401k Plan data: OVERLAKE OBSTETRICIANS AND GYNECOLOGISTS, PC 401K PROFIT SHARING PLAN plan

OVERLAKE OBSTETRICIANS AND GYNECOLOGISTS, PC 401K PROFIT SHARING PLAN 401k Plan overview

Plan Name	OVERLAKE OBSTETRICIANS AND GYNECOLOGISTS, PC 401K PROFIT SHARING PLAN
Plan identification number	001

OVERLAKE OBSTETRICIANS AND GYNECOLOGISTS, PC 401K PROFIT SHARING PLAN 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.
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

OVERLAKE OBSTETRICIANS AND GYNECOLOGISTS, PC has sponsored the creation of one or more 401k plans.

Company Name: OVERLAKE OBSTETRICIANS AND GYNECOLOGISTS, PC

Employer identification number (EIN): 910862042

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan OVERLAKE OBSTETRICIANS AND GYNECOLOGISTS, PC 401K PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01 EMILY PICKETT 2023-10-18
001 2021-01-01 TISH PAOLINO 2022-10-12
001 2020-01-01 TISH PAOLINO 2021-10-12 TISH PAOLINO 2021-10-12
001 2019-01-01 TISH PAOLINO 2020-10-09 TISH PAOLINO 2020-10-09
001 2018-01-01 TISH PAOLINO 2019-10-08
001 2017-01-01 LUCINDA BERRINGTON
001 2016-01-01 LUCINDA BERRINGTON
001 2015-01-01 LUCINDA BERRINGTON
001 2014-01-01 LUCINDA BERRINGTON
001 2013-01-01 LUCINDA BERRINGTON 2014-10-13
001 2012-01-01 JAMES HAINES 2013-07-05
001 2011-01-01 JAMES HAINES 2012-04-09
001 2010-01-01 JAMES HAINES 2011-04-11

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2022-01-01	EMILY PICKETT	2023-10-18
001	2021-01-01	TISH PAOLINO	2022-10-12
001	2020-01-01	TISH PAOLINO	2021-10-12	TISH PAOLINO	2021-10-12
001	2019-01-01	TISH PAOLINO	2020-10-09	TISH PAOLINO	2020-10-09
001	2018-01-01	TISH PAOLINO	2019-10-08
001	2017-01-01	LUCINDA BERRINGTON
001	2016-01-01	LUCINDA BERRINGTON
001	2015-01-01	LUCINDA BERRINGTON
001	2014-01-01	LUCINDA BERRINGTON
001	2013-01-01	LUCINDA BERRINGTON	2014-10-13
001	2012-01-01	JAMES HAINES	2013-07-05
001	2011-01-01	JAMES HAINES	2012-04-09
001	2010-01-01	JAMES HAINES	2011-04-11

Plan Statistics for OVERLAKE OBSTETRICIANS AND GYNECOLOGISTS, PC 401K PROFIT SHARING PLAN

401k plan membership statisitcs for OVERLAKE OBSTETRICIANS AND GYNECOLOGISTS, PC 401K PROFIT SHARING PLAN

Measure Date Value
2017: OVERLAKE OBSTETRICIANS AND GYNECOLOGISTS, PC 401K PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 35
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 32
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 24
Total of all active and inactive participants 2017-01-01 56
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 56
Number of participants with account balances 2017-01-01 48
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 3
2016: OVERLAKE OBSTETRICIANS AND GYNECOLOGISTS, PC 401K PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 57
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 66
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 66
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 66
Number of participants with account balances 2016-01-01 49
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 2
2015: OVERLAKE OBSTETRICIANS AND GYNECOLOGISTS, PC 401K PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 59
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 33
Number of retired or separated participants receiving benefits 2015-01-01 3
Number of other retired or separated participants entitled to future benefits 2015-01-01 21
Total of all active and inactive participants 2015-01-01 57
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 57
Number of participants with account balances 2015-01-01 52
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 3
2014: OVERLAKE OBSTETRICIANS AND GYNECOLOGISTS, PC 401K PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 61
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 37
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 16
Total of all active and inactive participants 2014-01-01 53
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 53
Number of participants with account balances 2014-01-01 53
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 1

