401k Plan data: 401(K) PROFIT-SHARING PLAN OF PACIFIC CLINICS plan

401(K) PROFIT-SHARING PLAN OF PACIFIC CLINICS 401k Plan overview

Plan Name	401(K) PROFIT-SHARING PLAN OF PACIFIC CLINICS
Plan identification number	006

401(K) PROFIT-SHARING PLAN OF PACIFIC CLINICS Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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.
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.
Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
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

PACIFIC CLINICS has sponsored the creation of one or more 401k plans.

Company Name: PACIFIC CLINICS

Employer identification number (EIN): 951644034

NAIC Classification: 621420
NAIC Description: Outpatient Mental Health and Substance Abuse Centers

Additional information about PACIFIC CLINICS

Jurisdiction of Incorporation: California Department of State

Incorporation Date:

Company Identification Number: C0194267

More information about PACIFIC CLINICS

Form 5500 Filing Information

Submission information for form 5500 for 401k plan 401(K) PROFIT-SHARING PLAN OF PACIFIC CLINICS

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
006 2020-05-01
006 2020-05-01
006 2019-05-01
006 2018-05-01
006 2017-05-01 JOSEPH WONG
006 2016-05-01 JOSEPH WONG 2018-02-12 JOSEPH WONG 2018-02-12

Plan Statistics for 401(K) PROFIT-SHARING PLAN OF PACIFIC CLINICS

401k plan membership statisitcs for 401(K) PROFIT-SHARING PLAN OF PACIFIC CLINICS

Measure Date Value
2020: 401(K) PROFIT-SHARING PLAN OF PACIFIC CLINICS 2020 401k membership
Total participants, beginning-of-year 2020-05-01 142
Total number of active participants reported on line 7a of the Form 5500 2020-05-01 113
Number of retired or separated participants receiving benefits 2020-05-01 0
Number of other retired or separated participants entitled to future benefits 2020-05-01 25
Total of all active and inactive participants 2020-05-01 138
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-05-01 0
Total participants 2020-05-01 138
Number of participants with account balances 2020-05-01 135
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-05-01 16
2019: 401(K) PROFIT-SHARING PLAN OF PACIFIC CLINICS 2019 401k membership
Total participants, beginning-of-year 2019-05-01 107
Total number of active participants reported on line 7a of the Form 5500 2019-05-01 123
Number of retired or separated participants receiving benefits 2019-05-01 0
Number of other retired or separated participants entitled to future benefits 2019-05-01 19
Total of all active and inactive participants 2019-05-01 142
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-05-01 0
Total participants 2019-05-01 142
Number of participants with account balances 2019-05-01 136
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-05-01 1
2018: 401(K) PROFIT-SHARING PLAN OF PACIFIC CLINICS 2018 401k membership
Total participants, beginning-of-year 2018-05-01 100
Total number of active participants reported on line 7a of the Form 5500 2018-05-01 94
Number of retired or separated participants receiving benefits 2018-05-01 0
Number of other retired or separated participants entitled to future benefits 2018-05-01 13
Total of all active and inactive participants 2018-05-01 107
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-05-01 0
Total participants 2018-05-01 107
Number of participants with account balances 2018-05-01 103
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-05-01 0
2017: 401(K) PROFIT-SHARING PLAN OF PACIFIC CLINICS 2017 401k membership
Total participants, beginning-of-year 2017-05-01 92
Total number of active participants reported on line 7a of the Form 5500 2017-05-01 95
Number of retired or separated participants receiving benefits 2017-05-01 0
Number of other retired or separated participants entitled to future benefits 2017-05-01 5
Total of all active and inactive participants 2017-05-01 100
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-05-01 0
Total participants 2017-05-01 100
Number of participants with account balances 2017-05-01 97
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-05-01 0

