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FORM 5500 DATA

American Surgical Assistants I 401k Profit Sharing Plan and Trust

Overview

Plan Information

  • Plan Year01/01/2019 — 12/31/2019
  • Date of Plan08/01/2006
  • Net Assets as of 12/31/2019 $10,769,651
  • 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 ArrangementInsurance Trust

Participant Information as of 12/31/2019

  • Active (Eligible) Participants500
  • Retired or separated participants receiving benefits3
  • Other retired or separated participants entitled to future benefits174
  • Subtotal677
  • Deceased participants whose beneficiaries are receiving or are entitled to receive benefits0
  • Total677
  • Total number of participants as of 01/01/2019963
  • Number of participants with account balances493
  • Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested95

Expenses

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

Sponsor Information

  • Address7324 Southwest Freeway, Suite 1550
  • CityHouston
  • StateTX
  • Zip77074
  • Telephone(713) 779-9800
  • EIN30-0213088
  • Industry Code621399
  • Named AdministratorMark Russell

Audit Information

  • Audit StatusAudited
  • AuditorRobertson & Robertson, PLLC
  • Auditor EIN26-1631123
  • 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.
2R Brokerage Window Participant-directed brokerage accounts provided as an investment option under the plan.
2S Automatic Enrollment Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
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? No
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 $500,000
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 $3,826,816
Contributions $2,244,970
Cash Contributions $2,244,970
Cash from Employers $404,523
Cash from Participants $1,643,700
Others (including rollovers) $196,747
Noncash Contributions $0
Total Earnings on Investments $1,581,846
Total Interest $12,199
Interest-Bearing Cash $0
U.S. Government Securities $0
Corporate Debt Instruments $0
Loans (other than to participants) $0
Participant Loans $12,199
Interest from Other Investments $0
Total Dividends $0
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 $0
Net investment gain (loss) from pooled separate accounts $1,569,647
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 $0
Other Income $0
Expenses $613,569
Total Benefit Payments $541,806
Directly to participants or beneficiaries, including direct rollovers $541,806
To insurance carriers for the provision of benefits $0
Other Benefit Payment Fees $0
Corrective Distributions $23,211
Certain deemed distributions of participant loans $36,647
Interest expense $0
Total Administrative Expenses $11,905
Professional Fees $0
Contract Administrator Fees $11,905
Investment Advisory and management fees $0
Other Administrative Fees $0
Net Income $3,213,247
Transfers of Assets to this Plan $0
Transfers of Assets from this Plan $0

Asset and Liability Statement

12/31/2019 12/31/2018 Change YOY
Total Assets $10,769,651 $7,556,404 42.52%
Total noninterest-bearing cash $0 $0 0.0%
Receivables $0 $0 0.0%
Employer Contributions $0 $0 0.0%
Participant Contributions $0 $0 0.0%
Other Contributions $0 $0 0.0%
General Investments $0 $0 0.0%
Interest-bearing cash $0 $0 0.0%
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 $214,774 $197,045 9.00%
Value of interest in common/collective trusts $0 $0 0.0%
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 $10,041,417 $6,862,641 46.32%
Value of funds held in insurance co. general account $513,460 $496,718 3.37%
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 $10,769,651 $7,556,404 42.52%

Service Providers

Persons Receiving Only Eligible Indirect Compensation

There is no information on eligible indirect compensation for this plan.

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
Northwestern Mut Inv Svc Insurance agents and brokers, Investment advisory (plan) Investment Advisory $0 $19,815 $19,815
Alliance Benefit Group of Houston Other fees Tpa Services $6,663 $4,245 $10,908
Massachusetts Mutual Life Inc Co Recordkeeping and information management (computing, tabulating, data processing, etc.), Insurance services, Participant loan processing, Participant communication, Direct payment from the plan, Sales loads (front end and deferred), Other commissions, Shareholder servicing fees, Sub-transfer agency fees, Float revenue, Distribution (12b-1) fees, Recordkeeping fees, Account maintenance fees, Insurance mortality and expense charge, Other fees NONE $5,242 $127 $5,369
Mesirow Financial Investments Other services NONE $0 $27 $27
Total $11,905 $24,214 $36,119

Indirect Compensation

Name Source of Indirect Compensation* Nature of Service Description of Indirect Compensation Indirect Compensation Paid by Plan
Northwestern Mutual Massmutual Life Insurance Company Insurance agents and brokers, Investment advisory (plan) Sales Commission $19,815
Alliance Benefit Group of Houston Massmutual Life Insurance Company Other fees Other Fees $4,245
*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
Separate Account 401 Hartford Life Insurance Company DFE: Pooled Separate Account $10,041,416
Total $10,041,416

Insurance Information

Insurance Information

Insurance Carrier Summary Persons Covered
Hartford Life Insurance Company 423
EIN 06-0974148
Industry Code 88072
Contract Number 832845
Contract Year 01/01/2019 — 12/31/2019
Value in General Account at Year End $513,460
Value in Separate Accounts at Year End $10,041,417
Insurance Fees and Commissions $24,060
Persons Receiving Commissions and Fees
Agent/Broker Organization Code Commissions Paid Fees Paid Purpose of Fees Paid
Northwestern Mutual Inv Svc 720 E Wisconsin Ave Milwaukee, WI 53202 Insurance Agent or Broker $19,815 $0 COMMISSIONS
Alliance Benefit Group of Houston I 7425 Hollister Houston, TX 77040 Third Party Administrator $0 $4,245 SALES / ADMINISTRATION
Allocated Funds
Type of Contract Group Deferred Annuity
Basis of premium rates
Premiums paid to carrier $4,089
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 PENSION FUNDING
Balance at the end of the previous year $496,718
Additions $100,823
Contributions Deposited during the year $77,179
Dividends and credits $0
Interest credited during the year $8,839
Transferred from separate account $12,623
Other $2,182
Total of Balance and Additions $597,541
Deductions $84,081
Disbursed from fund to pay benefits or purchase annuities during the year $12,007
Administration charge made by carrier $214
Transferred to Separate Account $71,228
Other $632
Balance at the end of the current year $513,460