401k Plan data: MIDWEST HEART DEFINED BENEFIT PENSION PLAN AND TRUST plan

MIDWEST HEART DEFINED BENEFIT PENSION PLAN AND TRUST 401k Plan overview

Plan Name	MIDWEST HEART DEFINED BENEFIT PENSION PLAN AND TRUST
Plan identification number	012

MIDWEST HEART DEFINED BENEFIT PENSION PLAN AND TRUST Benefits

401k Plan Type

Defined Benefit Pension

Plan Features/Benefits

Benefits are primarily pay related
Covered by PBGC - Plan is covered under the PBGC insurance program (see ERISA section 4021).
Plan covered by PBGC that was terminated and closed out for PBGC purposes - Before the end of the plan year (or a prior plan year), (1) the plan terminated in a standard (or distress) termination and completed the distribution of plan assets in satisfaction of all benefit liabilities (or all ERISA Title IV benefits for distress termination); or (2) a trustee was appointed for a terminated plan pursuant to ERISA section 4042.
Frozen Plan - As of the last day of the plan year, the plan provides that no participant will get any new benefit accrual (whether because of service or compensation).

401k Sponsoring company profile

MIDWEST HEART LLC has sponsored the creation of one or more 401k plans.

Company Name: MIDWEST HEART LLC

Employer identification number (EIN): 453990246

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MIDWEST HEART DEFINED BENEFIT PENSION PLAN AND TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
012 2016-01-01
012 2015-01-01
012 2014-01-01 JOSEPH MAREK
012 2013-01-01 JOSEPH MAREK
012 2012-01-01 JOSEPH MAREK JOSEPH MAREK 2013-10-14
012 2011-01-01 JOSEPH MAREK JOSEPH MAREK 2012-10-14

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
012	2016-01-01
012	2015-01-01
012	2014-01-01	JOSEPH MAREK
012	2013-01-01	JOSEPH MAREK
012	2012-01-01	JOSEPH MAREK	JOSEPH MAREK	2013-10-14
012	2011-01-01	JOSEPH MAREK	JOSEPH MAREK	2012-10-14

Plan Statistics for MIDWEST HEART DEFINED BENEFIT PENSION PLAN AND TRUST

401k plan membership statisitcs for MIDWEST HEART DEFINED BENEFIT PENSION PLAN AND TRUST