Measure	Date	Value
2020: 401(K) PROFIT-SHARING PLAN OF PACIFIC CLINICS 2020 401k membership
Total participants, beginning-of-year	2020-05-01	142
Total number of active participants reported on line 7a of the Form 5500	2020-05-01	113
Number of retired or separated participants receiving benefits	2020-05-01	0
Number of other retired or separated participants entitled to future benefits	2020-05-01	25
Total of all active and inactive participants	2020-05-01	138
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-05-01	0
Total participants	2020-05-01	138
Number of participants with account balances	2020-05-01	135
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-05-01	16
2019: 401(K) PROFIT-SHARING PLAN OF PACIFIC CLINICS 2019 401k membership
Total participants, beginning-of-year	2019-05-01	107
Total number of active participants reported on line 7a of the Form 5500	2019-05-01	123
Number of retired or separated participants receiving benefits	2019-05-01	0
Number of other retired or separated participants entitled to future benefits	2019-05-01	19
Total of all active and inactive participants	2019-05-01	142
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-05-01	0
Total participants	2019-05-01	142
Number of participants with account balances	2019-05-01	136
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-05-01	1
2018: 401(K) PROFIT-SHARING PLAN OF PACIFIC CLINICS 2018 401k membership
Total participants, beginning-of-year	2018-05-01	100
Total number of active participants reported on line 7a of the Form 5500	2018-05-01	94
Number of retired or separated participants receiving benefits	2018-05-01	0
Number of other retired or separated participants entitled to future benefits	2018-05-01	13
Total of all active and inactive participants	2018-05-01	107
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-05-01	0
Total participants	2018-05-01	107
Number of participants with account balances	2018-05-01	103
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-05-01	0
2017: 401(K) PROFIT-SHARING PLAN OF PACIFIC CLINICS 2017 401k membership
Total participants, beginning-of-year	2017-05-01	92
Total number of active participants reported on line 7a of the Form 5500	2017-05-01	95
Number of retired or separated participants receiving benefits	2017-05-01	0
Number of other retired or separated participants entitled to future benefits	2017-05-01	5
Total of all active and inactive participants	2017-05-01	100
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-05-01	0
Total participants	2017-05-01	100
Number of participants with account balances	2017-05-01	97
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-05-01	0

