401k Plan data: MADONNA PHYSICIANS SERVICES PC 401 K PROFIT SHARING PLAN TRUST plan

MADONNA PHYSICIANS SERVICES PC 401 K PROFIT SHARING PLAN TRUST 401k Plan overview

Plan Name	MADONNA PHYSICIANS SERVICES PC 401 K PROFIT SHARING PLAN TRUST
Plan identification number	001

MADONNA PHYSICIANS SERVICES PC 401 K PROFIT SHARING PLAN TRUST 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
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.
Participant-directed brokerage accounts provided as an investment option under the plan.
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

MADONNA PHYSICIANS SERVICES, PC has sponsored the creation of one or more 401k plans.

Company Name: MADONNA PHYSICIANS SERVICES, PC

Employer identification number (EIN): 113145579

NAIC Classification: 621340
NAIC Description: Offices of Physical, Occupational and Speech Therapists, and Audiologists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MADONNA PHYSICIANS SERVICES PC 401 K PROFIT SHARING PLAN TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2019-01-01
001 2018-01-01
001 2017-01-01
001 2016-01-01 ANTHONY J VIOLA
001 2015-01-01 ANTHONY J VIOLA
001 2014-01-01 ANTHONY J. VIOLA
001 2013-01-01 ANTHONY J. VIOLA
001 2012-01-01 MADONNA PHYSICIANS SERVICES 2013-07-23
001 2011-01-01 MADONNA PHYSICIANS SERVICES 2012-06-05
001 2010-01-01 MADONNA PHYSICIANS SERVICES 2011-06-21

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2019-01-01
001	2018-01-01
001	2017-01-01
001	2016-01-01	ANTHONY J VIOLA
001	2015-01-01	ANTHONY J VIOLA
001	2014-01-01	ANTHONY J. VIOLA
001	2013-01-01	ANTHONY J. VIOLA
001	2012-01-01	MADONNA PHYSICIANS SERVICES	2013-07-23
001	2011-01-01	MADONNA PHYSICIANS SERVICES	2012-06-05
001	2010-01-01	MADONNA PHYSICIANS SERVICES	2011-06-21

Plan Statistics for MADONNA PHYSICIANS SERVICES PC 401 K PROFIT SHARING PLAN TRUST

401k plan membership statisitcs for MADONNA PHYSICIANS SERVICES PC 401 K PROFIT SHARING PLAN TRUST

Measure Date Value
2016: MADONNA PHYSICIANS SERVICES PC 401 K PROFIT SHARING PLAN TRUST 2016 401k membership
Total participants, beginning-of-year 2016-01-01 54
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 41
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 9
Total of all active and inactive participants 2016-01-01 50
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 50
Number of participants with account balances 2016-01-01 38
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: MADONNA PHYSICIANS SERVICES PC 401 K PROFIT SHARING PLAN TRUST 2015 401k membership
Total participants, beginning-of-year 2015-01-01 41
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 27
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 11
Total of all active and inactive participants 2015-01-01 38
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 38
Number of participants with account balances 2015-01-01 38
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: MADONNA PHYSICIANS SERVICES PC 401 K PROFIT SHARING PLAN TRUST 2014 401k membership
Total participants, beginning-of-year 2014-01-01 57
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 45
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 11
Total of all active and inactive participants 2014-01-01 56
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 56
Number of participants with account balances 2014-01-01 41
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: MADONNA PHYSICIANS SERVICES PC 401 K PROFIT SHARING PLAN TRUST 2013 401k membership
Total participants, beginning-of-year 2013-01-01 56
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 43
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 13
Total of all active and inactive participants 2013-01-01 56
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 56
Number of participants with account balances 2013-01-01 47
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0

Measure	Date	Value
2016: MADONNA PHYSICIANS SERVICES PC 401 K PROFIT SHARING PLAN TRUST 2016 401k membership
Total participants, beginning-of-year	2016-01-01	54
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	41
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	9
Total of all active and inactive participants	2016-01-01	50
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	50
Number of participants with account balances	2016-01-01	38
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: MADONNA PHYSICIANS SERVICES PC 401 K PROFIT SHARING PLAN TRUST 2015 401k membership
Total participants, beginning-of-year	2015-01-01	41
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	27
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	11
Total of all active and inactive participants	2015-01-01	38
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	38
Number of participants with account balances	2015-01-01	38
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: MADONNA PHYSICIANS SERVICES PC 401 K PROFIT SHARING PLAN TRUST 2014 401k membership
Total participants, beginning-of-year	2014-01-01	57
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	45
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	11
Total of all active and inactive participants	2014-01-01	56
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	56
Number of participants with account balances	2014-01-01	41
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: MADONNA PHYSICIANS SERVICES PC 401 K PROFIT SHARING PLAN TRUST 2013 401k membership
Total participants, beginning-of-year	2013-01-01	56
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	43
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	13
Total of all active and inactive participants	2013-01-01	56
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	56
Number of participants with account balances	2013-01-01	47
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0

