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FORM 5500 DATA

Western Pennsylvania Anesthesia Associates, Limited Profit Sharing Plan

Overview

Plan Information

  • Plan Year01/01/2015 — 12/31/2015
  • Date of Plan01/02/1970
  • Net Assets as of 12/31/2015 $325,129
  • 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 12/31/2015

  • Active (Eligible) Participants8
  • Retired or separated participants receiving benefits0
  • Other retired or separated participants entitled to future benefits0
  • Subtotal8
  • Deceased participants whose beneficiaries are receiving or are entitled to receive benefits0
  • Total8
  • Total number of participants as of 01/01/201536
  • Number of participants with account balances8
  • 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

  • Address1501 Reedsdale Street Suite 4004
  • CityPittsburgh
  • StatePA
  • Zip15233-2317
  • Telephone(412) 363-5570
  • EIN25-1202257
  • Industry Code621111
  • Named AdministratorJames Mermigas
  • Named Plan SponsorJames Mermigas

Benefits Provided Under the Plan

Code Benefit Description
2A Age/Service Weighted or New Comparability or Similar Plan Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New Comparability or Similar Plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the threshold or additional rate allowed under the permitted disparity rules of section 401(l)
2E Profit-sharing A defined contribution plan that allows employer discretionary contributions. These plans often contain a 401(k) feature.
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.
2R Brokerage Window Participant-directed brokerage accounts provided as an investment option under the plan.

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 at any time hold 20% or more of its assets in any single security, debt, mortgage, parcel of real estate, or partnership/joint venture interest? No $0
Are you claiming a waiver of the annual examination and report of an independent qualified public accountant (IQPA) under 29 CFR 2520.104-46? Yes
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 $25,043
Contributions $0
Cash Contributions $0
Cash from Employers $0
Cash from Participants $0
Others (including rollovers) $0
Noncash Contributions $0
Other Income $25,043
Expenses $1,466,818
Total Benefit Payments $1,466,316
Corrective Distributions $0
Certain deemed distributions of participant loans $0
Other Expenses $0
Net Income $-1,441,775
Transfers of Assets to (from) this Plan $0

Asset and Liability Statement

12/31/2015 12/31/2014 Change YOY
Total Assets $325,129 $1,766,904 -81.60%
Total Liabilities $0 $0 0.0%
Net Assets $325,129 $1,766,904 -81.60%

Specific Assets Statement

Held? Amount
Total Specific Assets No $0
Partnership/joint venture interests No $0
Employer Real Property No $0
Real Estate No $0
Employer Securities No $0
Participant Loans No $0
Loans (other than to participants) No $0
Tangible Personal Property No $0

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

There are no service providers listed for this plan.

Indirect Compensation

There are no service providers with indirect compensation listed for this plan.

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

No investments information available for this plan.

Insurance Information

Insurance Information

There are no insurance carriers listed for this plan.