Financial Data on 401(K) PROFIT-SHARING PLAN OF PACIFIC CLINICS

Measure	Date	Value
2021 : 401(K) PROFIT-SHARING PLAN OF PACIFIC CLINICS 2021 401k financial data
Unrealized appreciation/depreciation of real estate assets	2021-04-30	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2021-04-30	$0
Total unrealized appreciation/depreciation of assets	2021-04-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-04-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-04-30	$0
Expenses. Interest paid	2021-04-30	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2021-04-30	$0
Total income from all sources (including contributions)	2021-04-30	$474,644
Total loss/gain on sale of assets	2021-04-30	$0
Total of all expenses incurred	2021-04-30	$112,865
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-04-30	$111,871
Expenses. Certain deemed distributions of participant loans	2021-04-30	$0
Value of total corrective distributions	2021-04-30	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-04-30	$207,684
Value of total assets at end of year	2021-04-30	$1,444,798
Value of total assets at beginning of year	2021-04-30	$1,083,019
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-04-30	$994
Total income from rents	2021-04-30	$0
Total interest from all sources	2021-04-30	$3,158
Total dividends received (eg from common stock, registered investment company shares)	2021-04-30	$12,547
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-04-30	No
Total dividends received from registered investment company shares (eg mutual funds)	2021-04-30	$12,547
Assets. Real estate other than employer real property at end of year	2021-04-30	$0
Assets. Real estate other than employer real property at beginning of year	2021-04-30	$0
Administrative expenses professional fees incurred	2021-04-30	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2021-04-30	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2021-04-30	$0
Was this plan covered by a fidelity bond	2021-04-30	Yes
Value of fidelity bond cover	2021-04-30	$1,000,000
If this is an individual account plan, was there a blackout period	2021-04-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-04-30	$0
Were there any nonexempt tranactions with any party-in-interest	2021-04-30	No
Contributions received from participants	2021-04-30	$162,686
Participant contributions at end of year	2021-04-30	$2,169
Participant contributions at beginning of year	2021-04-30	$2,279
Participant contributions at end of year	2021-04-30	$0
Participant contributions at beginning of year	2021-04-30	$4,828
Assets. Other investments not covered elsewhere at end of year	2021-04-30	$0
Assets. Other investments not covered elsewhere at beginning of year	2021-04-30	$0
Income. Received or receivable in cash from other sources (including rollovers)	2021-04-30	$44,998
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2021-04-30	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2021-04-30	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2021-04-30	$0
Assets. Loans (other than to participants) at end of year	2021-04-30	$0
Assets. Loans (other than to participants) at beginning of year	2021-04-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2021-04-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2021-04-30	$0
Other income not declared elsewhere	2021-04-30	$0
Administrative expenses (other) incurred	2021-04-30	$0
Liabilities. Value of operating payables at end of year	2021-04-30	$0
Liabilities. Value of operating payables at beginning of year	2021-04-30	$0
Total non interest bearing cash at end of year	2021-04-30	$0
Total non interest bearing cash at beginning of year	2021-04-30	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-04-30	No
Income. Non cash contributions	2021-04-30	$0
Value of net income/loss	2021-04-30	$361,779
Value of net assets at end of year (total assets less liabilities)	2021-04-30	$1,444,798
Value of net assets at beginning of year (total assets less liabilities)	2021-04-30	$1,083,019
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-04-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-04-30	No
Were any leases to which the plan was party in default or uncollectible	2021-04-30	No
Assets. partnership/joint venture interests at end of year	2021-04-30	$0
Assets. partnership/joint venture interests at beginning of year	2021-04-30	$0
Investment advisory and management fees	2021-04-30	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-04-30	$1,062,255
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-04-30	$577,737
Value of interest in pooled separate accounts at end of year	2021-04-30	$0
Value of interest in pooled separate accounts at beginning of year	2021-04-30	$0
Interest on participant loans	2021-04-30	$127
Income. Interest from loans (other than to participants)	2021-04-30	$0
Interest earned on other investments	2021-04-30	$3,031
Income. Interest from US Government securities	2021-04-30	$0
Income. Interest from corporate debt instruments	2021-04-30	$0
Value of interest in master investment trust accounts at end of year	2021-04-30	$0
Value of interest in master investment trust accounts at beginning of year	2021-04-30	$0
Value of interest in common/collective trusts at end of year	2021-04-30	$0
Value of interest in common/collective trusts at beginning of year	2021-04-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2021-04-30	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2021-04-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2021-04-30	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2021-04-30	$0
Assets. Value of investments in 103.12 investment entities at end of year	2021-04-30	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2021-04-30	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-04-30	$380,374
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-04-30	$287,787
Expenses. Payments to insurance carriers foe the provision of benefits	2021-04-30	$0
Asset value of US Government securities at end of year	2021-04-30	$0
Asset value of US Government securities at beginning of year	2021-04-30	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-04-30	$161,463
Net investment gain/loss from pooled separate accounts	2021-04-30	$89,792
Net investment gain or loss from common/collective trusts	2021-04-30	$0
