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FORM 5500 DATA

Aya Healthcare Services, Inc. 401k Plan

Overview

Plan Information

  • Plan Year01/01/2017 — 12/31/2017
  • Date of Plan01/01/2009
  • Net Assets as of 12/31/2017 $9,266,955
  • Plan Number1
  • Plan Type Single Employer
  • Is the plan collectively bargained? No
  • Did the plan file for an extension of time or the DFVC Program?Yes
  • Plan Funding ArrangementInsurance Trust
  • Plan Benefit Arrangement Trust

Participant Information as of 12/31/2017

  • Active (Eligible) Participants3,149
  • Retired or separated participants receiving benefits0
  • Other retired or separated participants entitled to future benefits251
  • Subtotal3,400
  • Deceased participants whose beneficiaries are receiving or are entitled to receive benefits0
  • Total3,400
  • Total number of participants as of 01/01/20172,067
  • Number of participants with account balances726
  • Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested0

Expenses

  • Total Benefit Payments$0
  • Corrective Distributions$0
  • Administrative Service Providers$0
  • Other Expenses$0
  • Total Expenses$0
  • Total Transfers$0

Sponsor Information

  • Address5930 Cornerstone Ct. W. #300
  • CitySan Diego
  • StateCA
  • Zip92121
  • Telephone(858) 458-4410
  • EIN27-1276573
  • Industry Code561300
  • Named AdministratorAmber Zeeb

Audit Information

  • Audit StatusAudited
  • AuditorPkf, LLP
  • Auditor EIN81-3391684
  • Audit Opinion Disclaimer
  • Audit TypeLimited Scope Audit

Benefits Provided Under the Plan

Code Benefit Description
2E Profit-sharing A defined contribution plan that allows employer discretionary contributions. These plans often contain a 401(k) feature.
2F ERISA section 404(c) Plan This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
2G 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.
2J 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.
2K 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 contributions 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.
2T Participant-directed Account Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
3D 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.

Questions and Answers

Question Answer Amount
During the plan year did the employer fail to transmit to the plan any participant contributions within the time period described in 29 CFT 2510.3-102? Yes $10,826
Were any loans by the plan or fixed income obligations due the plan in default as of the close of plan year or classified during the year as uncollectible? Disregard participant loans secured by participant's account balance. No
Were any leases to which the plan was a party in default or classified during the year as uncollectible? No
Were there any nonexempt transactions with any party-in-interest? No
Was this plan covered by a fidelity bond? Yes $1,000,000
Did the plan have a loss, whether or not reimbursed by the plan's fidelity bond, that was caused by fraud or dishonesty? No
Did the plan hold any assets whose current value was neither readily determinable on an established market nor set by an independent third party appraiser? No
Did the plan receive any noncash contributions whose value was neither readily determinable on an established market nor set by an independent third party appraiser? No
Did the plan have assets held for investment? Yes
Were any plan transactions or series of transactions in excess of 5% of the current value of plan assets? No
Were all the plan assets either distributed to participants or beneficiaries, transferred to another plan, or brought under the control of the PBGC? No
Has the plan failed to provide any benefit when due under the plan? No
If this is an individual account plan, was there a blackout period? No
If there was a blackout period, have you either provided the required notice or one of the exceptions to providing the notice applied under 29 CFR 2520.101-3? No

Financials

Income and Expense Statement

Income $5,111,848
Contributions $3,996,293
Cash Contributions $3,996,293
Cash from Employers $1,046,613
Cash from Participants $2,478,446
Others (including rollovers) $471,234
Noncash Contributions $0
Total Earnings on Investments $1,115,555
Total Interest $4,759
Interest-Bearing Cash $68
U.S. Government Securities $0
Corporate Debt Instruments $0
Loans (other than to participants) $0
Participant Loans $4,691
Interest from Other Investments $0
Total Dividends $134,821
Preferred Stock $0
Common Stock $0
Rents $0
Net gain (loss) on sale of assets $0
Aggregate Proceeds $0
Aggregate Carrying Amount $0
Total Unrealized Appreciation (depreciation) of assets $0
Real Estate $0
Other $0
Net investment gain (loss) from common/collective trusts $692,070
Net investment gain (loss) from pooled separate accounts $0
Net investment gain (loss) from master trust investment accounts $0
Net investment gain (loss) from 103-12 investment entities $0
Net investment gain (loss) from registered investment companies $283,905
Other Income $0
Expenses $264,459
Total Benefit Payments $209,175
Directly to participants or beneficiaries, including direct rollovers $209,175
To insurance carriers for the provision of benefits $0
Other Benefit Payment Fees $0
Corrective Distributions $0
Certain deemed distributions of participant loans $17,255
Interest expense $0
Total Administrative Expenses $38,029
Professional Fees $0
Contract Administrator Fees $38,029
Investment Advisory and management fees $0
Other Administrative Fees $0
Net Income $4,847,389
Transfers of Assets to this Plan $0
Transfers of Assets from this Plan $0

