanding balance	2017-12-31	0
Waiver amortization installment	2017-12-31	0
Total funding amount beforereflecting carryover/prefunding balances	2017-12-31	71,456
Carryover balance elected to use to offset funding requirement	2017-12-31	0
Prefunding balance elected to use to offset funding requirement	2017-12-31	0
Additional cash requirement	2017-12-31	71,456
Contributions allocatedtoward minimum required contributions for current year	2017-12-31	124,447
Unpaid minimum required contributions for current year	2017-12-31	0
Unpaid minimum required contributions for all years	2017-12-31	0
2016: SAN JUAN MEDICAL CLINIC, INC. DEFINED BENEFIT PLAN AND TRUST 2016 401k membership
Market value of plan assets	2016-12-31	301,334
Acturial value of plan assets	2016-12-31	301,334
Funding target for retired participants and beneficiaries receiving payment	2016-12-31	0
Number of terminated vested participants	2016-12-31	5
Fundng target for terminated vested participants	2016-12-31	4,661
Active participant vested funding target	2016-12-31	228,056
Number of active participants	2016-12-31	1
Total funding liabilities for active participants	2016-12-31	228,056
Total participant count	2016-12-31	6
Total funding target for all participants	2016-12-31	232,717
Balance at beginning of prior year after applicable adjustments	2016-12-31	0
Prefunding balance at beginning of prior year after applicable adjustments	2016-12-31	74,504
Carryover balanced portion elected for use to offset prior years funding requirement	2016-12-31	0
Prefunding balanced used to offset prior years funding requirement	2016-12-31	0
Amount remaining of carryover balance	2016-12-31	0
Amount remaining of prefunding balance	2016-12-31	74,504
Present value of excess contributions	2016-12-31	18,469
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance	2016-12-31	18,469
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance	2016-12-31	18,469
Reductions in caryover balances due to elections or deemed elections	2016-12-31	0
Reductions in prefunding balances due to elections or deemed elections	2016-12-31	47,477
Balance of carryovers at beginning of current year	2016-12-31	0
Balance of prefunding at beginning of current year	2016-12-31	46,330
Total employer contributions	2016-12-31	93,146
Total employee contributions	2016-12-31	0
Contributions allocated toward unpaid minimum require contributions from prior years	2016-12-31	0
Contributions made to avoid restrictions adjusted to valuation date	2016-12-31	0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date	2016-12-31	90,855
Unpaid minimum required contributions for all prior years	2016-12-31	0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years	2016-12-31	0
Remaining amount of unpaid minimum required contributions	2016-12-31	0
Minimum required contributions for current year target normal cost	2016-12-31	81,262
Net shortfall amortization installment of oustanding balance	2016-12-31	0
Waiver amortization installment	2016-12-31	0
Waived amount of outstanding balance	2016-12-31	0
Total funding amount beforereflecting carryover/prefunding balances	2016-12-31	61,792
Carryover balance elected to use to offset funding requirement	2016-12-31	0
Prefunding balance elected to use to offset funding requirement	2016-12-31	0
Additional cash requirement	2016-12-31	61,792
Contributions allocatedtoward minimum required contributions for current year	2016-12-31	90,855
Unpaid minimum required contributions for current year	2016-12-31	0
Unpaid minimum required contributions for all years	2016-12-31	0

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• SAN JUAN ROOFING & WATERPROOFING, INC. CASH BALANCE PLAN [EIN = 030493331]
• SAN JUAN PAUL INC 401(K) PROFIT SHARING PLAN & TRUST [EIN = 873445983]
• SAN JUAN ISLAND SEA SALT 401(K) PLAN [EIN = 461225093]
• SAN JUAN ISLAND COMMUNITY FOUNDATION 403(B) RETIREMENT PLAN [EIN = 911648730]
• SAN JUAN SUPER MARKET INC 401(K) PLAN [EIN = 874197222]

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