401k Plan data: CASCADE ANESTHESIA, INC. DEFINED BENEFIT PLAN plan

CASCADE ANESTHESIA, INC. DEFINED BENEFIT PLAN 401k Plan overview

Plan Name	CASCADE ANESTHESIA, INC. DEFINED BENEFIT PLAN
Plan identification number	002

CASCADE ANESTHESIA, INC. DEFINED BENEFIT PLAN Benefits

401k Plan Type

Defined Benefit Pension

Plan Features/Benefits

Benefits are primarily pay related
Cash balance or similar plan - Plan has a "cash balance" formula. For this purpose, a "cash balance" formula is a benefit formula in a defined benefit plan by whatever name (for example, personal account plan, pension equity plan, life cycle plan, cash account plan, etc.) that rather than, or in addition to, expressing the accrued benefit as a life annuity commencing at normal retirement age, defines benefits for each employee in terms more common to a defined contribution plan such as a single sum distribution amount (for example, 10 percent of final average pay times years of service, or the amount of the employee's hypothetical account balance).
Code section 414(k) arrangement - Benefits are based partly on the balance of the separate account of the participant (also include appropriate defined contribution pension feature codes).
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

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

Company Name: CASCADE ANESTHESIA, INC.

Employer identification number (EIN): 841270457

NAIC Classification: 621399
NAIC Description: Offices of All Other Miscellaneous Health Practitioners

Additional information about CASCADE ANESTHESIA, INC.

Jurisdiction of Incorporation: Colorado Department of State

Incorporation Date: 1994-05-04

Company Identification Number: 19941051417

Legal Registered Office Address: 9535 E Arbor Place

Englewood
United States of America (USA)
80111-5240

More information about CASCADE ANESTHESIA, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CASCADE ANESTHESIA, INC. DEFINED BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2021-01-01
002 2021-01-01 ROBERT ROTA
002 2020-01-01
002 2019-01-01
002 2018-01-01 ROBERT ROTA ROBERT ROTA 2019-05-31
002 2017-01-01 ROBERT ROTA ROBERT ROTA 2018-07-17
002 2016-01-01 ROBERT ROTA ROBERT ROTA 2017-07-28

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
002	2021-01-01
002	2021-01-01	ROBERT ROTA
002	2020-01-01
002	2019-01-01
002	2018-01-01	ROBERT ROTA	ROBERT ROTA	2019-05-31
002	2017-01-01	ROBERT ROTA	ROBERT ROTA	2018-07-17
002	2016-01-01	ROBERT ROTA	ROBERT ROTA	2017-07-28

