401k Plan data: NORTHERN CALIFORNIA SURGICAL GROUP, A MED. CORP. 401K PROFIT SHARING PLAN plan

NORTHERN CALIFORNIA SURGICAL GROUP, A MED. CORP. 401K PROFIT SHARING PLAN 401k Plan overview

Plan Name	NORTHERN CALIFORNIA SURGICAL GROUP, A MED. CORP. 401K PROFIT SHARING PLAN
Plan identification number	001

NORTHERN CALIFORNIA SURGICAL GROUP, A MED. CORP. 401K 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
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.
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

NORTHERN CALIFORNIA SURGICAL GROUP, A MEDICAL CORP. has sponsored the creation of one or more 401k plans.

Company Name: NORTHERN CALIFORNIA SURGICAL GROUP, A MEDICAL CORP.

Employer identification number (EIN): 680183058

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NORTHERN CALIFORNIA SURGICAL GROUP, A MED. CORP. 401K PROFIT SHARING PLAN

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 LAWRENCE GHELFI
001 2014-01-01 LAWRENCE GHELFI
001 2013-01-01 LAWRENCE GHELFI
001 2012-01-01 LAWRENCE GHELFI
001 2011-01-01 LAWRENCE GHELFI
001 2009-01-01 ROBERT GHELFI ROBERT GHELFI 2010-04-30

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2017-01-01
001	2016-01-01
001	2015-01-01	LAWRENCE GHELFI
001	2014-01-01	LAWRENCE GHELFI
001	2013-01-01	LAWRENCE GHELFI
001	2012-01-01	LAWRENCE GHELFI
001	2011-01-01	LAWRENCE GHELFI
001	2009-01-01	ROBERT GHELFI	ROBERT GHELFI	2010-04-30

Plan Statistics for NORTHERN CALIFORNIA SURGICAL GROUP, A MED. CORP. 401K PROFIT SHARING PLAN

401k plan membership statisitcs for NORTHERN CALIFORNIA SURGICAL GROUP, A MED. CORP. 401K PROFIT SHARING PLAN

Measure Date Value
2017: NORTHERN CALIFORNIA SURGICAL GROUP, A MED. CORP. 401K PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 2
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: NORTHERN CALIFORNIA SURGICAL GROUP, A MED. CORP. 401K PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 14
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 0
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 2
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: NORTHERN CALIFORNIA SURGICAL GROUP, A MED. CORP. 401K PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 15
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 10
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 6
Total of all active and inactive participants 2015-01-01 16
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 16
Number of participants with account balances 2015-01-01 14
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: NORTHERN CALIFORNIA SURGICAL GROUP, A MED. CORP. 401K PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 14
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 12
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 2
Total of all active and inactive participants 2014-01-01 14
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 14
Number of participants with account balances 2014-01-01 14
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: NORTHERN CALIFORNIA SURGICAL GROUP, A MED. CORP. 401K PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 17
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 13
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 1
Total of all active and inactive participants 2013-01-01 14
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 14
Number of participants with account balances 2013-01-01 14
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: NORTHERN CALIFORNIA SURGICAL GROUP, A MED. CORP. 401K PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 19
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 13
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 4
Total of all active and inactive participants 2012-01-01 17
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 17
Number of participants with account balances 2012-01-01 17
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: NORTHERN CALIFORNIA SURGICAL GROUP, A MED. CORP. 401K PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 20
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 14
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 5
Total of all active and inactive participants 2011-01-01 19
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 19
Number of participants with account balances 2011-01-01 19
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: NORTHERN CALIFORNIA SURGICAL GROUP, A MED. CORP. 401K PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 24
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 18
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 5
Total of all active and inactive participants 2009-01-01 23
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 23
Number of participants with account balances 2009-01-01 23
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2017: NORTHERN CALIFORNIA SURGICAL GROUP, A MED. CORP. 401K PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	2
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: NORTHERN CALIFORNIA SURGICAL GROUP, A MED. CORP. 401K PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	14
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	0
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	2
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: NORTHERN CALIFORNIA SURGICAL GROUP, A MED. CORP. 401K PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	15
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	10
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	6
Total of all active and inactive participants	2015-01-01	16
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	16
Number of participants with account balances	2015-01-01	14
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: NORTHERN CALIFORNIA SURGICAL GROUP, A MED. CORP. 401K PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	14
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	12
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	2
Total of all active and inactive participants	2014-01-01	14
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	14
Number of participants with account balances	2014-01-01	14
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: NORTHERN CALIFORNIA SURGICAL GROUP, A MED. CORP. 401K PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	17
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	13
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	1
Total of all active and inactive participants	2013-01-01	14
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	14
Number of participants with account balances	2013-01-01	14
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: NORTHERN CALIFORNIA SURGICAL GROUP, A MED. CORP. 401K PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	19
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	13
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	4
Total of all active and inactive participants	2012-01-01	17
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	17
Number of participants with account balances	2012-01-01	17
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: NORTHERN CALIFORNIA SURGICAL GROUP, A MED. CORP. 401K PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	20
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	14
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	5
Total of all active and inactive participants	2011-01-01	19
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	19
Number of participants with account balances	2011-01-01	19
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: NORTHERN CALIFORNIA SURGICAL GROUP, A MED. CORP. 401K PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	24
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	18
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	5
Total of all active and inactive participants	2009-01-01	23
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	23
Number of participants with account balances	2009-01-01	23
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on NORTHERN CALIFORNIA SURGICAL GROUP, A MED. CORP. 401K PROFIT SHARING PLAN

