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VALLEY KIDNEY SPECIALISTS, P.C. GROUP MEDICAL PLAN 401k Plan overview

Plan NameVALLEY KIDNEY SPECIALISTS, P.C. GROUP MEDICAL PLAN
Plan identification number 501

VALLEY KIDNEY SPECIALISTS, P.C. GROUP MEDICAL PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)

401k Sponsoring company profile

VALLEY KIDNEY SPECIALISTS, P.C. has sponsored the creation of one or more 401k plans.

Company Name:VALLEY KIDNEY SPECIALISTS, P.C.
Employer identification number (EIN):275456582
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan VALLEY KIDNEY SPECIALISTS, P.C. GROUP MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012019-01-01
5012018-01-01
5012017-01-01RAVINDRA BOLLU, MD
5012016-01-01RAVINDRA BOLLU, MD
5012015-07-01RAVINDRA BOLLU, MD
5012014-07-01RAVINDRA BOLLU, MD

Plan Statistics for VALLEY KIDNEY SPECIALISTS, P.C. GROUP MEDICAL PLAN

401k plan membership statisitcs for VALLEY KIDNEY SPECIALISTS, P.C. GROUP MEDICAL PLAN

Measure Date Value
2019: VALLEY KIDNEY SPECIALISTS, P.C. GROUP MEDICAL PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-010
Total number of active participants reported on line 7a of the Form 55002019-01-010
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-010
2018: VALLEY KIDNEY SPECIALISTS, P.C. GROUP MEDICAL PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0155
Total number of active participants reported on line 7a of the Form 55002018-01-0160
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-0160
2017: VALLEY KIDNEY SPECIALISTS, P.C. GROUP MEDICAL PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0147
Total number of active participants reported on line 7a of the Form 55002017-01-0155
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 participants2017-01-0155
2016: VALLEY KIDNEY SPECIALISTS, P.C. GROUP MEDICAL PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0150
Total number of active participants reported on line 7a of the Form 55002016-01-0145
Number of retired or separated participants receiving benefits2016-01-012
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-0147
2015: VALLEY KIDNEY SPECIALISTS, P.C. GROUP MEDICAL PLAN 2015 401k membership
Total participants, beginning-of-year2015-07-0146
Total number of active participants reported on line 7a of the Form 55002015-07-0148
Number of retired or separated participants receiving benefits2015-07-012
Number of other retired or separated participants entitled to future benefits2015-07-010
Total of all active and inactive participants2015-07-0150
2014: VALLEY KIDNEY SPECIALISTS, P.C. GROUP MEDICAL PLAN 2014 401k membership
Total participants, beginning-of-year2014-07-0149
Total number of active participants reported on line 7a of the Form 55002014-07-0146
Number of retired or separated participants receiving benefits2014-07-010
Number of other retired or separated participants entitled to future benefits2014-07-010
Total of all active and inactive participants2014-07-0146

