401k Plan data: PHILIP A. ROBINSON, M.D., F.I.D.S.A. DEFINED BENEFIT PENSION PLAN plan

PHILIP A. ROBINSON, M.D., F.I.D.S.A. DEFINED BENEFIT PENSION PLAN 401k Plan overview

Plan Name	PHILIP A. ROBINSON, M.D., F.I.D.S.A. DEFINED BENEFIT PENSION PLAN
Plan identification number	002

PHILIP A. ROBINSON, M.D., F.I.D.S.A. DEFINED BENEFIT PENSION PLAN Benefits

401k Plan Type

Defined Benefit Pension

Plan Features/Benefits

Benefits are primarily pay related
Benefits are primarily flat dollar (includes dollars per year of service)
Cash balance or similar plan - Plan has a "cash balance" formula. For this purpose, a "cash balance" formula is a benefit formula in a defined benefit plan by whatever name (for example, personal account plan, pension equity plan, life cycle plan, cash account plan, etc.) that rather than, or in addition to, expressing the accrued benefit as a life annuity commencing at normal retirement age, defines benefits for each employee in terms more common to a defined contribution plan such as a single sum distribution amount (for example, 10 percent of final average pay times years of service, or the amount of the employee's hypothetical account balance).
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.

401k Sponsoring company profile

PHILIP A. ROBINSON, M.D., F.I.D.S.A. has sponsored the creation of one or more 401k plans.

Company Name: PHILIP A. ROBINSON, M.D., F.I.D.S.A.

Employer identification number (EIN): 330783137

NAIC Classification: 621111
NAIC Description: Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PHILIP A. ROBINSON, M.D., F.I.D.S.A. DEFINED BENEFIT PENSION PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2023-01-01
002 2022-01-01
002 2021-01-01
002 2020-01-01
002 2019-01-01

Plan Statistics for PHILIP A. ROBINSON, M.D., F.I.D.S.A. DEFINED BENEFIT PENSION PLAN

401k plan membership statisitcs for PHILIP A. ROBINSON, M.D., F.I.D.S.A. DEFINED BENEFIT PENSION PLAN

