401k Plan data: NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN plan

NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 401k Plan overview

Plan Name	NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN
Plan identification number	001

NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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 theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
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.
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.
Participant-directed brokerage accounts provided as an investment option under the plan.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
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.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

NORTHWEST OHIO SURGICAL CENTERS INC. has sponsored the creation of one or more 401k plans.

Company Name: NORTHWEST OHIO SURGICAL CENTERS INC.

Employer identification number (EIN): 341392388

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2023-01-01 NANCY SHALL 2024-03-07
001 2022-01-01 NANCY SHALL 2023-03-06
001 2021-01-01 NANCY SHALL 2022-03-17
001 2020-01-01 NANCY SHALL 2021-03-08
001 2019-01-01 NANCY SHALL 2020-03-16
001 2018-01-01
001 2017-01-01
001 2016-01-01
001 2015-01-01
001 2014-01-01 NANCY SHALL
001 2013-01-01 NANCY SHALL
001 2012-01-01 NANCY SHALL 2013-10-02 NANCY SHALL 2013-10-02
001 2011-01-01 NANCY SHALL 2013-10-02 NANCY SHALL 2013-10-02
001 2010-01-01 M. PAUL TURNER
001 2009-01-01 M. PAUL TURNER - ACTUARY

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2023-01-01	NANCY SHALL	2024-03-07
001	2022-01-01	NANCY SHALL	2023-03-06
001	2021-01-01	NANCY SHALL	2022-03-17
001	2020-01-01	NANCY SHALL	2021-03-08
001	2019-01-01	NANCY SHALL	2020-03-16
001	2018-01-01
001	2017-01-01
001	2016-01-01
001	2015-01-01
001	2014-01-01	NANCY SHALL
001	2013-01-01	NANCY SHALL
001	2012-01-01	NANCY SHALL	2013-10-02	NANCY SHALL	2013-10-02
001	2011-01-01	NANCY SHALL	2013-10-02	NANCY SHALL	2013-10-02
001	2010-01-01	M. PAUL TURNER
001	2009-01-01	M. PAUL TURNER - ACTUARY

Plan Statistics for NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN

401k plan membership statisitcs for NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN

Measure Date Value
2023: NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2023 401k membership
Total participants, beginning-of-year 2023-01-01 38
Total number of active participants reported on line 7a of the Form 5500 2023-01-01 31
Number of retired or separated participants receiving benefits 2023-01-01 0
Number of other retired or separated participants entitled to future benefits 2023-01-01 10
Total of all active and inactive participants 2023-01-01 41
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2023-01-01 0
Total participants 2023-01-01 41
Number of participants with account balances 2023-01-01 40
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2023-01-01 1
2022: NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 37
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 29
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 8
Total of all active and inactive participants 2022-01-01 37
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 37
Number of participants with account balances 2022-01-01 37
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 35
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 29
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 8
Total of all active and inactive participants 2021-01-01 37
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 37
Number of participants with account balances 2021-01-01 31
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 37
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 32
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 4
Total of all active and inactive participants 2020-01-01 36
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 36
Number of participants with account balances 2020-01-01 31
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 32
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 32
Number of retired or separated participants receiving benefits 2019-01-01 1
Number of other retired or separated participants entitled to future benefits 2019-01-01 3
Total of all active and inactive participants 2019-01-01 36
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 36
Number of participants with account balances 2019-01-01 31
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 25
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 23
Number of retired or separated participants receiving benefits 2018-01-01 1
Number of other retired or separated participants entitled to future benefits 2018-01-01 5
Total of all active and inactive participants 2018-01-01 29
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 29
Number of participants with account balances 2018-01-01 24
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 29
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 22
Number of retired or separated participants receiving benefits 2017-01-01 1
Number of other retired or separated participants entitled to future benefits 2017-01-01 3
Total of all active and inactive participants 2017-01-01 26
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 26
Number of participants with account balances 2017-01-01 25
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 1
2016: NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 20
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 22
Number of retired or separated participants receiving benefits 2016-01-01 1
Number of other retired or separated participants entitled to future benefits 2016-01-01 4
Total of all active and inactive participants 2016-01-01 27
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 27
Number of participants with account balances 2016-01-01 25
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 18
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 14
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 3
Total of all active and inactive participants 2015-01-01 17
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 17
Number of participants with account balances 2015-01-01 17
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 17
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 15
Number of retired or separated participants receiving benefits 2014-01-01 1
Number of other retired or separated participants entitled to future benefits 2014-01-01 2
Total of all active and inactive participants 2014-01-01 18
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 18
Number of participants with account balances 2014-01-01 18
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 16
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 17
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 1
Total of all active and inactive participants 2013-01-01 18
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 18
Number of participants with account balances 2013-01-01 18
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2010: NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 5
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 5
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 0
Total of all active and inactive participants 2010-01-01 5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 5
Number of participants with account balances 2010-01-01 5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 5
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 5
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 0
Total of all active and inactive participants 2009-01-01 5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 5
Number of participants with account balances 2009-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2023: NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2023 401k membership
Total participants, beginning-of-year	2023-01-01	38
Total number of active participants reported on line 7a of the Form 5500	2023-01-01	31
Number of retired or separated participants receiving benefits	2023-01-01	0
Number of other retired or separated participants entitled to future benefits	2023-01-01	10
Total of all active and inactive participants	2023-01-01	41
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2023-01-01	0
Total participants	2023-01-01	41
Number of participants with account balances	2023-01-01	40
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2023-01-01	1
2022: NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	37
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	29
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	8
Total of all active and inactive participants	2022-01-01	37
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	37
Number of participants with account balances	2022-01-01	37
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	35
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	29
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	8
Total of all active and inactive participants	2021-01-01	37
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	37
Number of participants with account balances	2021-01-01	31
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	37
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	32
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	4
Total of all active and inactive participants	2020-01-01	36
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	36
Number of participants with account balances	2020-01-01	31
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	32
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	32
Number of retired or separated participants receiving benefits	2019-01-01	1
Number of other retired or separated participants entitled to future benefits	2019-01-01	3
Total of all active and inactive participants	2019-01-01	36
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	36
Number of participants with account balances	2019-01-01	31
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	25
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	23
Number of retired or separated participants receiving benefits	2018-01-01	1
Number of other retired or separated participants entitled to future benefits	2018-01-01	5
Total of all active and inactive participants	2018-01-01	29
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	29
Number of participants with account balances	2018-01-01	24
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	29
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	22
Number of retired or separated participants receiving benefits	2017-01-01	1
Number of other retired or separated participants entitled to future benefits	2017-01-01	3
Total of all active and inactive participants	2017-01-01	26
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	26
Number of participants with account balances	2017-01-01	25
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	1
2016: NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	20
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	22
Number of retired or separated participants receiving benefits	2016-01-01	1
Number of other retired or separated participants entitled to future benefits	2016-01-01	4
Total of all active and inactive participants	2016-01-01	27
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	27
Number of participants with account balances	2016-01-01	25
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	18
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	14
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	3
Total of all active and inactive participants	2015-01-01	17
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	17
Number of participants with account balances	2015-01-01	17
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	17
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	15
Number of retired or separated participants receiving benefits	2014-01-01	1
Number of other retired or separated participants entitled to future benefits	2014-01-01	2
Total of all active and inactive participants	2014-01-01	18
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	18
Number of participants with account balances	2014-01-01	18
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	16
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	17
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	1
Total of all active and inactive participants	2013-01-01	18
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	18
Number of participants with account balances	2013-01-01	18
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2010: NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	5
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	5
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	0
Total of all active and inactive participants	2010-01-01	5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	5
Number of participants with account balances	2010-01-01	5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	5
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	5
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	0
Total of all active and inactive participants	2009-01-01	5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	5
Number of participants with account balances	2009-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN

Measure	Date	Value
2023 : NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2023 401k financial data
Total income from all sources	2023-12-31	$1,188,950
Expenses. Total of all expenses incurred	2023-12-31	$343,761
Benefits paid (including direct rollovers)	2023-12-31	$314,825
Total plan assets at end of year	2023-12-31	$7,403,522
Total plan assets at beginning of year	2023-12-31	$6,558,333
Value of fidelity bond covering the plan	2023-12-31	$800,000
Total contributions received or receivable from participants	2023-12-31	$144,659
Other income received	2023-12-31	$807,286
Net income (gross income less expenses)	2023-12-31	$845,189
Net plan assets at end of year (total assets less liabilities)	2023-12-31	$7,403,522
Net plan assets at beginning of year (total assets less liabilities)	2023-12-31	$6,558,333
Assets. Value of participant loans	2023-12-31	$1,990
Assets. Value of assets in partnership/joint-venture interests	2023-12-31	$32,118
Total contributions received or receivable from employer(s)	2023-12-31	$237,005
Expenses. Administrative service providers (salaries,fees and commissions)	2023-12-31	$28,936
2022 : NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2022 401k financial data
Total income from all sources	2022-12-31	$-508,690
Expenses. Total of all expenses incurred	2022-12-31	$69,871
Benefits paid (including direct rollovers)	2022-12-31	$47,449
Total plan assets at end of year	2022-12-31	$6,558,333
Total plan assets at beginning of year	2022-12-31	$7,136,894
Value of fidelity bond covering the plan	2022-12-31	$800,000
Total contributions received or receivable from participants	2022-12-31	$141,018
Other income received	2022-12-31	$-852,368
Net income (gross income less expenses)	2022-12-31	$-578,561
Net plan assets at end of year (total assets less liabilities)	2022-12-31	$6,558,333
Net plan assets at beginning of year (total assets less liabilities)	2022-12-31	$7,136,894
Assets. Value of participant loans	2022-12-31	$3,310
Assets. Value of assets in partnership/joint-venture interests	2022-12-31	$35,254
Total contributions received or receivable from employer(s)	2022-12-31	$202,660
Expenses. Administrative service providers (salaries,fees and commissions)	2022-12-31	$22,422
2021 : NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2021 401k financial data
Total income from all sources	2021-12-31	$742,525
Expenses. Total of all expenses incurred	2021-12-31	$49,605
Benefits paid (including direct rollovers)	2021-12-31	$8,563
Total plan assets at end of year	2021-12-31	$7,136,894
Total plan assets at beginning of year	2021-12-31	$6,443,974
Value of fidelity bond covering the plan	2021-12-31	$800,000
Total contributions received or receivable from participants	2021-12-31	$136,134
Other income received	2021-12-31	$546,199
Net income (gross income less expenses)	2021-12-31	$692,920
Net plan assets at end of year (total assets less liabilities)	2021-12-31	$7,136,894
Net plan assets at beginning of year (total assets less liabilities)	2021-12-31	$6,443,974
Assets. Value of assets in partnership/joint-venture interests	2021-12-31	$36,919
Total contributions received or receivable from employer(s)	2021-12-31	$60,192
Expenses. Administrative service providers (salaries,fees and commissions)	2021-12-31	$41,042
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
2020 : NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2020 401k financial data
Total income from all sources	2020-12-31	$802,353
Expenses. Total of all expenses incurred	2020-12-31	$23,607
Benefits paid (including direct rollovers)	2020-12-31	$806
Total plan assets at end of year	2020-12-31	$6,443,974
Total plan assets at beginning of year	2020-12-31	$5,665,228
Value of fidelity bond covering the plan	2020-12-31	$800,000
Total contributions received or receivable from participants	2020-12-31	$119,912
Other income received	2020-12-31	$618,393
Net income (gross income less expenses)	2020-12-31	$778,746
Net plan assets at end of year (total assets less liabilities)	2020-12-31	$6,443,974
Net plan assets at beginning of year (total assets less liabilities)	2020-12-31	$5,665,228
Assets. Value of assets in partnership/joint-venture interests	2020-12-31	$41,151
Total contributions received or receivable from employer(s)	2020-12-31	$64,048
Value of certain deemed distributions of participant loans	2020-12-31	$22,801
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
2019 : NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2019 401k financial data
Total income from all sources	2019-12-31	$851,302
Expenses. Total of all expenses incurred	2019-12-31	$34,711
Benefits paid (including direct rollovers)	2019-12-31	$12,529
Total plan assets at end of year	2019-12-31	$5,665,228
Total plan assets at beginning of year	2019-12-31	$4,848,637
Value of fidelity bond covering the plan	2019-12-31	$800,000
Total contributions received or receivable from participants	2019-12-31	$119,935
Contributions received from other sources (not participants or employers)	2019-12-31	$1,630
Other income received	2019-12-31	$667,437
Net income (gross income less expenses)	2019-12-31	$816,591
Net plan assets at end of year (total assets less liabilities)	2019-12-31	$5,665,228
Net plan assets at beginning of year (total assets less liabilities)	2019-12-31	$4,848,637
Assets. Value of assets in partnership/joint-venture interests	2019-12-31	$39,161
Total contributions received or receivable from employer(s)	2019-12-31	$62,300
Value of certain deemed distributions of participant loans	2019-12-31	$22,182
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
2018 : NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2018 401k financial data
Total income from all sources	2018-12-31	$11,292
Expenses. Total of all expenses incurred	2018-12-31	$93,451
Benefits paid (including direct rollovers)	2018-12-31	$72,184
Total plan assets at end of year	2018-12-31	$4,848,637
Total plan assets at beginning of year	2018-12-31	$4,930,796
Value of fidelity bond covering the plan	2018-12-31	$800,000
Total contributions received or receivable from participants	2018-12-31	$89,225
Other income received	2018-12-31	$-120,086
Net income (gross income less expenses)	2018-12-31	$-82,159
Net plan assets at end of year (total assets less liabilities)	2018-12-31	$4,848,637
Net plan assets at beginning of year (total assets less liabilities)	2018-12-31	$4,930,796
Assets. Value of assets in partnership/joint-venture interests	2018-12-31	$37,604
Total contributions received or receivable from employer(s)	2018-12-31	$42,153
Expenses. Administrative service providers (salaries,fees and commissions)	2018-12-31	$21,267
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
