401k Plan data: NORTHWEST SURGICAL GROUP, P.C. EMPLOYEE PENSION PLAN plan

NORTHWEST SURGICAL GROUP, P.C. EMPLOYEE PENSION PLAN 401k Plan overview

Plan Name	NORTHWEST SURGICAL GROUP, P.C. EMPLOYEE PENSION PLAN
Plan identification number	003

NORTHWEST SURGICAL GROUP, P.C. EMPLOYEE PENSION PLAN Benefits

401k Plan Type	Defined Benefit Pension
Plan Features/Benefits	Benefits are primarily pay related 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

NORTHWEST SURGICAL GROUP, P.C. has sponsored the creation of one or more 401k plans.

Company Name: NORTHWEST SURGICAL GROUP, P.C.

Employer identification number (EIN): 860575860

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

Additional information about NORTHWEST SURGICAL GROUP, P.C.

Jurisdiction of Incorporation: Washington Secretary of State Corporations Division

Incorporation Date: 1987-02-23

Company Identification Number: 601009261

Legal Registered Office Address: 3920 CAPITAL MALL DR SW STE201

OLYMPIA
United States of America (USA)
985020000

More information about NORTHWEST SURGICAL GROUP, P.C.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NORTHWEST SURGICAL GROUP, P.C. EMPLOYEE PENSION PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
003 2017-01-01
003 2016-01-01
003 2015-01-01
003 2014-01-01 WILLIAM WILLIARD, M.D. 2015-06-30
003 2013-01-01 WILLIAM WILLIARD, M.D. 2014-06-19
003 2012-01-01 WILLIAM WILLIARD, M.D. 2013-10-14
003 2011-01-01 WILLIAM WILLIARD, M.D. 2012-05-29
003 2010-01-01 WILLIAM WILLIARD, M.D.
003 2009-01-01 WILLIAM WILLIARD, M.D.

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
003	2017-01-01
003	2016-01-01
003	2015-01-01
003	2014-01-01	WILLIAM WILLIARD, M.D.	2015-06-30
003	2013-01-01	WILLIAM WILLIARD, M.D.	2014-06-19
003	2012-01-01	WILLIAM WILLIARD, M.D.	2013-10-14
003	2011-01-01	WILLIAM WILLIARD, M.D.	2012-05-29
003	2010-01-01	WILLIAM WILLIARD, M.D.
003	2009-01-01	WILLIAM WILLIARD, M.D.

Plan Statistics for NORTHWEST SURGICAL GROUP, P.C. EMPLOYEE PENSION PLAN

401k plan membership statisitcs for NORTHWEST SURGICAL GROUP, P.C. EMPLOYEE PENSION PLAN