Measure	Date	Value
2017 : NORTHERN CALIFORNIA SURGICAL GROUP, A MED. CORP. 401K PROFIT SHARING PLAN 2017 401k financial data
Total plan liabilities at end of year	2017-04-30	$0
Total plan liabilities at beginning of year	2017-04-30	$0
Total income from all sources	2017-04-30	$1,618
Expenses. Total of all expenses incurred	2017-04-30	$158,900
Benefits paid (including direct rollovers)	2017-04-30	$158,900
Total plan assets at end of year	2017-04-30	$0
Total plan assets at beginning of year	2017-04-30	$157,282
Value of fidelity bond covering the plan	2017-04-30	$500,000
Total contributions received or receivable from participants	2017-04-30	$0
Expenses. Other expenses not covered elsewhere	2017-04-30	$0
Contributions received from other sources (not participants or employers)	2017-04-30	$0
Other income received	2017-04-30	$1,618
Noncash contributions received	2017-04-30	$0
Net income (gross income less expenses)	2017-04-30	$-157,282
Net plan assets at end of year (total assets less liabilities)	2017-04-30	$0
Net plan assets at beginning of year (total assets less liabilities)	2017-04-30	$157,282
Total contributions received or receivable from employer(s)	2017-04-30	$0
Value of certain deemed distributions of participant loans	2017-04-30	$0
Value of corrective distributions	2017-04-30	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2017-04-30	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-04-30	$0
2016 : NORTHERN CALIFORNIA SURGICAL GROUP, A MED. CORP. 401K 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	$184,454
Expenses. Total of all expenses incurred	2016-12-31	$6,669,641
Benefits paid (including direct rollovers)	2016-12-31	$6,642,365
Total plan assets at end of year	2016-12-31	$157,282
Total plan assets at beginning of year	2016-12-31	$6,642,469
Value of fidelity bond covering the plan	2016-12-31	$500,000
Assets. Value of tangible personal property	2016-12-31	$0
Total contributions received or receivable from participants	2016-12-31	$0
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	$184,454
Noncash contributions received	2016-12-31	$0
Net income (gross income less expenses)	2016-12-31	$-6,485,187
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$157,282
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$6,642,469
Assets. Value of assets in partnership/joint-venture interests	2016-12-31	$14,531
Total contributions received or receivable from employer(s)	2016-12-31	$0
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	$27,276
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
2015 : NORTHERN CALIFORNIA SURGICAL GROUP, A MED. CORP. 401K PROFIT SHARING PLAN 2015 401k financial data
Total plan liabilities at end of year	2015-12-31	$0
Total plan liabilities at beginning of year	2015-12-31	$0
Total income from all sources	2015-12-31	$76,968
Expenses. Total of all expenses incurred	2015-12-31	$1,376,153
Benefits paid (including direct rollovers)	2015-12-31	$1,330,242
Total plan assets at end of year	2015-12-31	$6,642,469
Total plan assets at beginning of year	2015-12-31	$7,941,654
Value of fidelity bond covering the plan	2015-12-31	$500,000
Assets. Value of tangible personal property	2015-12-31	$4,000
Total contributions received or receivable from participants	2015-12-31	$83,903
Expenses. Other expenses not covered elsewhere	2015-12-31	$0
Contributions received from other sources (not participants or employers)	2015-12-31	$0
Other income received	2015-12-31	$-89,717
Noncash contributions received	2015-12-31	$0
Net income (gross income less expenses)	2015-12-31	$-1,299,185
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$6,642,469
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$7,941,654
Assets. Value of assets in partnership/joint-venture interests	2015-12-31	$14,531
Total contributions received or receivable from employer(s)	2015-12-31	$82,782
Value of certain deemed distributions of participant loans	2015-12-31	$0
Value of corrective distributions	2015-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2015-12-31	$45,911
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
