401k Plan data: BERKELEY EYE CENTER EMPLOYEE BENEFIT PLAN TRUST plan

BERKELEY EYE CENTER EMPLOYEE BENEFIT PLAN TRUST 401k Plan overview

Plan Name	BERKELEY EYE CENTER EMPLOYEE BENEFIT PLAN TRUST
Plan identification number	505

BERKELEY EYE CENTER EMPLOYEE BENEFIT PLAN TRUST Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision)

401k Sponsoring company profile

BERKELEY EYE INSTITUTE, PA DBA BERKELEY EYE CENTER has sponsored the creation of one or more 401k plans.

Company Name: BERKELEY EYE INSTITUTE, PA DBA BERKELEY EYE CENTER

Employer identification number (EIN): 432012505

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BERKELEY EYE CENTER EMPLOYEE BENEFIT PLAN TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
505 2015-01-01 RON COPELAND
505 2014-01-01 RON COPELAND
505 2013-01-01 RON COPELAND
505 2012-01-01 RON COPELAND RON COPELAND 2013-10-15
505 2011-01-01 RON COPELAND RON COPELAND 2012-10-16

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
505	2015-01-01	RON COPELAND
505	2014-01-01	RON COPELAND
505	2013-01-01	RON COPELAND
505	2012-01-01	RON COPELAND	RON COPELAND	2013-10-15
505	2011-01-01	RON COPELAND	RON COPELAND	2012-10-16

Plan Statistics for BERKELEY EYE CENTER EMPLOYEE BENEFIT PLAN TRUST

401k plan membership statisitcs for BERKELEY EYE CENTER EMPLOYEE BENEFIT PLAN TRUST

Measure Date Value
2015: BERKELEY EYE CENTER EMPLOYEE BENEFIT PLAN TRUST 2015 401k membership
Total participants, beginning-of-year 2015-01-01 0
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 0
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 0
2014: BERKELEY EYE CENTER EMPLOYEE BENEFIT PLAN TRUST 2014 401k membership
Total participants, beginning-of-year 2014-01-01 176
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 191
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 2014-01-01 191
2013: BERKELEY EYE CENTER EMPLOYEE BENEFIT PLAN TRUST 2013 401k membership
Total participants, beginning-of-year 2013-01-01 152
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 167
Total of all active and inactive participants 2013-01-01 167
2012: BERKELEY EYE CENTER EMPLOYEE BENEFIT PLAN TRUST 2012 401k membership
Total participants, beginning-of-year 2012-01-01 247
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 138
Total of all active and inactive participants 2012-01-01 138
Total participants 2012-01-01 138
2011: BERKELEY EYE CENTER EMPLOYEE BENEFIT PLAN TRUST 2011 401k membership
Total participants, beginning-of-year 2011-01-01 246
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 247
Total of all active and inactive participants 2011-01-01 247
Total participants 2011-01-01 247

Measure	Date	Value
2015: BERKELEY EYE CENTER EMPLOYEE BENEFIT PLAN TRUST 2015 401k membership
Total participants, beginning-of-year	2015-01-01	0
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	0
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	0
2014: BERKELEY EYE CENTER EMPLOYEE BENEFIT PLAN TRUST 2014 401k membership
Total participants, beginning-of-year	2014-01-01	176
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	191
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	191
2013: BERKELEY EYE CENTER EMPLOYEE BENEFIT PLAN TRUST 2013 401k membership
Total participants, beginning-of-year	2013-01-01	152
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	167
Total of all active and inactive participants	2013-01-01	167
2012: BERKELEY EYE CENTER EMPLOYEE BENEFIT PLAN TRUST 2012 401k membership
Total participants, beginning-of-year	2012-01-01	247
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	138
Total of all active and inactive participants	2012-01-01	138
Total participants	2012-01-01	138
2011: BERKELEY EYE CENTER EMPLOYEE BENEFIT PLAN TRUST 2011 401k membership
Total participants, beginning-of-year	2011-01-01	246
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	247
Total of all active and inactive participants	2011-01-01	247
Total participants	2011-01-01	247