Financial Data on VALLEY KIDNEY SPECIALISTS, P.C. GROUP MEDICAL PLAN

Measure Date Value
2019 : VALLEY KIDNEY SPECIALISTS, P.C. GROUP MEDICAL PLAN 2019 401k financial data
Total plan liabilities at end of year2019-12-31$0
Total plan liabilities at beginning of year2019-12-31$34,153
Total income from all sources2019-12-31$179
Expenses. Total of all expenses incurred2019-12-31$174,549
Benefits paid (including direct rollovers)2019-12-31$-28,284
Total plan assets at end of year2019-12-31$0
Total plan assets at beginning of year2019-12-31$208,523
Value of fidelity bond covering the plan2019-12-31$1,000,000
Total contributions received or receivable from participants2019-12-31$0
Contributions received from other sources (not participants or employers)2019-12-31$0
Other income received2019-12-31$179
Net income (gross income less expenses)2019-12-31$-174,370
Net plan assets at end of year (total assets less liabilities)2019-12-31$0
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$174,370
Total contributions received or receivable from employer(s)2019-12-31$0
Value of corrective distributions2019-12-31$202,833
2018 : VALLEY KIDNEY SPECIALISTS, P.C. GROUP MEDICAL PLAN 2018 401k financial data
Total plan liabilities at end of year2018-12-31$34,153
Total plan liabilities at beginning of year2018-12-31$36,115
Total income from all sources2018-12-31$701,722
Expenses. Total of all expenses incurred2018-12-31$578,760
Benefits paid (including direct rollovers)2018-12-31$198,914
Total plan assets at end of year2018-12-31$208,523
Total plan assets at beginning of year2018-12-31$87,523
Value of fidelity bond covering the plan2018-12-31$1,000,000
Total contributions received or receivable from participants2018-12-31$108,092
Expenses. Other expenses not covered elsewhere2018-12-31$260,497
Contributions received from other sources (not participants or employers)2018-12-31$1,069
Other income received2018-12-31$470
Net income (gross income less expenses)2018-12-31$122,962
Net plan assets at end of year (total assets less liabilities)2018-12-31$174,370
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$51,408
Total contributions received or receivable from employer(s)2018-12-31$592,091
Value of corrective distributions2018-12-31$87,711
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$31,638
2017 : VALLEY KIDNEY SPECIALISTS, P.C. GROUP MEDICAL PLAN 2017 401k financial data
Total plan liabilities at end of year2017-12-31$36,115
Total plan liabilities at beginning of year2017-12-31$47,371
Total income from all sources2017-12-31$581,367
Expenses. Total of all expenses incurred2017-12-31$500,469
Benefits paid (including direct rollovers)2017-12-31$249,519
Total plan assets at end of year2017-12-31$87,523
Total plan assets at beginning of year2017-12-31$17,881
Value of fidelity bond covering the plan2017-12-31$1,000,000
Total contributions received or receivable from participants2017-12-31$72,870
Expenses. Other expenses not covered elsewhere2017-12-31$213,040
Contributions received from other sources (not participants or employers)2017-12-31$922
Other income received2017-12-31$91
Net income (gross income less expenses)2017-12-31$80,898
Net plan assets at end of year (total assets less liabilities)2017-12-31$51,408
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$-29,490
Total contributions received or receivable from employer(s)2017-12-31$507,484
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$37,910
2016 : VALLEY KIDNEY SPECIALISTS, P.C. GROUP MEDICAL PLAN 2016 401k financial data
Total plan liabilities at end of year2016-12-31$47,371
Total plan liabilities at beginning of year2016-12-31$31,959
Total income from all sources2016-12-31$425,304
Expenses. Total of all expenses incurred2016-12-31$454,913
Benefits paid (including direct rollovers)2016-12-31$262,297
Total plan assets at end of year2016-12-31$17,881
Total plan assets at beginning of year2016-12-31$32,078
Value of fidelity bond covering the plan2016-12-31$1,000,000
Total contributions received or receivable from participants2016-12-31$72,006
Expenses. Other expenses not covered elsewhere2016-12-31$160,259
Contributions received from other sources (not participants or employers)2016-12-31$777
Other income received2016-12-31$26
Net income (gross income less expenses)2016-12-31$-29,609
Net plan assets at end of year (total assets less liabilities)2016-12-31$-29,490
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$119
Total contributions received or receivable from employer(s)2016-12-31$352,495
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$32,357
2015 : VALLEY KIDNEY SPECIALISTS, P.C. GROUP MEDICAL PLAN 2015 401k financial data
Total plan liabilities at end of year2015-12-31$31,959
Total plan liabilities at beginning of year2015-12-31$64,004
Total income from all sources2015-12-31$222,423
Expenses. Total of all expenses incurred2015-12-31$167,221
Benefits paid (including direct rollovers)2015-12-31$70,783
Total plan assets at end of year2015-12-31$32,078
Total plan assets at beginning of year2015-12-31$8,921
Value of fidelity bond covering the plan2015-12-31$1,000,000
Total contributions received or receivable from participants2015-12-31$25,248
Expenses. Other expenses not covered elsewhere2015-12-31$80,953
Contributions received from other sources (not participants or employers)2015-12-31$386
Other income received2015-12-31$9
Net income (gross income less expenses)2015-12-31$55,202
Net plan assets at end of year (total assets less liabilities)2015-12-31$119
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$-55,083
Total contributions received or receivable from employer(s)2015-12-31$196,780
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$15,485
Total plan liabilities at end of year2015-06-30$64,004
Total income from all sources2015-06-30$431,530
Expenses. Total of all expenses incurred2015-06-30$486,613
Benefits paid (including direct rollovers)2015-06-30$285,400
Total plan assets at end of year2015-06-30$8,921
Value of fidelity bond covering the plan2015-06-30$1,000,000
Total contributions received or receivable from participants2015-06-30$65,054
Expenses. Other expenses not covered elsewhere2015-06-30$169,522
Contributions received from other sources (not participants or employers)2015-06-30$0
Other income received2015-06-30$40
Net income (gross income less expenses)2015-06-30$-55,083
Net plan assets at end of year (total assets less liabilities)2015-06-30$-55,083
Net plan assets at beginning of year (total assets less liabilities)2015-06-30$0
Total contributions received or receivable from employer(s)2015-06-30$366,436
Expenses. Administrative service providers (salaries,fees and commissions)2015-06-30$31,691

Form 5500 Responses for VALLEY KIDNEY SPECIALISTS, P.C. GROUP MEDICAL PLAN

2019: VALLEY KIDNEY SPECIALISTS, P.C. GROUP MEDICAL PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingYes
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement - TrustYes
2018: VALLEY KIDNEY SPECIALISTS, P.C. GROUP MEDICAL PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: VALLEY KIDNEY SPECIALISTS, P.C. GROUP MEDICAL PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: VALLEY KIDNEY SPECIALISTS, P.C. GROUP MEDICAL PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: VALLEY KIDNEY SPECIALISTS, P.C. GROUP MEDICAL PLAN 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01Submission has been amendedNo
2015-07-01This submission is the final filingNo
2015-07-01This return/report is a short plan year return/report (less than 12 months)Yes
2015-07-01Plan is a collectively bargained planNo
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan funding arrangement – TrustYes
2015-07-01Plan benefit arrangement – InsuranceYes
2015-07-01Plan benefit arrangement - TrustYes
2014: VALLEY KIDNEY SPECIALISTS, P.C. GROUP MEDICAL PLAN 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01First time form 5500 has been submittedYes
2014-07-01Submission has been amendedNo
2014-07-01This submission is the final filingNo
2014-07-01This return/report is a short plan year return/report (less than 12 months)No
2014-07-01Plan is a collectively bargained planNo
2014-07-01Plan funding arrangement – TrustYes
2014-07-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberVERIS
Policy instance 1
Insurance contract or identification numberVERIS
Number of Individuals Covered60
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $218,950
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberVERIS
Policy instance 1
Insurance contract or identification numberVERIS
Number of Individuals Covered55
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $174,894
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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