401k Plan data: AMBULATORY ANESTHESIA SERVICES/HERBERT KLOSS, MD, PLLC DEFINED BENEFIT PENSION PLAN plan

AMBULATORY ANESTHESIA SERVICES/HERBERT KLOSS, MD, PLLC DEFINED BENEFIT PENSION PLAN 401k Plan overview

Plan Name	AMBULATORY ANESTHESIA SERVICES/HERBERT KLOSS, MD, PLLC DEFINED BENEFIT PENSION PLAN
Plan identification number	001

AMBULATORY ANESTHESIA SERVICES/HERBERT KLOSS, MD, PLLC DEFINED BENEFIT PENSION PLAN Benefits

401k Plan Type	Defined Benefit Pension
Plan Features/Benefits	Benefits are primarily pay related Plan covering Self-Employed individuals. 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

AMBULATORY ANESTHESIA SERVICES/HERBERT KLOSS MD PLLC has sponsored the creation of one or more 401k plans.

Company Name: AMBULATORY ANESTHESIA SERVICES/HERBERT KLOSS MD PLLC

Employer identification number (EIN): 260153135

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan AMBULATORY ANESTHESIA SERVICES/HERBERT KLOSS, MD, PLLC DEFINED BENEFIT PENSION PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2017-01-01 HERBERT KLOSS 2018-06-16
001 2016-01-01 HERBERT KLOSS 2017-07-24
001 2015-01-01 HERBERT KLOSS 2016-06-28
001 2014-01-01 HERBERT KLOSS
001 2013-01-01 HERBERT KLOSS
001 2012-01-01 HERBERT KLOSS
001 2011-01-01 HERBERT KLOSS
001 2010-01-01 HERBERT KLOSS
001 2009-01-01 HERBERT KLOSS
001 2009-01-01 HERBERT KLOSS

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2017-01-01	HERBERT KLOSS	2018-06-16
001	2016-01-01	HERBERT KLOSS	2017-07-24
001	2015-01-01	HERBERT KLOSS	2016-06-28
001	2014-01-01	HERBERT KLOSS
001	2013-01-01	HERBERT KLOSS
001	2012-01-01	HERBERT KLOSS
001	2011-01-01	HERBERT KLOSS
001	2010-01-01	HERBERT KLOSS
001	2009-01-01	HERBERT KLOSS
001	2009-01-01	HERBERT KLOSS

Plan Statistics for AMBULATORY ANESTHESIA SERVICES/HERBERT KLOSS, MD, PLLC DEFINED BENEFIT PENSION PLAN

401k plan membership statisitcs for AMBULATORY ANESTHESIA SERVICES/HERBERT KLOSS, MD, PLLC DEFINED BENEFIT PENSION PLAN

