401k Plan data: EAST PORTLAND IMAGING CENTER, P.C. GROUP MED, RX, VISION & DENTAL plan

EAST PORTLAND IMAGING CENTER, P.C. GROUP MED, RX, VISION & DENTAL 401k Plan overview

Plan Name	EAST PORTLAND IMAGING CENTER, P.C. GROUP MED, RX, VISION & DENTAL
Plan identification number	505

EAST PORTLAND IMAGING CENTER, P.C. GROUP MED, RX, VISION & DENTAL Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Dental Vision

401k Sponsoring company profile

EPIC IMAGING, P.C. has sponsored the creation of one or more 401k plans.

Company Name: EPIC IMAGING, P.C.

Employer identification number (EIN): 930584121

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EAST PORTLAND IMAGING CENTER, P.C. GROUP MED, RX, VISION & DENTAL

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
505 2016-01-01 RICHARD NAFFZIGER RICHARD NAFFZIGER 2017-08-07
505 2015-01-01 RICHARD NAFFZIGER RICHARD NAFFZIGER 2016-08-16
505 2014-01-01 RICHARD NAFFZIGER RICHARD NAFFZIGER 2015-09-21
505 2013-01-01 RICHARD NAFFZIGER RICHARD NAFFZIGER 2014-10-23
505 2012-01-01 RICHARD NAFFZIGER RICHARD NAFFZIGER 2013-10-14
505 2011-01-01 RICHARD NAFFZIGER
505 2010-01-01 RICHARD NAFFZIGER
505 2009-01-01 RICHARD NAFFZIGER 2010-09-30
505 2009-01-01 RICHARD NAFFZIGER
505 2009-01-01 RICHARD NAFFZIGER

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
505	2016-01-01	RICHARD NAFFZIGER	RICHARD NAFFZIGER	2017-08-07
505	2015-01-01	RICHARD NAFFZIGER	RICHARD NAFFZIGER	2016-08-16
505	2014-01-01	RICHARD NAFFZIGER	RICHARD NAFFZIGER	2015-09-21
505	2013-01-01	RICHARD NAFFZIGER	RICHARD NAFFZIGER	2014-10-23
505	2012-01-01	RICHARD NAFFZIGER	RICHARD NAFFZIGER	2013-10-14
505	2011-01-01	RICHARD NAFFZIGER
505	2010-01-01	RICHARD NAFFZIGER
505	2009-01-01		RICHARD NAFFZIGER	2010-09-30
505	2009-01-01	RICHARD NAFFZIGER
505	2009-01-01	RICHARD NAFFZIGER

Plan Statistics for EAST PORTLAND IMAGING CENTER, P.C. GROUP MED, RX, VISION & DENTAL

401k plan membership statisitcs for EAST PORTLAND IMAGING CENTER, P.C. GROUP MED, RX, VISION & DENTAL

Measure Date Value
2016: EAST PORTLAND IMAGING CENTER, P.C. GROUP MED, RX, VISION & DENTAL 2016 401k membership
Total participants, beginning-of-year 2016-01-01 170
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 20
Total of all active and inactive participants 2016-01-01 20
Total participants 2016-01-01 20
2015: EAST PORTLAND IMAGING CENTER, P.C. GROUP MED, RX, VISION & DENTAL 2015 401k membership
Total participants, beginning-of-year 2015-01-01 161
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 170
Total of all active and inactive participants 2015-01-01 170
Total participants 2015-01-01 170
2014: EAST PORTLAND IMAGING CENTER, P.C. GROUP MED, RX, VISION & DENTAL 2014 401k membership
Total participants, beginning-of-year 2014-01-01 188
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 161
Total of all active and inactive participants 2014-01-01 161
Total participants 2014-01-01 161
2013: EAST PORTLAND IMAGING CENTER, P.C. GROUP MED, RX, VISION & DENTAL 2013 401k membership
Total participants, beginning-of-year 2013-01-01 221
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 188
Total of all active and inactive participants 2013-01-01 188
Total participants 2013-01-01 188
2012: EAST PORTLAND IMAGING CENTER, P.C. GROUP MED, RX, VISION & DENTAL 2012 401k membership
Total participants, beginning-of-year 2012-01-01 221
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 221
Total of all active and inactive participants 2012-01-01 221
Total participants 2012-01-01 221
2011: EAST PORTLAND IMAGING CENTER, P.C. GROUP MED, RX, VISION & DENTAL 2011 401k membership
Total participants, beginning-of-year 2011-01-01 155
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 221
Total of all active and inactive participants 2011-01-01 221
Total participants 2011-01-01 221
2010: EAST PORTLAND IMAGING CENTER, P.C. GROUP MED, RX, VISION & DENTAL 2010 401k membership
Total participants, beginning-of-year 2010-01-01 136
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 155
Total of all active and inactive participants 2010-01-01 155
Total participants 2010-01-01 155
2009: EAST PORTLAND IMAGING CENTER, P.C. GROUP MED, RX, VISION & DENTAL 2009 401k membership
Total participants, beginning-of-year 2009-01-01 117
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 136
Total of all active and inactive participants 2009-01-01 136
Total participants 2009-01-01 136