2017 : NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2017 401k financial data
Total income from all sources	2017-12-31	$597,011
Expenses. Total of all expenses incurred	2017-12-31	$178,054
Benefits paid (including direct rollovers)	2017-12-31	$157,708
Total plan assets at end of year	2017-12-31	$4,930,796
Total plan assets at beginning of year	2017-12-31	$4,511,839
Value of fidelity bond covering the plan	2017-12-31	$800,000
Total contributions received or receivable from participants	2017-12-31	$103,687
Other income received	2017-12-31	$448,748
Net income (gross income less expenses)	2017-12-31	$418,957
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$4,930,796
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$4,511,839
Assets. Value of assets in partnership/joint-venture interests	2017-12-31	$37,710
Total contributions received or receivable from employer(s)	2017-12-31	$44,576
Value of certain deemed distributions of participant loans	2017-12-31	$20,346
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
2016 : NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2016 401k financial data
Total income from all sources	2016-12-31	$332,816
Expenses. Total of all expenses incurred	2016-12-31	$336,022
Benefits paid (including direct rollovers)	2016-12-31	$317,178
Total plan assets at end of year	2016-12-31	$4,511,839
Total plan assets at beginning of year	2016-12-31	$4,515,045
Value of fidelity bond covering the plan	2016-12-31	$800,000
Total contributions received or receivable from participants	2016-12-31	$48,985
Other income received	2016-12-31	$268,567
Net income (gross income less expenses)	2016-12-31	$-3,206
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$4,511,839
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$4,515,045
Assets. Value of assets in partnership/joint-venture interests	2016-12-31	$38,736
Total contributions received or receivable from employer(s)	2016-12-31	$15,264
Expenses. Administrative service providers (salaries,fees and commissions)	2016-12-31	$18,844
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
2015 : NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2015 401k financial data
Total income from all sources	2015-12-31	$90,546
Expenses. Total of all expenses incurred	2015-12-31	$67,204
Benefits paid (including direct rollovers)	2015-12-31	$48,133
Total plan assets at end of year	2015-12-31	$4,515,045
Total plan assets at beginning of year	2015-12-31	$4,491,703
Value of fidelity bond covering the plan	2015-12-31	$500,000
Total contributions received or receivable from participants	2015-12-31	$42,091
Other income received	2015-12-31	$38,110
Net income (gross income less expenses)	2015-12-31	$23,342
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$4,515,045
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$4,491,703
Assets. Value of assets in partnership/joint-venture interests	2015-12-31	$356,291
Total contributions received or receivable from employer(s)	2015-12-31	$10,345
Expenses. Administrative service providers (salaries,fees and commissions)	2015-12-31	$19,071
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
2014 : NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2014 401k financial data
Total income from all sources	2014-12-31	$407,205
Expenses. Total of all expenses incurred	2014-12-31	$1,176,105
Benefits paid (including direct rollovers)	2014-12-31	$1,161,500
Total plan assets at end of year	2014-12-31	$4,491,703
Total plan assets at beginning of year	2014-12-31	$5,260,603
Value of fidelity bond covering the plan	2014-12-31	$500,000
Total contributions received or receivable from participants	2014-12-31	$11,188
Other income received	2014-12-31	$358,807
Net income (gross income less expenses)	2014-12-31	$-768,900
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$4,491,703
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$5,260,603
Assets. Value of participant loans	2014-12-31	$0
Assets. Value of assets in partnership/joint-venture interests	2014-12-31	$355,395
Total contributions received or receivable from employer(s)	2014-12-31	$37,210
Expenses. Administrative service providers (salaries,fees and commissions)	2014-12-31	$14,605
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
2013 : NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2013 401k financial data
Total income from all sources	2013-12-31	$515,888
Expenses. Total of all expenses incurred	2013-12-31	$2,560
Benefits paid (including direct rollovers)	2013-12-31	$583
Total plan assets at end of year	2013-12-31	$5,260,603
Total plan assets at beginning of year	2013-12-31	$4,747,275
Value of fidelity bond covering the plan	2013-12-31	$265,000
Total contributions received or receivable from participants	2013-12-31	$32,887
Other income received	2013-12-31	$471,884
Net income (gross income less expenses)	2013-12-31	$513,328
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$5,260,603
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$4,747,275
Assets. Value of participant loans	2013-12-31	$1,684
Assets. Value of assets in partnership/joint-venture interests	2013-12-31	$200,000
Total contributions received or receivable from employer(s)	2013-12-31	$11,117
Expenses. Administrative service providers (salaries,fees and commissions)	2013-12-31	$1,977
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
2010 : NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2010 401k financial data
Total plan liabilities at end of year	2010-12-31	$0
Total plan liabilities at beginning of year	2010-12-31	$0
Total income from all sources	2010-12-31	$380,371
Expenses. Total of all expenses incurred	2010-12-31	$19,847
Benefits paid (including direct rollovers)	2010-12-31	$19,847
Total plan assets at end of year	2010-12-31	$2,836,783
Total plan assets at beginning of year	2010-12-31	$2,476,259
Total contributions received or receivable from participants	2010-12-31	$34,914
Expenses. Other expenses not covered elsewhere	2010-12-31	$0
Contributions received from other sources (not participants or employers)	2010-12-31	$0
Other income received	2010-12-31	$345,457
Noncash contributions received	2010-12-31	$0
Net income (gross income less expenses)	2010-12-31	$360,524
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$2,836,783
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$2,476,259
Total contributions received or receivable from employer(s)	2010-12-31	$0
Value of certain deemed distributions of participant loans	2010-12-31	$0
Value of corrective distributions	2010-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
2009 : NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN

2023: NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2023 form 5500 responses
2023-01-01	Type of plan entity	Single employer plan
2023-01-01	Submission has been amended	No
2023-01-01	This submission is the final filing	No
2023-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2023-01-01	Plan is a collectively bargained plan	No
2023-01-01	Plan funding arrangement – Insurance	Yes
2023-01-01	Plan funding arrangement – Trust	Yes
2023-01-01	Plan benefit arrangement – Insurance	Yes
2023-01-01	Plan benefit arrangement - Trust	Yes
2022: NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	Yes
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2010: NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: NORTHWEST OHIO SURGICAL CENTERS, INC. 401(K) PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-825274

Policy instance

Insurance contract or identification number	GA-825274
Number of Individuals Covered	29
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $560
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $560
Insurance broker organization code?	3

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-825274

Policy instance

Insurance contract or identification number	GA-825274
Number of Individuals Covered	28
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $2,670
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,654
Insurance broker organization code?	3

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-825274

Policy instance

Insurance contract or identification number	GA-825274
Number of Individuals Covered	28
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $1,520
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,520
Insurance broker organization code?	3

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-825274

Policy instance

Insurance contract or identification number	GA-825274
Number of Individuals Covered	23
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $1,702
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,702
Insurance broker organization code?	3

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-825274

Policy instance

Insurance contract or identification number	GA-825274
Number of Individuals Covered	23
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $1,788
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	1788
Additional information about fees paid to insurance broker	COMMISSIONS
Insurance broker organization code?	3
Insurance broker name	MERRILL LYNCH LIFE AGENCY

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-825274

Policy instance

Insurance contract or identification number	GA-825274
Number of Individuals Covered	14
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $716
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	696
Additional information about fees paid to insurance broker	COMMISSIONS
Insurance broker organization code?	3
Insurance broker name	PENSION INNOVATIONS & CONSULTING

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-825274

Policy instance

Insurance contract or identification number	GA-825274
Number of Individuals Covered	14
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $618
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	549
Additional information about fees paid to insurance broker	COMMISSIONS
Insurance broker organization code?	3
Insurance broker name	PENSION INNOVATIONS & CONSULTING

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-825274

Policy instance

Insurance contract or identification number	GA-825274
Number of Individuals Covered	10
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $349
Total amount of fees paid to insurance company	USD $44
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $349
Amount paid for insurance broker fees	0
Insurance broker organization code?	1
Additional information about fees paid to insurance broker	TPA FEES
Insurance broker name	PENSION INNOVATIONS & CONSULTING

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Company Name:	NORTHWEST OHIO SURGICAL CENTERS INC.
Employer identification number (EIN):	341392388
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)