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ILLINOIS VALLEY SURGICAL ASSOCIATES PROFIT SHARING 401(K) PLAN 401k Plan overview

Plan NameILLINOIS VALLEY SURGICAL ASSOCIATES PROFIT SHARING 401(K) PLAN
Plan identification number 001

ILLINOIS VALLEY SURGICAL ASSOCIATES PROFIT SHARING 401(K) PLAN Benefits

401k Plan TypeDefined 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.
  • Partial participant-directed account plan - Participants have the opportunity to direct the investment of a portion of 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

ILLINOIS VALLEY SURGICAL ASSOCIATES, S.C. has sponsored the creation of one or more 401k plans.

Company Name:ILLINOIS VALLEY SURGICAL ASSOCIATES, S.C.
Employer identification number (EIN):392009048
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ILLINOIS VALLEY SURGICAL ASSOCIATES PROFIT SHARING 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012021-11-01JOSEPH KOKOSZKA OR ROBERT WOJCIK2023-06-27
0012020-11-01JOSEPH KOKOSZKA OR ROBERT WOJCIK2022-08-15
0012019-11-01JOSEPH KOKOSZKA OR ROBERT WOJCIK2021-02-17
0012018-11-01JOSEPH KOKOSZKA OR ROBERT WOJCIK2020-07-22
0012017-11-01JOSEPH KOKOSZKA OR ROBERT WOJCIK2019-05-15
0012016-11-01
0012015-11-01
0012014-11-01
0012013-11-01JOSEPH KOKOSZKA OR ROBERT WOJCIK
0012012-11-01JOSEPH KOKOSZKA OR ROBERT WOJCIK
0012011-11-01JOSEPH KOKOSZKA OR ROBERT WOJCIK
0012010-11-01JOSEPH KOKOSZKA OR ROBERT WOJCIK
0012009-11-01JOSEPH KOKOSZKA

Plan Statistics for ILLINOIS VALLEY SURGICAL ASSOCIATES PROFIT SHARING 401(K) PLAN

401k plan membership statisitcs for ILLINOIS VALLEY SURGICAL ASSOCIATES PROFIT SHARING 401(K) PLAN

Measure Date Value
2021: ILLINOIS VALLEY SURGICAL ASSOCIATES PROFIT SHARING 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year2021-11-0112
Total number of active participants reported on line 7a of the Form 55002021-11-0110
Number of retired or separated participants receiving benefits2021-11-010
Number of other retired or separated participants entitled to future benefits2021-11-012
Total of all active and inactive participants2021-11-0112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-11-010
Total participants2021-11-0112
Number of participants with account balances2021-11-0112
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-11-010
2020: ILLINOIS VALLEY SURGICAL ASSOCIATES PROFIT SHARING 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year2020-11-0114
Total number of active participants reported on line 7a of the Form 55002020-11-0111
Number of retired or separated participants receiving benefits2020-11-010
Number of other retired or separated participants entitled to future benefits2020-11-011
Total of all active and inactive participants2020-11-0112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-11-010
Total participants2020-11-0112
Number of participants with account balances2020-11-0112
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-11-010
2019: ILLINOIS VALLEY SURGICAL ASSOCIATES PROFIT SHARING 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-11-0114
Total number of active participants reported on line 7a of the Form 55002019-11-0112
Number of retired or separated participants receiving benefits2019-11-011
Number of other retired or separated participants entitled to future benefits2019-11-010
Total of all active and inactive participants2019-11-0113
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-11-010
Total participants2019-11-0113
Number of participants with account balances2019-11-0113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-11-010
2018: ILLINOIS VALLEY SURGICAL ASSOCIATES PROFIT SHARING 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year2018-11-0115
Total number of active participants reported on line 7a of the Form 55002018-11-0112
Number of retired or separated participants receiving benefits2018-11-011
Number of other retired or separated participants entitled to future benefits2018-11-011
Total of all active and inactive participants2018-11-0114
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-11-010
Total participants2018-11-0114
Number of participants with account balances2018-11-0114
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-11-010
2017: ILLINOIS VALLEY SURGICAL ASSOCIATES PROFIT SHARING 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year2017-11-0115
Total number of active participants reported on line 7a of the Form 55002017-11-0113
Number of retired or separated participants receiving benefits2017-11-010
Number of other retired or separated participants entitled to future benefits2017-11-012