Measure Date Value
2017: AMBULATORY ANESTHESIA SERVICES/HERBERT KLOSS, MD, PLLC DEFINED BENEFIT PENSION PLAN 2017 401k membership
Market value of plan assets 2017-12-31 2,157,093
Acturial value of plan assets 2017-12-31 2,157,093
Funding target for retired participants and beneficiaries receiving payment 2017-12-31 0
Number of terminated vested participants 2017-12-31 0
Fundng target for terminated vested participants 2017-12-31 0
Active participant vested funding target 2017-12-31 1,866,338
Number of active participants 2017-12-31 1
Total funding liabilities for active participants 2017-12-31 1,866,338
Total participant count 2017-12-31 1
Total funding target for all participants 2017-12-31 1,866,338
Balance at beginning of prior year after applicable adjustments 2017-12-31 0
Prefunding balance at beginning of prior year after applicable adjustments 2017-12-31 0
Carryover balanced portion elected for use to offset prior years funding requirement 2017-12-31 0
Prefunding balanced used to offset prior years funding requirement 2017-12-31 0
Amount remaining of carryover balance 2017-12-31 0
Amount remaining of prefunding balance 2017-12-31 0
Present value of excess contributions 2017-12-31 85,533
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance 2017-12-31 85,533
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance 2017-12-31 0
Reductions in caryover balances due to elections or deemed elections 2017-12-31 0
Reductions in prefunding balances due to elections or deemed elections 2017-12-31 0
Balance of carryovers at beginning of current year 2017-12-31 0
Balance of prefunding at beginning of current year 2017-12-31 0
Total employer contributions 2017-12-31 250,000
Total employee contributions 2017-12-31 0
Contributions allocated toward unpaid minimum require contributions from prior years 2017-12-31 0
Contributions made to avoid restrictions adjusted to valuation date 2017-12-31 0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date 2017-12-31 246,249
Unpaid minimum required contributions for all prior years 2017-12-31 0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years 2017-12-31 0
Remaining amount of unpaid minimum required contributions 2017-12-31 0
Minimum required contributions for current year target normal cost 2017-12-31 207,370
Net shortfall amortization installment of oustanding balance 2017-12-31 0
Waiver amortization installment 2017-12-31 0
Total funding amount beforereflecting carryover/prefunding balances 2017-12-31 0
Carryover balance elected to use to offset funding requirement 2017-12-31 0
Prefunding balance elected to use to offset funding requirement 2017-12-31 0
Additional cash requirement 2017-12-31 0
Contributions allocatedtoward minimum required contributions for current year 2017-12-31 246,249
Unpaid minimum required contributions for current year 2017-12-31 0
Unpaid minimum required contributions for all years 2017-12-31 0
2016: AMBULATORY ANESTHESIA SERVICES/HERBERT KLOSS, MD, PLLC DEFINED BENEFIT PENSION PLAN 2016 401k membership
Market value of plan assets 2016-12-31 1,879,932
Acturial value of plan assets 2016-12-31 1,879,932
Funding target for retired participants and beneficiaries receiving payment 2016-12-31 0
Number of terminated vested participants 2016-12-31 1
Fundng target for terminated vested participants 2016-12-31 100,898
Active participant vested funding target 2016-12-31 1,667,289
Number of active participants 2016-12-31 1
Total funding liabilities for active participants 2016-12-31 1,667,289
Total participant count 2016-12-31 2
Total funding target for all participants 2016-12-31 1,768,187
Balance at beginning of prior year after applicable adjustments 2016-12-31 0
Prefunding balance at beginning of prior year after applicable adjustments 2016-12-31 8,053
Carryover balanced portion elected for use to offset prior years funding requirement 2016-12-31 0
Prefunding balanced used to offset prior years funding requirement 2016-12-31 0
Amount remaining of carryover balance 2016-12-31 0
Amount remaining of prefunding balance 2016-12-31 8,053
Present value of excess contributions 2016-12-31 124,211
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance 2016-12-31 124,211
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance 2016-12-31 0
Reductions in caryover balances due to elections or deemed elections 2016-12-31 0
Reductions in prefunding balances due to elections or deemed elections 2016-12-31 7,886
Balance of carryovers at beginning of current year 2016-12-31 0
Balance of prefunding at beginning of current year 2016-12-31 0
Total employer contributions 2016-12-31 200,000
Total employee contributions 2016-12-31 0
Contributions allocated toward unpaid minimum require contributions from prior years 2016-12-31 0
Contributions made to avoid restrictions adjusted to valuation date 2016-12-31 0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date 2016-12-31 199,542
Unpaid minimum required contributions for all prior years 2016-12-31 0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years 2016-12-31 0
Remaining amount of unpaid minimum required contributions 2016-12-31 0
Minimum required contributions for current year target normal cost 2016-12-31 225,754
Net shortfall amortization installment of oustanding balance 2016-12-31 0
Waiver amortization installment 2016-12-31 0
Total funding amount beforereflecting carryover/prefunding balances 2016-12-31 114,009
Carryover balance elected to use to offset funding requirement 2016-12-31 0