Measure Date Value
2017: NORTHWEST SURGICAL GROUP, P.C. EMPLOYEE PENSION PLAN 2017 401k membership
Market value of plan assets 2017-12-31 2,381,797
Acturial value of plan assets 2017-12-31 2,381,797
Funding target for retired participants and beneficiaries receiving payment 2017-12-31 0
Number of terminated vested participants 2017-12-31 1
Fundng target for terminated vested participants 2017-12-31 17,899
Active participant vested funding target 2017-12-31 1,810,126
Number of active participants 2017-12-31 3
Total funding liabilities for active participants 2017-12-31 1,810,126
Total participant count 2017-12-31 4
Total funding target for all participants 2017-12-31 1,828,025
Balance at beginning of prior year after applicable adjustments 2017-12-31 0
Prefunding balance at beginning of prior year after applicable adjustments 2017-12-31 0
Carryover balanced portion elected for use to offset prior years funding requirement 2017-12-31 0
Prefunding balanced used to offset prior years funding requirement 2017-12-31 0
Amount remaining of carryover balance 2017-12-31 0
Amount remaining of prefunding balance 2017-12-31 0
Present value of excess contributions 2017-12-31 175,862
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance 2017-12-31 175,862
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance 2017-12-31 0
Reductions in caryover balances due to elections or deemed elections 2017-12-31 0
Reductions in prefunding balances due to elections or deemed elections 2017-12-31 0
Balance of carryovers at beginning of current year 2017-12-31 0
Balance of prefunding at beginning of current year 2017-12-31 0
Total employer contributions 2017-12-31 0
Total employee contributions 2017-12-31 0
Contributions allocated toward unpaid minimum require contributions from prior years 2017-12-31 0
Contributions made to avoid restrictions adjusted to valuation date 2017-12-31 0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date 2017-12-31 0
Unpaid minimum required contributions for all prior years 2017-12-31 0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years 2017-12-31 0
Remaining amount of unpaid minimum required contributions 2017-12-31 0
Minimum required contributions for current year target normal cost 2017-12-31 224,821
Net shortfall amortization installment of oustanding balance 2017-12-31 0
Waiver amortization installment 2017-12-31 0
Total funding amount beforereflecting carryover/prefunding balances 2017-12-31 0
Carryover balance elected to use to offset funding requirement 2017-12-31 0
Prefunding balance elected to use to offset funding requirement 2017-12-31 0
Additional cash requirement 2017-12-31 0
Contributions allocatedtoward minimum required contributions for current year 2017-12-31 0
Unpaid minimum required contributions for current year 2017-12-31 0
Unpaid minimum required contributions for all years 2017-12-31 0
2016: NORTHWEST SURGICAL GROUP, P.C. EMPLOYEE PENSION PLAN 2016 401k membership
Market value of plan assets 2016-12-31 2,174,463
Acturial value of plan assets 2016-12-31 2,174,463
Funding target for retired participants and beneficiaries receiving payment 2016-12-31 0
Number of terminated vested participants 2016-12-31 0
Fundng target for terminated vested participants 2016-12-31 0
Active participant vested funding target 2016-12-31 1,543,092
Number of active participants 2016-12-31 4
Total funding liabilities for active participants 2016-12-31 1,553,179
Total participant count 2016-12-31 4
Total funding target for all participants 2016-12-31 1,553,179
Balance at beginning of prior year after applicable adjustments 2016-12-31 0
Prefunding balance at beginning of prior year after applicable adjustments 2016-12-31 0
Carryover balanced portion elected for use to offset prior years funding requirement 2016-12-31 0
Prefunding balanced used to offset prior years funding requirement 2016-12-31 0
Amount remaining of carryover balance 2016-12-31 0
Amount remaining of prefunding balance 2016-12-31 0
Present value of excess contributions 2016-12-31 290,126
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance 2016-12-31 290,126
Balance of carryovers at beginning of current year 2016-12-31 0
Balance of prefunding at beginning of current year 2016-12-31 0
Total employer contributions 2016-12-31 180,000
Total employee contributions 2016-12-31 0
Contributions allocated toward unpaid minimum require contributions from prior years 2016-12-31 0
Contributions made to avoid restrictions adjusted to valuation date 2016-12-31 0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date 2016-12-31 175,862
Unpaid minimum required contributions for all prior years 2016-12-31 0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years 2016-12-31 0
Remaining amount of unpaid minimum required contributions 2016-12-31 0
Minimum required contributions for current year target normal cost 2016-12-31 132,619
Net shortfall amortization installment of oustanding balance 2016-12-31 0
Waiver amortization installment 2016-12-31 0
Waived amount of outstanding balance 2016-12-31 0
Total funding amount beforereflecting carryover/prefunding balances 2016-12-31 0
Carryover balance elected to use to offset funding requirement 2016-12-31 0
Prefunding balance elected to use to offset funding requirement 2016-12-31 0
Additional cash requirement 2016-12-31 0
Contributions allocatedtoward minimum required contributions for current year 2016-12-31 175,862
Unpaid minimum required contributions for current year 2016-12-31 0
Unpaid minimum required contributions for all years 2016-12-31 0
2010: NORTHWEST SURGICAL GROUP, P.C. EMPLOYEE PENSION PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 5
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 3
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 2
Total of all active and inactive participants 2010-01-01 5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: NORTHWEST SURGICAL GROUP, P.C. EMPLOYEE PENSION PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 5
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 5
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 5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 1