Total of all active and inactive participants2017-11-0115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-11-010
Total participants2017-11-0115
Number of participants with account balances2017-11-0115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-11-010
2016: ILLINOIS VALLEY SURGICAL ASSOCIATES PROFIT SHARING 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year2016-11-0114
Total number of active participants reported on line 7a of the Form 55002016-11-0113
Number of retired or separated participants receiving benefits2016-11-010
Number of other retired or separated participants entitled to future benefits2016-11-012
Total of all active and inactive participants2016-11-0115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-11-010
Total participants2016-11-0115
Number of participants with account balances2016-11-0115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-11-010
2015: ILLINOIS VALLEY SURGICAL ASSOCIATES PROFIT SHARING 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year2015-11-0115
Total number of active participants reported on line 7a of the Form 55002015-11-0111
Number of retired or separated participants receiving benefits2015-11-010
Number of other retired or separated participants entitled to future benefits2015-11-012
Total of all active and inactive participants2015-11-0113
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-11-010
Total participants2015-11-0113
Number of participants with account balances2015-11-0113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-11-010
2014: ILLINOIS VALLEY SURGICAL ASSOCIATES PROFIT SHARING 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year2014-11-0118
Total number of active participants reported on line 7a of the Form 55002014-11-0112
Number of retired or separated participants receiving benefits2014-11-011
Number of other retired or separated participants entitled to future benefits2014-11-012
Total of all active and inactive participants2014-11-0115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-11-010
Total participants2014-11-0115
Number of participants with account balances2014-11-0115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-11-010
2013: ILLINOIS VALLEY SURGICAL ASSOCIATES PROFIT SHARING 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year2013-11-0115
Total number of active participants reported on line 7a of the Form 55002013-11-0112
Number of retired or separated participants receiving benefits2013-11-012
Number of other retired or separated participants entitled to future benefits2013-11-012
Total of all active and inactive participants2013-11-0116
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-11-010
Total participants2013-11-0116
Number of participants with account balances2013-11-0116
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-11-010
2012: ILLINOIS VALLEY SURGICAL ASSOCIATES PROFIT SHARING 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year2012-11-0117
Total number of active participants reported on line 7a of the Form 55002012-11-0113
Number of retired or separated participants receiving benefits2012-11-010
Number of other retired or separated participants entitled to future benefits2012-11-012
Total of all active and inactive participants2012-11-0115
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-11-010
Total participants2012-11-0115
Number of participants with account balances2012-11-0115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-11-010
2011: ILLINOIS VALLEY SURGICAL ASSOCIATES PROFIT SHARING 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year2011-11-0117
Total number of active participants reported on line 7a of the Form 55002011-11-0113
Number of retired or separated participants receiving benefits2011-11-010
Number of other retired or separated participants entitled to future benefits2011-11-013
Total of all active and inactive participants2011-11-0116
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-11-010
Total participants2011-11-0116
Number of participants with account balances2011-11-0116
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-11-010
2010: ILLINOIS VALLEY SURGICAL ASSOCIATES PROFIT SHARING 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year2010-11-0122
Total number of active participants reported on line 7a of the Form 55002010-11-0112
Number of retired or separated participants receiving benefits2010-11-014
Number of other retired or separated participants entitled to future benefits2010-11-010
Total of all active and inactive participants2010-11-0116
