401k Plan data: EDWIN K. CHAN, MD., PC., 401(K) PROFIT SHARING PLAN plan

EDWIN K. CHAN, MD., PC., 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan Name	EDWIN K. CHAN, MD., PC., 401(K) PROFIT SHARING PLAN
Plan identification number	002

EDWIN K. CHAN, MD., PC., 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
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.
Partial participant-directed account plan - Participants have the opportunity to direct the investment of a portion of 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.
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.

401k Sponsoring company profile

FLUSHING ADMINISTRATIVE SERVICES LLC has sponsored the creation of one or more 401k plans.

Company Name: FLUSHING ADMINISTRATIVE SERVICES LLC

Employer identification number (EIN): 352507427

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EDWIN K. CHAN, MD., PC., 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2017-01-01 EDWIN K. CHAN
002 2016-01-01 EDWIN K. CHAN
002 2016-01-01 EDWIN K. CHAN

Plan id#	Filing Submission Date	Name of Administrator
002	2017-01-01	EDWIN K. CHAN
002	2016-01-01	EDWIN K. CHAN
002	2016-01-01	EDWIN K. CHAN

Plan Statistics for EDWIN K. CHAN, MD., PC., 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for EDWIN K. CHAN, MD., PC., 401(K) PROFIT SHARING PLAN

Measure Date Value
2017: EDWIN K. CHAN, MD., PC., 401(K) PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 6
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 5
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 1
Total of all active and inactive participants 2017-01-01 6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 6
Number of participants with account balances 2017-01-01 6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: EDWIN K. CHAN, MD., PC., 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 4
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 5
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 5
Number of participants with account balances 2016-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 1

Measure	Date	Value
2017: EDWIN K. CHAN, MD., PC., 401(K) PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	6
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	5
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	1
Total of all active and inactive participants	2017-01-01	6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	6
Number of participants with account balances	2017-01-01	6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: EDWIN K. CHAN, MD., PC., 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	4
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	5
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	5
Number of participants with account balances	2016-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	1

Financial Data on EDWIN K. CHAN, MD., PC., 401(K) PROFIT SHARING PLAN

Measure	Date	Value
2017 : EDWIN K. CHAN, MD., PC., 401(K) PROFIT SHARING PLAN 2017 401k financial data
Transfers to/from the plan	2017-12-31	$0
Total plan liabilities at end of year	2017-12-31	$0
Total plan liabilities at beginning of year	2017-12-31	$0
Total income from all sources	2017-12-31	$106,609
Expenses. Total of all expenses incurred	2017-12-31	$2,978
Benefits paid (including direct rollovers)	2017-12-31	$0
Total plan assets at end of year	2017-12-31	$707,056
Total plan assets at beginning of year	2017-12-31	$603,425
Total contributions received or receivable from participants	2017-12-31	$0
Expenses. Other expenses not covered elsewhere	2017-12-31	$0
Contributions received from other sources (not participants or employers)	2017-12-31	$0
Other income received	2017-12-31	$75,041
Noncash contributions received	2017-12-31	$0
Net income (gross income less expenses)	2017-12-31	$103,631
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$707,056
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$603,425
Total contributions received or receivable from employer(s)	2017-12-31	$31,568
Value of certain deemed distributions of participant loans	2017-12-31	$0
Value of corrective distributions	2017-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2017-12-31	$2,978
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
2016 : EDWIN K. CHAN, MD., PC., 401(K) PROFIT SHARING PLAN 2016 401k financial data
Transfers to/from the plan	2016-12-31	$0
Total plan liabilities at end of year	2016-12-31	$0
Total plan liabilities at beginning of year	2016-12-31	$0
Total income from all sources	2016-12-31	$341,151
Expenses. Total of all expenses incurred	2016-12-31	$0
Benefits paid (including direct rollovers)	2016-12-31	$0
Total plan assets at end of year	2016-12-31	$1,066,219
Total plan assets at beginning of year	2016-12-31	$725,068
Total contributions received or receivable from participants	2016-12-31	$36,000
Expenses. Other expenses not covered elsewhere	2016-12-31	$0
Contributions received from other sources (not participants or employers)	2016-12-31	$0
Other income received	2016-12-31	$277,890
Noncash contributions received	2016-12-31	$0
Net income (gross income less expenses)	2016-12-31	$341,151
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$1,066,219
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$725,068
Total contributions received or receivable from employer(s)	2016-12-31	$27,261
Value of certain deemed distributions of participant loans	2016-12-31	$0
Value of corrective distributions	2016-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2016-12-31	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0

Form 5500 Responses for EDWIN K. CHAN, MD., PC., 401(K) PROFIT SHARING PLAN

2017: EDWIN K. CHAN, MD., PC., 401(K) PROFIT SHARING PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: EDWIN K. CHAN, MD., PC., 401(K) PROFIT SHARING PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	Yes
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

160208900

Policy instance

Insurance contract or identification number	160208900
Number of Individuals Covered	2
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Are there contracts with allocated funds for individual policies?	1
Life Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

Potentially related plans

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Company Name:	FLUSHING ADMINISTRATIVE SERVICES LLC
Employer identification number (EIN):	352507427
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)