401k Plan data: PSP OF ANESTHESIA SCHEDULING SERVICES, INC. FBO FINE plan

PSP OF ANESTHESIA SCHEDULING SERVICES, INC. FBO FINE 401k Plan overview

Plan Name	PSP OF ANESTHESIA SCHEDULING SERVICES, INC. FBO FINE
Plan identification number	001

PSP OF ANESTHESIA SCHEDULING SERVICES, INC. FBO FINE Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Participant-directed brokerage accounts provided as an investment option under the plan.
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

ANESTHESIA SCHEDULING SERVICES, INC has sponsored the creation of one or more 401k plans.

Company Name: ANESTHESIA SCHEDULING SERVICES, INC

Employer identification number (EIN): 464258003

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PSP OF ANESTHESIA SCHEDULING SERVICES, INC. FBO FINE

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2017-01-01
001 2016-01-01
001 2015-01-01 MARK ANDREW FINE

Plan Statistics for PSP OF ANESTHESIA SCHEDULING SERVICES, INC. FBO FINE

401k plan membership statisitcs for PSP OF ANESTHESIA SCHEDULING SERVICES, INC. FBO FINE

Measure Date Value
2017: PSP OF ANESTHESIA SCHEDULING SERVICES, INC. FBO FINE 2017 401k membership
Total participants, beginning-of-year 2017-01-01 1
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 0
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 0
Total of all active and inactive participants 2017-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 0
Number of participants with account balances 2017-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: PSP OF ANESTHESIA SCHEDULING SERVICES, INC. FBO FINE 2016 401k membership
Total participants, beginning-of-year 2016-01-01 2
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 2
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 2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 2
Number of participants with account balances 2016-01-01 2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: PSP OF ANESTHESIA SCHEDULING SERVICES, INC. FBO FINE 2015 401k membership
Total participants, beginning-of-year 2015-01-01 0
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 2
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 0
Total of all active and inactive participants 2015-01-01 2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 2
Number of participants with account balances 2015-01-01 2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0

Measure	Date	Value
2017: PSP OF ANESTHESIA SCHEDULING SERVICES, INC. FBO FINE 2017 401k membership
Total participants, beginning-of-year	2017-01-01	1
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	0
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	0
Total of all active and inactive participants	2017-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	0
Number of participants with account balances	2017-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: PSP OF ANESTHESIA SCHEDULING SERVICES, INC. FBO FINE 2016 401k membership
Total participants, beginning-of-year	2016-01-01	2
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	2
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	2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	2
Number of participants with account balances	2016-01-01	2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: PSP OF ANESTHESIA SCHEDULING SERVICES, INC. FBO FINE 2015 401k membership
Total participants, beginning-of-year	2015-01-01	0
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	2
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	0
Total of all active and inactive participants	2015-01-01	2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	2
Number of participants with account balances	2015-01-01	2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0

Financial Data on PSP OF ANESTHESIA SCHEDULING SERVICES, INC. FBO FINE

Measure	Date	Value
2017 : PSP OF ANESTHESIA SCHEDULING SERVICES, INC. FBO FINE 2017 401k financial data
Transfers to/from the plan	2017-12-31	$-146,332
Total plan liabilities at end of year	2017-12-31	$0
Total income from all sources	2017-12-31	$0
Expenses. Total of all expenses incurred	2017-12-31	$0
Total plan assets at end of year	2017-12-31	$0
Total plan assets at beginning of year	2017-12-31	$146,332
Value of fidelity bond covering the plan	2017-12-31	$500,000
Net income (gross income less expenses)	2017-12-31	$0
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$0
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$146,332
2016 : PSP OF ANESTHESIA SCHEDULING SERVICES, INC. FBO FINE 2016 401k financial data
Total income from all sources	2016-12-31	$86,355
Expenses. Total of all expenses incurred	2016-12-31	$0
Total plan assets at end of year	2016-12-31	$146,332
Total plan assets at beginning of year	2016-12-31	$59,977
Value of fidelity bond covering the plan	2016-12-31	$500,000
Other income received	2016-12-31	$9,355
Net income (gross income less expenses)	2016-12-31	$86,355
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$146,332
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$59,977
Total contributions received or receivable from employer(s)	2016-12-31	$77,000
2015 : PSP OF ANESTHESIA SCHEDULING SERVICES, INC. FBO FINE 2015 401k financial data
Total income from all sources	2015-12-31	$59,977
Expenses. Total of all expenses incurred	2015-12-31	$0
Total plan assets at end of year	2015-12-31	$59,977
Total plan assets at beginning of year	2015-12-31	$0
Value of fidelity bond covering the plan	2015-12-31	$500,000
Total contributions received or receivable from participants	2015-12-31	$18,000
Other income received	2015-12-31	$-1,023
Net income (gross income less expenses)	2015-12-31	$59,977
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$59,977
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$0
Total contributions received or receivable from employer(s)	2015-12-31	$43,000

Form 5500 Responses for PSP OF ANESTHESIA SCHEDULING SERVICES, INC. FBO FINE

2017: PSP OF ANESTHESIA SCHEDULING SERVICES, INC. FBO FINE 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	Yes
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: PSP OF ANESTHESIA SCHEDULING SERVICES, INC. FBO FINE 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: PSP OF ANESTHESIA SCHEDULING SERVICES, INC. FBO FINE 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	First time form 5500 has been submitted	Yes
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	ANESTHESIA SCHEDULING SERVICES, INC
Employer identification number (EIN):	464258003
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)