401k Plan data: PANAMA CITY SURGERY CENTER 401(K) PROFIT SHARING PLAN & TRUST plan

PANAMA CITY SURGERY CENTER 401(K) PROFIT SHARING PLAN & TRUST 401k Plan overview

Plan Name	PANAMA CITY SURGERY CENTER 401(K) PROFIT SHARING PLAN & TRUST
Plan identification number	001

PANAMA CITY SURGERY CENTER 401(K) PROFIT SHARING PLAN & TRUST Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
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.
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

PANAMA CITY SURGERY CENTER, LLC has sponsored the creation of one or more 401k plans.

Company Name: PANAMA CITY SURGERY CENTER, LLC

Employer identification number (EIN): 481255983

NAIC Classification: 812990
NAIC Description: All Other Personal Services

Additional information about PANAMA CITY SURGERY CENTER, LLC

Jurisdiction of Incorporation: Florida Department of State Division of Corporations

Incorporation Date: 2002-04-03

Company Identification Number: L02000008069

Legal Registered Office Address: 1200 S PINE ISLAND RD

PLANTATION

33324

More information about PANAMA CITY SURGERY CENTER, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PANAMA CITY SURGERY CENTER 401(K) PROFIT SHARING PLAN & TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2020-01-01 MICHAEL MADEWELL 2021-09-29
001 2019-01-01 MICHAEL MADEWELL 2021-01-14
001 2018-01-01 MICHAEL MADEWELL 2019-10-08
001 2017-01-01 MICHAEL MADEWELL 2019-02-28
001 2016-01-01 MICHAEL MADEWELL 2017-10-13
001 2015-01-01 MICHAEL MADEWELL
001 2014-01-01
001 2013-01-01
001 2012-01-01 MIKE MADEWELL 2013-10-09 MIKE MADEWELL 2013-10-09
001 2011-01-01 MIKE MADEWELL 2012-09-06 MIKE MADEWELL 2012-09-06
001 2010-01-01 MIKE MADEWELL MIKE MADEWELL 2011-10-05
001 2009-01-01 MIKE MADEWELL MIKE MADEWELL 2010-09-29

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2020-01-01	MICHAEL MADEWELL	2021-09-29
001	2019-01-01	MICHAEL MADEWELL	2021-01-14
001	2018-01-01	MICHAEL MADEWELL	2019-10-08
001	2017-01-01	MICHAEL MADEWELL	2019-02-28
001	2016-01-01	MICHAEL MADEWELL	2017-10-13
001	2015-01-01	MICHAEL MADEWELL
001	2014-01-01
001	2013-01-01
001	2012-01-01	MIKE MADEWELL	2013-10-09	MIKE MADEWELL	2013-10-09
001	2011-01-01	MIKE MADEWELL	2012-09-06	MIKE MADEWELL	2012-09-06
001	2010-01-01	MIKE MADEWELL		MIKE MADEWELL	2011-10-05
001	2009-01-01	MIKE MADEWELL		MIKE MADEWELL	2010-09-29

Plan Statistics for PANAMA CITY SURGERY CENTER 401(K) PROFIT SHARING PLAN & TRUST

401k plan membership statisitcs for PANAMA CITY SURGERY CENTER 401(K) PROFIT SHARING PLAN & TRUST

Measure Date Value
2015: PANAMA CITY SURGERY CENTER 401(K) PROFIT SHARING 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 16
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 51
Total of all active and inactive participants 2015-01-01 67
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 67
Number of participants with account balances 2015-01-01 65
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2010: PANAMA CITY SURGERY CENTER 401(K) PROFIT SHARING PLAN & TRUST 2010 401k membership
Total participants, beginning-of-year 2010-01-01 59
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 54
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 1
Total of all active and inactive participants 2010-01-01 55
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 55
Number of participants with account balances 2010-01-01 30
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: PANAMA CITY SURGERY CENTER 401(K) PROFIT SHARING PLAN & TRUST 2009 401k membership
Total participants, beginning-of-year 2009-01-01 58
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 59
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 0
Total of all active and inactive participants 2009-01-01 59
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 59
Number of participants with account balances 2009-01-01 28
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2015: PANAMA CITY SURGERY CENTER 401(K) PROFIT SHARING 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	16
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	51
Total of all active and inactive participants	2015-01-01	67
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	67
Number of participants with account balances	2015-01-01	65
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2010: PANAMA CITY SURGERY CENTER 401(K) PROFIT SHARING PLAN & TRUST 2010 401k membership
Total participants, beginning-of-year	2010-01-01	59
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	54
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	1
Total of all active and inactive participants	2010-01-01	55
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	55
Number of participants with account balances	2010-01-01	30
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: PANAMA CITY SURGERY CENTER 401(K) PROFIT SHARING PLAN & TRUST 2009 401k membership
Total participants, beginning-of-year	2009-01-01	58
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	59
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	0
Total of all active and inactive participants	2009-01-01	59
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	59
Number of participants with account balances	2009-01-01	28
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on PANAMA CITY SURGERY CENTER 401(K) PROFIT SHARING PLAN & TRUST