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-11-010
Total participants2010-11-0116
Number of participants with account balances2010-11-0116
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-11-010
2009: ILLINOIS VALLEY SURGICAL ASSOCIATES PROFIT SHARING 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year2009-11-0120
Total number of active participants reported on line 7a of the Form 55002009-11-0111
Number of retired or separated participants receiving benefits2009-11-010
Number of other retired or separated participants entitled to future benefits2009-11-018
Total of all active and inactive participants2009-11-0119
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-11-010
Total participants2009-11-0119
Number of participants with account balances2009-11-0119
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-11-010

Financial Data on ILLINOIS VALLEY SURGICAL ASSOCIATES PROFIT SHARING 401(K) PLAN

Measure Date Value
2022 : ILLINOIS VALLEY SURGICAL ASSOCIATES PROFIT SHARING 401(K) PLAN 2022 401k financial data
Total income from all sources2022-10-31$-1,085,771
Expenses. Total of all expenses incurred2022-10-31$0
Total plan assets at end of year2022-10-31$5,725,315
Total plan assets at beginning of year2022-10-31$6,811,086
Value of fidelity bond covering the plan2022-10-31$500,000
Total contributions received or receivable from participants2022-10-31$120,036
Other income received2022-10-31$-1,233,848
Net income (gross income less expenses)2022-10-31$-1,085,771
Net plan assets at end of year (total assets less liabilities)2022-10-31$5,725,315
Net plan assets at beginning of year (total assets less liabilities)2022-10-31$6,811,086
Assets. Value of assets in partnership/joint-venture interests2022-10-31$50,346
Total contributions received or receivable from employer(s)2022-10-31$28,041
2021 : ILLINOIS VALLEY SURGICAL ASSOCIATES PROFIT SHARING 401(K) PLAN 2021 401k financial data
Total income from all sources2021-10-31$1,768,860
Expenses. Total of all expenses incurred2021-10-31$12,318
Benefits paid (including direct rollovers)2021-10-31$3,292
Total plan assets at end of year2021-10-31$6,811,086
Total plan assets at beginning of year2021-10-31$5,054,544
Value of fidelity bond covering the plan2021-10-31$500,000
Total contributions received or receivable from participants2021-10-31$136,977
Other income received2021-10-31$1,521,718
Net income (gross income less expenses)2021-10-31$1,756,542
Net plan assets at end of year (total assets less liabilities)2021-10-31$6,811,086
Net plan assets at beginning of year (total assets less liabilities)2021-10-31$5,054,544
Assets. Value of assets in partnership/joint-venture interests2021-10-31$50,488
Total contributions received or receivable from employer(s)2021-10-31$110,165
Expenses. Administrative service providers (salaries,fees and commissions)2021-10-31$9,026
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-10-31$0
2020 : ILLINOIS VALLEY SURGICAL ASSOCIATES PROFIT SHARING 401(K) PLAN 2020 401k financial data
Total income from all sources2020-10-31$436,786
Expenses. Total of all expenses incurred2020-10-31$10,626
Benefits paid (including direct rollovers)2020-10-31$4,952
Total plan assets at end of year2020-10-31$5,054,544
Total plan assets at beginning of year2020-10-31$4,628,384
Value of fidelity bond covering the plan2020-10-31$500,000
Total contributions received or receivable from participants2020-10-31$121,081
Other income received2020-10-31$216,011
Net income (gross income less expenses)2020-10-31$426,160
Net plan assets at end of year (total assets less liabilities)2020-10-31$5,054,544
Net plan assets at beginning of year (total assets less liabilities)2020-10-31$4,628,384
Assets. Value of assets in partnership/joint-venture interests2020-10-31$68,422
Total contributions received or receivable from employer(s)2020-10-31$99,694
Expenses. Administrative service providers (salaries,fees and commissions)2020-10-31$5,674
2019 : ILLINOIS VALLEY SURGICAL ASSOCIATES PROFIT SHARING 401(K) PLAN 2019 401k financial data
Total income from all sources2019-10-31$554,251
Expenses. Total of all expenses incurred2019-10-31$3,859
Benefits paid (including direct rollovers)2019-10-31$649
Total plan assets at end of year2019-10-31$4,628,384
Total plan assets at beginning of year2019-10-31$4,077,992
Value of fidelity bond covering the plan2019-10-31$400,000
Total contributions received or receivable from participants2019-10-31$115,573
Contributions received from other sources (not participants or employers)2019-10-31$0