2014 : NORTHERN CALIFORNIA SURGICAL GROUP, A MED. CORP. 401K PROFIT SHARING PLAN 2014 401k financial data
Total plan liabilities at end of year	2014-12-31	$0
Total plan liabilities at beginning of year	2014-12-31	$0
Total income from all sources	2014-12-31	$725,010
Expenses. Total of all expenses incurred	2014-12-31	$576,261
Benefits paid (including direct rollovers)	2014-12-31	$530,667
Total plan assets at end of year	2014-12-31	$7,941,654
Total plan assets at beginning of year	2014-12-31	$7,792,905
Value of fidelity bond covering the plan	2014-12-31	$500,000
Assets. Value of tangible personal property	2014-12-31	$4,000
Total contributions received or receivable from participants	2014-12-31	$65,404
Expenses. Other expenses not covered elsewhere	2014-12-31	$0
Contributions received from other sources (not participants or employers)	2014-12-31	$158,837
Other income received	2014-12-31	$413,305
Noncash contributions received	2014-12-31	$0
Net income (gross income less expenses)	2014-12-31	$148,749
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$7,941,654
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$7,792,905
Assets. Value of assets in partnership/joint-venture interests	2014-12-31	$14,531
Total contributions received or receivable from employer(s)	2014-12-31	$87,464
Value of certain deemed distributions of participant loans	2014-12-31	$0
Value of corrective distributions	2014-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2014-12-31	$45,594
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
2013 : NORTHERN CALIFORNIA SURGICAL GROUP, A MED. CORP. 401K PROFIT SHARING PLAN 2013 401k financial data
Transfers to/from the plan	2013-12-31	$0
Total plan liabilities at end of year	2013-12-31	$0
Total plan liabilities at beginning of year	2013-12-31	$3,950
Total income from all sources	2013-12-31	$1,665,504
Expenses. Total of all expenses incurred	2013-12-31	$153,406
Benefits paid (including direct rollovers)	2013-12-31	$116,446
Total plan assets at end of year	2013-12-31	$7,792,905
Total plan assets at beginning of year	2013-12-31	$6,284,757
Value of fidelity bond covering the plan	2013-12-31	$500,000
Assets. Value of tangible personal property	2013-12-31	$4,000
Total contributions received or receivable from participants	2013-12-31	$86,362
Expenses. Other expenses not covered elsewhere	2013-12-31	$0
Contributions received from other sources (not participants or employers)	2013-12-31	$0
Other income received	2013-12-31	$1,523,332
Noncash contributions received	2013-12-31	$0
Net income (gross income less expenses)	2013-12-31	$1,512,098
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$7,792,905
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$6,280,807
Assets. Value of participant loans	2013-12-31	$0
Assets. Value of assets in partnership/joint-venture interests	2013-12-31	$14,531
Total contributions received or receivable from employer(s)	2013-12-31	$55,810
Value of certain deemed distributions of participant loans	2013-12-31	$0
Value of corrective distributions	2013-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2013-12-31	$36,960
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
2012 : NORTHERN CALIFORNIA SURGICAL GROUP, A MED. CORP. 401K PROFIT SHARING PLAN 2012 401k financial data
Transfers to/from the plan	2012-12-31	$0
Total plan liabilities at end of year	2012-12-31	$3,950
Total plan liabilities at beginning of year	2012-12-31	$3,950
Total income from all sources	2012-12-31	$913,825
Expenses. Total of all expenses incurred	2012-12-31	$199,625
Benefits paid (including direct rollovers)	2012-12-31	$167,470
Total plan assets at end of year	2012-12-31	$6,284,757
Total plan assets at beginning of year	2012-12-31	$5,570,557
Value of fidelity bond covering the plan	2012-12-31	$500,000
Assets. Value of tangible personal property	2012-12-31	$4,000
Total contributions received or receivable from participants	2012-12-31	$82,224
Expenses. Other expenses not covered elsewhere	2012-12-31	$0
Contributions received from other sources (not participants or employers)	2012-12-31	$17,898
Other income received	2012-12-31	$675,011