Measure	Date	Value
2015 : PANAMA CITY SURGERY CENTER 401(K) PROFIT SHARING PLAN & TRUST 2015 401k financial data
Transfers to/from the plan	2015-12-31	$0
Total plan liabilities at end of year	2015-12-31	$0
Total plan liabilities at beginning of year	2015-12-31	$0
Total income from all sources	2015-12-31	$949,118
Expenses. Total of all expenses incurred	2015-12-31	$44,196
Benefits paid (including direct rollovers)	2015-12-31	$38,298
Total plan assets at end of year	2015-12-31	$904,922
Total plan assets at beginning of year	2015-12-31	$0
Value of fidelity bond covering the plan	2015-12-31	$0
Total contributions received or receivable from participants	2015-12-31	$108,642
Expenses. Other expenses not covered elsewhere	2015-12-31	$0
Contributions received from other sources (not participants or employers)	2015-12-31	$0
Other income received	2015-12-31	$776,398
Net income (gross income less expenses)	2015-12-31	$904,922
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$904,922
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$0
Total contributions received or receivable from employer(s)	2015-12-31	$64,078
Value of certain deemed distributions of participant loans	2015-12-31	$0
Value of corrective distributions	2015-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2015-12-31	$5,898
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Funding deficiency by the employer to the plan for this plan year	2015-12-31	$0
Minimum employer required contribution for this plan year	2015-12-31	$0
Amount contributed by the employer to the plan for this plan year	2015-12-31	$0
2010 : PANAMA CITY SURGERY CENTER 401(K) PROFIT SHARING PLAN & TRUST 2010 401k financial data
Total income from all sources	2010-12-31	$111,797
Expenses. Total of all expenses incurred	2010-12-31	$48,861
Benefits paid (including direct rollovers)	2010-12-31	$48,861
Total plan assets at end of year	2010-12-31	$424,916
Total plan assets at beginning of year	2010-12-31	$361,980
Value of fidelity bond covering the plan	2010-12-31	$50,000
Total contributions received or receivable from participants	2010-12-31	$39,269
Contributions received from other sources (not participants or employers)	2010-12-31	$0
Other income received	2010-12-31	$41,129
Net income (gross income less expenses)	2010-12-31	$62,936
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$424,916
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$361,980
Assets. Value of participant loans	2010-12-31	$813
Total contributions received or receivable from employer(s)	2010-12-31	$31,399

Form 5500 Responses for PANAMA CITY SURGERY CENTER 401(K) PROFIT SHARING PLAN & TRUST

2015: PANAMA CITY SURGERY CENTER 401(K) PROFIT SHARING PLAN & TRUST 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2010: PANAMA CITY SURGERY CENTER 401(K) PROFIT SHARING PLAN & TRUST 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: PANAMA CITY SURGERY CENTER 401(K) PROFIT SHARING PLAN & TRUST 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 – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

GP 69610

Policy instance

Insurance contract or identification number	GP 69610
Number of Individuals Covered	37
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $907
Total amount of fees paid to insurance company	USD $20

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Company Name:	PANAMA CITY SURGERY CENTER, LLC
Employer identification number (EIN):	481255983
NAIC Classification:	812990
NAIC Description:	All Other Personal Services

Jurisdiction of Incorporation:	Florida Department of State Division of Corporations
Incorporation Date:	2002-04-03
Company Identification Number:	L02000008069
Legal Registered Office Address:	1200 S PINE ISLAND RD PLANTATION 33324