Other income received2019-10-31$330,160
Net income (gross income less expenses)2019-10-31$550,392
Net plan assets at end of year (total assets less liabilities)2019-10-31$4,628,384
Net plan assets at beginning of year (total assets less liabilities)2019-10-31$4,077,992
Assets. Value of assets in partnership/joint-venture interests2019-10-31$74,581
Total contributions received or receivable from employer(s)2019-10-31$108,518
Expenses. Administrative service providers (salaries,fees and commissions)2019-10-31$3,210
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-10-31$0
2017 : ILLINOIS VALLEY SURGICAL ASSOCIATES PROFIT SHARING 401(K) PLAN 2017 401k financial data
Total income from all sources2017-10-31$767,885
Expenses. Total of all expenses incurred2017-10-31$845
Total plan assets at end of year2017-10-31$3,968,061
Total plan assets at beginning of year2017-10-31$3,201,021
Value of fidelity bond covering the plan2017-10-31$300,000
Total contributions received or receivable from participants2017-10-31$104,510
Other income received2017-10-31$561,868
Net income (gross income less expenses)2017-10-31$767,040
Net plan assets at end of year (total assets less liabilities)2017-10-31$3,968,061
Net plan assets at beginning of year (total assets less liabilities)2017-10-31$3,201,021
Assets. Value of assets in partnership/joint-venture interests2017-10-31$138,512
Total contributions received or receivable from employer(s)2017-10-31$101,507
Expenses. Administrative service providers (salaries,fees and commissions)2017-10-31$845
2016 : ILLINOIS VALLEY SURGICAL ASSOCIATES PROFIT SHARING 401(K) PLAN 2016 401k financial data
Total income from all sources2016-10-31$213,176
Expenses. Total of all expenses incurred2016-10-31$30,808
Benefits paid (including direct rollovers)2016-10-31$30,808
Total plan assets at end of year2016-10-31$3,201,021
Total plan assets at beginning of year2016-10-31$3,018,653
Value of fidelity bond covering the plan2016-10-31$300,000
Total contributions received or receivable from participants2016-10-31$97,342
Other income received2016-10-31$20,030
Net income (gross income less expenses)2016-10-31$182,368
Net plan assets at end of year (total assets less liabilities)2016-10-31$3,201,021
Net plan assets at beginning of year (total assets less liabilities)2016-10-31$3,018,653
Assets. Value of assets in partnership/joint-venture interests2016-10-31$133,687
Total contributions received or receivable from employer(s)2016-10-31$95,804
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-10-31$0
2015 : ILLINOIS VALLEY SURGICAL ASSOCIATES PROFIT SHARING 401(K) PLAN 2015 401k financial data
Total income from all sources2015-10-31$199,854
Expenses. Total of all expenses incurred2015-10-31$230,296
Benefits paid (including direct rollovers)2015-10-31$230,296
Total plan assets at end of year2015-10-31$3,018,653
Total plan assets at beginning of year2015-10-31$3,049,095
Value of fidelity bond covering the plan2015-10-31$300,000
Total contributions received or receivable from participants2015-10-31$102,612
Contributions received from other sources (not participants or employers)2015-10-31$1,772
Other income received2015-10-31$-2,180
Net income (gross income less expenses)2015-10-31$-30,442
Net plan assets at end of year (total assets less liabilities)2015-10-31$3,018,653
Net plan assets at beginning of year (total assets less liabilities)2015-10-31$3,049,095
Assets. Value of assets in partnership/joint-venture interests2015-10-31$125,719
Total contributions received or receivable from employer(s)2015-10-31$97,650
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-10-31$0
2014 : ILLINOIS VALLEY SURGICAL ASSOCIATES PROFIT SHARING 401(K) PLAN 2014 401k financial data
Total income from all sources2014-10-31$429,035
Expenses. Total of all expenses incurred2014-10-31$0
Total plan assets at end of year2014-10-31$3,049,095
Total plan assets at beginning of year2014-10-31$2,620,060
Value of fidelity bond covering the plan2014-10-31$300,000
Total contributions received or receivable from participants2014-10-31$94,450
Contributions received from other sources (not participants or employers)2014-10-31$532
Other income received2014-10-31$204,430
Net income (gross income less expenses)2014-10-31$429,035
Net plan assets at end of year (total assets less liabilities)2014-10-31$3,049,095
Net plan assets at beginning of year (total assets less liabilities)2014-10-31$2,620,060
Assets. Value of assets in partnership/joint-venture interests2014-10-31$119,373
Total contributions received or receivable from employer(s)2014-10-31$129,623