Measure	Date	Value
2017: NORTHWEST SURGICAL GROUP, P.C. EMPLOYEE PENSION PLAN 2017 401k membership
Market value of plan assets	2017-12-31	2,381,797
Acturial value of plan assets	2017-12-31	2,381,797
Funding target for retired participants and beneficiaries receiving payment	2017-12-31	0
Number of terminated vested participants	2017-12-31	1
Fundng target for terminated vested participants	2017-12-31	17,899
Active participant vested funding target	2017-12-31	1,810,126
Number of active participants	2017-12-31	3
Total funding liabilities for active participants	2017-12-31	1,810,126
Total participant count	2017-12-31	4
Total funding target for all participants	2017-12-31	1,828,025
Balance at beginning of prior year after applicable adjustments	2017-12-31	0
Prefunding balance at beginning of prior year after applicable adjustments	2017-12-31	0
Carryover balanced portion elected for use to offset prior years funding requirement	2017-12-31	0
Prefunding balanced used to offset prior years funding requirement	2017-12-31	0
Amount remaining of carryover balance	2017-12-31	0
Amount remaining of prefunding balance	2017-12-31	0
Present value of excess contributions	2017-12-31	175,862
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance	2017-12-31	175,862
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance	2017-12-31	0
Reductions in caryover balances due to elections or deemed elections	2017-12-31	0
Reductions in prefunding balances due to elections or deemed elections	2017-12-31	0
Balance of carryovers at beginning of current year	2017-12-31	0
Balance of prefunding at beginning of current year	2017-12-31	0
Total employer contributions	2017-12-31	0
Total employee contributions	2017-12-31	0
Contributions allocated toward unpaid minimum require contributions from prior years	2017-12-31	0
Contributions made to avoid restrictions adjusted to valuation date	2017-12-31	0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date	2017-12-31	0
Unpaid minimum required contributions for all prior years	2017-12-31	0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years	2017-12-31	0
Remaining amount of unpaid minimum required contributions	2017-12-31	0
Minimum required contributions for current year target normal cost	2017-12-31	224,821
Net shortfall amortization installment of oustanding balance	2017-12-31	0
Waiver amortization installment	2017-12-31	0
Total funding amount beforereflecting carryover/prefunding balances	2017-12-31	0
Carryover balance elected to use to offset funding requirement	2017-12-31	0
Prefunding balance elected to use to offset funding requirement	2017-12-31	0
Additional cash requirement	2017-12-31	0
Contributions allocatedtoward minimum required contributions for current year	2017-12-31	0
Unpaid minimum required contributions for current year	2017-12-31	0
Unpaid minimum required contributions for all years	2017-12-31	0
2016: NORTHWEST SURGICAL GROUP, P.C. EMPLOYEE PENSION PLAN 2016 401k membership
Market value of plan assets	2016-12-31	2,174,463
Acturial value of plan assets	2016-12-31	2,174,463
Funding target for retired participants and beneficiaries receiving payment	2016-12-31	0
Number of terminated vested participants	2016-12-31	0
Fundng target for terminated vested participants	2016-12-31	0
Active participant vested funding target	2016-12-31	1,543,092
Number of active participants	2016-12-31	4
Total funding liabilities for active participants	2016-12-31	1,553,179
Total participant count	2016-12-31	4
Total funding target for all participants	2016-12-31	1,553,179
Balance at beginning of prior year after applicable adjustments	2016-12-31	0
Prefunding balance at beginning of prior year after applicable adjustments	2016-12-31	0
Carryover balanced portion elected for use to offset prior years funding requirement	2016-12-31	0
Prefunding balanced used to offset prior years funding requirement	2016-12-31	0
Amount remaining of carryover balance	2016-12-31	0
Amount remaining of prefunding balance	2016-12-31	0
Present value of excess contributions	2016-12-31	290,126
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance	2016-12-31	290,126
Balance of carryovers at beginning of current year	2016-12-31	0
Balance of prefunding at beginning of current year	2016-12-31	0
Total employer contributions	2016-12-31	180,000
Total employee contributions	2016-12-31	0
Contributions allocated toward unpaid minimum require contributions from prior years	2016-12-31	0
Contributions made to avoid restrictions adjusted to valuation date	2016-12-31	0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date	2016-12-31	175,862
Unpaid minimum required contributions for all prior years	2016-12-31	0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years	2016-12-31	0
Remaining amount of unpaid minimum required contributions	2016-12-31	0
Minimum required contributions for current year target normal cost	2016-12-31	132,619
Net shortfall amortization installment of oustanding balance	2016-12-31	0
Waiver amortization installment	2016-12-31	0
Waived amount of outstanding balance	2016-12-31	0
Total funding amount beforereflecting carryover/prefunding balances	2016-12-31	0
Carryover balance elected to use to offset funding requirement	2016-12-31	0
Prefunding balance elected to use to offset funding requirement	2016-12-31	0
Additional cash requirement	2016-12-31	0
Contributions allocatedtoward minimum required contributions for current year	2016-12-31	175,862
Unpaid minimum required contributions for current year	2016-12-31	0
Unpaid minimum required contributions for all years	2016-12-31	0
2010: NORTHWEST SURGICAL GROUP, P.C. EMPLOYEE PENSION PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	5
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	3
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	2
Total of all active and inactive participants	2010-01-01	5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: NORTHWEST SURGICAL GROUP, P.C. EMPLOYEE PENSION PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	5
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	5
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	5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	1