Financial Data on BERKELEY EYE CENTER EMPLOYEE BENEFIT PLAN TRUST

Measure	Date	Value
2015 : BERKELEY EYE CENTER EMPLOYEE BENEFIT PLAN TRUST 2015 401k financial data
Total income from all sources	2015-12-31	$0
Expenses. Total of all expenses incurred	2015-12-31	$307
Benefits paid (including direct rollovers)	2015-12-31	$307
Total plan assets at end of year	2015-12-31	$0
Total plan assets at beginning of year	2015-12-31	$307
Value of fidelity bond covering the plan	2015-12-31	$2,000,000
Net income (gross income less expenses)	2015-12-31	$-307
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$0
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$307
2014 : BERKELEY EYE CENTER EMPLOYEE BENEFIT PLAN TRUST 2014 401k financial data
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$12,848
Total income from all sources (including contributions)	2014-12-31	$1,015,423
Total of all expenses incurred	2014-12-31	$1,002,268
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$896,310
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$1,015,423
Value of total assets at end of year	2014-12-31	$307
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$105,958
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2014-12-31	$0
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$500,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$263,566
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2014-12-31	$896,310
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2014-12-31	$12,848
Administrative expenses (other) incurred	2014-12-31	$105,958
Total non interest bearing cash at end of year	2014-12-31	$307
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$13,155
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$307
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$-12,848
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$751,857
Did the plan have assets held for investment	2014-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	No
Opinion of an independent qualified public accountant for this plan	2014-12-31	Unqualified
Accountancy firm name	2014-12-31	MOORE, REICHL & BAKER, PC
Accountancy firm EIN	2014-12-31	760520230
2013 : BERKELEY EYE CENTER EMPLOYEE BENEFIT PLAN TRUST 2013 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$12,848
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$34,788
Total income from all sources (including contributions)	2013-12-31	$836,178
Total of all expenses incurred	2013-12-31	$814,238
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$730,109
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$836,178
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$84,129
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$500,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$222,895
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2013-12-31	$730,109
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2013-12-31	$12,848
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2013-12-31	$34,788
Administrative expenses (other) incurred	2013-12-31	$84,129
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$21,940
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$-12,848
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$-34,788
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$613,283
Did the plan have assets held for investment	2013-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	No
Opinion of an independent qualified public accountant for this plan	2013-12-31	Unqualified
Accountancy firm name	2013-12-31	MOORE, REICHL & BAKER, PC
Accountancy firm EIN	2013-12-31	760520230
2012 : BERKELEY EYE CENTER EMPLOYEE BENEFIT PLAN TRUST 2012 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$34,788
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$75,219
Total income from all sources (including contributions)	2012-12-31	$650,632
Total of all expenses incurred	2012-12-31	$610,201
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$538,268
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$650,632
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$71,933
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Was this plan covered by a fidelity bond	2012-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$181,486
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2012-12-31	$34,788
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2012-12-31	$75,219
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$40,431
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$-34,788
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$-75,219
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Expenses. Payments to insurance carriers foe the provision of benefits	2012-12-31	$538,268
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$469,146
Contract administrator fees	2012-12-31	$71,933
Did the plan have assets held for investment	2012-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	No
Opinion of an independent qualified public accountant for this plan	2012-12-31	Unqualified
Accountancy firm name	2012-12-31	EEPB, P.C.
Accountancy firm EIN	2012-12-31	760222094
2011 : BERKELEY EYE CENTER EMPLOYEE BENEFIT PLAN TRUST 2011 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$75,219
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$458,000
Total of all expenses incurred	2011-12-31	$533,219
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$467,495
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$458,000
Value of total assets at end of year	2011-12-31	$0
Value of total assets at beginning of year	2011-12-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$65,724
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Administrative expenses professional fees incurred	2011-12-31	$65,724
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$2,000,000
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$171,577
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2011-12-31	$287,301
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2011-12-31	$75,219
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2011-12-31	$0
Total non interest bearing cash at end of year	2011-12-31	$0
Total non interest bearing cash at beginning of year	2011-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$-75,219
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$-75,219
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Expenses. Payments to insurance carriers foe the provision of benefits	2011-12-31	$180,194
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$286,423
Did the plan have assets held for investment	2011-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	No
Opinion of an independent qualified public accountant for this plan	2011-12-31	Unqualified
Accountancy firm name	2011-12-31	EEPB, P.C.
Accountancy firm EIN	2011-12-31	760222094

Form 5500 Responses for BERKELEY EYE CENTER EMPLOYEE BENEFIT PLAN TRUST

2015: BERKELEY EYE CENTER EMPLOYEE BENEFIT PLAN TRUST 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	This submission is the final filing	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: BERKELEY EYE CENTER EMPLOYEE BENEFIT PLAN TRUST 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: BERKELEY EYE CENTER EMPLOYEE BENEFIT PLAN TRUST 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: BERKELEY EYE CENTER EMPLOYEE BENEFIT PLAN TRUST 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 funding arrangement – General assets of the sponsor	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2012-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: BERKELEY EYE CENTER EMPLOYEE BENEFIT PLAN TRUST 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	First time form 5500 has been submitted	Yes
2011-01-01	Submission has been amended	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2011-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

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Company Name:	BERKELEY EYE INSTITUTE, PA DBA BERKELEY EYE CENTER
Employer identification number (EIN):	432012505
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)