Measure Date Value
2016: MIDWEST HEART DEFINED BENEFIT PENSION PLAN AND TRUST 2016 401k membership
Market value of plan assets 2016-08-31 22,756,526
Acturial value of plan assets 2016-08-31 23,654,141
Funding target for retired participants and beneficiaries receiving payment 2016-08-31 4,841,742
Number of terminated vested participants 2016-08-31 78
Fundng target for terminated vested participants 2016-08-31 2,086,536
Active participant vested funding target 2016-08-31 12,700,501
Number of active participants 2016-08-31 156
Total funding liabilities for active participants 2016-08-31 12,961,307
Total participant count 2016-08-31 252
Total funding target for all participants 2016-08-31 19,889,585
Balance at beginning of prior year after applicable adjustments 2016-08-31 0
Prefunding balance at beginning of prior year after applicable adjustments 2016-08-31 0
Carryover balanced portion elected for use to offset prior years funding requirement 2016-08-31 0
Prefunding balanced used to offset prior years funding requirement 2016-08-31 0
Amount remaining of carryover balance 2016-08-31 0
Amount remaining of prefunding balance 2016-08-31 0
Present value of excess contributions 2016-08-31 4,931,734
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance 2016-08-31 5,239,474
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance 2016-08-31 5,239,474
Reductions in caryover balances due to elections or deemed elections 2016-08-31 0
Reductions in prefunding balances due to elections or deemed elections 2016-08-31 1,724,918
Balance of carryovers at beginning of current year 2016-08-31 0
Balance of prefunding at beginning of current year 2016-08-31 3,514,556
Total employer contributions 2016-08-31 0
Total employee contributions 2016-08-31 0
Contributions allocated toward unpaid minimum require contributions from prior years 2016-08-31 0
Contributions made to avoid restrictions adjusted to valuation date 2016-08-31 0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date 2016-08-31 0
Unpaid minimum required contributions for all prior years 2016-08-31 0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years 2016-08-31 0
Remaining amount of unpaid minimum required contributions 2016-08-31 0
Minimum required contributions for current year target normal cost 2016-08-31 250,000
Net shortfall amortization installment of oustanding balance 2016-08-31 0
Waiver amortization installment 2016-08-31 0
Waived amount of outstanding balance 2016-08-31 0
Total funding amount beforereflecting carryover/prefunding balances 2016-08-31 0
Carryover balance elected to use to offset funding requirement 2016-08-31 0
Prefunding balance elected to use to offset funding requirement 2016-08-31 0
Additional cash requirement 2016-08-31 0
Contributions allocatedtoward minimum required contributions for current year 2016-08-31 0
Unpaid minimum required contributions for current year 2016-08-31 0
Unpaid minimum required contributions for all years 2016-08-31 0
Total participants, beginning-of-year 2016-01-01 252
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 151
Number of retired or separated participants receiving benefits 2016-01-01 20
Number of other retired or separated participants entitled to future benefits 2016-01-01 76
Total of all active and inactive participants 2016-01-01 247
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 247
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: MIDWEST HEART DEFINED BENEFIT PENSION PLAN AND TRUST 2015 401k membership
Total participants, beginning-of-year 2015-01-01 264
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 156
Number of retired or separated participants receiving benefits 2015-01-01 18
Number of other retired or separated participants entitled to future benefits 2015-01-01 78
Total of all active and inactive participants 2015-01-01 252
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 252
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: MIDWEST HEART DEFINED BENEFIT PENSION PLAN AND TRUST 2014 401k membership
Total participants, beginning-of-year 2014-01-01 269
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 161
Number of retired or separated participants receiving benefits 2014-01-01 15
Number of other retired or separated participants entitled to future benefits 2014-01-01 88
Total of all active and inactive participants 2014-01-01 264
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 264
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: MIDWEST HEART DEFINED BENEFIT PENSION PLAN AND TRUST 2013 401k membership
Total participants, beginning-of-year 2013-01-01 285
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 182
Number of retired or separated participants receiving benefits 2013-01-01 15
Number of other retired or separated participants entitled to future benefits 2013-01-01 72
Total of all active and inactive participants 2013-01-01 269
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 269
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: MIDWEST HEART DEFINED BENEFIT PENSION PLAN AND TRUST 2012 401k membership
Total participants, beginning-of-year 2012-01-01 358
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 200
Number of retired or separated participants receiving benefits 2012-01-01 14
Number of other retired or separated participants entitled to future benefits 2012-01-01 71
Total of all active and inactive participants 2012-01-01 285
Total participants 2012-01-01 285
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: MIDWEST HEART DEFINED BENEFIT PENSION PLAN AND TRUST 2011 401k membership
Total participants, beginning-of-year 2011-01-01 366
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 206
Number of retired or separated participants receiving benefits 2011-01-01 9
Number of other retired or separated participants entitled to future benefits 2011-01-01 143
Total of all active and inactive participants 2011-01-01 358
Total participants 2011-01-01 358
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 2