Prefunding balance elected to use to offset funding requirement 2016-12-31 0
Additional cash requirement 2016-12-31 114,009
Contributions allocatedtoward minimum required contributions for current year 2016-12-31 199,542
Unpaid minimum required contributions for current year 2016-12-31 0
Unpaid minimum required contributions for all years 2016-12-31 0
2014: AMBULATORY ANESTHESIA SERVICES/HERBERT KLOSS, MD, PLLC DEFINED BENEFIT PENSION PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 2
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 2
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 0
Total of all active and inactive participants 2014-01-01 2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: AMBULATORY ANESTHESIA SERVICES/HERBERT KLOSS, MD, PLLC DEFINED BENEFIT PENSION PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 3
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 2
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 0
Total of all active and inactive participants 2013-01-01 2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 2
Number of participants with account balances 2013-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: AMBULATORY ANESTHESIA SERVICES/HERBERT KLOSS, MD, PLLC DEFINED BENEFIT PENSION PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 3
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 3
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 0
Total of all active and inactive participants 2012-01-01 3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 3
2011: AMBULATORY ANESTHESIA SERVICES/HERBERT KLOSS, MD, PLLC DEFINED BENEFIT PENSION PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 2
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 1
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 0
Total of all active and inactive participants 2011-01-01 1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 1
2010: AMBULATORY ANESTHESIA SERVICES/HERBERT KLOSS, MD, PLLC DEFINED BENEFIT PENSION PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 2
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 1
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 1
Total of all active and inactive participants 2010-01-01 2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: AMBULATORY ANESTHESIA SERVICES/HERBERT KLOSS, MD, PLLC DEFINED BENEFIT PENSION PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 2
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 1
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 0
Total of all active and inactive participants 2009-01-01 1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 1
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: AMBULATORY ANESTHESIA SERVICES/HERBERT KLOSS, MD, PLLC DEFINED BENEFIT PENSION PLAN 2017 401k membership
Market value of plan assets	2017-12-31	2,157,093
Acturial value of plan assets	2017-12-31	2,157,093
Funding target for retired participants and beneficiaries receiving payment	2017-12-31	0
Number of terminated vested participants	2017-12-31	0
Fundng target for terminated vested participants	2017-12-31	0
Active participant vested funding target	2017-12-31	1,866,338
Number of active participants	2017-12-31	1
Total funding liabilities for active participants	2017-12-31	1,866,338
Total participant count	2017-12-31	1
Total funding target for all participants	2017-12-31	1,866,338
Balance at beginning of prior year after applicable adjustments	2017-12-31	0
Prefunding balance at beginning of prior year after applicable adjustments	2017-12-31	0
Carryover balanced portion elected for use to offset prior years funding requirement	2017-12-31	0
Prefunding balanced used to offset prior years funding requirement	2017-12-31	0
Amount remaining of carryover balance	2017-12-31	0
Amount remaining of prefunding balance	2017-12-31	0
Present value of excess contributions	2017-12-31	85,533
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance	2017-12-31	85,533
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance	2017-12-31	0
Reductions in caryover balances due to elections or deemed elections	2017-12-31	0
Reductions in prefunding balances due to elections or deemed elections	2017-12-31	0
Balance of carryovers at beginning of current year	2017-12-31	0
Balance of prefunding at beginning of current year	2017-12-31	0
Total employer contributions	2017-12-31	250,000
Total employee contributions	2017-12-31	0
Contributions allocated toward unpaid minimum require contributions from prior years	2017-12-31	0
Contributions made to avoid restrictions adjusted to valuation date	2017-12-31	0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date	2017-12-31	246,249
Unpaid minimum required contributions for all prior years	2017-12-31	0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years	2017-12-31	0
Remaining amount of unpaid minimum required contributions	2017-12-31	0
Minimum required contributions for current year target normal cost	2017-12-31	207,370
Net shortfall amortization installment of oustanding balance	2017-12-31	0
Waiver amortization installment	2017-12-31	0
Total funding amount beforereflecting carryover/prefunding balances	2017-12-31	0
Carryover balance elected to use to offset funding requirement	2017-12-31	0
Prefunding balance elected to use to offset funding requirement	2017-12-31	0
Additional cash requirement	2017-12-31	0
Contributions allocatedtoward minimum required contributions for current year	2017-12-31	246,249
