Back to top
FORM 5500 DATA

403(b) Thrift Plan of Pacific Clinics

Overview

Plan Information

  • Plan Year07/01/2017 — 06/30/2018
  • Date of Plan01/01/2002
  • Net Assets as of 06/30/2018 $39,372,281
  • Plan Number4
  • 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
  • Plan Benefit ArrangementInsurance

Participant Information as of 06/30/2018

  • Active (Eligible) Participants1,171
  • Retired or separated participants receiving benefits0
  • Other retired or separated participants entitled to future benefits473
  • Subtotal1,644
  • Deceased participants whose beneficiaries are receiving or are entitled to receive benefits5
  • Total1,649
  • Total number of participants as of 07/01/20171,528
  • Number of participants with account balances1,499
  • Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested139

Expenses

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

Sponsor Information

  • Address800 S Santa Anita Ave Fl 3
  • CityArcadia
  • StateCA
  • Zip91006
  • Telephone(626) 254-5000
  • EIN95-1644034
  • Industry Code813000
  • Named AdministratorJoseph Wong

Audit Information

  • Audit StatusAudited
  • AuditorRsm Us LLP
  • Auditor EIN42-0714325
  • Audit Opinion Disclaimer
  • Audit TypeLimited Scope Audit

Benefits Provided Under the Plan

Code Benefit Description
2L Code section 403(b)(1) arrangement A 403(b) plan, also known as a tax-sheltered annuity (TSA) plan, is a retirement plan for certain employees of public schools, employees of certain tax-exempt organizations, and certain ministers.

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 $2,000,000
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 $6,380,342
Contributions $3,625,239
Cash Contributions $3,625,239
Cash from Employers $666,395
Cash from Participants $2,330,214
Others (including rollovers) $628,630
Noncash Contributions $0
Total Earnings on Investments $2,755,103
Total Interest $160,410
Interest-Bearing Cash $0
U.S. Government Securities $0
Corporate Debt Instruments $0
Loans (other than to participants) $0
Participant Loans $0
Interest from Other Investments $160,410
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 $2,594,693
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 $3,229,247
Total Benefit Payments $3,219,425
Directly to participants or beneficiaries, including direct rollovers $3,219,425
To insurance carriers for the provision of benefits $0
Other Benefit Payment Fees $0
Corrective Distributions $0
Certain deemed distributions of participant loans $9,822
Interest expense $0
Total Administrative Expenses $0
Professional Fees $0
Contract Administrator Fees $0
Investment Advisory and management fees $0
Other Administrative Fees $0
Net Income $3,151,095
Transfers of Assets to this Plan $0
Transfers of Assets from this Plan $0

Asset and Liability Statement

06/30/2018 06/30/2017 Change YOY
Total Assets $39,372,281 $36,221,186 8.70%
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 $0 $0 0.0%
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 $28,442,258 $25,424,292 11.87%
Value of funds held in insurance co. general account $10,930,023 $10,796,894 1.23%
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 $39,372,281 $36,221,186 8.70%

Service Providers

Persons Receiving Only Eligible Indirect Compensation

  • Fidelity Management and Research Co
  • The Vanguard Group Inc
  • Deutsche Investment Management Amer
  • Oppenheimer Funds Inc
  • American Century Investment Managem
  • Calvert Investment Management Inc
  • Capital Research and Management Com
  • Pimco
  • T Rowe Price Associates Inc
  • Mfs Variable Insurance Trust III

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
Mutual of America Life Insurance Co Claims processing, Recordkeeping and information management (computing, tabulating, data processing, etc.), Participant loan processing, Account maintenance fees Insurance Carrier $627 $0 $627
Total $627 $0 $627

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

Name of Investment Investment Manager Type of Investment Dollar Value
Separate Account Number Hs2 Mutual of America DFE: Pooled Separate Account $28,442,258
Total $28,442,258

Insurance Information

Insurance Information

Insurance Carrier Summary Persons Covered
Mutual of America 1,649
EIN 13-1614399
Industry Code 88668
Contract Number 248004I
Contract Year 07/01/2017 — 06/30/2018
Value in General Account at Year End $10,930,023
Value in Separate Accounts at Year End $28,442,258
Insurance Fees and Commissions $6,788
Persons Receiving Commissions and Fees
Agent/Broker Organization Code Commissions Paid Fees Paid Purpose of Fees Paid
Los Angeles Regional Office 111 West Ocean Blvd Suite 925 Long Beach, CA 90802 -7931 Insurance Agent or Broker $0 $6,788 PORTION OF INCENTIVE COMP PROGRAM
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 Deposit Administration
Balance at the end of the previous year $10,796,894
Additions $1,208,144
Contributions Deposited during the year $835,037
Dividends and credits $0
Interest credited during the year $160,410
Transferred from separate account $0
Other $212,697
Total of Balance and Additions $12,005,038
Deductions $1,075,015
Disbursed from fund to pay benefits or purchase annuities during the year $994,304
Administration charge made by carrier $0
Transferred to Separate Account $80,711
Other $0
Balance at the end of the current year $10,930,023