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-10-31$0
2013 : ILLINOIS VALLEY SURGICAL ASSOCIATES PROFIT SHARING 401(K) PLAN 2013 401k financial data
Total income from all sources2013-10-31$647,090
Expenses. Total of all expenses incurred2013-10-31$31,356
Benefits paid (including direct rollovers)2013-10-31$30,299
Total plan assets at end of year2013-10-31$2,620,060
Total plan assets at beginning of year2013-10-31$2,004,326
Value of fidelity bond covering the plan2013-10-31$210,000
Total contributions received or receivable from participants2013-10-31$123,010
Other income received2013-10-31$397,341
Net income (gross income less expenses)2013-10-31$615,734
Net plan assets at end of year (total assets less liabilities)2013-10-31$2,620,060
Net plan assets at beginning of year (total assets less liabilities)2013-10-31$2,004,326
Assets. Value of assets in partnership/joint-venture interests2013-10-31$110,166
Total contributions received or receivable from employer(s)2013-10-31$126,739
Expenses. Administrative service providers (salaries,fees and commissions)2013-10-31$1,057
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-10-31$0
2012 : ILLINOIS VALLEY SURGICAL ASSOCIATES PROFIT SHARING 401(K) PLAN 2012 401k financial data
Total income from all sources2012-10-31$355,373
Expenses. Total of all expenses incurred2012-10-31$29,330
Benefits paid (including direct rollovers)2012-10-31$22,070
Total plan assets at end of year2012-10-31$2,004,326
Total plan assets at beginning of year2012-10-31$1,678,283
Value of fidelity bond covering the plan2012-10-31$210,000
Total contributions received or receivable from participants2012-10-31$91,564
Contributions received from other sources (not participants or employers)2012-10-31$310
Other income received2012-10-31$140,270
Net income (gross income less expenses)2012-10-31$326,043
Net plan assets at end of year (total assets less liabilities)2012-10-31$2,004,326
Net plan assets at beginning of year (total assets less liabilities)2012-10-31$1,678,283
Assets. Value of assets in partnership/joint-venture interests2012-10-31$104,547
Total contributions received or receivable from employer(s)2012-10-31$123,229
Expenses. Administrative service providers (salaries,fees and commissions)2012-10-31$7,260
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-10-31$0
2011 : ILLINOIS VALLEY SURGICAL ASSOCIATES PROFIT SHARING 401(K) PLAN 2011 401k financial data
Total income from all sources2011-10-31$205,362
Expenses. Total of all expenses incurred2011-10-31$174,039
Benefits paid (including direct rollovers)2011-10-31$159,398
Total plan assets at end of year2011-10-31$1,678,283
Total plan assets at beginning of year2011-10-31$1,646,960
Value of fidelity bond covering the plan2011-10-31$210,000
Total contributions received or receivable from participants2011-10-31$83,530
Contributions received from other sources (not participants or employers)2011-10-31$7,951
Other income received2011-10-31$18,396
Net income (gross income less expenses)2011-10-31$31,323
Net plan assets at end of year (total assets less liabilities)2011-10-31$1,678,283
Net plan assets at beginning of year (total assets less liabilities)2011-10-31$1,646,960
Assets. Value of assets in partnership/joint-venture interests2011-10-31$49,720
Total contributions received or receivable from employer(s)2011-10-31$95,485
Expenses. Administrative service providers (salaries,fees and commissions)2011-10-31$14,641
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-10-31$0

Form 5500 Responses for ILLINOIS VALLEY SURGICAL ASSOCIATES PROFIT SHARING 401(K) PLAN

2021: ILLINOIS VALLEY SURGICAL ASSOCIATES PROFIT SHARING 401(K) PLAN 2021 form 5500 responses
2021-11-01Type of plan entitySingle employer plan
2021-11-01Submission has been amendedNo
2021-11-01This submission is the final filingNo
2021-11-01This return/report is a short plan year return/report (less than 12 months)No
2021-11-01Plan is a collectively bargained planNo
2021-11-01Plan funding arrangement – InsuranceYes
2021-11-01Plan funding arrangement – TrustYes
2021-11-01Plan benefit arrangement – InsuranceYes
2021-11-01Plan benefit arrangement - TrustYes
2020: ILLINOIS VALLEY SURGICAL ASSOCIATES PROFIT SHARING 401(K) PLAN 2020 form 5500 responses
2020-11-01Type of plan entitySingle employer plan
2020-11-01Submission has been amendedNo
2020-11-01This submission is the final filingNo
2020-11-01This return/report is a short plan year return/report (less than 12 months)No
2020-11-01Plan is a collectively bargained planNo
