FIVE STAR MANAGEMENT SERVICES, LLC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan FIVE STAR URGENT CARE 401(K) PLAN
| Measure | Date | Value |
|---|
| 2016: FIVE STAR URGENT CARE 401(K) PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 143 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 0 |
| Total of all active and inactive participants | 2016-01-01 | 0 |
| Total participants | 2016-01-01 | 0 |
| 2015: FIVE STAR URGENT CARE 401(K) PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 98 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 143 |
| Number of retired or separated participants receiving benefits | 2015-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-01-01 | 9 |
| Total of all active and inactive participants | 2015-01-01 | 152 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2015-01-01 | 0 |
| Total participants | 2015-01-01 | 152 |
| Number of participants with account balances | 2015-01-01 | 64 |
| 2014: FIVE STAR URGENT CARE 401(K) PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 55 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 90 |
| Number of retired or separated participants receiving benefits | 2014-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-01-01 | 8 |
| Total of all active and inactive participants | 2014-01-01 | 98 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2014-01-01 | 0 |
| Total participants | 2014-01-01 | 98 |
| Number of participants with account balances | 2014-01-01 | 42 |
| 2013: FIVE STAR URGENT CARE 401(K) PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 0 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 51 |
| 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 | 55 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2013-01-01 | 0 |
| Total participants | 2013-01-01 | 55 |
| Number of participants with account balances | 2013-01-01 | 29 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2013-01-01 | 0 |
| Measure | Date | Value |
|---|
| 2016 : FIVE STAR URGENT CARE 401(K) PLAN 2016 401k financial data |
|---|
| Total income from all sources (including contributions) | 2016-12-31 | $405,375 |
| Total of all expenses incurred | 2016-12-31 | $1,168,173 |
| Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2016-12-31 | $1,149,806 |
| Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2016-12-31 | $338,961 |
| Value of total assets at beginning of year | 2016-12-31 | $762,798 |
| Total of administrative expenses incurred including professional, contract, advisory and management fees | 2016-12-31 | $18,367 |
| Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2016-12-31 | Yes |
| Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan | 2016-12-31 | $0 |
| Was this plan covered by a fidelity bond | 2016-12-31 | Yes |
| Value of fidelity bond cover | 2016-12-31 | $100,000 |
| If this is an individual account plan, was there a blackout period | 2016-12-31 | No |
| Were there any nonexempt tranactions with any party-in-interest | 2016-12-31 | No |
| Contributions received from participants | 2016-12-31 | $194,287 |
| Income. Received or receivable in cash from other sources (including rollovers) | 2016-12-31 | $78,005 |
| Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-12-31 | No |
| Value of net income/loss | 2016-12-31 | $-762,798 |
| Value of net assets at beginning of year (total assets less liabilities) | 2016-12-31 | $762,798 |
| Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2016-12-31 | No |
| Were any loans by the plan or fixed income obligations due to the plan in default | 2016-12-31 | No |
| Were any leases to which the plan was party in default or uncollectible | 2016-12-31 | No |
| Investment advisory and management fees | 2016-12-31 | $6,936 |
| Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2016-12-31 | $762,798 |
| Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2016-12-31 | $66,414 |
| Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2016-12-31 | No |
| Was there a failure to transmit to the plan any participant contributions | 2016-12-31 | No |
| Has the plan failed to provide any benefit when due under the plan | 2016-12-31 | No |
| Contributions received in cash from employer | 2016-12-31 | $66,669 |
| Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2016-12-31 | $1,149,806 |
| Contract administrator fees | 2016-12-31 | $11,431 |
| Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2016-12-31 | No |
| Did the plan have assets held for investment | 2016-12-31 | No |
| Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2016-12-31 | No |
| Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2016-12-31 | Yes |
| Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2016-12-31 | Yes |
| Opinion of an independent qualified public accountant for this plan | 2016-12-31 | Disclaimer |
| Accountancy firm name | 2016-12-31 | JEFFREY L. OFFHAUS CPA, LLC |
| Accountancy firm EIN | 2016-12-31 | 202368569 |
| 2015 : FIVE STAR URGENT CARE 401(K) PLAN 2015 401k financial data |
|---|
| Total income from all sources | 2015-12-31 | $366,960 |
| Expenses. Total of all expenses incurred | 2015-12-31 | $25,453 |
| Benefits paid (including direct rollovers) | 2015-12-31 | $16,852 |
| Total plan assets at end of year | 2015-12-31 | $762,798 |
| Total plan assets at beginning of year | 2015-12-31 | $421,291 |
| Value of fidelity bond covering the plan | 2015-12-31 | $100,000 |
| Total contributions received or receivable from participants | 2015-12-31 | $261,867 |
| Contributions received from other sources (not participants or employers) | 2015-12-31 | $25,741 |
| Other income received | 2015-12-31 | $-3,962 |
| Net income (gross income less expenses) | 2015-12-31 | $341,507 |
| Net plan assets at end of year (total assets less liabilities) | 2015-12-31 | $762,798 |
| Net plan assets at beginning of year (total assets less liabilities) | 2015-12-31 | $421,291 |
| Total contributions received or receivable from employer(s) | 2015-12-31 | $83,314 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2015-12-31 | $8,601 |
| 2014 : FIVE STAR URGENT CARE 401(K) PLAN 2014 401k financial data |
|---|
| Total income from all sources | 2014-12-31 | $272,245 |
| Expenses. Total of all expenses incurred | 2014-12-31 | $26,037 |
| Benefits paid (including direct rollovers) | 2014-12-31 | $20,376 |
| Total plan assets at end of year | 2014-12-31 | $421,291 |
| Total plan assets at beginning of year | 2014-12-31 | $175,083 |
| Value of fidelity bond covering the plan | 2014-12-31 | $100,000 |
| Total contributions received or receivable from participants | 2014-12-31 | $214,028 |
| Other income received | 2014-12-31 | $-6,281 |
| Net income (gross income less expenses) | 2014-12-31 | $246,208 |
| Net plan assets at end of year (total assets less liabilities) | 2014-12-31 | $421,291 |
| Net plan assets at beginning of year (total assets less liabilities) | 2014-12-31 | $175,083 |
| Total contributions received or receivable from employer(s) | 2014-12-31 | $64,498 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2014-12-31 | $5,661 |
| 2013 : FIVE STAR URGENT CARE 401(K) PLAN 2013 401k financial data |
|---|
| Total income from all sources | 2013-12-31 | $178,856 |
| Expenses. Total of all expenses incurred | 2013-12-31 | $3,773 |
| Benefits paid (including direct rollovers) | 2013-12-31 | $2,258 |
| Total plan assets at end of year | 2013-12-31 | $175,083 |
| Value of fidelity bond covering the plan | 2013-12-31 | $100,000 |
| Total contributions received or receivable from participants | 2013-12-31 | $117,216 |
| Other income received | 2013-12-31 | $11,248 |
| Net income (gross income less expenses) | 2013-12-31 | $175,083 |
| Net plan assets at end of year (total assets less liabilities) | 2013-12-31 | $175,083 |
| Total contributions received or receivable from employer(s) | 2013-12-31 | $50,392 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2013-12-31 | $1,515 |
