401k Plan data: LAKESIDE SURGERY CENTER LLC 401 K PROFIT SHARING PLAN TRUST plan

LAKESIDE SURGERY CENTER LLC 401 K PROFIT SHARING PLAN TRUST 401k Plan overview

Plan Name	LAKESIDE SURGERY CENTER LLC 401 K PROFIT SHARING PLAN TRUST
Plan identification number	001

LAKESIDE SURGERY CENTER LLC 401 K PROFIT SHARING PLAN TRUST 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.
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.
Prototype plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion or notification letter; and under which a seperate funding medium (for example, a seperate trust or custodial account) is established for the use of each adopting employer.

401k Sponsoring company profile

LAKESIDE SURGERY CENTER LLC has sponsored the creation of one or more 401k plans.

Company Name: LAKESIDE SURGERY CENTER LLC

Employer identification number (EIN): 364457576

NAIC Classification: 621493
NAIC Description: Freestanding Ambulatory Surgical and Emergency Centers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LAKESIDE SURGERY CENTER LLC 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 2015-01-01 ANITA NAYAK 2016-07-20
001 2014-01-01 ANITA NAYAK 2015-05-29
001 2013-01-01 ROMELSON ALMONTE 2014-05-07
001 2012-01-01 LAKESIDE SURGERY CENTER LLC 2013-05-22
001 2011-01-01 LAKESIDE SURGERY CENTER LLC 2012-05-15
001 2010-01-01 LAKESIDE SURGERY CENTER LLC 2011-05-02
001 2008-01-01 ROMELSON ALMONTE
001 2007-01-01 ROMELSON ALMONTE

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2015-01-01	ANITA NAYAK	2016-07-20
001	2014-01-01	ANITA NAYAK	2015-05-29
001	2013-01-01	ROMELSON ALMONTE	2014-05-07
001	2012-01-01	LAKESIDE SURGERY CENTER LLC	2013-05-22
001	2011-01-01	LAKESIDE SURGERY CENTER LLC	2012-05-15
001	2010-01-01	LAKESIDE SURGERY CENTER LLC	2011-05-02
001	2008-01-01	ROMELSON ALMONTE
001	2007-01-01	ROMELSON ALMONTE

Plan Statistics for LAKESIDE SURGERY CENTER LLC 401 K PROFIT SHARING PLAN TRUST

401k plan membership statisitcs for LAKESIDE SURGERY CENTER LLC 401 K PROFIT SHARING PLAN TRUST

Measure Date Value
2008: LAKESIDE SURGERY CENTER LLC 401 K PROFIT SHARING PLAN TRUST 2008 401k membership
Total participants, beginning-of-year 2008-01-01 28
Total number of active participants reported on line 7a of the Form 5500 2008-01-01 31
Number of retired or separated participants receiving benefits 2008-01-01 0
Number of other retired or separated participants entitled to future benefits 2008-01-01 1
Total of all active and inactive participants 2008-01-01 32
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2008-01-01 0
Total participants 2008-01-01 32
Number of participants with account balances 2008-01-01 4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2008-01-01 0
2007: LAKESIDE SURGERY CENTER LLC 401 K PROFIT SHARING PLAN TRUST 2007 401k membership
Total participants, beginning-of-year 2007-01-01 25
Total number of active participants reported on line 7a of the Form 5500 2007-01-01 27
Number of retired or separated participants receiving benefits 2007-01-01 0
Number of other retired or separated participants entitled to future benefits 2007-01-01 1
Total of all active and inactive participants 2007-01-01 28
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2007-01-01 0
Total participants 2007-01-01 28
Number of participants with account balances 2007-01-01 4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2007-01-01 0