Measure	Date	Value
2016: EAST PORTLAND IMAGING CENTER, P.C. GROUP MED, RX, VISION & DENTAL 2016 401k membership
Total participants, beginning-of-year	2016-01-01	170
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	20
Total of all active and inactive participants	2016-01-01	20
Total participants	2016-01-01	20
2015: EAST PORTLAND IMAGING CENTER, P.C. GROUP MED, RX, VISION & DENTAL 2015 401k membership
Total participants, beginning-of-year	2015-01-01	161
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	170
Total of all active and inactive participants	2015-01-01	170
Total participants	2015-01-01	170
2014: EAST PORTLAND IMAGING CENTER, P.C. GROUP MED, RX, VISION & DENTAL 2014 401k membership
Total participants, beginning-of-year	2014-01-01	188
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	161
Total of all active and inactive participants	2014-01-01	161
Total participants	2014-01-01	161
2013: EAST PORTLAND IMAGING CENTER, P.C. GROUP MED, RX, VISION & DENTAL 2013 401k membership
Total participants, beginning-of-year	2013-01-01	221
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	188
Total of all active and inactive participants	2013-01-01	188
Total participants	2013-01-01	188
2012: EAST PORTLAND IMAGING CENTER, P.C. GROUP MED, RX, VISION & DENTAL 2012 401k membership
Total participants, beginning-of-year	2012-01-01	221
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	221
Total of all active and inactive participants	2012-01-01	221
Total participants	2012-01-01	221
2011: EAST PORTLAND IMAGING CENTER, P.C. GROUP MED, RX, VISION & DENTAL 2011 401k membership
Total participants, beginning-of-year	2011-01-01	155
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	221
Total of all active and inactive participants	2011-01-01	221
Total participants	2011-01-01	221
2010: EAST PORTLAND IMAGING CENTER, P.C. GROUP MED, RX, VISION & DENTAL 2010 401k membership
Total participants, beginning-of-year	2010-01-01	136
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	155
Total of all active and inactive participants	2010-01-01	155
Total participants	2010-01-01	155
2009: EAST PORTLAND IMAGING CENTER, P.C. GROUP MED, RX, VISION & DENTAL 2009 401k membership
Total participants, beginning-of-year	2009-01-01	117
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	136
Total of all active and inactive participants	2009-01-01	136
Total participants	2009-01-01	136

Form 5500 Responses for EAST PORTLAND IMAGING CENTER, P.C. GROUP MED, RX, VISION & DENTAL

2016: EAST PORTLAND IMAGING CENTER, P.C. GROUP MED, RX, VISION & DENTAL 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 benefit arrangement – Insurance	Yes
2015: EAST PORTLAND IMAGING CENTER, P.C. GROUP MED, RX, VISION & DENTAL 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 benefit arrangement – Insurance	Yes
2014: EAST PORTLAND IMAGING CENTER, P.C. GROUP MED, RX, VISION & DENTAL 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 – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: EAST PORTLAND IMAGING CENTER, P.C. GROUP MED, RX, VISION & DENTAL 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: EAST PORTLAND IMAGING CENTER, P.C. GROUP MED, RX, VISION & DENTAL 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: EAST PORTLAND IMAGING CENTER, P.C. GROUP MED, RX, VISION & DENTAL 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2010: EAST PORTLAND IMAGING CENTER, P.C. GROUP MED, RX, VISION & DENTAL 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	Yes
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 – Insurance	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2009: EAST PORTLAND IMAGING CENTER, P.C. GROUP MED, RX, VISION & DENTAL 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	Yes
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 – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number	239171
Policy instance	2
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number	00610177
Policy instance	1
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number	00610177
Policy instance	1
PACIFICSOURCE HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 54976 )
Policy contract number	G0030248
Policy instance	2
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number	542
Policy instance	1
PACIFICSOURCE HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 54976 )
Policy contract number	G0030248
Policy instance	2
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number	542
Policy instance	1
PACIFICSOURCE HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 54976 )
Policy contract number	G0030248
Policy instance	2
LIFEWISE HEALTH PLAN OF OREGON, INC. (National Association of Insurance Commissioners NAIC id number: 84930 )
Policy contract number	1027383
Policy instance	1
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number	542
Policy instance	2
PACIFICSOURCE HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 54976 )
Policy contract number	G0030248
Policy instance	3
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 )
Policy contract number	542
Policy instance	1
UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )
Policy contract number	G000ABYW
Policy instance	2
LIFEWISE HEALTH PLAN OF OREGON, INC. (National Association of Insurance Commissioners NAIC id number: 84930 )
Policy contract number	1027383
Policy instance	3

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Company Name:	EPIC IMAGING, P.C.
Employer identification number (EIN):	930584121
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)