Financial Data on MADONNA PHYSICIANS SERVICES PC 401 K PROFIT SHARING PLAN TRUST

Measure	Date	Value
2016 : MADONNA PHYSICIANS SERVICES PC 401 K PROFIT SHARING PLAN TRUST 2016 401k financial data
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	$335,854
Expenses. Total of all expenses incurred	2016-12-31	$191,919
Benefits paid (including direct rollovers)	2016-12-31	$175,131
Total plan assets at end of year	2016-12-31	$1,929,878
Total plan assets at beginning of year	2016-12-31	$1,785,943
Total contributions received or receivable from participants	2016-12-31	$137,689
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	$141,771
Noncash contributions received	2016-12-31	$0
Net income (gross income less expenses)	2016-12-31	$143,935
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$1,929,878
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$1,785,943
Assets. Value of participant loans	2016-12-31	$70,354
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2016-12-31	$100,463
Total contributions received or receivable from employer(s)	2016-12-31	$56,394
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	$16,788
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
2015 : MADONNA PHYSICIANS SERVICES PC 401 K PROFIT SHARING PLAN TRUST 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	$209,586
Expenses. Total of all expenses incurred	2015-12-31	$99,531
Benefits paid (including direct rollovers)	2015-12-31	$82,634
Total plan assets at end of year	2015-12-31	$1,785,943
Total plan assets at beginning of year	2015-12-31	$1,675,888
Total contributions received or receivable from participants	2015-12-31	$130,106
Expenses. Other expenses not covered elsewhere	2015-12-31	$365
Contributions received from other sources (not participants or employers)	2015-12-31	$0
Other income received	2015-12-31	$-1,087
Noncash contributions received	2015-12-31	$0
Net income (gross income less expenses)	2015-12-31	$110,055
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$1,785,943
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$1,675,888
Assets. Value of participant loans	2015-12-31	$50,987
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2015-12-31	$100,463
Total contributions received or receivable from employer(s)	2015-12-31	$80,567
Value of certain deemed distributions of participant loans	2015-12-31	$423
Value of corrective distributions	2015-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2015-12-31	$16,109
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
2014 : MADONNA PHYSICIANS SERVICES PC 401 K PROFIT SHARING PLAN TRUST 2014 401k financial data
Transfers to/from the plan	2014-12-31	$0
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	$297,433
Expenses. Total of all expenses incurred	2014-12-31	$145,158
Benefits paid (including direct rollovers)	2014-12-31	$130,507
Total plan assets at end of year	2014-12-31	$1,675,888
Total plan assets at beginning of year	2014-12-31	$1,523,613
Total contributions received or receivable from participants	2014-12-31	$136,068
Expenses. Other expenses not covered elsewhere	2014-12-31	$0
Contributions received from other sources (not participants or employers)	2014-12-31	$899
Other income received	2014-12-31	$75,459
Noncash contributions received	2014-12-31	$0
Net income (gross income less expenses)	2014-12-31	$152,275
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$1,675,888
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$1,523,613
Assets. Value of participant loans	2014-12-31	$75,069
Total contributions received or receivable from employer(s)	2014-12-31	$85,007
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	$14,651
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
2013 : MADONNA PHYSICIANS SERVICES PC 401 K PROFIT SHARING PLAN TRUST 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 income from all sources	2013-12-31	$422,661
Expenses. Total of all expenses incurred	2013-12-31	$88,971
Benefits paid (including direct rollovers)	2013-12-31	$87,834
Total plan assets at end of year	2013-12-31	$1,523,613
Total plan assets at beginning of year	2013-12-31	$1,189,923
Total contributions received or receivable from participants	2013-12-31	$153,204
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	$179,425
Noncash contributions received	2013-12-31	$0
Net income (gross income less expenses)	2013-12-31	$333,690
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$1,523,613
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$1,189,923
Assets. Value of participant loans	2013-12-31	$28,830
Total contributions received or receivable from employer(s)	2013-12-31	$90,032
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	$1,137
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0

Form 5500 Responses for MADONNA PHYSICIANS SERVICES PC 401 K PROFIT SHARING PLAN TRUST

2016: MADONNA PHYSICIANS SERVICES PC 401 K PROFIT SHARING PLAN TRUST 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 - Trust	Yes
2015: MADONNA PHYSICIANS SERVICES PC 401 K PROFIT SHARING PLAN TRUST 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 - Trust	Yes
2014: MADONNA PHYSICIANS SERVICES PC 401 K PROFIT SHARING PLAN TRUST 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 - Trust	Yes
2013: MADONNA PHYSICIANS SERVICES PC 401 K PROFIT SHARING PLAN TRUST 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 - Trust	Yes

Insurance Providers Used on plan

FIRST GREAT WEST LIFE INSURANCE & ANNUITY CO (National Association of Insurance Commissioners NAIC id number: 60214 )

Policy contract number

386550-01

Policy instance

Insurance contract or identification number	386550-01
Number of Individuals Covered	38
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
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?	Yes
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
Other information about contract	GROUP ANNUITY

FIRST GREAT WEST LIFE INSURANCE & ANNUITY CO (National Association of Insurance Commissioners NAIC id number: 60214 )

Policy contract number

386550-01

Policy instance

Insurance contract or identification number	386550-01
Number of Individuals Covered	3
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
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?	Yes
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
Other information about contract	GROUP ANNUITY

FIRST GREAT WEST LIFE INSURANCE & ANNUITY CO (National Association of Insurance Commissioners NAIC id number: 60214 )

Policy contract number

386550-01

Policy instance

Insurance contract or identification number	386550-01
Number of Individuals Covered	4
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
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?	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

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Company Name:	MADONNA PHYSICIANS SERVICES, PC
Employer identification number (EIN):	113145579
NAIC Classification:	621340
NAIC Description:	Offices of Physical, Occupational and Speech Therapists, and Audiologists