Asset and Liability Statement

12/31/2017 12/31/2016 Change YOY
Total Assets $9,266,955 $4,419,566 109.68%
Total noninterest-bearing cash $0 $0 0.0%
Receivables $149,954 $93,216 60.87%
Employer Contributions $42,212 $27,667 52.57%
Participant Contributions $107,742 $65,549 64.37%
Other Contributions $0 $0 0.0%
General Investments $6,541 $5,362 21.99%
Interest-bearing cash $6,541 $5,362 21.99%
U.S. Government Securities $0 $0 0.0%
Corporate Debt Instruments $0 $0 0.0%
Preferred $0 $0 0.0%
All Other $0 $0 0.0%
Corporate Stocks $0 $0 0.0%
Preferred $0 $0 0.0%
Common $0 $0 0.0%
Partnership/joint venture interests $0 $0 0.0%
Real estate (other than employer real property) $0 $0 0.0%
Loans (other than to participants) $0 $0 0.0%
Participants Loans $194,984 $61,374 217.70%
Value of interest in common/collective trusts $5,451,316 $2,548,127 113.93%
Value of interest in pooled separate accounts $0 $0 0.0%
Value of interest in master trust investment accounts $0 $0 0.0%
Value of interest in 103-12 investment entities $0 $0 0.0%
Value of interest in registered investment companies $3,292,008 $1,642,120 100.47%
Value of funds held in insurance co. general account $172,152 $69,367 148.18%
Other Investments $0 $0 0.0%
Employer-related Investments $0 $0 0.0%
Employer Securities $0 $0 0.0%
Employer Real Property $0 $0 0.0%
Buildings and other property used in plan operation $0 $0 0.0%
Total Liabilities $0 $0 0.0%
Benefit Claims Payable (1) $0 $0 0.0%
Operating Payables (1) $0 $0 0.0%
Acquisition Indebtedness (1) $0 $0 0.0%
Other liabilities (1) $0 $0 0.0%
Net Assets $9,266,955 $4,419,566 109.68%

Service Providers

Persons Receiving Only Eligible Indirect Compensation

  • Great West Life & Annuity Ins. Co

Other Service Providers Receiving Direct or Indirect Compensation

Name Nature of Service Relationship to Plan Sponsor Direct Compensation Paid by Plan Indirect Compensation Paid by Plan Total Compensation
Great West Life & Annuity Ins Co Recordkeeping fees Recordkeeper $35,292 $0 $35,292
Cambridge Investment Research Inc Other commissions Broker/ Advisor $0 $29,861 $29,861
San Diego Pension Consultants Contract Administrator Contract Administrator $3,511 $6,090 $9,601
Empower Retirement Advisory Service Investment management Investment Management $401 $0 $401
Total $39,204 $35,951 $75,155

Indirect Compensation

Name Source of Indirect Compensation* Nature of Service Description of Indirect Compensation Indirect Compensation Paid by Plan
Cambridge Investment Research Inc. Great West Life & Annuity Ins Co Other commissions Other Commissions $29,861
San Diego Pension Consultants Great West Life & Annuity Ins Co Contract Administrator Tpa Allowance Payment $6,090
*As outlined by the Form 5500 Instructions for service providers with indirect compensation.

Service Providers Who Fail or Refuse to Provide Information

There are no service providers who failed or refused to provide information.

Termination Information on Accountants and Enrolled Actuaries

There is no termination information for this plan.

Investments

Investments

Name of Investment Investment Manager Type of Investment Dollar Value
Putnam Retirement Adv 2045 V Putnam Investments DFE: Common/Collective Trust $1,931,554
Putnam Retirement Adv 2055 V Putnam Investments DFE: Common/Collective Trust $1,747,350
Putnam Retirement Adv 2035 V Putnam Investments DFE: Common/Collective Trust $1,113,062
Putnam Retirement Adv 2025 V Putnam Investments DFE: Common/Collective Trust $296,301
Putnam Retirement Adv 2050 V Putnam Investments DFE: Common/Collective Trust $157,942
Putnam Retirement Adv Maturity V Putnam Investments DFE: Common/Collective Trust $95,341
Putnam Retirement Adv 2040 V Putnam Investments DFE: Common/Collective Trust $57,041
Putnam Retirement Adv 2030 V Putnam Investments DFE: Common/Collective Trust $43,256
Putnam Retirement Adv 2020 V Putnam Investments DFE: Common/Collective Trust $9,469
Total $5,451,316

Insurance Information

Insurance Information

Insurance Carrier Summary Persons Covered
Great West Life & Annuity Insurance Company 50
EIN 84-0467907
Industry Code 68322
Contract Number 371967-01
Contract Year 01/01/2017 — 12/31/2017
Value in General Account at Year End $178,693
Value in Separate Accounts at Year End $0
Insurance Fees and Commissions $610
Persons Receiving Commissions and Fees
Agent/Broker Organization Code Commissions Paid Fees Paid Purpose of Fees Paid
Cambridge Investment Research Inc. 5375 Mira Sorrento Pl., Ste. 400 San Diego, CA 92121 Insurance Agent or Broker $610 $0
Allocated Funds
Type of Contract Unspecified
Basis of premium rates
Premiums paid to carrier $0
Premiums due but unpaid at the end of the year $0
If the carrier, service, or other organization incurred any specific costs in connection with the acquisition or retention of the contract or policy, enter amount $0
Specify the nature of the costs
Unallocated Funds
Type of Contract GROUP ANNUITY CONTRACT
Balance at the end of the previous year $74,729
Additions $146,510
Contributions Deposited during the year $53,808
Dividends and credits $0
Interest credited during the year $1,378
Transferred from separate account $87,473
Other $3,851
Total of Balance and Additions $221,239
Deductions $42,546
Disbursed from fund to pay benefits or purchase annuities during the year $40,654
Administration charge made by carrier $60
Transferred to Separate Account $1,832
Other $0
Balance at the end of the current year $178,693