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AUBURN FAMILY MEDICAL CENTER, INC. P.S. 401(K) PLAN 401k Plan overview

Plan NameAUBURN FAMILY MEDICAL CENTER, INC. P.S. 401(K) PLAN
Plan identification number 001

AUBURN FAMILY MEDICAL CENTER, INC. P.S. 401(K) PLAN Benefits

401k Plan TypeDefined 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

AUBURN FAMILY MEDICAL CENTER, INC. P. S. has sponsored the creation of one or more 401k plans.

Company Name:AUBURN FAMILY MEDICAL CENTER, INC. P. S.
Employer identification number (EIN):911035593
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan AUBURN FAMILY MEDICAL CENTER, INC. P.S. 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012017-01-01CHARLES WARNER
0012016-01-01CHARLES WARNER
0012015-01-01CHARLES WARNER
0012014-01-01CHARLES WARNER
0012013-01-01CHARLES WARNER2014-05-20
0012012-01-01CHARLES WARNER2013-06-18
0012011-01-01CHARLES WARNER2012-07-17
0012010-01-01CHARLES WARNER2011-06-15

Plan Statistics for AUBURN FAMILY MEDICAL CENTER, INC. P.S. 401(K) PLAN

401k plan membership statisitcs for AUBURN FAMILY MEDICAL CENTER, INC. P.S. 401(K) PLAN

Measure Date Value
2017: AUBURN FAMILY MEDICAL CENTER, INC. P.S. 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0117
Total number of active participants reported on line 7a of the Form 55002017-01-010
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-010
Number of participants with account balances2017-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: AUBURN FAMILY MEDICAL CENTER, INC. P.S. 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0116
Total number of active participants reported on line 7a of the Form 55002016-01-0115
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-012
Total of all active and inactive participants2016-01-0117
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-0117
Number of participants with account balances2016-01-0117
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: AUBURN FAMILY MEDICAL CENTER, INC. P.S. 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0119
Total number of active participants reported on line 7a of the Form 55002015-01-0111
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-015
Total of all active and inactive participants2015-01-0116
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-0116
Number of participants with account balances2015-01-0116
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-011
2014: AUBURN FAMILY MEDICAL CENTER, INC. P.S. 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0120
Total number of active participants reported on line 7a of the Form 55002014-01-0113
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-016
Total of all active and inactive participants2014-01-0119
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-0119
Number of participants with account balances2014-01-0119
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-012