Financial Data on NORTHWEST SURGICAL GROUP, P.C. EMPLOYEE PENSION PLAN

Measure	Date	Value
2010 : NORTHWEST SURGICAL GROUP, P.C. EMPLOYEE PENSION PLAN 2010 401k financial data
Transfers to/from the plan	2010-12-31	$0
Total plan liabilities at end of year	2010-12-31	$0
Total plan liabilities at beginning of year	2010-12-31	$0
Total income from all sources	2010-12-31	$276,742
Expenses. Total of all expenses incurred	2010-12-31	$0
Total plan assets at end of year	2010-12-31	$437,490
Total plan assets at beginning of year	2010-12-31	$160,748
Value of fidelity bond covering the plan	2010-12-31	$250,000
Total contributions received or receivable from participants	2010-12-31	$0
Contributions received from other sources (not participants or employers)	2010-12-31	$0
Other income received	2010-12-31	$18,100
Noncash contributions received	2010-12-31	$0
Net income (gross income less expenses)	2010-12-31	$276,742
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$437,490
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$160,748
Total contributions received or receivable from employer(s)	2010-12-31	$258,642
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
2009 : NORTHWEST SURGICAL GROUP, P.C. EMPLOYEE PENSION PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for NORTHWEST SURGICAL GROUP, P.C. EMPLOYEE PENSION PLAN

2010: NORTHWEST SURGICAL GROUP, P.C. EMPLOYEE PENSION PLAN 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 – Trust	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: NORTHWEST SURGICAL GROUP, P.C. EMPLOYEE PENSION PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	First time form 5500 has been submitted	Yes
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 – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	NORTHWEST SURGICAL GROUP, P.C.
Employer identification number (EIN):	860575860
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)

Jurisdiction of Incorporation:	Washington Secretary of State Corporations Division
Incorporation Date:	1987-02-23
Company Identification Number:	601009261
Legal Registered Office Address:	3920 CAPITAL MALL DR SW STE201 OLYMPIA United States of America (USA) 985020000