Measure	Date	Value
2016: MIDWEST HEART DEFINED BENEFIT PENSION PLAN AND TRUST 2016 401k membership
Market value of plan assets	2016-08-31	22,756,526
Acturial value of plan assets	2016-08-31	23,654,141
Funding target for retired participants and beneficiaries receiving payment	2016-08-31	4,841,742
Number of terminated vested participants	2016-08-31	78
Fundng target for terminated vested participants	2016-08-31	2,086,536
Active participant vested funding target	2016-08-31	12,700,501
Number of active participants	2016-08-31	156
Total funding liabilities for active participants	2016-08-31	12,961,307
Total participant count	2016-08-31	252
Total funding target for all participants	2016-08-31	19,889,585
Balance at beginning of prior year after applicable adjustments	2016-08-31	0
Prefunding balance at beginning of prior year after applicable adjustments	2016-08-31	0
Carryover balanced portion elected for use to offset prior years funding requirement	2016-08-31	0
Prefunding balanced used to offset prior years funding requirement	2016-08-31	0
Amount remaining of carryover balance	2016-08-31	0
Amount remaining of prefunding balance	2016-08-31	0
Present value of excess contributions	2016-08-31	4,931,734
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance	2016-08-31	5,239,474
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance	2016-08-31	5,239,474
Reductions in caryover balances due to elections or deemed elections	2016-08-31	0
Reductions in prefunding balances due to elections or deemed elections	2016-08-31	1,724,918
Balance of carryovers at beginning of current year	2016-08-31	0
Balance of prefunding at beginning of current year	2016-08-31	3,514,556
Total employer contributions	2016-08-31	0
Total employee contributions	2016-08-31	0
Contributions allocated toward unpaid minimum require contributions from prior years	2016-08-31	0
Contributions made to avoid restrictions adjusted to valuation date	2016-08-31	0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date	2016-08-31	0
Unpaid minimum required contributions for all prior years	2016-08-31	0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years	2016-08-31	0
Remaining amount of unpaid minimum required contributions	2016-08-31	0
Minimum required contributions for current year target normal cost	2016-08-31	250,000
Net shortfall amortization installment of oustanding balance	2016-08-31	0
Waiver amortization installment	2016-08-31	0
Waived amount of outstanding balance	2016-08-31	0
Total funding amount beforereflecting carryover/prefunding balances	2016-08-31	0
Carryover balance elected to use to offset funding requirement	2016-08-31	0
Prefunding balance elected to use to offset funding requirement	2016-08-31	0
Additional cash requirement	2016-08-31	0
Contributions allocatedtoward minimum required contributions for current year	2016-08-31	0
Unpaid minimum required contributions for current year	2016-08-31	0
Unpaid minimum required contributions for all years	2016-08-31	0
Total participants, beginning-of-year	2016-01-01	252
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	151
Number of retired or separated participants receiving benefits	2016-01-01	20
Number of other retired or separated participants entitled to future benefits	2016-01-01	76
Total of all active and inactive participants	2016-01-01	247
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	247
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: MIDWEST HEART DEFINED BENEFIT PENSION PLAN AND TRUST 2015 401k membership
Total participants, beginning-of-year	2015-01-01	264
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	156
Number of retired or separated participants receiving benefits	2015-01-01	18
Number of other retired or separated participants entitled to future benefits	2015-01-01	78
Total of all active and inactive participants	2015-01-01	252
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	252
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: MIDWEST HEART DEFINED BENEFIT PENSION PLAN AND TRUST 2014 401k membership
Total participants, beginning-of-year	2014-01-01	269
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	161
Number of retired or separated participants receiving benefits	2014-01-01	15
Number of other retired or separated participants entitled to future benefits	2014-01-01	88
Total of all active and inactive participants	2014-01-01	264
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	264
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: MIDWEST HEART DEFINED BENEFIT PENSION PLAN AND TRUST 2013 401k membership
Total participants, beginning-of-year	2013-01-01	285
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	182
Number of retired or separated participants receiving benefits	2013-01-01	15
Number of other retired or separated participants entitled to future benefits	2013-01-01	72
Total of all active and inactive participants	2013-01-01	269
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	269
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: MIDWEST HEART DEFINED BENEFIT PENSION PLAN AND TRUST 2012 401k membership
Total participants, beginning-of-year	2012-01-01	358
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	200
Number of retired or separated participants receiving benefits	2012-01-01	14
Number of other retired or separated participants entitled to future benefits	2012-01-01	71
Total of all active and inactive participants	2012-01-01	285
Total participants	2012-01-01	285
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: MIDWEST HEART DEFINED BENEFIT PENSION PLAN AND TRUST 2011 401k membership
Total participants, beginning-of-year	2011-01-01	366
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	206
Number of retired or separated participants receiving benefits	2011-01-01	9
Number of other retired or separated participants entitled to future benefits	2011-01-01	143
Total of all active and inactive participants	2011-01-01	358
Total participants	2011-01-01	358
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	2