Financial Data on AUBURN FAMILY MEDICAL CENTER, INC. P.S. 401(K) PLAN

Measure Date Value
2017 : AUBURN FAMILY MEDICAL CENTER, INC. P.S. 401(K) PLAN 2017 401k financial data
Transfers to/from the plan2017-09-12$0
Total plan liabilities at end of year2017-09-12$0
Total plan liabilities at beginning of year2017-09-12$0
Total income from all sources2017-09-12$590,756
Expenses. Total of all expenses incurred2017-09-12$4,879,670
Benefits paid (including direct rollovers)2017-09-12$4,878,456
Total plan assets at end of year2017-09-12$0
Total plan assets at beginning of year2017-09-12$4,288,914
Value of fidelity bond covering the plan2017-09-12$450,000
Total contributions received or receivable from participants2017-09-12$85,111
Expenses. Other expenses not covered elsewhere2017-09-12$0
Contributions received from other sources (not participants or employers)2017-09-12$0
Other income received2017-09-12$461,272
Noncash contributions received2017-09-12$0
Net income (gross income less expenses)2017-09-12$-4,288,914
Net plan assets at end of year (total assets less liabilities)2017-09-12$0
Net plan assets at beginning of year (total assets less liabilities)2017-09-12$4,288,914
Total contributions received or receivable from employer(s)2017-09-12$44,373
Value of certain deemed distributions of participant loans2017-09-12$0
Value of corrective distributions2017-09-12$0
Expenses. Administrative service providers (salaries,fees and commissions)2017-09-12$1,214
2016 : AUBURN FAMILY MEDICAL CENTER, INC. P.S. 401(K) PLAN 2016 401k financial data
Transfers to/from the plan2016-12-31$0
Total plan liabilities at end of year2016-12-31$0
Total plan liabilities at beginning of year2016-12-31$0
Total income from all sources2016-12-31$456,985
Expenses. Total of all expenses incurred2016-12-31$31,872
Benefits paid (including direct rollovers)2016-12-31$31,822
Total plan assets at end of year2016-12-31$4,288,914
Total plan assets at beginning of year2016-12-31$3,863,801
Value of fidelity bond covering the plan2016-12-31$450,000
Total contributions received or receivable from participants2016-12-31$87,072
Expenses. Other expenses not covered elsewhere2016-12-31$0
Contributions received from other sources (not participants or employers)2016-12-31$0
Other income received2016-12-31$303,621
Noncash contributions received2016-12-31$0
Net income (gross income less expenses)2016-12-31$425,113
Net plan assets at end of year (total assets less liabilities)2016-12-31$4,288,914
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$3,863,801
Total contributions received or receivable from employer(s)2016-12-31$66,292
Value of certain deemed distributions of participant loans2016-12-31$0
Value of corrective distributions2016-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2016-12-31$50
2015 : AUBURN FAMILY MEDICAL CENTER, INC. P.S. 401(K) PLAN 2015 401k financial data
Transfers to/from the plan2015-12-31$0
Total plan liabilities at end of year2015-12-31$0
Total plan liabilities at beginning of year2015-12-31$0
Total income from all sources2015-12-31$130,221
Expenses. Total of all expenses incurred2015-12-31$98,449
Benefits paid (including direct rollovers)2015-12-31$97,880
Total plan assets at end of year2015-12-31$3,863,801
Total plan assets at beginning of year2015-12-31$3,832,029
Value of fidelity bond covering the plan2015-12-31$450,000
Total contributions received or receivable from participants2015-12-31$89,616
Expenses. Other expenses not covered elsewhere2015-12-31$0
Contributions received from other sources (not participants or employers)2015-12-31$0
Other income received2015-12-31$2,825
Noncash contributions received2015-12-31$0
Net income (gross income less expenses)2015-12-31$31,772
Net plan assets at end of year (total assets less liabilities)2015-12-31$3,863,801
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$3,832,029
Total contributions received or receivable from employer(s)2015-12-31$37,780
Value of certain deemed distributions of participant loans2015-12-31$0
Value of corrective distributions2015-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2015-12-31$569
2014 : AUBURN FAMILY MEDICAL CENTER, INC. P.S. 401(K) PLAN 2014 401k financial data
Transfers to/from the plan2014-12-31$0
Total plan liabilities at end of year2014-12-31$0
Total plan liabilities at beginning of year2014-12-31$778
Total income from all sources2014-12-31$332,593
Expenses. Total of all expenses incurred2014-12-31$141,914
Benefits paid (including direct rollovers)2014-12-31$141,584
Total plan assets at end of year2014-12-31$3,832,029
Total plan assets at beginning of year2014-12-31$3,642,128
Value of fidelity bond covering the plan2014-12-31$450,000
Total contributions received or receivable from participants2014-12-31$93,644
Expenses. Other expenses not covered elsewhere2014-12-31$0
Contributions received from other sources (not participants or employers)2014-12-31$0
Other income received2014-12-31$165,329
Noncash contributions received2014-12-31$0
Net income (gross income less expenses)2014-12-31$190,679
Net plan assets at end of year (total assets less liabilities)2014-12-31$3,832,029
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$3,641,350
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-1022014-12-31$0
Total contributions received or receivable from employer(s)2014-12-31$73,620
Value of certain deemed distributions of participant loans2014-12-31$0
Value of corrective distributions2014-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2014-12-31$330

Form 5500 Responses for AUBURN FAMILY MEDICAL CENTER, INC. P.S. 401(K) PLAN

2017: AUBURN FAMILY MEDICAL CENTER, INC. P.S. 401(K) PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingYes
2017-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement - TrustYes
2016: AUBURN FAMILY MEDICAL CENTER, INC. P.S. 401(K) PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement - TrustYes
2015: AUBURN FAMILY MEDICAL CENTER, INC. P.S. 401(K) PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement - TrustYes
2014: AUBURN FAMILY MEDICAL CENTER, INC. P.S. 401(K) PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberGAP54FC57
Policy instance 1
Insurance contract or identification numberGAP54FC57
Number of Individuals Covered0
Insurance policy start date2014-01-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $8,394
Total amount of fees paid to insurance companyUSD $2,098
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 BrokerUSD $8,394
Amount paid for insurance broker fees0
Insurance broker nameNATIONAL ASSOC INC NW

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