| Plan Name | PACIFIC SPINE SPECIALISTS 401K & PROFIT SHARING PLAN |
| Plan identification number | 001 |
| 401k Plan Type | Defined Contribution Pension |
| Plan Features/Benefits |
|
| Company Name: | PACIFIC SPINE SPECIALISTS, LLC |
| Employer identification number (EIN): | 931278671 |
| NAIC Classification: | 621111 |
| NAIC Description: | Offices of Physicians (except Mental Health Specialists) |
Additional information about PACIFIC SPINE SPECIALISTS, LLC
| Jurisdiction of Incorporation: | Oregon Secretary of State Corporations Division |
| Incorporation Date: | 1999-10-12 |
| Company Identification Number: | 71541180 |
| Legal Registered Office Address: |
19260 SW 65TH AVE STE 270 TUALATIN United States of America (USA) 97062 |
More information about PACIFIC SPINE SPECIALISTS, LLC
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 001 | 2020-01-01 | EDWARD ROJAS | 2021-04-07 | ||
| 001 | 2019-01-01 | EDWARD ROJAS | 2020-05-18 | ||
| 001 | 2018-01-01 | ||||
| 001 | 2016-01-01 | ||||
| 001 | 2015-01-01 | ||||
| 001 | 2014-01-01 | TIMOTHY KEENEN | 2015-10-14 | ||
| 001 | 2013-01-01 | MICHAEL GEORGE | 2014-10-14 | ||
| 001 | 2012-01-01 | MICHAEL GEORGE | 2013-10-15 | ||
| 001 | 2011-01-01 | LISA JACKA | 2012-10-15 | ||
| 001 | 2010-01-01 | MICHAEL GEORGE | 2011-10-14 | ||
| 001 | 2007-01-01 |
| Measure | Date | Value |
|---|---|---|
| 2018 : PACIFIC SPINE SPECIALISTS 401K & PROFIT SHARING PLAN 2018 401k financial data | ||
| Transfers to/from the plan | 2018-12-31 | $0 |
| Total plan liabilities at end of year | 2018-12-31 | $0 |
| Total plan liabilities at beginning of year | 2018-12-31 | $0 |
| Total income from all sources | 2018-12-31 | $520,971 |
| Expenses. Total of all expenses incurred | 2018-12-31 | $4,554 |
| Benefits paid (including direct rollovers) | 2018-12-31 | $2,402 |
| Total plan assets at end of year | 2018-12-31 | $516,417 |
| Total plan assets at beginning of year | 2018-12-31 | $0 |
| Value of fidelity bond covering the plan | 2018-12-31 | $60,000 |
| Total contributions received or receivable from participants | 2018-12-31 | $4,350 |
| Expenses. Other expenses not covered elsewhere | 2018-12-31 | $0 |
| Contributions received from other sources (not participants or employers) | 2018-12-31 | $0 |
| Other income received | 2018-12-31 | $516,621 |
| Net income (gross income less expenses) | 2018-12-31 | $516,417 |
| Net plan assets at end of year (total assets less liabilities) | 2018-12-31 | $516,417 |
| Net plan assets at beginning of year (total assets less liabilities) | 2018-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2018-12-31 | $0 |
| Value of certain deemed distributions of participant loans | 2018-12-31 | $0 |
| Value of corrective distributions | 2018-12-31 | $0 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2018-12-31 | $2,152 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2018-12-31 | $0 |
| Funding deficiency by the employer to the plan for this plan year | 2018-12-31 | $0 |
| Minimum employer required contribution for this plan year | 2018-12-31 | $0 |
| Amount contributed by the employer to the plan for this plan year | 2018-12-31 | $0 |
| 2016 : PACIFIC SPINE SPECIALISTS 401K & PROFIT SHARING PLAN 2016 401k financial data | ||
| Total income from all sources | 2016-12-31 | $80,037 |
| Expenses. Total of all expenses incurred | 2016-12-31 | $12,125 |
| Benefits paid (including direct rollovers) | 2016-12-31 | $6,337 |
| Total plan assets at end of year | 2016-12-31 | $707,381 |
| Total plan assets at beginning of year | 2016-12-31 | $639,469 |
| Value of fidelity bond covering the plan | 2016-12-31 | $700,000 |
| Total contributions received or receivable from participants | 2016-12-31 | $26,850 |
| Other income received | 2016-12-31 | $35,710 |
| Net income (gross income less expenses) | 2016-12-31 | $67,912 |
| Net plan assets at end of year (total assets less liabilities) | 2016-12-31 | $707,381 |
| Net plan assets at beginning of year (total assets less liabilities) | 2016-12-31 | $639,469 |
| Total contributions received or receivable from employer(s) | 2016-12-31 | $17,477 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2016-12-31 | $5,788 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2016-12-31 | $0 |
| 2015 : PACIFIC SPINE SPECIALISTS 401K & PROFIT SHARING PLAN 2015 401k financial data | ||
| Total plan liabilities at beginning of year | 2015-12-31 | $112 |
| Total income from all sources | 2015-12-31 | $15,419 |
| Expenses. Total of all expenses incurred | 2015-12-31 | $29,485 |
| Benefits paid (including direct rollovers) | 2015-12-31 | $29,468 |
| Total plan assets at end of year | 2015-12-31 | $639,469 |
| Total plan assets at beginning of year | 2015-12-31 | $653,647 |
| Value of fidelity bond covering the plan | 2015-12-31 | $700,000 |
| Total contributions received or receivable from participants | 2015-12-31 | $25,800 |
| Other income received | 2015-12-31 | $-34,950 |
| Net income (gross income less expenses) | 2015-12-31 | $-14,066 |
| Net plan assets at end of year (total assets less liabilities) | 2015-12-31 | $639,469 |
| Net plan assets at beginning of year (total assets less liabilities) | 2015-12-31 | $653,535 |
| Total contributions received or receivable from employer(s) | 2015-12-31 | $24,569 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2015-12-31 | $17 |
| Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2015-12-31 | $0 |
| 2018: PACIFIC SPINE SPECIALISTS 401K & PROFIT SHARING PLAN 2018 form 5500 responses | ||
|---|---|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Submission has been amended | No |
| 2018-01-01 | This submission is the final filing | No |
| 2018-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-01-01 | Plan is a collectively bargained plan | No |
| 2018-01-01 | Plan funding arrangement – Trust | Yes |
| 2018-01-01 | Plan benefit arrangement - Trust | Yes |
| 2016: PACIFIC SPINE SPECIALISTS 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 – Trust | Yes |
| 2016-01-01 | Plan benefit arrangement - Trust | Yes |
| 2015: PACIFIC SPINE SPECIALISTS 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 – Trust | Yes |
| 2015-01-01 | Plan benefit arrangement - Trust | Yes |
| 2007: PACIFIC SPINE SPECIALISTS 401K & PROFIT SHARING PLAN 2007 form 5500 responses | ||
| 2007-01-01 | Submission has been amended | No |
| 2007-01-01 | This submission is the final filing | No |
| 2007-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2007-01-01 | Plan is a collectively bargained plan | No |