401k Plan data: NORTHWEST ANESTHESIA, P.A. CASH BALANCE DEFINED BENEFIT PLAN plan

NORTHWEST ANESTHESIA, P.A. CASH BALANCE DEFINED BENEFIT PLAN 401k Plan overview

Plan Name	NORTHWEST ANESTHESIA, P.A. CASH BALANCE DEFINED BENEFIT PLAN
Plan identification number	003

NORTHWEST ANESTHESIA, P.A. CASH BALANCE DEFINED BENEFIT PLAN Benefits

401k Plan Type

Defined Benefit Pension

Plan Features/Benefits

Benefits are primarily pay related
Cash balance or similar plan - Plan has a "cash balance" formula. For this purpose, a "cash balance" formula is a benefit formula in a defined benefit plan by whatever name (for example, personal account plan, pension equity plan, life cycle plan, cash account plan, etc.) that rather than, or in addition to, expressing the accrued benefit as a life annuity commencing at normal retirement age, defines benefits for each employee in terms more common to a defined contribution plan such as a single sum distribution amount (for example, 10 percent of final average pay times years of service, or the amount of the employee's hypothetical account balance).
Covered by PBGC - Plan is covered under the PBGC insurance program (see ERISA section 4021).
Plan covered by PBGC that was terminated and closed out for PBGC purposes - Before the end of the plan year (or a prior plan year), (1) the plan terminated in a standard (or distress) termination and completed the distribution of plan assets in satisfaction of all benefit liabilities (or all ERISA Title IV benefits for distress termination); or (2) a trustee was appointed for a terminated plan pursuant to ERISA section 4042.

401k Sponsoring company profile

NORTHWEST ANESTHESIA, P.A. has sponsored the creation of one or more 401k plans.

Company Name: NORTHWEST ANESTHESIA, P.A.

Employer identification number (EIN): 411227535

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NORTHWEST ANESTHESIA, P.A. CASH BALANCE DEFINED BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
003 2017-01-01 RICHARD SKOOG 2017-10-09 RICHARD SKOOG 2017-10-09
003 2016-01-01 RICHARD SKOOG 2017-10-09 RICHARD SKOOG 2017-10-09
003 2015-01-01 RICHARD SKOOG 2016-10-14 RICHARD SKOOG 2016-10-14
003 2014-01-01 DAVID ROTHSCHILLER 2015-07-24 DAVID ROTHSCHILLER 2015-07-24
003 2013-01-01 DAVID ROTHSCHILLER 2014-07-28
003 2012-01-01 DAVID ROTHSCHILLER 2013-07-30 DAVID ROTHSCHILLER 2013-07-30
003 2011-01-01 CRAIG PELL 2012-07-30
003 2010-01-01 BRIAN PONTO 2011-07-12 BRIAN PONTO 2011-07-12
003 2009-01-01 BRIAN PONTO BRIAN PONTO 2010-10-14

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
003	2017-01-01	RICHARD SKOOG	2017-10-09	RICHARD SKOOG	2017-10-09
003	2016-01-01	RICHARD SKOOG	2017-10-09	RICHARD SKOOG	2017-10-09
003	2015-01-01	RICHARD SKOOG	2016-10-14	RICHARD SKOOG	2016-10-14
003	2014-01-01	DAVID ROTHSCHILLER	2015-07-24	DAVID ROTHSCHILLER	2015-07-24
003	2013-01-01	DAVID ROTHSCHILLER	2014-07-28
003	2012-01-01	DAVID ROTHSCHILLER	2013-07-30	DAVID ROTHSCHILLER	2013-07-30
003	2011-01-01	CRAIG PELL	2012-07-30
003	2010-01-01	BRIAN PONTO	2011-07-12	BRIAN PONTO	2011-07-12
003	2009-01-01	BRIAN PONTO		BRIAN PONTO	2010-10-14

Plan Statistics for NORTHWEST ANESTHESIA, P.A. CASH BALANCE DEFINED BENEFIT PLAN

401k plan membership statisitcs for NORTHWEST ANESTHESIA, P.A. CASH BALANCE DEFINED BENEFIT PLAN

