401k Plan data: ABILENE DIAGNOSTIC CLINIC PLLC DBPP & T #3 plan

ABILENE DIAGNOSTIC CLINIC PLLC DBPP & T #3 401k Plan overview

Plan Name	ABILENE DIAGNOSTIC CLINIC PLLC DBPP & T #3
Plan identification number	004

ABILENE DIAGNOSTIC CLINIC PLLC DBPP & T #3 Benefits

401k Plan Type	Defined Benefit Pension
Plan Features/Benefits	Benefits are primarily pay related Covered by PBGC - Plan is covered under the PBGC insurance program (see ERISA section 4021). Frozen Plan - As of the last day of the plan year, the plan provides that no participant will get any new benefit accrual (whether because of service or compensation).

401k Sponsoring company profile

ABILENE DIAGNOSTIC CLINIC, PLLC has sponsored the creation of one or more 401k plans.

Company Name: ABILENE DIAGNOSTIC CLINIC, PLLC

Employer identification number (EIN): 752624216

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ABILENE DIAGNOSTIC CLINIC PLLC DBPP & T #3

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
004 2016-01-01 ANDREW KOUBA 2017-11-03
004 2015-01-01
004 2014-01-01 LINDA STANLEY 2015-10-05
004 2013-01-01 LINDA STANLEY 2014-10-02
004 2012-01-01 LINDA STANLEY 2013-10-10
004 2011-01-01 LINDA STANLEY 2012-10-10
004 2010-01-01 LINDA STANLEY 2011-07-18

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
004	2016-01-01	ANDREW KOUBA	2017-11-03
004	2015-01-01
004	2014-01-01	LINDA STANLEY	2015-10-05
004	2013-01-01	LINDA STANLEY	2014-10-02
004	2012-01-01	LINDA STANLEY	2013-10-10
004	2011-01-01	LINDA STANLEY	2012-10-10
004	2010-01-01	LINDA STANLEY	2011-07-18

Plan Statistics for ABILENE DIAGNOSTIC CLINIC PLLC DBPP & T #3

401k plan membership statisitcs for ABILENE DIAGNOSTIC CLINIC PLLC DBPP & T #3

Measure Date Value
2016: ABILENE DIAGNOSTIC CLINIC PLLC DBPP & T #3 2016 401k membership
Market value of plan assets 2016-09-01 550,718
Acturial value of plan assets 2016-09-01 550,718
Funding target for retired participants and beneficiaries receiving payment 2016-09-01 0
Number of terminated vested participants 2016-09-01 1
Fundng target for terminated vested participants 2016-09-01 534,806
Active participant vested funding target 2016-09-01 0
Number of active participants 2016-09-01 0
Total funding liabilities for active participants 2016-09-01 0
Total participant count 2016-09-01 1
Total funding target for all participants 2016-09-01 534,806
Balance at beginning of prior year after applicable adjustments 2016-09-01 55,976
Prefunding balance at beginning of prior year after applicable adjustments 2016-09-01 0
Amount remaining of carryover balance 2016-09-01 55,976
Amount remaining of prefunding balance 2016-09-01 0
Present value of excess contributions 2016-09-01 0
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance 2016-09-01 0
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance 2016-09-01 0
Reductions in prefunding balances due to elections or deemed elections 2016-09-01 0
Balance of carryovers at beginning of current year 2016-09-01 54,353
Balance of prefunding at beginning of current year 2016-09-01 0
Total employer contributions 2016-09-01 0
Total employee contributions 2016-09-01 0
Contributions allocated toward unpaid minimum require contributions from prior years 2016-09-01 0
Contributions made to avoid restrictions adjusted to valuation date 2016-09-01 0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date 2016-09-01 0
Unpaid minimum required contributions for all prior years 2016-09-01 0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years 2016-09-01 0
Remaining amount of unpaid minimum required contributions 2016-09-01 0
Minimum required contributions for current year target normal cost 2016-09-01 3,156
Net shortfall amortization installment of oustanding balance 2016-09-01 0
Waiver amortization installment 2016-09-01 0
Total funding amount beforereflecting carryover/prefunding balances 2016-09-01 3,156
Carryover balance elected to use to offset funding requirement 2016-09-01 3,156
Prefunding balance elected to use to offset funding requirement 2016-09-01 0
Additional cash requirement 2016-09-01 0
Contributions allocatedtoward minimum required contributions for current year 2016-09-01 0
Unpaid minimum required contributions for current year 2016-09-01 0
Unpaid minimum required contributions for all years 2016-09-01 0

Measure	Date	Value
2016: ABILENE DIAGNOSTIC CLINIC PLLC DBPP & T #3 2016 401k membership
Market value of plan assets	2016-09-01	550,718
Acturial value of plan assets	2016-09-01	550,718
Funding target for retired participants and beneficiaries receiving payment	2016-09-01	0
Number of terminated vested participants	2016-09-01	1
Fundng target for terminated vested participants	2016-09-01	534,806
Active participant vested funding target	2016-09-01	0
Number of active participants	2016-09-01	0
Total funding liabilities for active participants	2016-09-01	0
Total participant count	2016-09-01	1
Total funding target for all participants	2016-09-01	534,806
Balance at beginning of prior year after applicable adjustments	2016-09-01	55,976
Prefunding balance at beginning of prior year after applicable adjustments	2016-09-01	0
Amount remaining of carryover balance	2016-09-01	55,976
Amount remaining of prefunding balance	2016-09-01	0
Present value of excess contributions	2016-09-01	0
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance	2016-09-01	0
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance	2016-09-01	0
Reductions in prefunding balances due to elections or deemed elections	2016-09-01	0
Balance of carryovers at beginning of current year	2016-09-01	54,353
Balance of prefunding at beginning of current year	2016-09-01	0
Total employer contributions	2016-09-01	0
Total employee contributions	2016-09-01	0
Contributions allocated toward unpaid minimum require contributions from prior years	2016-09-01	0
Contributions made to avoid restrictions adjusted to valuation date	2016-09-01	0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date	2016-09-01	0
Unpaid minimum required contributions for all prior years	2016-09-01	0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years	2016-09-01	0
Remaining amount of unpaid minimum required contributions	2016-09-01	0
Minimum required contributions for current year target normal cost	2016-09-01	3,156
Net shortfall amortization installment of oustanding balance	2016-09-01	0
Waiver amortization installment	2016-09-01	0
Total funding amount beforereflecting carryover/prefunding balances	2016-09-01	3,156
Carryover balance elected to use to offset funding requirement	2016-09-01	3,156
Prefunding balance elected to use to offset funding requirement	2016-09-01	0
Additional cash requirement	2016-09-01	0
Contributions allocatedtoward minimum required contributions for current year	2016-09-01	0
Unpaid minimum required contributions for current year	2016-09-01	0
Unpaid minimum required contributions for all years	2016-09-01	0

Potentially related plans

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Company Name:	ABILENE DIAGNOSTIC CLINIC, PLLC
Employer identification number (EIN):	752624216
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)