Noncash contributions received	2012-12-31	$0
Net income (gross income less expenses)	2012-12-31	$714,200
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$6,280,807
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$5,566,607
Assets. Value of participant loans	2012-12-31	$698
Assets. Value of assets in partnership/joint-venture interests	2012-12-31	$14,531
Total contributions received or receivable from employer(s)	2012-12-31	$138,692
Value of certain deemed distributions of participant loans	2012-12-31	$0
Value of corrective distributions	2012-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2012-12-31	$32,155
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
2011 : NORTHERN CALIFORNIA SURGICAL GROUP, A MED. CORP. 401K PROFIT SHARING PLAN 2011 401k financial data
Total plan liabilities at end of year	2011-12-31	$3,950
Total plan liabilities at beginning of year	2011-12-31	$0
Total income from all sources	2011-12-31	$29,900
Expenses. Total of all expenses incurred	2011-12-31	$127,641
Benefits paid (including direct rollovers)	2011-12-31	$101,459
Total plan assets at end of year	2011-12-31	$5,570,557
Total plan assets at beginning of year	2011-12-31	$5,664,348
Value of fidelity bond covering the plan	2011-12-31	$500,000
Assets. Value of tangible personal property	2011-12-31	$4,000
Total contributions received or receivable from participants	2011-12-31	$90,218
Expenses. Other expenses not covered elsewhere	2011-12-31	$0
Contributions received from other sources (not participants or employers)	2011-12-31	$0
Other income received	2011-12-31	$-207,340
Noncash contributions received	2011-12-31	$0
Net income (gross income less expenses)	2011-12-31	$-97,741
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$5,566,607
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$5,664,348
Assets. Value of participant loans	2011-12-31	$1,037
Assets. Value of assets in partnership/joint-venture interests	2011-12-31	$14,531
Total contributions received or receivable from employer(s)	2011-12-31	$147,022
Value of certain deemed distributions of participant loans	2011-12-31	$0
Value of corrective distributions	2011-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$26,182
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
2010 : NORTHERN CALIFORNIA SURGICAL GROUP, A MED. CORP. 401K PROFIT SHARING PLAN 2010 401k financial data
Transfers to/from the plan	2010-12-31	$0
Total plan liabilities at end of year	2010-12-31	$0
Total plan liabilities at beginning of year	2010-12-31	$0
Total income from all sources	2010-12-31	$826,948
Expenses. Total of all expenses incurred	2010-12-31	$590,639
Benefits paid (including direct rollovers)	2010-12-31	$566,066
Total plan assets at end of year	2010-12-31	$5,664,348
Total plan assets at beginning of year	2010-12-31	$5,428,039
Value of fidelity bond covering the plan	2010-12-31	$500,000
Assets. Value of tangible personal property	2010-12-31	$4,000
Total contributions received or receivable from participants	2010-12-31	$83,180
Expenses. Other expenses not covered elsewhere	2010-12-31	$0
Contributions received from other sources (not participants or employers)	2010-12-31	$0
Other income received	2010-12-31	$598,564
Noncash contributions received	2010-12-31	$0
Net income (gross income less expenses)	2010-12-31	$236,309
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$5,664,348
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$5,428,039
Assets. Value of participant loans	2010-12-31	$9,340
Assets. Value of assets in partnership/joint-venture interests	2010-12-31	$14,531
Total contributions received or receivable from employer(s)	2010-12-31	$145,204
Value of certain deemed distributions of participant loans	2010-12-31	$0
Value of corrective distributions	2010-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$24,573
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
2009 : NORTHERN CALIFORNIA SURGICAL GROUP, A MED. CORP. 401K PROFIT SHARING PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for NORTHERN CALIFORNIA SURGICAL GROUP, A MED. CORP. 401K PROFIT SHARING PLAN