Measure Date Value
2016: NORTHWEST ANESTHESIA, P.A. CASH BALANCE DEFINED BENEFIT PLAN 2016 401k membership
Market value of plan assets 2016-12-31 9,261,593
Acturial value of plan assets 2016-12-31 9,261,593
Funding target for retired participants and beneficiaries receiving payment 2016-12-31 0
Number of terminated vested participants 2016-12-31 7
Fundng target for terminated vested participants 2016-12-31 39,090
Active participant vested funding target 2016-12-31 6,031,940
Number of active participants 2016-12-31 49
Total funding liabilities for active participants 2016-12-31 6,041,892
Total participant count 2016-12-31 56
Total funding target for all participants 2016-12-31 6,080,982
Balance at beginning of prior year after applicable adjustments 2016-12-31 334,865
Prefunding balance at beginning of prior year after applicable adjustments 2016-12-31 0
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 2016-12-31 334,865
Amount remaining of prefunding balance 2016-12-31 0
Present value of excess contributions 2016-12-31 1,016,415
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance 2016-12-31 1,079,433
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 0
Balance of carryovers at beginning of current year 2016-12-31 334,363
Balance of prefunding at beginning of current year 2016-12-31 0
Total employer contributions 2016-12-31 771,599
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 2016-12-31 741,778
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 1,106,293
Total funding amount beforereflecting carryover/prefunding balances 2016-12-31 0
Additional cash requirement 2016-12-31 0
Contributions allocatedtoward minimum required contributions for current year 2016-12-31 741,778
Unpaid minimum required contributions for current year 2016-12-31 0
Unpaid minimum required contributions for all years 2016-12-31 0
2009: NORTHWEST ANESTHESIA, P.A. CASH BALANCE DEFINED BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 50
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 47
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 3
Total of all active and inactive participants 2009-01-01 50
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 50
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2016: NORTHWEST ANESTHESIA, P.A. CASH BALANCE DEFINED BENEFIT PLAN 2016 401k membership
Market value of plan assets	2016-12-31	9,261,593
Acturial value of plan assets	2016-12-31	9,261,593
Funding target for retired participants and beneficiaries receiving payment	2016-12-31	0
Number of terminated vested participants	2016-12-31	7
Fundng target for terminated vested participants	2016-12-31	39,090
Active participant vested funding target	2016-12-31	6,031,940
Number of active participants	2016-12-31	49
Total funding liabilities for active participants	2016-12-31	6,041,892
Total participant count	2016-12-31	56
Total funding target for all participants	2016-12-31	6,080,982
Balance at beginning of prior year after applicable adjustments	2016-12-31	334,865
Prefunding balance at beginning of prior year after applicable adjustments	2016-12-31	0
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	334,865
Amount remaining of prefunding balance	2016-12-31	0
Present value of excess contributions	2016-12-31	1,016,415
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance	2016-12-31	1,079,433
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	0
Balance of carryovers at beginning of current year	2016-12-31	334,363
Balance of prefunding at beginning of current year	2016-12-31	0
Total employer contributions	2016-12-31	771,599
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	741,778
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	1,106,293
Total funding amount beforereflecting carryover/prefunding balances	2016-12-31	0
Additional cash requirement	2016-12-31	0
Contributions allocatedtoward minimum required contributions for current year	2016-12-31	741,778
Unpaid minimum required contributions for current year	2016-12-31	0
Unpaid minimum required contributions for all years	2016-12-31	0
2009: NORTHWEST ANESTHESIA, P.A. CASH BALANCE DEFINED BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	50
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	47
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	3
Total of all active and inactive participants	2009-01-01	50
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	50
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on NORTHWEST ANESTHESIA, P.A. CASH BALANCE DEFINED BENEFIT PLAN

Measure	Date	Value
2009 : NORTHWEST ANESTHESIA, P.A. CASH BALANCE DEFINED BENEFIT 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 NORTHWEST ANESTHESIA, P.A. CASH BALANCE DEFINED BENEFIT PLAN

2009: NORTHWEST ANESTHESIA, P.A. CASH BALANCE DEFINED BENEFIT 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:	NORTHWEST ANESTHESIA, P.A.
Employer identification number (EIN):	411227535
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)