Net gain/loss from 103.12 investment entities	2021-04-30	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-04-30	No
Was there a failure to transmit to the plan any participant contributions	2021-04-30	No
Has the plan failed to provide any benefit when due under the plan	2021-04-30	No
Assets. Invements in employer securities at end of year	2021-04-30	$0
Assets. Invements in employer securities at beginning of year	2021-04-30	$0
Assets. Value of employer real property at end of year	2021-04-30	$0
Assets. Value of employer real property at beginning of year	2021-04-30	$0
Contributions received in cash from employer	2021-04-30	$0
Employer contributions (assets) at end of year	2021-04-30	$0
Employer contributions (assets) at beginning of year	2021-04-30	$210,388
Income. Dividends from preferred stock	2021-04-30	$0
Income. Dividends from common stock	2021-04-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-04-30	$111,871
Asset. Corporate debt instrument preferred debt at end of year	2021-04-30	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2021-04-30	$0
Asset. Corporate debt instrument debt (other) at end of year	2021-04-30	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2021-04-30	$0
Contract administrator fees	2021-04-30	$994
Assets. Corporate common stocks other than exployer securities at end of year	2021-04-30	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2021-04-30	$0
Liabilities. Value of benefit claims payable at end of year	2021-04-30	$0
Liabilities. Value of benefit claims payable at beginning of year	2021-04-30	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2021-04-30	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2021-04-30	$0
Did the plan have assets held for investment	2021-04-30	Yes
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	2021-04-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-04-30	No
Aggregate proceeds on sale of assets	2021-04-30	$0
Aggregate carrying amount (costs) on sale of assets	2021-04-30	$0
Liabilities. Value of acquisition indebtedness at end of year	2021-04-30	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2021-04-30	$0
Opinion of an independent qualified public accountant for this plan	2021-04-30	Disclaimer
Accountancy firm name	2021-04-30	RMS US LLP
Accountancy firm EIN	2021-04-30	420714325
2020 : 401(K) PROFIT-SHARING PLAN OF PACIFIC CLINICS 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-04-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-04-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-04-30	$0
Total income from all sources (including contributions)	2020-04-30	$511,681
Total loss/gain on sale of assets	2020-04-30	$0
Total of all expenses incurred	2020-04-30	$19,216
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-04-30	$19,216
Expenses. Certain deemed distributions of participant loans	2020-04-30	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-04-30	$522,550
Value of total assets at end of year	2020-04-30	$1,083,019
Value of total assets at beginning of year	2020-04-30	$590,554
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-04-30	$0
Total interest from all sources	2020-04-30	$4,185
Total dividends received (eg from common stock, registered investment company shares)	2020-04-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-04-30	No
Was this plan covered by a fidelity bond	2020-04-30	Yes
Value of fidelity bond cover	2020-04-30	$1,000,000
If this is an individual account plan, was there a blackout period	2020-04-30	No
Were there any nonexempt tranactions with any party-in-interest	2020-04-30	No
Contributions received from participants	2020-04-30	$133,814
Participant contributions at end of year	2020-04-30	$2,279
Participant contributions at beginning of year	2020-04-30	$0
Participant contributions at end of year	2020-04-30	$4,828
Income. Received or receivable in cash from other sources (including rollovers)	2020-04-30	$14,098
Other income not declared elsewhere	2020-04-30	$0
Administrative expenses (other) incurred	2020-04-30	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-04-30	No
Value of net income/loss	2020-04-30	$492,465
Value of net assets at end of year (total assets less liabilities)	2020-04-30	$1,083,019
Value of net assets at beginning of year (total assets less liabilities)	2020-04-30	$590,554
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-04-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-04-30	No
Were any leases to which the plan was party in default or uncollectible	2020-04-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-04-30	$577,737
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-04-30	$386,511
Interest on participant loans	2020-04-30	$134
Interest earned on other investments	2020-04-30	$4,051
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-04-30	$287,787
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-04-30	$204,043
Expenses. Payments to insurance carriers foe the provision of benefits	2020-04-30	$0
Net investment gain/loss from pooled separate accounts	2020-04-30	$-15,054
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-04-30	No
Was there a failure to transmit to the plan any participant contributions	2020-04-30	No
Has the plan failed to provide any benefit when due under the plan	2020-04-30	No
Contributions received in cash from employer	2020-04-30	$374,638
Employer contributions (assets) at end of year	2020-04-30	$210,388
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-04-30	$19,216
Did the plan have assets held for investment	2020-04-30	Yes
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	2020-04-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-04-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2020-04-30	Yes
Opinion of an independent qualified public accountant for this plan	2020-04-30	Disclaimer
Accountancy firm name	2020-04-30	RSM US LLP
Accountancy firm EIN	2020-04-30	420714325
2019 : 401(K) PROFIT-SHARING PLAN OF PACIFIC CLINICS 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-04-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-04-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-04-30	$0
Total income from all sources (including contributions)	2019-04-30	$307,312
Total loss/gain on sale of assets	2019-04-30	$0
Total of all expenses incurred	2019-04-30	$10,994
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-04-30	$10,994