Measure	Date	Value
2017: OVERLAKE OBSTETRICIANS AND GYNECOLOGISTS, PC 401K PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	35
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	32
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	24
Total of all active and inactive participants	2017-01-01	56
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	56
Number of participants with account balances	2017-01-01	48
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	3
2016: OVERLAKE OBSTETRICIANS AND GYNECOLOGISTS, PC 401K PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	57
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	66
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	66
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	66
Number of participants with account balances	2016-01-01	49
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	2
2015: OVERLAKE OBSTETRICIANS AND GYNECOLOGISTS, PC 401K PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	59
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	33
Number of retired or separated participants receiving benefits	2015-01-01	3
Number of other retired or separated participants entitled to future benefits	2015-01-01	21
Total of all active and inactive participants	2015-01-01	57
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	57
Number of participants with account balances	2015-01-01	52
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	3
2014: OVERLAKE OBSTETRICIANS AND GYNECOLOGISTS, PC 401K PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	61
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	37
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	16
Total of all active and inactive participants	2014-01-01	53
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	53
Number of participants with account balances	2014-01-01	53
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	1

Financial Data on OVERLAKE OBSTETRICIANS AND GYNECOLOGISTS, PC 401K PROFIT SHARING PLAN

Measure	Date	Value
2017 : OVERLAKE OBSTETRICIANS AND GYNECOLOGISTS, PC 401K PROFIT SHARING PLAN 2017 401k financial data
Total income from all sources	2017-12-31	$1,907,347
Expenses. Total of all expenses incurred	2017-12-31	$5,236,263
Benefits paid (including direct rollovers)	2017-12-31	$5,110,677
Total plan assets at end of year	2017-12-31	$8,788,849
Total plan assets at beginning of year	2017-12-31	$12,117,765
Value of fidelity bond covering the plan	2017-12-31	$500,000
Total contributions received or receivable from participants	2017-12-31	$200,552
Other income received	2017-12-31	$1,632,701
Net income (gross income less expenses)	2017-12-31	$-3,328,916
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$8,788,849
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$12,117,765
Assets. Value of participant loans	2017-12-31	$7,565
Assets. Value of assets in partnership/joint-venture interests	2017-12-31	$0
Total contributions received or receivable from employer(s)	2017-12-31	$74,094
Expenses. Administrative service providers (salaries,fees and commissions)	2017-12-31	$125,586
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
2016 : OVERLAKE OBSTETRICIANS AND GYNECOLOGISTS, PC 401K PROFIT SHARING PLAN 2016 401k financial data
Total plan liabilities at beginning of year	2016-12-31	$0
Total income from all sources	2016-12-31	$1,380,898
Expenses. Total of all expenses incurred	2016-12-31	$110,786
Benefits paid (including direct rollovers)	2016-12-31	$77,229
Total plan assets at end of year	2016-12-31	$12,117,765
Total plan assets at beginning of year	2016-12-31	$10,847,653
Value of fidelity bond covering the plan	2016-12-31	$500,000
Total contributions received or receivable from participants	2016-12-31	$229,730
Contributions received from other sources (not participants or employers)	2016-12-31	$40,663
Other income received	2016-12-31	$1,032,466
Net income (gross income less expenses)	2016-12-31	$1,270,112
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$12,117,765
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$10,847,653
Assets. Value of participant loans	2016-12-31	$13,022
Assets. Value of assets in partnership/joint-venture interests	2016-12-31	$192,457
Total contributions received or receivable from employer(s)	2016-12-31	$78,039
Expenses. Administrative service providers (salaries,fees and commissions)	2016-12-31	$33,557
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
2015 : OVERLAKE OBSTETRICIANS AND GYNECOLOGISTS, PC 401K PROFIT SHARING PLAN 2015 401k financial data
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	$143,582
Expenses. Total of all expenses incurred	2015-12-31	$508,737
Benefits paid (including direct rollovers)	2015-12-31	$471,183
Total plan assets at end of year	2015-12-31	$10,847,653
Total plan assets at beginning of year	2015-12-31	$11,212,808
Value of fidelity bond covering the plan	2015-12-31	$500,000
Total contributions received or receivable from participants	2015-12-31	$211,438
Expenses. Other expenses not covered elsewhere	2015-12-31	$37,554
Other income received	2015-12-31	$-293,477
Net income (gross income less expenses)	2015-12-31	$-365,155
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$10,847,653
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$11,212,808
Assets. Value of participant loans	2015-12-31	$20,450
Assets. Value of assets in partnership/joint-venture interests	2015-12-31	$175,420
Total contributions received or receivable from employer(s)	2015-12-31	$225,621
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
2014 : OVERLAKE OBSTETRICIANS AND GYNECOLOGISTS, PC 401K PROFIT SHARING PLAN 2014 401k financial data
Total plan liabilities at end of year	2014-12-31	$0
Total income from all sources	2014-12-31	$1,058,930
Expenses. Total of all expenses incurred	2014-12-31	$318,024
Benefits paid (including direct rollovers)	2014-12-31	$319,525
Total plan assets at end of year	2014-12-31	$11,259,074
Total plan assets at beginning of year	2014-12-31	$10,518,168
Value of fidelity bond covering the plan	2014-12-31	$500,000
Total contributions received or receivable from participants	2014-12-31	$505,313
Expenses. Other expenses not covered elsewhere	2014-12-31	$-2,619
Other income received	2014-12-31	$179,166
Net income (gross income less expenses)	2014-12-31	$740,906
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$11,259,074
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$10,518,168
Assets. Value of participant loans	2014-12-31	$27,787
Assets. Value of assets in partnership/joint-venture interests	2014-12-31	$193,212
Total contributions received or receivable from employer(s)	2014-12-31	$374,451
Value of corrective distributions	2014-12-31	$1,118
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0