2020-11-01Plan funding arrangement – InsuranceYes
2020-11-01Plan funding arrangement – TrustYes
2020-11-01Plan benefit arrangement – InsuranceYes
2020-11-01Plan benefit arrangement - TrustYes
2019: ILLINOIS VALLEY SURGICAL ASSOCIATES PROFIT SHARING 401(K) PLAN 2019 form 5500 responses
2019-11-01Type of plan entitySingle employer plan
2019-11-01Submission has been amendedNo
2019-11-01This submission is the final filingNo
2019-11-01This return/report is a short plan year return/report (less than 12 months)No
2019-11-01Plan is a collectively bargained planNo
2019-11-01Plan funding arrangement – InsuranceYes
2019-11-01Plan funding arrangement – TrustYes
2019-11-01Plan benefit arrangement – InsuranceYes
2019-11-01Plan benefit arrangement - TrustYes
2018: ILLINOIS VALLEY SURGICAL ASSOCIATES PROFIT SHARING 401(K) PLAN 2018 form 5500 responses
2018-11-01Type of plan entitySingle employer plan
2018-11-01Submission has been amendedNo
2018-11-01This submission is the final filingNo
2018-11-01This return/report is a short plan year return/report (less than 12 months)No
2018-11-01Plan is a collectively bargained planNo
2018-11-01Plan funding arrangement – InsuranceYes
2018-11-01Plan funding arrangement – TrustYes
2018-11-01Plan benefit arrangement – InsuranceYes
2018-11-01Plan benefit arrangement - TrustYes
2017: ILLINOIS VALLEY SURGICAL ASSOCIATES PROFIT SHARING 401(K) PLAN 2017 form 5500 responses
2017-11-01Type of plan entitySingle employer plan
2017-11-01Submission has been amendedNo
2017-11-01This submission is the final filingNo
2017-11-01This return/report is a short plan year return/report (less than 12 months)No
2017-11-01Plan is a collectively bargained planNo
2017-11-01Plan funding arrangement – InsuranceYes
2017-11-01Plan funding arrangement – TrustYes
2017-11-01Plan benefit arrangement – InsuranceYes
2017-11-01Plan benefit arrangement - TrustYes
2016: ILLINOIS VALLEY SURGICAL ASSOCIATES PROFIT SHARING 401(K) PLAN 2016 form 5500 responses
2016-11-01Type of plan entitySingle employer plan
2016-11-01Submission has been amendedNo
2016-11-01This submission is the final filingNo
2016-11-01This return/report is a short plan year return/report (less than 12 months)No
2016-11-01Plan is a collectively bargained planNo
2016-11-01Plan funding arrangement – InsuranceYes
2016-11-01Plan funding arrangement – TrustYes
2016-11-01Plan benefit arrangement – InsuranceYes
2016-11-01Plan benefit arrangement - TrustYes
2015: ILLINOIS VALLEY SURGICAL ASSOCIATES PROFIT SHARING 401(K) PLAN 2015 form 5500 responses
2015-11-01Type of plan entitySingle employer plan
2015-11-01Submission has been amendedNo
2015-11-01This submission is the final filingNo
2015-11-01This return/report is a short plan year return/report (less than 12 months)No
2015-11-01Plan is a collectively bargained planNo
2015-11-01Plan funding arrangement – InsuranceYes
2015-11-01Plan funding arrangement – TrustYes
2015-11-01Plan benefit arrangement – InsuranceYes
2015-11-01Plan benefit arrangement - TrustYes
2014: ILLINOIS VALLEY SURGICAL ASSOCIATES PROFIT SHARING 401(K) PLAN 2014 form 5500 responses
2014-11-01Type of plan entitySingle employer plan
2014-11-01Submission has been amendedNo
2014-11-01This submission is the final filingNo
2014-11-01This return/report is a short plan year return/report (less than 12 months)No
2014-11-01Plan is a collectively bargained planNo
2014-11-01Plan funding arrangement – InsuranceYes
2014-11-01Plan funding arrangement – TrustYes
2014-11-01Plan benefit arrangement – InsuranceYes
2014-11-01Plan benefit arrangement - TrustYes
2013: ILLINOIS VALLEY SURGICAL ASSOCIATES PROFIT SHARING 401(K) PLAN 2013 form 5500 responses
2013-11-01Type of plan entitySingle employer plan
2013-11-01Submission has been amendedNo
2013-11-01This submission is the final filingNo
2013-11-01This return/report is a short plan year return/report (less than 12 months)No
2013-11-01Plan is a collectively bargained planNo
2013-11-01Plan funding arrangement – InsuranceYes
2013-11-01Plan funding arrangement – TrustYes
2013-11-01Plan benefit arrangement – InsuranceYes
2013-11-01Plan benefit arrangement - TrustYes
2012: ILLINOIS VALLEY SURGICAL ASSOCIATES PROFIT SHARING 401(K) PLAN 2012 form 5500 responses
2012-11-01Type of plan entitySingle employer plan
2012-11-01Submission has been amendedNo
2012-11-01This submission is the final filingNo
2012-11-01This return/report is a short plan year return/report (less than 12 months)No
2012-11-01Plan is a collectively bargained planNo
2012-11-01Plan funding arrangement – InsuranceYes
2012-11-01Plan funding arrangement – TrustYes