Measure Date Value
2022: PHILIP A. ROBINSON, M.D., F.I.D.S.A. DEFINED BENEFIT PENSION PLAN 2022 401k membership
Market value of plan assets 2022-12-31 512,125
Acturial value of plan assets 2022-12-31 512,125
Funding target for retired participants and beneficiaries receiving payment 2022-12-31 0
Number of terminated vested participants 2022-12-31 0
Fundng target for terminated vested participants 2022-12-31 0
Active participant vested funding target 2022-12-31 453,983
Number of active participants 2022-12-31 2
Total funding liabilities for active participants 2022-12-31 453,983
Total participant count 2022-12-31 2
Total funding target for all participants 2022-12-31 453,983
Balance at beginning of prior year after applicable adjustments 2022-12-31 0
Prefunding balance at beginning of prior year after applicable adjustments 2022-12-31 0
Carryover balanced portion elected for use to offset prior years funding requirement 2022-12-31 0
Prefunding balanced used to offset prior years funding requirement 2022-12-31 0
Amount remaining of carryover balance 2022-12-31 0
Amount remaining of prefunding balance 2022-12-31 0
Present value of excess contributions 2022-12-31 203,716
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance 2022-12-31 203,716
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance 2022-12-31 0
Reductions in caryover balances due to elections or deemed elections 2022-12-31 0
Reductions in prefunding balances due to elections or deemed elections 2022-12-31 0
Balance of carryovers at beginning of current year 2022-12-31 0
Balance of prefunding at beginning of current year 2022-12-31 0
Total employer contributions 2022-12-31 328,657
Total employee contributions 2022-12-31 0
Contributions allocated toward unpaid minimum require contributions from prior years 2022-12-31 0
Contributions made to avoid restrictions adjusted to valuation date 2022-12-31 0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date 2022-12-31 332,803
Unpaid minimum required contributions for all prior years 2022-12-31 0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years 2022-12-31 0
Remaining amount of unpaid minimum required contributions 2022-12-31 0
Minimum required contributions for current year target normal cost 2022-12-31 161,399
Net shortfall amortization installment of oustanding balance 2022-12-31 0
Waiver amortization installment 2022-12-31 0
Total funding amount beforereflecting carryover/prefunding balances 2022-12-31 103,257
Carryover balance elected to use to offset funding requirement 2022-12-31 0
Prefunding balance elected to use to offset funding requirement 2022-12-31 0
Additional cash requirement 2022-12-31 103,257
Contributions allocatedtoward minimum required contributions for current year 2022-12-31 332,803
Unpaid minimum required contributions for current year 2022-12-31 0
Unpaid minimum required contributions for all years 2022-12-31 0
2021: PHILIP A. ROBINSON, M.D., F.I.D.S.A. DEFINED BENEFIT PENSION PLAN 2021 401k membership
Market value of plan assets 2021-12-31 354,954
Acturial value of plan assets 2021-12-31 354,954
Funding target for retired participants and beneficiaries receiving payment 2021-12-31 0
Number of terminated vested participants 2021-12-31 0
Fundng target for terminated vested participants 2021-12-31 0
Active participant vested funding target 2021-12-31 280,560
Number of active participants 2021-12-31 2
Total funding liabilities for active participants 2021-12-31 280,560
Total participant count 2021-12-31 2
Total funding target for all participants 2021-12-31 280,560
Balance at beginning of prior year after applicable adjustments 2021-12-31 0
Prefunding balance at beginning of prior year after applicable adjustments 2021-12-31 0
Carryover balanced portion elected for use to offset prior years funding requirement 2021-12-31 0
Prefunding balanced used to offset prior years funding requirement 2021-12-31 0
Amount remaining of carryover balance 2021-12-31 0
Amount remaining of prefunding balance 2021-12-31 0
Present value of excess contributions 2021-12-31 0
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance 2021-12-31 0
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance 2021-12-31 0
Reductions in caryover balances due to elections or deemed elections 2021-12-31 0
Reductions in prefunding balances due to elections or deemed elections 2021-12-31 0
Balance of carryovers at beginning of current year 2021-12-31 0
Balance of prefunding at beginning of current year 2021-12-31 0
Total employer contributions 2021-12-31 265,000
Total employee contributions 2021-12-31 0
Contributions allocated toward unpaid minimum require contributions from prior years 2021-12-31 0
Contributions made to avoid restrictions adjusted to valuation date 2021-12-31 0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date 2021-12-31 269,370
Unpaid minimum required contributions for all prior years 2021-12-31 0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years 2021-12-31 0
Remaining amount of unpaid minimum required contributions 2021-12-31 0
Minimum required contributions for current year target normal cost 2021-12-31 140,048
Net shortfall amortization installment of oustanding balance 2021-12-31 0
Waiver amortization installment 2021-12-31 0
Total funding amount beforereflecting carryover/prefunding balances 2021-12-31 65,654
Additional cash requirement 2021-12-31 65,654
Contributions allocatedtoward minimum required contributions for current year 2021-12-31 269,370
Unpaid minimum required contributions for current year 2021-12-31 0
Unpaid minimum required contributions for all years 2021-12-31 0