Form 5500 Responses for OVERLAKE OBSTETRICIANS AND GYNECOLOGISTS, PC 401K PROFIT SHARING PLAN

2017: OVERLAKE OBSTETRICIANS AND GYNECOLOGISTS, PC 401K PROFIT SHARING PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: OVERLAKE OBSTETRICIANS AND GYNECOLOGISTS, PC 401K 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 – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: OVERLAKE OBSTETRICIANS AND GYNECOLOGISTS, PC 401K 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 – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: OVERLAKE OBSTETRICIANS AND GYNECOLOGISTS, PC 401K PROFIT SHARING PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

CUNA MUTUAL (National Association of Insurance Commissioners NAIC id number: 62626 )

Policy contract number

146-0810-0

Policy instance

Insurance contract or identification number	146-0810-0
Number of Individuals Covered	3
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $975
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Commission paid to Insurance Broker	USD $975
Insurance broker organization code?	3
Insurance broker name	JEFFREY J. HENSLER

CUNA MUTUAL (National Association of Insurance Commissioners NAIC id number: 62626 )

Policy contract number

146-0810-0

Policy instance

Insurance contract or identification number	146-0810-0
Number of Individuals Covered	3
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $569
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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
Commission paid to Insurance Broker	USD $569
Insurance broker organization code?	3
Insurance broker name	JEFFREY J. HENSLER

CUNA MUTUAL (National Association of Insurance Commissioners NAIC id number: 62626 )

Policy contract number

146-0810-0

Policy instance

Insurance contract or identification number	146-0810-0
Number of Individuals Covered	4
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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

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Company Name:	OVERLAKE OBSTETRICIANS AND GYNECOLOGISTS, PC
Employer identification number (EIN):	910862042
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)