Unpaid minimum required contributions for current year	2017-12-31	0
Unpaid minimum required contributions for all years	2017-12-31	0
2016: AMBULATORY ANESTHESIA SERVICES/HERBERT KLOSS, MD, PLLC DEFINED BENEFIT PENSION PLAN 2016 401k membership
Market value of plan assets	2016-12-31	1,879,932
Acturial value of plan assets	2016-12-31	1,879,932
Funding target for retired participants and beneficiaries receiving payment	2016-12-31	0
Number of terminated vested participants	2016-12-31	1
Fundng target for terminated vested participants	2016-12-31	100,898
Active participant vested funding target	2016-12-31	1,667,289
Number of active participants	2016-12-31	1
Total funding liabilities for active participants	2016-12-31	1,667,289
Total participant count	2016-12-31	2
Total funding target for all participants	2016-12-31	1,768,187
Balance at beginning of prior year after applicable adjustments	2016-12-31	0
Prefunding balance at beginning of prior year after applicable adjustments	2016-12-31	8,053
Carryover balanced portion elected for use to offset prior years funding requirement	2016-12-31	0
Prefunding balanced used to offset prior years funding requirement	2016-12-31	0
Amount remaining of carryover balance	2016-12-31	0
Amount remaining of prefunding balance	2016-12-31	8,053
Present value of excess contributions	2016-12-31	124,211
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance	2016-12-31	124,211
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance	2016-12-31	0
Reductions in caryover balances due to elections or deemed elections	2016-12-31	0
Reductions in prefunding balances due to elections or deemed elections	2016-12-31	7,886
Balance of carryovers at beginning of current year	2016-12-31	0
Balance of prefunding at beginning of current year	2016-12-31	0
Total employer contributions	2016-12-31	200,000
Total employee contributions	2016-12-31	0
Contributions allocated toward unpaid minimum require contributions from prior years	2016-12-31	0
Contributions made to avoid restrictions adjusted to valuation date	2016-12-31	0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date	2016-12-31	199,542
Unpaid minimum required contributions for all prior years	2016-12-31	0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years	2016-12-31	0
Remaining amount of unpaid minimum required contributions	2016-12-31	0
Minimum required contributions for current year target normal cost	2016-12-31	225,754
Net shortfall amortization installment of oustanding balance	2016-12-31	0
Waiver amortization installment	2016-12-31	0
Total funding amount beforereflecting carryover/prefunding balances	2016-12-31	114,009
Carryover balance elected to use to offset funding requirement	2016-12-31	0
Prefunding balance elected to use to offset funding requirement	2016-12-31	0
Additional cash requirement	2016-12-31	114,009
Contributions allocatedtoward minimum required contributions for current year	2016-12-31	199,542
Unpaid minimum required contributions for current year	2016-12-31	0
Unpaid minimum required contributions for all years	2016-12-31	0
2014: AMBULATORY ANESTHESIA SERVICES/HERBERT KLOSS, MD, PLLC DEFINED BENEFIT PENSION PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	2
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	2
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	0
Total of all active and inactive participants	2014-01-01	2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: AMBULATORY ANESTHESIA SERVICES/HERBERT KLOSS, MD, PLLC DEFINED BENEFIT PENSION PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	3
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	2
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	0
Total of all active and inactive participants	2013-01-01	2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	2
Number of participants with account balances	2013-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: AMBULATORY ANESTHESIA SERVICES/HERBERT KLOSS, MD, PLLC DEFINED BENEFIT PENSION PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	3
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	3
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	0
Total of all active and inactive participants	2012-01-01	3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	3
2011: AMBULATORY ANESTHESIA SERVICES/HERBERT KLOSS, MD, PLLC DEFINED BENEFIT PENSION PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	2
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	1
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	0
Total of all active and inactive participants	2011-01-01	1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	1
2010: AMBULATORY ANESTHESIA SERVICES/HERBERT KLOSS, MD, PLLC DEFINED BENEFIT PENSION PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	2
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	1
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	1
Total of all active and inactive participants	2010-01-01	2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: AMBULATORY ANESTHESIA SERVICES/HERBERT KLOSS, MD, PLLC DEFINED BENEFIT PENSION PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	2
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	1
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	0
Total of all active and inactive participants	2009-01-01	1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on AMBULATORY ANESTHESIA SERVICES/HERBERT KLOSS, MD, PLLC DEFINED BENEFIT PENSION PLAN