2020: PHILIP A. ROBINSON, M.D., F.I.D.S.A. DEFINED BENEFIT PENSION PLAN 2020 401k membership
Market value of plan assets 2020-12-31 84,391
Acturial value of plan assets 2020-12-31 84,391
Funding target for retired participants and beneficiaries receiving payment 2020-12-31 0
Number of terminated vested participants 2020-12-31 0
Fundng target for terminated vested participants 2020-12-31 0
Active participant vested funding target 2020-12-31 133,879
Number of active participants 2020-12-31 2
Total funding liabilities for active participants 2020-12-31 133,879
Total participant count 2020-12-31 2
Total funding target for all participants 2020-12-31 133,879
Balance at beginning of prior year after applicable adjustments 2020-12-31 0
Prefunding balance at beginning of prior year after applicable adjustments 2020-12-31 0
Carryover balanced portion elected for use to offset prior years funding requirement 2020-12-31 0
Prefunding balanced used to offset prior years funding requirement 2020-12-31 0
Amount remaining of carryover balance 2020-12-31 0
Amount remaining of prefunding balance 2020-12-31 0
Present value of excess contributions 2020-12-31 33,957
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance 2020-12-31 33,957
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance 2020-12-31 0
Reductions in caryover balances due to elections or deemed elections 2020-12-31 0
Reductions in prefunding balances due to elections or deemed elections 2020-12-31 0
Balance of carryovers at beginning of current year 2020-12-31 0
Balance of prefunding at beginning of current year 2020-12-31 0
Total employer contributions 2020-12-31 210,000
Total employee contributions 2020-12-31 0
Contributions allocated toward unpaid minimum require contributions from prior years 2020-12-31 0
Contributions made to avoid restrictions adjusted to valuation date 2020-12-31 0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date 2020-12-31 211,216
Liquidity shortfalls end of Q1 2020-12-31 0
Liquidity shortfalls end of Q2 2020-12-31 0
Liquidity shortfalls end of Q3 2020-12-31 0
Liquidity shortfalls end of Q4 2020-12-31 0
Unpaid minimum required contributions for all prior years 2020-12-31 0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years 2020-12-31 0
Remaining amount of unpaid minimum required contributions 2020-12-31 0
Minimum required contributions for current year target normal cost 2020-12-31 133,894
Net shortfall amortization installment of oustanding balance 2020-12-31 49,488
Waiver amortization installment 2020-12-31 0
Total funding amount beforereflecting carryover/prefunding balances 2020-12-31 143,091
Additional cash requirement 2020-12-31 143,091
Contributions allocatedtoward minimum required contributions for current year 2020-12-31 211,216
Unpaid minimum required contributions for current year 2020-12-31 0
Unpaid minimum required contributions for all years 2020-12-31 0
2019: PHILIP A. ROBINSON, M.D., F.I.D.S.A. DEFINED BENEFIT PENSION PLAN 2019 401k membership
Market value of plan assets 2019-12-31 0
Acturial value of plan assets 2019-12-31 0
Funding target for retired participants and beneficiaries receiving payment 2019-12-31 0
Number of terminated vested participants 2019-12-31 0
Fundng target for terminated vested participants 2019-12-31 0
Active participant vested funding target 2019-12-31 52,789
Number of active participants 2019-12-31 2
Total funding liabilities for active participants 2019-12-31 52,789
Total participant count 2019-12-31 2
Total funding target for all participants 2019-12-31 52,789
Balance at beginning of prior year after applicable adjustments 2019-12-31 0
Prefunding balance at beginning of prior year after applicable adjustments 2019-12-31 0
Carryover balanced portion elected for use to offset prior years funding requirement 2019-12-31 0
Prefunding balanced used to offset prior years funding requirement 2019-12-31 0
Amount remaining of carryover balance 2019-12-31 0
Amount remaining of prefunding balance 2019-12-31 0
Present value of excess contributions 2019-12-31 0
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance 2019-12-31 0
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance 2019-12-31 0
Reductions in caryover balances due to elections or deemed elections 2019-12-31 0
Reductions in prefunding balances due to elections or deemed elections 2019-12-31 0
Balance of carryovers at beginning of current year 2019-12-31 0
Balance of prefunding at beginning of current year 2019-12-31 0
Total employer contributions 2019-12-31 63,000
Total employee contributions 2019-12-31 0
Contributions allocated toward unpaid minimum require contributions from prior years 2019-12-31 0
Contributions made to avoid restrictions adjusted to valuation date 2019-12-31 0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date 2019-12-31 61,864
Unpaid minimum required contributions for all prior years 2019-12-31 0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years 2019-12-31 0
Remaining amount of unpaid minimum required contributions 2019-12-31 0
Minimum required contributions for current year target normal cost 2019-12-31 287
Net shortfall amortization installment of oustanding balance 2019-12-31 52,789
Waiver amortization installment 2019-12-31 0
Total funding amount beforereflecting carryover/prefunding balances 2019-12-31 8,865
Additional cash requirement 2019-12-31 8,865
Contributions allocatedtoward minimum required contributions for current year 2019-12-31 61,864
Unpaid minimum required contributions for current year 2019-12-31 0
Unpaid minimum required contributions for all years 2019-12-31 0