Financial Data on CASCADE ANESTHESIA, INC. DEFINED BENEFIT PLAN

Measure	Date	Value
2021 : CASCADE ANESTHESIA, INC. DEFINED BENEFIT PLAN 2021 401k financial data
Total income from all sources	2021-12-31	$186,279
Expenses. Total of all expenses incurred	2021-12-31	$106,626
Benefits paid (including direct rollovers)	2021-12-31	$104,385
Total plan assets at end of year	2021-12-31	$1,458,979
Total plan assets at beginning of year	2021-12-31	$1,379,326
Total contributions received or receivable from participants	2021-12-31	$190,000
Other income received	2021-12-31	$-3,721
Net income (gross income less expenses)	2021-12-31	$79,653
Net plan assets at end of year (total assets less liabilities)	2021-12-31	$1,458,979
Net plan assets at beginning of year (total assets less liabilities)	2021-12-31	$1,379,326
Expenses. Administrative service providers (salaries,fees and commissions)	2021-12-31	$2,241
2020 : CASCADE ANESTHESIA, INC. DEFINED BENEFIT PLAN 2020 401k financial data
Total income from all sources	2020-12-31	$220,996
Expenses. Total of all expenses incurred	2020-12-31	$2,086
Total plan assets at end of year	2020-12-31	$1,379,326
Total plan assets at beginning of year	2020-12-31	$1,160,416
Other income received	2020-12-31	$20,996
Net income (gross income less expenses)	2020-12-31	$218,910
Net plan assets at end of year (total assets less liabilities)	2020-12-31	$1,379,326
Net plan assets at beginning of year (total assets less liabilities)	2020-12-31	$1,160,416
Total contributions received or receivable from employer(s)	2020-12-31	$200,000
Expenses. Administrative service providers (salaries,fees and commissions)	2020-12-31	$2,086
2019 : CASCADE ANESTHESIA, INC. DEFINED BENEFIT PLAN 2019 401k financial data
Total income from all sources	2019-12-31	$363,434
Expenses. Total of all expenses incurred	2019-12-31	$1,761
Total plan assets at end of year	2019-12-31	$1,160,416
Total plan assets at beginning of year	2019-12-31	$798,743
Other income received	2019-12-31	$59,049
Net income (gross income less expenses)	2019-12-31	$361,673
Net plan assets at end of year (total assets less liabilities)	2019-12-31	$1,160,416
Net plan assets at beginning of year (total assets less liabilities)	2019-12-31	$798,743
Total contributions received or receivable from employer(s)	2019-12-31	$304,385
Expenses. Administrative service providers (salaries,fees and commissions)	2019-12-31	$1,761
2018 : CASCADE ANESTHESIA, INC. DEFINED BENEFIT PLAN 2018 401k financial data
Total income from all sources	2018-12-31	$200,305
Expenses. Total of all expenses incurred	2018-12-31	$1,173
Total plan assets at end of year	2018-12-31	$798,743
Total plan assets at beginning of year	2018-12-31	$599,611
Other income received	2018-12-31	$305
Net income (gross income less expenses)	2018-12-31	$199,132
Net plan assets at end of year (total assets less liabilities)	2018-12-31	$798,743
Net plan assets at beginning of year (total assets less liabilities)	2018-12-31	$599,611
Total contributions received or receivable from employer(s)	2018-12-31	$200,000
Expenses. Administrative service providers (salaries,fees and commissions)	2018-12-31	$1,173
2017 : CASCADE ANESTHESIA, INC. DEFINED BENEFIT PLAN 2017 401k financial data
Total income from all sources	2017-12-31	$264,937
Expenses. Total of all expenses incurred	2017-12-31	$1,228
Total plan assets at end of year	2017-12-31	$599,611
Total plan assets at beginning of year	2017-12-31	$335,902
Other income received	2017-12-31	$2,391
Net income (gross income less expenses)	2017-12-31	$263,709
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$599,611
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$335,902
Total contributions received or receivable from employer(s)	2017-12-31	$262,546
Expenses. Administrative service providers (salaries,fees and commissions)	2017-12-31	$1,228
2016 : CASCADE ANESTHESIA, INC. DEFINED BENEFIT PLAN 2016 401k financial data
Total income from all sources	2016-12-31	$335,902
Total plan assets at end of year	2016-12-31	$335,902
Total plan assets at beginning of year	2016-12-31	$0
Net income (gross income less expenses)	2016-12-31	$335,902
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$335,902
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$0
Total contributions received or receivable from employer(s)	2016-12-31	$335,902

Form 5500 Responses for CASCADE ANESTHESIA, INC. DEFINED BENEFIT PLAN

2021: CASCADE ANESTHESIA, INC. DEFINED BENEFIT PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: CASCADE ANESTHESIA, INC. DEFINED BENEFIT PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: CASCADE ANESTHESIA, INC. DEFINED BENEFIT PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: CASCADE ANESTHESIA, INC. DEFINED BENEFIT PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: CASCADE ANESTHESIA, INC. DEFINED BENEFIT PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: CASCADE ANESTHESIA, INC. DEFINED BENEFIT PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	First time form 5500 has been submitted	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	CASCADE ANESTHESIA, INC.
Employer identification number (EIN):	841270457
NAIC Classification:	621399
NAIC Description:	Offices of All Other Miscellaneous Health Practitioners

Jurisdiction of Incorporation:	Colorado Department of State
Incorporation Date:	1994-05-04
Company Identification Number:	19941051417
Legal Registered Office Address:	9535 E Arbor Place Englewood United States of America (USA) 80111-5240