2017: NORTHERN CALIFORNIA SURGICAL GROUP, A MED. CORP. 401K PROFIT SHARING PLAN 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)	Yes
2017-01-01	Plan is a collectively bargained plan	No
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: NORTHERN CALIFORNIA SURGICAL GROUP, A MED. CORP. 401K PROFIT SHARING PLAN 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 – 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
2015: NORTHERN CALIFORNIA SURGICAL GROUP, A MED. CORP. 401K PROFIT SHARING PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
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 – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: NORTHERN CALIFORNIA SURGICAL GROUP, A MED. CORP. 401K PROFIT SHARING PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: NORTHERN CALIFORNIA SURGICAL GROUP, A MED. CORP. 401K PROFIT SHARING PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: NORTHERN CALIFORNIA SURGICAL GROUP, A MED. CORP. 401K PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: NORTHERN CALIFORNIA SURGICAL GROUP, A MED. CORP. 401K PROFIT SHARING PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: NORTHERN CALIFORNIA SURGICAL GROUP, A MED. CORP. 401K PROFIT SHARING PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

69545

Policy instance

Insurance contract or identification number	69545
Number of Individuals Covered	0
Insurance policy start date	2016-01-01
Insurance policy end date	2016-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $1,979
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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
Amount paid for insurance broker fees	998
Additional information about fees paid to insurance broker	TPA COMPENSATION
Insurance broker organization code?	5
Insurance broker name	KMS FINANCIAL SERVICES, INC.

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

69545

Policy instance

Insurance contract or identification number	69545
Number of Individuals Covered	7
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $2,480
Total amount of fees paid to insurance company	USD $400
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,480
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	BROKER COMMISSION
Insurance broker organization code?	3
Insurance broker name	BIDWELL CONSULTING SERVICES, INC.

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

69545

Policy instance

Insurance contract or identification number	69545
Number of Individuals Covered	8
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $2,233
Total amount of fees paid to insurance company	USD $374
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Broker	USD $2,233
Insurance broker organization code?	3
Amount paid for insurance broker fees	374
Additional information about fees paid to insurance broker	TPA COMPENSATION
Insurance broker name	BIDWELL CONSULTING SERVICES, INC.

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

69545

Policy instance

Insurance contract or identification number	69545
Number of Individuals Covered	8
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $1,616
Total amount of fees paid to insurance company	USD $612
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Broker	USD $1,616
Insurance broker organization code?	3
Amount paid for insurance broker fees	612
Additional information about fees paid to insurance broker	TPA COMPENSATION
Insurance broker name	BIDWELL CONSULTING SERVICES, INC.

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

69545

Policy instance

Insurance contract or identification number	69545
Number of Individuals Covered	11
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $1,315
Total amount of fees paid to insurance company	USD $131
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Broker	USD $1,315
Insurance broker organization code?	3
Amount paid for insurance broker fees	131
Additional information about fees paid to insurance broker	TPA COMPENSATION
Insurance broker name	BIDWELL CONSULTING SERVICES, INC.

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

69545

Policy instance

Insurance contract or identification number	69545
Number of Individuals Covered	12
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $1,101
Total amount of fees paid to insurance company	USD $109
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

69545

Policy instance

Insurance contract or identification number	69545
Number of Individuals Covered	12
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $779
Total amount of fees paid to insurance company	USD $73
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Broker	USD $779
Insurance broker organization code?	3
Amount paid for insurance broker fees	73
Additional information about fees paid to insurance broker	TPA COMPENSATION
Insurance broker name	BIDWELL CONSULTING SERVICES, INC.

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Company Name:	NORTHERN CALIFORNIA SURGICAL GROUP, A MEDICAL CORP.
Employer identification number (EIN):	680183058
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)