2012-11-01Plan benefit arrangement – InsuranceYes
2012-11-01Plan benefit arrangement - TrustYes
2011: ILLINOIS VALLEY SURGICAL ASSOCIATES PROFIT SHARING 401(K) PLAN 2011 form 5500 responses
2011-11-01Type of plan entitySingle employer plan
2011-11-01Submission has been amendedNo
2011-11-01This submission is the final filingNo
2011-11-01This return/report is a short plan year return/report (less than 12 months)No
2011-11-01Plan is a collectively bargained planNo
2011-11-01Plan funding arrangement – InsuranceYes
2011-11-01Plan funding arrangement – TrustYes
2011-11-01Plan benefit arrangement – InsuranceYes
2011-11-01Plan benefit arrangement - TrustYes
2010: ILLINOIS VALLEY SURGICAL ASSOCIATES PROFIT SHARING 401(K) PLAN 2010 form 5500 responses
2010-11-01Type of plan entitySingle employer plan
2010-11-01Submission has been amendedNo
2010-11-01This submission is the final filingNo
2010-11-01This return/report is a short plan year return/report (less than 12 months)No
2010-11-01Plan is a collectively bargained planNo
2010-11-01Plan funding arrangement – TrustYes
2010-11-01Plan benefit arrangement - TrustYes
2009: ILLINOIS VALLEY SURGICAL ASSOCIATES PROFIT SHARING 401(K) PLAN 2009 form 5500 responses
2009-11-01Type of plan entitySingle employer plan
2009-11-01Submission has been amendedNo
2009-11-01This submission is the final filingNo
2009-11-01This return/report is a short plan year return/report (less than 12 months)No
2009-11-01Plan is a collectively bargained planNo
2009-11-01Plan funding arrangement – InsuranceYes
2009-11-01Plan funding arrangement – TrustYes
2009-11-01Plan benefit arrangement – InsuranceYes
2009-11-01Plan 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 number48670
Policy instance 1
Insurance contract or identification number48670
Number of Individuals Covered12
Insurance policy start date2021-11-01
Insurance policy end date2022-10-31
Total amount of commissions paid to insurance brokerUSD $24,370
Total amount of fees paid to insurance companyUSD $2,686
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $24,370
Insurance broker organization code?3
Amount paid for insurance broker fees2686
Additional information about fees paid to insurance brokerTPA FORUM COMPENSATION
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number48670
Policy instance 1
Insurance contract or identification number48670
Number of Individuals Covered14
Insurance policy start date2020-11-01
Insurance policy end date2021-10-31
Total amount of commissions paid to insurance brokerUSD $27,121
Total amount of fees paid to insurance companyUSD $2,655
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $27,121
Insurance broker organization code?3
Amount paid for insurance broker fees2655
Additional information about fees paid to insurance brokerTPA FORUM COMPENSATION
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number48670
Policy instance 1
Insurance contract or identification number48670
Number of Individuals Covered13
Insurance policy start date2019-11-01
Insurance policy end date2020-10-31
Total amount of commissions paid to insurance brokerUSD $11,430
Total amount of fees paid to insurance companyUSD $2,030
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,430
Insurance broker organization code?3
Amount paid for insurance broker fees2030
Additional information about fees paid to insurance brokerTPA FORUM COMPENSATION
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number48670
Policy instance 1
Insurance contract or identification number48670
Number of Individuals Covered14
Insurance policy start date2018-11-01
Insurance policy end date2019-10-31
Total amount of commissions paid to insurance brokerUSD $18,294
Total amount of fees paid to insurance companyUSD $1,833
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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees1833
Additional information about fees paid to insurance brokerTPA FORUM COMPENSATION
Insurance broker organization code?5
Commission paid to Insurance BrokerUSD $18,294
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number48670
Policy instance 1
Insurance contract or identification number48670
Number of Individuals Covered15
Insurance policy start date2017-11-01
Insurance policy end date2018-10-31
Total amount of commissions paid to insurance brokerUSD $17,655
Total amount of fees paid to insurance companyUSD $1,769
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?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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