Measure	Date	Value
2008: LAKESIDE SURGERY CENTER LLC 401 K PROFIT SHARING PLAN TRUST 2008 401k membership
Total participants, beginning-of-year	2008-01-01	28
Total number of active participants reported on line 7a of the Form 5500	2008-01-01	31
Number of retired or separated participants receiving benefits	2008-01-01	0
Number of other retired or separated participants entitled to future benefits	2008-01-01	1
Total of all active and inactive participants	2008-01-01	32
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2008-01-01	0
Total participants	2008-01-01	32
Number of participants with account balances	2008-01-01	4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2008-01-01	0
2007: LAKESIDE SURGERY CENTER LLC 401 K PROFIT SHARING PLAN TRUST 2007 401k membership
Total participants, beginning-of-year	2007-01-01	25
Total number of active participants reported on line 7a of the Form 5500	2007-01-01	27
Number of retired or separated participants receiving benefits	2007-01-01	0
Number of other retired or separated participants entitled to future benefits	2007-01-01	1
Total of all active and inactive participants	2007-01-01	28
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2007-01-01	0
Total participants	2007-01-01	28
Number of participants with account balances	2007-01-01	4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2007-01-01	0

Financial Data on LAKESIDE SURGERY CENTER LLC 401 K PROFIT SHARING PLAN TRUST

Measure	Date	Value
2008 : LAKESIDE SURGERY CENTER LLC 401 K PROFIT SHARING PLAN TRUST 2008 401k financial data
Transfers to/from the plan	2008-12-31	$0
Total plan liabilities at end of year	2008-12-31	$0
Total plan liabilities at beginning of year	2008-12-31	$0
Total income from all sources	2008-12-31	$-24,352
Expenses. Total of all expenses incurred	2008-12-31	$0
Benefits paid (including direct rollovers)	2008-12-31	$0
Total plan assets at end of year	2008-12-31	$37,826
Total plan assets at beginning of year	2008-12-31	$62,178
Total contributions received or receivable from participants	2008-12-31	$378
Expenses. Other expenses not covered elsewhere	2008-12-31	$0
Contributions received from other sources (not participants or employers)	2008-12-31	$0
Other income received	2008-12-31	$-24,730
Net income (gross income less expenses)	2008-12-31	$-24,352
Net plan assets at end of year (total assets less liabilities)	2008-12-31	$37,826
Net plan assets at beginning of year (total assets less liabilities)	2008-12-31	$62,178
Total contributions received or receivable from employer(s)	2008-12-31	$0
Value of certain deemed distributions of participant loans	2008-12-31	$0
Value of corrective distributions	2008-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2008-12-31	$0
2007 : LAKESIDE SURGERY CENTER LLC 401 K PROFIT SHARING PLAN TRUST 2007 401k financial data
Transfers to/from the plan	2007-12-31	$0
Total plan liabilities at end of year	2007-12-31	$0
Total plan liabilities at beginning of year	2007-12-31	$0
Total income from all sources	2007-12-31	$8,230
Expenses. Total of all expenses incurred	2007-12-31	$0
Benefits paid (including direct rollovers)	2007-12-31	$0
Total plan assets at end of year	2007-12-31	$62,178
Total plan assets at beginning of year	2007-12-31	$53,948
Total contributions received or receivable from participants	2007-12-31	$2,869
Expenses. Other expenses not covered elsewhere	2007-12-31	$0
Contributions received from other sources (not participants or employers)	2007-12-31	$0
Other income received	2007-12-31	$5,361
Net income (gross income less expenses)	2007-12-31	$8,230
Net plan assets at end of year (total assets less liabilities)	2007-12-31	$62,178
Net plan assets at beginning of year (total assets less liabilities)	2007-12-31	$53,948
Total contributions received or receivable from employer(s)	2007-12-31	$0
Value of certain deemed distributions of participant loans	2007-12-31	$0
Value of corrective distributions	2007-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2007-12-31	$0
2006 : LAKESIDE SURGERY CENTER LLC 401 K PROFIT SHARING PLAN TRUST 2006 401k financial data
Transfers to/from the plan	2006-12-31	$0
Total plan liabilities at end of year	2006-12-31	$0
Total plan liabilities at beginning of year	2006-12-31	$0
Total income from all sources	2006-12-31	$46,301
Expenses. Total of all expenses incurred	2006-12-31	$0
Benefits paid (including direct rollovers)	2006-12-31	$0
Total plan assets at end of year	2006-12-31	$53,948
Total plan assets at beginning of year	2006-12-31	$7,648
Total contributions received or receivable from participants	2006-12-31	$3,549
Expenses. Other expenses not covered elsewhere	2006-12-31	$0
Contributions received from other sources (not participants or employers)	2006-12-31	$36,903
Other income received	2006-12-31	$5,849
Net income (gross income less expenses)	2006-12-31	$46,301
Net plan assets at end of year (total assets less liabilities)	2006-12-31	$53,948
Net plan assets at beginning of year (total assets less liabilities)	2006-12-31	$7,648
Total contributions received or receivable from employer(s)	2006-12-31	$0
Value of corrective distributions	2006-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2006-12-31	$0
2005 : LAKESIDE SURGERY CENTER LLC 401 K PROFIT SHARING PLAN TRUST 2005 401k financial data
Transfers to/from the plan	2005-12-31	$0
Total plan liabilities at end of year	2005-12-31	$0
Total plan liabilities at beginning of year	2005-12-31	$0
Total income from all sources	2005-12-31	$3,878
Expenses. Total of all expenses incurred	2005-12-31	$0
Benefits paid (including direct rollovers)	2005-12-31	$0
Total plan assets at end of year	2005-12-31	$7,648
Total plan assets at beginning of year	2005-12-31	$3,770
Total contributions received or receivable from participants	2005-12-31	$3,495
Expenses. Other expenses not covered elsewhere	2005-12-31	$0
Contributions received from other sources (not participants or employers)	2005-12-31	$0
Other income received	2005-12-31	$383
Net income (gross income less expenses)	2005-12-31	$3,878
Net plan assets at end of year (total assets less liabilities)	2005-12-31	$7,648
Net plan assets at beginning of year (total assets less liabilities)	2005-12-31	$3,770
Total contributions received or receivable from employer(s)	2005-12-31	$0
Value of corrective distributions	2005-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2005-12-31	$0
2004 : LAKESIDE SURGERY CENTER LLC 401 K PROFIT SHARING PLAN TRUST 2004 401k financial data
Transfers to/from the plan	2004-12-31	$0
Total plan liabilities at end of year	2004-12-31	$0
Total income from all sources	2004-12-31	$3,771
Expenses. Total of all expenses incurred	2004-12-31	$0
Benefits paid (including direct rollovers)	2004-12-31	$0
Total plan assets at end of year	2004-12-31	$3,770
Total contributions received or receivable from participants	2004-12-31	$3,541
Expenses. Other expenses not covered elsewhere	2004-12-31	$0
Contributions received from other sources (not participants or employers)	2004-12-31	$0
Other income received	2004-12-31	$230
Net income (gross income less expenses)	2004-12-31	$3,771
Net plan assets at end of year (total assets less liabilities)	2004-12-31	$3,770
Total contributions received or receivable from employer(s)	2004-12-31	$0
Value of corrective distributions	2004-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2004-12-31	$0