Expenses. Certain deemed distributions of participant loans	2019-04-30	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-04-30	$284,654
Value of total assets at end of year	2019-04-30	$590,554
Value of total assets at beginning of year	2019-04-30	$294,236
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-04-30	$0
Total interest from all sources	2019-04-30	$2,661
Total dividends received (eg from common stock, registered investment company shares)	2019-04-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-04-30	No
Was this plan covered by a fidelity bond	2019-04-30	Yes
Value of fidelity bond cover	2019-04-30	$2,000,000
If this is an individual account plan, was there a blackout period	2019-04-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-04-30	$0
Were there any nonexempt tranactions with any party-in-interest	2019-04-30	No
Contributions received from participants	2019-04-30	$101,455
Income. Received or receivable in cash from other sources (including rollovers)	2019-04-30	$4,739
Other income not declared elsewhere	2019-04-30	$0
Administrative expenses (other) incurred	2019-04-30	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-04-30	No
Value of net income/loss	2019-04-30	$296,318
Value of net assets at end of year (total assets less liabilities)	2019-04-30	$590,554
Value of net assets at beginning of year (total assets less liabilities)	2019-04-30	$294,236
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-04-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-04-30	No
Were any leases to which the plan was party in default or uncollectible	2019-04-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-04-30	$386,511
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-04-30	$192,313
Interest on participant loans	2019-04-30	$0
Interest earned on other investments	2019-04-30	$2,661
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-04-30	$204,043
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-04-30	$101,923
Expenses. Payments to insurance carriers foe the provision of benefits	2019-04-30	$0
Net investment gain/loss from pooled separate accounts	2019-04-30	$19,997
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-04-30	No
Was there a failure to transmit to the plan any participant contributions	2019-04-30	No
Has the plan failed to provide any benefit when due under the plan	2019-04-30	No
Contributions received in cash from employer	2019-04-30	$178,460
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-04-30	$10,994
Did the plan have assets held for investment	2019-04-30	Yes
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	2019-04-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-04-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-04-30	Yes
Opinion of an independent qualified public accountant for this plan	2019-04-30	Disclaimer
Accountancy firm name	2019-04-30	RSM US LLP
Accountancy firm EIN	2019-04-30	420714325
2018 : 401(K) PROFIT-SHARING PLAN OF PACIFIC CLINICS 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-04-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-04-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-04-30	$0
Total income from all sources (including contributions)	2018-04-30	$239,182
Total loss/gain on sale of assets	2018-04-30	$0
Total of all expenses incurred	2018-04-30	$1,828
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-04-30	$1,828
Expenses. Certain deemed distributions of participant loans	2018-04-30	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-04-30	$228,535
Value of total assets at end of year	2018-04-30	$294,236
Value of total assets at beginning of year	2018-04-30	$56,882
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-04-30	$0
Total interest from all sources	2018-04-30	$1,049
Total dividends received (eg from common stock, registered investment company shares)	2018-04-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-04-30	No
Was this plan covered by a fidelity bond	2018-04-30	Yes
Value of fidelity bond cover	2018-04-30	$2,000,000
If this is an individual account plan, was there a blackout period	2018-04-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-04-30	$0
Were there any nonexempt tranactions with any party-in-interest	2018-04-30	No
Contributions received from participants	2018-04-30	$86,719
Income. Received or receivable in cash from other sources (including rollovers)	2018-04-30	$2,866
Other income not declared elsewhere	2018-04-30	$0
Administrative expenses (other) incurred	2018-04-30	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-04-30	No
Value of net income/loss	2018-04-30	$237,354
Value of net assets at end of year (total assets less liabilities)	2018-04-30	$294,236
Value of net assets at beginning of year (total assets less liabilities)	2018-04-30	$56,882
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-04-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-04-30	No
Were any leases to which the plan was party in default or uncollectible	2018-04-30	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-04-30	$192,313
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-04-30	$39,980
Interest on participant loans	2018-04-30	$0
Interest earned on other investments	2018-04-30	$1,049
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-04-30	$101,923
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-04-30	$16,902
Expenses. Payments to insurance carriers foe the provision of benefits	2018-04-30	$0
Net investment gain/loss from pooled separate accounts	2018-04-30	$9,598
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-04-30	No
Was there a failure to transmit to the plan any participant contributions	2018-04-30	No
Has the plan failed to provide any benefit when due under the plan	2018-04-30	No
Contributions received in cash from employer	2018-04-30	$138,950
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-04-30	$1,828
Did the plan have assets held for investment	2018-04-30	Yes
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	2018-04-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-04-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-04-30	Yes
Opinion of an independent qualified public accountant for this plan	2018-04-30	Disclaimer
Accountancy firm name	2018-04-30	RSM US LLP
Accountancy firm EIN	2018-04-30	420714325