Measure	Date	Value
2014 : AMBULATORY ANESTHESIA SERVICES/HERBERT KLOSS, MD, PLLC DEFINED BENEFIT PENSION PLAN 2014 401k financial data
Total income from all sources	2014-12-31	$365,974
Expenses. Total of all expenses incurred	2014-12-31	$23,068
Benefits paid (including direct rollovers)	2014-12-31	$0
Total plan assets at end of year	2014-12-31	$1,601,611
Total plan assets at beginning of year	2014-12-31	$1,258,705
Value of fidelity bond covering the plan	2014-12-31	$50,000
Total contributions received or receivable from participants	2014-12-31	$0
Contributions received from other sources (not participants or employers)	2014-12-31	$0
Other income received	2014-12-31	$95,974
Noncash contributions received	2014-12-31	$0
Net income (gross income less expenses)	2014-12-31	$342,906
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$1,601,611
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$1,258,705
Total contributions received or receivable from employer(s)	2014-12-31	$270,000
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	$23,068
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
2013 : AMBULATORY ANESTHESIA SERVICES/HERBERT KLOSS, MD, PLLC DEFINED BENEFIT PENSION PLAN 2013 401k financial data
Total income from all sources	2013-12-31	$309,352
Expenses. Total of all expenses incurred	2013-12-31	$2,891
Benefits paid (including direct rollovers)	2013-12-31	$2,891
Total plan assets at end of year	2013-12-31	$1,258,705
Total plan assets at beginning of year	2013-12-31	$952,244
Value of fidelity bond covering the plan	2013-12-31	$4,000,000
Other income received	2013-12-31	$158,344
Net income (gross income less expenses)	2013-12-31	$306,461
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$1,258,705
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$952,244
Total contributions received or receivable from employer(s)	2013-12-31	$151,008
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
2012 : AMBULATORY ANESTHESIA SERVICES/HERBERT KLOSS, MD, PLLC DEFINED BENEFIT PENSION PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$253,913
Expenses. Total of all expenses incurred	2012-12-31	$13,343
Total plan assets at end of year	2012-12-31	$952,244
Total plan assets at beginning of year	2012-12-31	$711,674
Expenses. Other expenses not covered elsewhere	2012-12-31	$13,343
Other income received	2012-12-31	$78,913
Net income (gross income less expenses)	2012-12-31	$240,570
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$952,244
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$711,674
Total contributions received or receivable from employer(s)	2012-12-31	$175,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
2011 : AMBULATORY ANESTHESIA SERVICES/HERBERT KLOSS, MD, PLLC DEFINED BENEFIT PENSION PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$229,979
Expenses. Total of all expenses incurred	2011-12-31	$11,107
Benefits paid (including direct rollovers)	2011-12-31	$2,909
Total plan assets at end of year	2011-12-31	$711,674
Total plan assets at beginning of year	2011-12-31	$492,802
Other income received	2011-12-31	$4,769
Net income (gross income less expenses)	2011-12-31	$218,872
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$711,674
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$492,802
Total contributions received or receivable from employer(s)	2011-12-31	$225,210
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$8,198
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
2010 : AMBULATORY ANESTHESIA SERVICES/HERBERT KLOSS, MD, PLLC DEFINED BENEFIT PENSION PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$203,266
Expenses. Total of all expenses incurred	2010-12-31	$0
Total plan assets at end of year	2010-12-31	$492,802
Total plan assets at beginning of year	2010-12-31	$289,536
Other income received	2010-12-31	$53,266
Net income (gross income less expenses)	2010-12-31	$203,266
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$492,802
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$289,536
Total contributions received or receivable from employer(s)	2010-12-31	$150,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
2009 : AMBULATORY ANESTHESIA SERVICES/HERBERT KLOSS, MD, PLLC DEFINED BENEFIT PENSION 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 AMBULATORY ANESTHESIA SERVICES/HERBERT KLOSS, MD, PLLC DEFINED BENEFIT PENSION PLAN

2014: AMBULATORY ANESTHESIA SERVICES/HERBERT KLOSS, MD, PLLC DEFINED BENEFIT PENSION PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: AMBULATORY ANESTHESIA SERVICES/HERBERT KLOSS, MD, PLLC DEFINED BENEFIT PENSION PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: AMBULATORY ANESTHESIA SERVICES/HERBERT KLOSS, MD, PLLC DEFINED BENEFIT PENSION PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: AMBULATORY ANESTHESIA SERVICES/HERBERT KLOSS, MD, PLLC DEFINED BENEFIT PENSION 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 – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: AMBULATORY ANESTHESIA SERVICES/HERBERT KLOSS, MD, PLLC DEFINED BENEFIT PENSION PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: AMBULATORY ANESTHESIA SERVICES/HERBERT KLOSS, MD, PLLC DEFINED BENEFIT PENSION 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 – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	AMBULATORY ANESTHESIA SERVICES/HERBERT KLOSS MD PLLC
Employer identification number (EIN):	260153135
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)