Form 5500 Responses for LAKESIDE SURGERY CENTER LLC 401 K PROFIT SHARING PLAN TRUST

2008: LAKESIDE SURGERY CENTER LLC 401 K PROFIT SHARING PLAN TRUST 2008 form 5500 responses
2008-01-01	Type of plan entity	Single employer plan
2008-01-01	Submission has been amended	No
2008-01-01	This submission is the final filing	No
2008-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2008-01-01	Plan is a collectively bargained plan	No
2008-01-01	Plan funding arrangement – Trust	Yes
2008-01-01	Plan benefit arrangement - Trust	Yes
2007: LAKESIDE SURGERY CENTER LLC 401 K PROFIT SHARING PLAN TRUST 2007 form 5500 responses
2007-01-01	Type of plan entity	Single employer plan
2007-01-01	Submission has been amended	No
2007-01-01	This submission is the final filing	No
2007-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2007-01-01	Plan is a collectively bargained plan	No
2007-01-01	Plan funding arrangement – Trust	Yes
2007-01-01	Plan benefit arrangement - Trust	Yes

Potentially related plans

LAKESIDE SURGERY CENTER 401K PLAN [EIN = 752714441]

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Company Name:	LAKESIDE SURGERY CENTER LLC
Employer identification number (EIN):	364457576
NAIC Classification:	621493
NAIC Description:	Freestanding Ambulatory Surgical and Emergency Centers