Measure	Date	Value
2022: PHILIP A. ROBINSON, M.D., F.I.D.S.A. DEFINED BENEFIT PENSION PLAN 2022 401k membership
Market value of plan assets	2022-12-31	512,125
Acturial value of plan assets	2022-12-31	512,125
Funding target for retired participants and beneficiaries receiving payment	2022-12-31	0
Number of terminated vested participants	2022-12-31	0
Fundng target for terminated vested participants	2022-12-31	0
Active participant vested funding target	2022-12-31	453,983
Number of active participants	2022-12-31	2
Total funding liabilities for active participants	2022-12-31	453,983
Total participant count	2022-12-31	2
Total funding target for all participants	2022-12-31	453,983
Balance at beginning of prior year after applicable adjustments	2022-12-31	0
Prefunding balance at beginning of prior year after applicable adjustments	2022-12-31	0
Carryover balanced portion elected for use to offset prior years funding requirement	2022-12-31	0
Prefunding balanced used to offset prior years funding requirement	2022-12-31	0
Amount remaining of carryover balance	2022-12-31	0
Amount remaining of prefunding balance	2022-12-31	0
Present value of excess contributions	2022-12-31	203,716
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance	2022-12-31	203,716
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance	2022-12-31	0
Reductions in caryover balances due to elections or deemed elections	2022-12-31	0
Reductions in prefunding balances due to elections or deemed elections	2022-12-31	0
Balance of carryovers at beginning of current year	2022-12-31	0
Balance of prefunding at beginning of current year	2022-12-31	0
Total employer contributions	2022-12-31	328,657
Total employee contributions	2022-12-31	0
Contributions allocated toward unpaid minimum require contributions from prior years	2022-12-31	0
Contributions made to avoid restrictions adjusted to valuation date	2022-12-31	0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date	2022-12-31	332,803
Unpaid minimum required contributions for all prior years	2022-12-31	0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years	2022-12-31	0
Remaining amount of unpaid minimum required contributions	2022-12-31	0
Minimum required contributions for current year target normal cost	2022-12-31	161,399
Net shortfall amortization installment of oustanding balance	2022-12-31	0
Waiver amortization installment	2022-12-31	0
Total funding amount beforereflecting carryover/prefunding balances	2022-12-31	103,257
Carryover balance elected to use to offset funding requirement	2022-12-31	0
Prefunding balance elected to use to offset funding requirement	2022-12-31	0
Additional cash requirement	2022-12-31	103,257
Contributions allocatedtoward minimum required contributions for current year	2022-12-31	332,803
Unpaid minimum required contributions for current year	2022-12-31	0
Unpaid minimum required contributions for all years	2022-12-31	0
2021: PHILIP A. ROBINSON, M.D., F.I.D.S.A. DEFINED BENEFIT PENSION PLAN 2021 401k membership
Market value of plan assets	2021-12-31	354,954
Acturial value of plan assets	2021-12-31	354,954
Funding target for retired participants and beneficiaries receiving payment	2021-12-31	0
Number of terminated vested participants	2021-12-31	0
Fundng target for terminated vested participants	2021-12-31	0
Active participant vested funding target	2021-12-31	280,560
Number of active participants	2021-12-31	2
Total funding liabilities for active participants	2021-12-31	280,560
Total participant count	2021-12-31	2
Total funding target for all participants	2021-12-31	280,560
Balance at beginning of prior year after applicable adjustments	2021-12-31	0
Prefunding balance at beginning of prior year after applicable adjustments	2021-12-31	0
Carryover balanced portion elected for use to offset prior years funding requirement	2021-12-31	0
Prefunding balanced used to offset prior years funding requirement	2021-12-31	0
Amount remaining of carryover balance	2021-12-31	0
Amount remaining of prefunding balance	2021-12-31	0
Present value of excess contributions	2021-12-31	0
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance	2021-12-31	0
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance	2021-12-31	0
Reductions in caryover balances due to elections or deemed elections	2021-12-31	0
Reductions in prefunding balances due to elections or deemed elections	2021-12-31	0
Balance of carryovers at beginning of current year	2021-12-31	0
Balance of prefunding at beginning of current year	2021-12-31	0
Total employer contributions	2021-12-31	265,000
Total employee contributions	2021-12-31	0
Contributions allocated toward unpaid minimum require contributions from prior years	2021-12-31	0
Contributions made to avoid restrictions adjusted to valuation date	2021-12-31	0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date	2021-12-31	269,370
Unpaid minimum required contributions for all prior years	2021-12-31	0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years	2021-12-31	0
Remaining amount of unpaid minimum required contributions	2021-12-31	0
Minimum required contributions for current year target normal cost	2021-12-31	140,048
Net shortfall amortization installment of oustanding balance	2021-12-31	0
Waiver amortization installment	2021-12-31	0
Total funding amount beforereflecting carryover/prefunding balances	2021-12-31	65,654
Additional cash requirement	2021-12-31	65,654
Contributions allocatedtoward minimum required contributions for current year	2021-12-31	269,370
Unpaid minimum required contributions for current year	2021-12-31	0
Unpaid minimum required contributions for all years	2021-12-31	0
2020: PHILIP A. ROBINSON, M.D., F.I.D.S.A. DEFINED BENEFIT PENSION PLAN 2020 401k membership
Market value of plan assets	2020-12-31	84,391
