401k Plan data: SOUTHEAST EYE SPECIALISTS, PLLC 401(K) PROFIT SHARING PLAN plan

SOUTHEAST EYE SPECIALISTS, PLLC 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan Name	SOUTHEAST EYE SPECIALISTS, PLLC 401(K) PROFIT SHARING PLAN
Plan identification number	001

SOUTHEAST EYE SPECIALISTS, PLLC 401(K) PROFIT SHARING PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
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.
Plan covering Self-Employed individuals.
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.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

SOUTHEAST EYE SPECIALISTS, PLLC has sponsored the creation of one or more 401k plans.

Company Name: SOUTHEAST EYE SPECIALISTS, PLLC

Employer identification number (EIN): 621791165

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SOUTHEAST EYE SPECIALISTS, PLLC 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2016-01-01 JOHN R BIERLY
001 2015-01-01 JOHN R BIERLY
001 2014-01-01 JOHN R. BIERLY 2015-10-12
001 2013-01-01 JOHN R. BIERLY 2014-07-31 JOHN R. BIERLY 2014-07-31
001 2012-01-01 JOHN R. BIERLY 2013-07-25 JOHN R. BIERLY 2013-07-25
001 2011-01-01 C. PAT HILLIARD 2012-10-10
001 2010-01-01 C. PAT HILLIARD 2011-10-13

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2016-01-01	JOHN R BIERLY
001	2015-01-01	JOHN R BIERLY
001	2014-01-01	JOHN R. BIERLY	2015-10-12
001	2013-01-01	JOHN R. BIERLY	2014-07-31	JOHN R. BIERLY	2014-07-31
001	2012-01-01	JOHN R. BIERLY	2013-07-25	JOHN R. BIERLY	2013-07-25
001	2011-01-01	C. PAT HILLIARD	2012-10-10
001	2010-01-01	C. PAT HILLIARD	2011-10-13

Plan Statistics for SOUTHEAST EYE SPECIALISTS, PLLC 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for SOUTHEAST EYE SPECIALISTS, PLLC 401(K) PROFIT SHARING PLAN

Measure Date Value
2016: SOUTHEAST EYE SPECIALISTS, PLLC 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 167
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 129
Number of retired or separated participants receiving benefits 2016-01-01 5
Number of other retired or separated participants entitled to future benefits 2016-01-01 23
Total of all active and inactive participants 2016-01-01 157
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 157
Number of participants with account balances 2016-01-01 156
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 14
2015: SOUTHEAST EYE SPECIALISTS, PLLC 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 142
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 113
Number of retired or separated participants receiving benefits 2015-01-01 6
Number of other retired or separated participants entitled to future benefits 2015-01-01 33
Total of all active and inactive participants 2015-01-01 152
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 152
Number of participants with account balances 2015-01-01 151
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 8

Measure	Date	Value
2016: SOUTHEAST EYE SPECIALISTS, PLLC 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	167
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	129
Number of retired or separated participants receiving benefits	2016-01-01	5
Number of other retired or separated participants entitled to future benefits	2016-01-01	23
Total of all active and inactive participants	2016-01-01	157
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	157
Number of participants with account balances	2016-01-01	156
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	14
2015: SOUTHEAST EYE SPECIALISTS, PLLC 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	142
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	113
Number of retired or separated participants receiving benefits	2015-01-01	6
Number of other retired or separated participants entitled to future benefits	2015-01-01	33
Total of all active and inactive participants	2015-01-01	152
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	152
Number of participants with account balances	2015-01-01	151
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	8

Financial Data on SOUTHEAST EYE SPECIALISTS, PLLC 401(K) PROFIT SHARING PLAN

Measure	Date	Value
2016 : SOUTHEAST EYE SPECIALISTS, PLLC 401(K) PROFIT SHARING PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$12,795
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$12,412
Total income from all sources (including contributions)	2016-12-31	$1,462,770
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$188,513
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$180,979
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$831,979
Value of total assets at end of year	2016-12-31	$9,539,607
Value of total assets at beginning of year	2016-12-31	$8,264,967
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$7,534
Total interest from all sources	2016-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Administrative expenses professional fees incurred	2016-12-31	$7,534
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$500,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$411,067
Participant contributions at end of year	2016-12-31	$665
Participant contributions at beginning of year	2016-12-31	$8,855
Liabilities. Value of operating payables at end of year	2016-12-31	$12,795
Liabilities. Value of operating payables at beginning of year	2016-12-31	$12,412
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$1,274,257
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$9,526,812
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$8,252,555
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$9,320,882
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$8,034,288
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$630,791
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$420,912
Employer contributions (assets) at end of year	2016-12-31	$218,060
Employer contributions (assets) at beginning of year	2016-12-31	$221,824
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$180,979
Did the plan have assets held for investment	2016-12-31	Yes
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	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	HENDERSON, HUTCHERSON & MCCULLOUGH
Accountancy firm EIN	2016-12-31	621114363
2015 : SOUTHEAST EYE SPECIALISTS, PLLC 401(K) PROFIT SHARING PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$12,412
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$792,591
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$176,926
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$164,115
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$711,978
Value of total assets at end of year	2015-12-31	$8,264,967
Value of total assets at beginning of year	2015-12-31	$7,636,890
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$12,811
Total interest from all sources	2015-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Administrative expenses professional fees incurred	2015-12-31	$12,811
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$500,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$336,008
Participant contributions at end of year	2015-12-31	$8,855
Liabilities. Value of operating payables at end of year	2015-12-31	$12,412
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$615,665
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$8,252,555
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$7,636,890
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$8,034,288
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$7,456,385
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$80,613
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$375,970
Employer contributions (assets) at end of year	2015-12-31	$221,824
Employer contributions (assets) at beginning of year	2015-12-31	$180,505
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$164,115
Did the plan have assets held for investment	2015-12-31	Yes
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	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	HENDERSON, HUTCHERSON & MCCULLOUGH
Accountancy firm EIN	2015-12-31	621114363

Form 5500 Responses for SOUTHEAST EYE SPECIALISTS, PLLC 401(K) PROFIT SHARING PLAN

2016: SOUTHEAST EYE SPECIALISTS, PLLC 401(K) PROFIT SHARING PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: SOUTHEAST EYE SPECIALISTS, PLLC 401(K) PROFIT SHARING PLAN 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

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Company Name:	SOUTHEAST EYE SPECIALISTS, PLLC
Employer identification number (EIN):	621791165
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)