Form 5500 Responses for 401(K) PROFIT-SHARING PLAN OF PACIFIC CLINICS

2020: 401(K) PROFIT-SHARING PLAN OF PACIFIC CLINICS 2020 form 5500 responses
2020-05-01	Type of plan entity	Single employer plan
2020-05-01	Submission has been amended	Yes
2020-05-01	This submission is the final filing	No
2020-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-05-01	Plan is a collectively bargained plan	No
2020-05-01	Plan funding arrangement – Insurance	Yes
2020-05-01	Plan funding arrangement – Trust	Yes
2020-05-01	Plan benefit arrangement – Insurance	Yes
2020-05-01	Plan benefit arrangement - Trust	Yes
2019: 401(K) PROFIT-SHARING PLAN OF PACIFIC CLINICS 2019 form 5500 responses
2019-05-01	Type of plan entity	Single employer plan
2019-05-01	Submission has been amended	No
2019-05-01	This submission is the final filing	No
2019-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-05-01	Plan is a collectively bargained plan	No
2019-05-01	Plan funding arrangement – Insurance	Yes
2019-05-01	Plan benefit arrangement – Insurance	Yes
2018: 401(K) PROFIT-SHARING PLAN OF PACIFIC CLINICS 2018 form 5500 responses
2018-05-01	Type of plan entity	Single employer plan
2018-05-01	Submission has been amended	No
2018-05-01	This submission is the final filing	No
2018-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-05-01	Plan is a collectively bargained plan	No
2018-05-01	Plan funding arrangement – Insurance	Yes
2018-05-01	Plan benefit arrangement – Insurance	Yes
2017: 401(K) PROFIT-SHARING PLAN OF PACIFIC CLINICS 2017 form 5500 responses
2017-05-01	Type of plan entity	Single employer plan
2017-05-01	Submission has been amended	No
2017-05-01	This submission is the final filing	No
2017-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-05-01	Plan is a collectively bargained plan	No
2017-05-01	Plan funding arrangement – Insurance	Yes
2017-05-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

140027-01

Policy instance

Insurance contract or identification number	140027-01
Number of Individuals Covered	54
Insurance policy start date	2020-05-01
Insurance policy end date	2021-04-30
Are there contracts with allocated funds for individual policies?	0
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?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
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

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

060044A

Policy instance

Insurance contract or identification number	060044A
Number of Individuals Covered	0
Insurance policy start date	2020-05-01
Insurance policy end date	2021-04-30
Are there contracts with allocated funds for individual policies?	0
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	1
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?	No
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

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

060044A

Policy instance

Insurance contract or identification number	060044A
Number of Individuals Covered	142
Insurance policy start date	2019-05-01
Insurance policy end date	2020-04-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $908
Are there contracts with allocated funds for individual policies?	0
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	1
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?	No
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 $0
Amount paid for insurance broker fees	908
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

060044A

Policy instance

Insurance contract or identification number	060044A
Number of Individuals Covered	107
Insurance policy start date	2018-05-01
Insurance policy end date	2019-04-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $905
Are there contracts with allocated funds for individual policies?	0
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	1
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?	No
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 $0
Amount paid for insurance broker fees	905
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

060044A

Policy instance

Insurance contract or identification number	060044A
Number of Individuals Covered	102
Insurance policy start date	2017-05-01
Insurance policy end date	2018-04-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $83
Are there contracts with allocated funds for individual policies?	0
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	1
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?	No
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

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Company Name:	PACIFIC CLINICS
Employer identification number (EIN):	951644034
NAIC Classification:	621420
NAIC Description:	Outpatient Mental Health and Substance Abuse Centers

Jurisdiction of Incorporation:	California Department of State
Incorporation Date:
Company Identification Number:	C0194267