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DA VINCI FOOT AND ANKLE 401(K) PLAN 401k Plan overview

Plan NameDA VINCI FOOT AND ANKLE 401(K) PLAN
Plan identification number 001

DA VINCI FOOT AND ANKLE 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.
  • 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.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Participant-directed brokerage accounts provided as an investment option under the plan.
  • 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

DA VINCI FOOT AND ANKLE has sponsored the creation of one or more 401k plans.

Company Name:DA VINCI FOOT AND ANKLE
Employer identification number (EIN):475644731
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DA VINCI FOOT AND ANKLE 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01ALLISON MENKE2023-10-04 ALLISON MENKE2023-10-04
0012021-01-01ALLISON MENKE2022-10-13 ALLISON MENKE2022-10-13
0012020-01-01CHRISTOPHER MENKE2021-10-12 CHRISTOPHER MENKE2021-10-12
0012019-01-01
0012018-01-01CHRISTOPHER MENKE CHRISTOPHER MENKE2019-07-24
0012017-01-01CHRISTOPHER MENKE CHRISTOPHER MENKE2018-10-13
0012016-01-01CHRISTOPHER MENKE2017-10-12 CHRISTOPHER MENKE2017-10-12

Plan Statistics for DA VINCI FOOT AND ANKLE 401(K) PLAN

401k plan membership statisitcs for DA VINCI FOOT AND ANKLE 401(K) PLAN

Measure Date Value
2019: DA VINCI FOOT AND ANKLE 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-018
Total number of active participants reported on line 7a of the Form 55002019-01-018
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 participants2019-01-018
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-018
Number of participants with account balances2019-01-014
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: DA VINCI FOOT AND ANKLE 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-016
Total number of active participants reported on line 7a of the Form 55002018-01-016
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 participants2018-01-016
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-016
Number of participants with account balances2018-01-012
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: DA VINCI FOOT AND ANKLE 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-012
Total number of active participants reported on line 7a of the Form 55002017-01-012
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 participants2017-01-012
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-012
Number of participants with account balances2017-01-012
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010

Financial Data on DA VINCI FOOT AND ANKLE 401(K) PLAN

Measure Date Value
2019 : DA VINCI FOOT AND ANKLE 401(K) PLAN 2019 401k financial data
Transfers to/from the plan2019-12-31$0
Total plan liabilities at end of year2019-12-31$0
Total plan liabilities at beginning of year2019-12-31$0
Total income from all sources2019-12-31$192,810
Expenses. Total of all expenses incurred2019-12-31$185
Benefits paid (including direct rollovers)2019-12-31$0
Total plan assets at end of year2019-12-31$347,277
Total plan assets at beginning of year2019-12-31$154,652
Total contributions received or receivable from participants2019-12-31$40,728
Expenses. Other expenses not covered elsewhere2019-12-31$0
Contributions received from other sources (not participants or employers)2019-12-31$100,000
Other income received2019-12-31$39,887
Noncash contributions received2019-12-31$0
Net income (gross income less expenses)2019-12-31$192,625
Net plan assets at end of year (total assets less liabilities)2019-12-31$347,277
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$154,652
Assets. Value of participant loans2019-12-31$44,594
Total contributions received or receivable from employer(s)2019-12-31$12,195
Value of certain deemed distributions of participant loans2019-12-31$0
Value of corrective distributions2019-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$185
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
2018 : DA VINCI FOOT AND ANKLE 401(K) PLAN 2018 401k financial data
Transfers to/from the plan2018-12-31$0
Total plan liabilities at end of year2018-12-31$0
Total plan liabilities at beginning of year2018-12-31$0
Total income from all sources2018-12-31$33,246
Expenses. Total of all expenses incurred2018-12-31$0
Benefits paid (including direct rollovers)2018-12-31$0
Total plan assets at end of year2018-12-31$154,652
Total plan assets at beginning of year2018-12-31$121,406
Total contributions received or receivable from participants2018-12-31$37,000
Expenses. Other expenses not covered elsewhere2018-12-31$0
Contributions received from other sources (not participants or employers)2018-12-31$0
Other income received2018-12-31$-14,154
Noncash contributions received2018-12-31$0
Net income (gross income less expenses)2018-12-31$33,246
Net plan assets at end of year (total assets less liabilities)2018-12-31$154,652
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$121,406
Assets. Value of participant loans2018-12-31$7,592
Total contributions received or receivable from employer(s)2018-12-31$10,400
Value of certain deemed distributions of participant loans2018-12-31$0
Value of corrective distributions2018-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
2017 : DA VINCI FOOT AND ANKLE 401(K) PLAN 2017 401k financial data
Transfers to/from the plan2017-12-31$0
Total plan liabilities at end of year2017-12-31$0
Total plan liabilities at beginning of year2017-12-31$0
Total income from all sources2017-12-31$121,406
Expenses. Total of all expenses incurred2017-12-31$0
Benefits paid (including direct rollovers)2017-12-31$0
Total plan assets at end of year2017-12-31$121,406
Total plan assets at beginning of year2017-12-31$0
Total contributions received or receivable from participants2017-12-31$37,136
Expenses. Other expenses not covered elsewhere2017-12-31$0
Contributions received from other sources (not participants or employers)2017-12-31$77,406
Other income received2017-12-31$1,603
Noncash contributions received2017-12-31$0
Net income (gross income less expenses)2017-12-31$121,406
Net plan assets at end of year (total assets less liabilities)2017-12-31$121,406
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$0
Assets. Value of participant loans2017-12-31$16,086
Total contributions received or receivable from employer(s)2017-12-31$5,261
Value of certain deemed distributions of participant loans2017-12-31$0
Value of corrective distributions2017-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2017-12-31$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0

Form 5500 Responses for DA VINCI FOOT AND ANKLE 401(K) PLAN

2019: DA VINCI FOOT AND ANKLE 401(K) 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 filingNo
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 – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: DA VINCI FOOT AND ANKLE 401(K) 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: DA VINCI FOOT AND ANKLE 401(K) 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

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number131243
Policy instance 1
Insurance contract or identification number131243
Number of Individuals Covered4
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $318
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?Yes
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
Amount paid for insurance broker fees318
Additional information about fees paid to insurance brokerLOAN FEE AND TPA COMPENSATION
Insurance broker organization code?5
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number131243
Policy instance 1
Insurance contract or identification number131243
Number of Individuals Covered2
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $775
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?Yes
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
Amount paid for insurance broker fees775
Additional information about fees paid to insurance brokerTPA COMPENSATION
Insurance broker organization code?5
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number131243
Policy instance 1
Insurance contract or identification number131243
Number of Individuals Covered2
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $126
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?Yes
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
Amount paid for insurance broker fees126
Additional information about fees paid to insurance brokerTPA COMPENSATION
Insurance broker organization code?5
Insurance broker namePROFESSIONAL PENSION SERVICES, INC.

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