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C E PROVIDER SERVICES RETIREMENT PLAN 401k Plan overview

Plan NameC E PROVIDER SERVICES RETIREMENT PLAN
Plan identification number 001

C E PROVIDER SERVICES RETIREMENT PLAN Benefits

401k Plan TypeDefined 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.
  • 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

JOHNSEN HEALTH SERVICES, LLC has sponsored the creation of one or more 401k plans.

Company Name:JOHNSEN HEALTH SERVICES, LLC
Employer identification number (EIN):203389446
NAIC Classification:621498
NAIC Description:All Other Outpatient Care Centers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan C E PROVIDER SERVICES RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012017-01-01
0012016-01-01
0012015-01-01
0012014-01-01

Plan Statistics for C E PROVIDER SERVICES RETIREMENT PLAN

401k plan membership statisitcs for C E PROVIDER SERVICES RETIREMENT PLAN

Measure Date Value
2017: C E PROVIDER SERVICES RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-017
Total number of active participants reported on line 7a of the Form 55002017-01-010
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-010
Number of participants with account balances2017-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: C E PROVIDER SERVICES RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-017
Total number of active participants reported on line 7a of the Form 55002016-01-017
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-017
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-017
Number of participants with account balances2016-01-017
2015: C E PROVIDER SERVICES RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-016
Total number of active participants reported on line 7a of the Form 55002015-01-016
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-016
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-016
Number of participants with account balances2015-01-016
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: C E PROVIDER SERVICES RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-010
Total number of active participants reported on line 7a of the Form 55002014-01-015
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-015
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-015
Number of participants with account balances2014-01-015
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010

Financial Data on C E PROVIDER SERVICES RETIREMENT PLAN

Measure Date Value
2017 : C E PROVIDER SERVICES RETIREMENT PLAN 2017 401k financial data
Total income from all sources2017-07-17$8,136
Expenses. Total of all expenses incurred2017-07-17$178,643
Benefits paid (including direct rollovers)2017-07-17$178,643
Total plan assets at end of year2017-07-17$0
Total plan assets at beginning of year2017-07-17$170,507
Other income received2017-07-17$8,136
Net income (gross income less expenses)2017-07-17$-170,507
Net plan assets at end of year (total assets less liabilities)2017-07-17$0
Net plan assets at beginning of year (total assets less liabilities)2017-07-17$170,507
2016 : C E PROVIDER SERVICES RETIREMENT PLAN 2016 401k financial data
Total income from all sources2016-12-31$80,112
Total plan assets at end of year2016-12-31$170,507
Total plan assets at beginning of year2016-12-31$90,395
Total contributions received or receivable from participants2016-12-31$22,373
Other income received2016-12-31$7,681
Net income (gross income less expenses)2016-12-31$80,112
Net plan assets at end of year (total assets less liabilities)2016-12-31$170,507
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$90,395
Total contributions received or receivable from employer(s)2016-12-31$50,058
2015 : C E PROVIDER SERVICES RETIREMENT PLAN 2015 401k financial data
Total income from all sources2015-12-31$26,568
Total plan assets at end of year2015-12-31$90,395
Total plan assets at beginning of year2015-12-31$63,827
Total contributions received or receivable from participants2015-12-31$22,230
Noncash contributions received2015-12-31$-3,708
Net income (gross income less expenses)2015-12-31$26,568
Net plan assets at end of year (total assets less liabilities)2015-12-31$90,395
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$63,827
Total contributions received or receivable from employer(s)2015-12-31$8,046
2014 : C E PROVIDER SERVICES RETIREMENT PLAN 2014 401k financial data
Total income from all sources2014-12-31$63,827
Total plan assets at end of year2014-12-31$63,827
Total plan assets at beginning of year2014-12-31$0
Total contributions received or receivable from participants2014-12-31$19,560
Other income received2014-12-31$89
Net income (gross income less expenses)2014-12-31$63,827
Net plan assets at end of year (total assets less liabilities)2014-12-31$63,827
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$0
Total contributions received or receivable from employer(s)2014-12-31$44,178

Form 5500 Responses for C E PROVIDER SERVICES RETIREMENT PLAN

2017: C E PROVIDER SERVICES RETIREMENT PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01This submission is the final filingYes
2017-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement - TrustYes
2016: C E PROVIDER SERVICES RETIREMENT PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement - TrustYes
2015: C E PROVIDER SERVICES RETIREMENT PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement - TrustYes
2014: C E PROVIDER SERVICES RETIREMENT PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01First time form 5500 has been submittedYes
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number115035
Policy instance 1
Insurance contract or identification number115035
Number of Individuals Covered7
Insurance policy start date2016-01-01
Insurance policy end date2016-12-31
Total amount of commissions paid to insurance brokerUSD $1,060
Total amount of fees paid to insurance companyUSD $49
Commission paid to Insurance BrokerUSD $530
Insurance broker organization code?3
Amount paid for insurance broker fees49
Insurance broker nameHUBER, ERICKSON & BOWMAN
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number115035
Policy instance 1
Insurance contract or identification number115035
Number of Individuals Covered6
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $740
Commission paid to Insurance BrokerUSD $498
Insurance broker organization code?3
Insurance broker nameWORLD EQUITY GROUP, INC
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number115035
Policy instance 1
Insurance contract or identification number115035
Number of Individuals Covered5
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $48
Commission paid to Insurance BrokerUSD $48
Insurance broker nameAXA NETWORK LLC

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