Financial Data on MIDWEST HEART DEFINED BENEFIT PENSION PLAN AND TRUST

Measure	Date	Value
2016 : MIDWEST HEART DEFINED BENEFIT PENSION PLAN AND TRUST 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-08-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-08-31	$42,171
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-08-31	$55,840
Total income from all sources (including contributions)	2016-08-31	$2,141,197
Total loss/gain on sale of assets	2016-08-31	$0
Total of all expenses incurred	2016-08-31	$693,296
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-08-31	$619,862
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-08-31	$0
Value of total assets at end of year	2016-08-31	$24,190,758
Value of total assets at beginning of year	2016-08-31	$22,756,526
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-08-31	$73,434
Total interest from all sources	2016-08-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2016-08-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-08-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2016-08-31	$0
Was this plan covered by a fidelity bond	2016-08-31	Yes
Value of fidelity bond cover	2016-08-31	$500,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-08-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-08-31	No
Assets. Other investments not covered elsewhere at end of year	2016-08-31	$8,342
Assets. Other investments not covered elsewhere at beginning of year	2016-08-31	$8,214
Other income not declared elsewhere	2016-08-31	$128
Administrative expenses (other) incurred	2016-08-31	$73,434
Liabilities. Value of operating payables at end of year	2016-08-31	$42,171
Liabilities. Value of operating payables at beginning of year	2016-08-31	$55,840
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-08-31	No
Value of net income/loss	2016-08-31	$1,447,901
Value of net assets at end of year (total assets less liabilities)	2016-08-31	$24,148,587
Value of net assets at beginning of year (total assets less liabilities)	2016-08-31	$22,700,686
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-08-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-08-31	No
Were any leases to which the plan was party in default or uncollectible	2016-08-31	No
Value of interest in pooled separate accounts at end of year	2016-08-31	$24,182,416
Value of interest in pooled separate accounts at beginning of year	2016-08-31	$22,748,312
Net investment gain/loss from pooled separate accounts	2016-08-31	$2,141,069
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-08-31	Yes
Was there a failure to transmit to the plan any participant contributions	2016-08-31	No
Has the plan failed to provide any benefit when due under the plan	2016-08-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-08-31	$619,862
Did the plan have assets held for investment	2016-08-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-08-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-08-31	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-08-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-08-31	Disclaimer
Accountancy firm name	2016-08-31	MANN WEITZ AND ASSOCIATES
Accountancy firm EIN	2016-08-31	363963131
2015 : MIDWEST HEART DEFINED BENEFIT PENSION PLAN AND TRUST 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$55,840
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$55,095
Total income from all sources (including contributions)	2015-12-31	$4,907,086
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$1,822,351
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$1,486,012
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$5,207,423
Value of total assets at end of year	2015-12-31	$22,756,526
Value of total assets at beginning of year	2015-12-31	$19,671,046
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$336,339
Total interest from all sources	2015-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$500,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Assets. Other investments not covered elsewhere at end of year	2015-12-31	$8,214
Assets. Other investments not covered elsewhere at beginning of year	2015-12-31	$7,414
Other income not declared elsewhere	2015-12-31	$801
Administrative expenses (other) incurred	2015-12-31	$336,339
Liabilities. Value of operating payables at end of year	2015-12-31	$55,840
Liabilities. Value of operating payables at beginning of year	2015-12-31	$55,095
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$3,084,735
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$22,700,686
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$19,615,951
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in pooled separate accounts at end of year	2015-12-31	$22,748,312
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$19,663,632
Net investment gain/loss from pooled separate accounts	2015-12-31	$-301,138
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$5,207,423
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$1,486,012
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	MANN WEITZ AND ASSOCIATES
Accountancy firm EIN	2015-12-31	363963131
2014 : MIDWEST HEART DEFINED BENEFIT PENSION PLAN AND TRUST 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$55,095
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$80,161
Total income from all sources (including contributions)	2014-12-31	$1,626,852
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$619,200
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$425,495
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$0
Value of total assets at end of year	2014-12-31	$19,671,046
Value of total assets at beginning of year	2014-12-31	$18,688,460
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$193,705
Total interest from all sources	2014-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Administrative expenses professional fees incurred	2014-12-31	$178,027
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$500,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Assets. Other investments not covered elsewhere at end of year	2014-12-31	$7,414
Assets. Other investments not covered elsewhere at beginning of year	2014-12-31	$6,950
Other income not declared elsewhere	2014-12-31	$464
Administrative expenses (other) incurred	2014-12-31	$3,042
Liabilities. Value of operating payables at end of year	2014-12-31	$55,095
Liabilities. Value of operating payables at beginning of year	2014-12-31	$80,161
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$1,007,652
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$19,615,951
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$18,608,299
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Investment advisory and management fees	2014-12-31	$10,881
Value of interest in pooled separate accounts at end of year	2014-12-31	$19,663,632
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$18,681,510
Net investment gain/loss from pooled separate accounts	2014-12-31	$1,626,388
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$425,495
Contract administrator fees	2014-12-31	$1,755
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	MANN WEITZ AND ASSOCIATES
Accountancy firm EIN	2014-12-31	363963131
2013 : MIDWEST HEART DEFINED BENEFIT PENSION PLAN AND TRUST 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$80,161
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$35,120
Total income from all sources (including contributions)	2013-12-31	$446
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$2,043,056
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$1,695,364
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$0