Acturial value of plan assets	2020-12-31	84,391
Funding target for retired participants and beneficiaries receiving payment	2020-12-31	0
Number of terminated vested participants	2020-12-31	0
Fundng target for terminated vested participants	2020-12-31	0
Active participant vested funding target	2020-12-31	133,879
Number of active participants	2020-12-31	2
Total funding liabilities for active participants	2020-12-31	133,879
Total participant count	2020-12-31	2
Total funding target for all participants	2020-12-31	133,879
Balance at beginning of prior year after applicable adjustments	2020-12-31	0
Prefunding balance at beginning of prior year after applicable adjustments	2020-12-31	0
Carryover balanced portion elected for use to offset prior years funding requirement	2020-12-31	0
Prefunding balanced used to offset prior years funding requirement	2020-12-31	0
Amount remaining of carryover balance	2020-12-31	0
Amount remaining of prefunding balance	2020-12-31	0
Present value of excess contributions	2020-12-31	33,957
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance	2020-12-31	33,957
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance	2020-12-31	0
Reductions in caryover balances due to elections or deemed elections	2020-12-31	0
Reductions in prefunding balances due to elections or deemed elections	2020-12-31	0
Balance of carryovers at beginning of current year	2020-12-31	0
Balance of prefunding at beginning of current year	2020-12-31	0
Total employer contributions	2020-12-31	210,000
Total employee contributions	2020-12-31	0
Contributions allocated toward unpaid minimum require contributions from prior years	2020-12-31	0
Contributions made to avoid restrictions adjusted to valuation date	2020-12-31	0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date	2020-12-31	211,216
Liquidity shortfalls end of Q1	2020-12-31	0
Liquidity shortfalls end of Q2	2020-12-31	0
Liquidity shortfalls end of Q3	2020-12-31	0
Liquidity shortfalls end of Q4	2020-12-31	0
Unpaid minimum required contributions for all prior years	2020-12-31	0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years	2020-12-31	0
Remaining amount of unpaid minimum required contributions	2020-12-31	0
Minimum required contributions for current year target normal cost	2020-12-31	133,894
Net shortfall amortization installment of oustanding balance	2020-12-31	49,488
Waiver amortization installment	2020-12-31	0
Total funding amount beforereflecting carryover/prefunding balances	2020-12-31	143,091
Additional cash requirement	2020-12-31	143,091
Contributions allocatedtoward minimum required contributions for current year	2020-12-31	211,216
Unpaid minimum required contributions for current year	2020-12-31	0
Unpaid minimum required contributions for all years	2020-12-31	0
2019: PHILIP A. ROBINSON, M.D., F.I.D.S.A. DEFINED BENEFIT PENSION PLAN 2019 401k membership
Market value of plan assets	2019-12-31	0
Acturial value of plan assets	2019-12-31	0
Funding target for retired participants and beneficiaries receiving payment	2019-12-31	0
Number of terminated vested participants	2019-12-31	0
Fundng target for terminated vested participants	2019-12-31	0
Active participant vested funding target	2019-12-31	52,789
Number of active participants	2019-12-31	2
Total funding liabilities for active participants	2019-12-31	52,789
Total participant count	2019-12-31	2
Total funding target for all participants	2019-12-31	52,789
Balance at beginning of prior year after applicable adjustments	2019-12-31	0
Prefunding balance at beginning of prior year after applicable adjustments	2019-12-31	0
Carryover balanced portion elected for use to offset prior years funding requirement	2019-12-31	0
Prefunding balanced used to offset prior years funding requirement	2019-12-31	0
Amount remaining of carryover balance	2019-12-31	0
Amount remaining of prefunding balance	2019-12-31	0
Present value of excess contributions	2019-12-31	0
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance	2019-12-31	0
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance	2019-12-31	0
Reductions in caryover balances due to elections or deemed elections	2019-12-31	0
Reductions in prefunding balances due to elections or deemed elections	2019-12-31	0
Balance of carryovers at beginning of current year	2019-12-31	0
Balance of prefunding at beginning of current year	2019-12-31	0
Total employer contributions	2019-12-31	63,000
Total employee contributions	2019-12-31	0
Contributions allocated toward unpaid minimum require contributions from prior years	2019-12-31	0
Contributions made to avoid restrictions adjusted to valuation date	2019-12-31	0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date	2019-12-31	61,864
Unpaid minimum required contributions for all prior years	2019-12-31	0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years	2019-12-31	0
Remaining amount of unpaid minimum required contributions	2019-12-31	0
Minimum required contributions for current year target normal cost	2019-12-31	287
Net shortfall amortization installment of oustanding balance	2019-12-31	52,789
Waiver amortization installment	2019-12-31	0
Total funding amount beforereflecting carryover/prefunding balances	2019-12-31	8,865
Additional cash requirement	2019-12-31	8,865
Contributions allocatedtoward minimum required contributions for current year	2019-12-31	61,864
Unpaid minimum required contributions for current year	2019-12-31	0
Unpaid minimum required contributions for all years	2019-12-31	0

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Company Name:	PHILIP A. ROBINSON, M.D., F.I.D.S.A.
Employer identification number (EIN):	330783137
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2023-01-01
002	2022-01-01
002	2021-01-01
002	2020-01-01
002	2019-01-01