Value of total assets at end of year	2013-12-31	$18,688,460
Value of total assets at beginning of year	2013-12-31	$20,686,029
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$347,692
Total interest from all sources	2013-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$500,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Assets. Other investments not covered elsewhere at end of year	2013-12-31	$6,950
Assets. Other investments not covered elsewhere at beginning of year	2013-12-31	$6,504
Other income not declared elsewhere	2013-12-31	$446
Administrative expenses (other) incurred	2013-12-31	$343,845
Liabilities. Value of operating payables at end of year	2013-12-31	$80,161
Liabilities. Value of operating payables at beginning of year	2013-12-31	$1,034
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$-2,042,610
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$18,608,299
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$20,650,909
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Value of interest in pooled separate accounts at end of year	2013-12-31	$18,681,510
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$20,679,525
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$1,695,364
Contract administrator fees	2013-12-31	$3,847
Liabilities. Value of benefit claims payable at end of year	2013-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2013-12-31	$34,086
Did the plan have assets held for investment	2013-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	MANN WEITZ AND ASSOCIATES
Accountancy firm EIN	2013-12-31	363963131
2012 : MIDWEST HEART DEFINED BENEFIT PENSION PLAN AND TRUST 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$35,120
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$20,860
Total income from all sources (including contributions)	2012-12-31	$426
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$2,128,309
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$1,783,678
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$0
Value of total assets at end of year	2012-12-31	$20,686,029
Value of total assets at beginning of year	2012-12-31	$22,799,652
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$344,631
Total interest from all sources	2012-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2012-12-31	$0
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$500,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Assets. Other investments not covered elsewhere at end of year	2012-12-31	$6,504
Assets. Other investments not covered elsewhere at beginning of year	2012-12-31	$6,076
Other income not declared elsewhere	2012-12-31	$428
Administrative expenses (other) incurred	2012-12-31	$338,668
Liabilities. Value of operating payables at end of year	2012-12-31	$1,034
Liabilities. Value of operating payables at beginning of year	2012-12-31	$1,134
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$-2,127,883
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$20,650,909
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$22,778,792
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in pooled separate accounts at end of year	2012-12-31	$20,679,525
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$22,674,576
Net investment gain/loss from pooled separate accounts	2012-12-31	$-2
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Employer contributions (assets) at beginning of year	2012-12-31	$119,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$1,783,678
Contract administrator fees	2012-12-31	$5,963
Liabilities. Value of benefit claims payable at end of year	2012-12-31	$34,086
Liabilities. Value of benefit claims payable at beginning of year	2012-12-31	$19,726
Did the plan have assets held for investment	2012-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	MANN WEITZ AND ASSOCIATES
Accountancy firm EIN	2012-12-31	363963131
2011 : MIDWEST HEART DEFINED BENEFIT PENSION PLAN AND TRUST 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$20,860
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$2,538,196
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$206,202
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$202,100
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$2,074,061
Value of total assets at end of year	2011-12-31	$22,799,652
Value of total assets at beginning of year	2011-12-31	$20,446,798
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$4,102
Total interest from all sources	2011-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2011-12-31	$0
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$500,000
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Assets. Other investments not covered elsewhere at end of year	2011-12-31	$6,076
Assets. Other investments not covered elsewhere at beginning of year	2011-12-31	$5,660
Other income not declared elsewhere	2011-12-31	$415
Administrative expenses (other) incurred	2011-12-31	$316
Liabilities. Value of operating payables at end of year	2011-12-31	$1,134
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$2,331,994
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$22,778,792
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$20,446,798
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in pooled separate accounts at end of year	2011-12-31	$22,674,576
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$18,839,338
Net investment gain/loss from pooled separate accounts	2011-12-31	$463,720
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	Yes
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$2,074,061
Employer contributions (assets) at end of year	2011-12-31	$119,000
Employer contributions (assets) at beginning of year	2011-12-31	$1,601,800
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$202,100
Contract administrator fees	2011-12-31	$3,786
Liabilities. Value of benefit claims payable at end of year	2011-12-31	$19,726
Did the plan have assets held for investment	2011-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	MANN WEITZ AND ASSOCIATES
Accountancy firm EIN	2011-12-31	363963131

Form 5500 Responses for MIDWEST HEART DEFINED BENEFIT PENSION PLAN AND TRUST

2016: MIDWEST HEART DEFINED BENEFIT PENSION PLAN AND TRUST 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	Yes
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
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: MIDWEST HEART DEFINED BENEFIT PENSION PLAN AND TRUST 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: MIDWEST HEART DEFINED BENEFIT PENSION PLAN AND TRUST 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: MIDWEST HEART DEFINED BENEFIT PENSION PLAN AND TRUST 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
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 – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: MIDWEST HEART DEFINED BENEFIT PENSION PLAN AND TRUST 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: MIDWEST HEART DEFINED BENEFIT PENSION PLAN AND TRUST 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

809894

Policy instance

Insurance contract or identification number	809894
Number of Individuals Covered	252
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $38,321
Total amount of fees paid to insurance company	USD $9,580
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 $38,321
Insurance broker organization code?	3
Amount paid for insurance broker fees	9580
Additional information about fees paid to insurance broker	REFERRAL/SERVICE FEE
Insurance broker name	THE ANGELL PENSION GROUP, INC.

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

SA 12863

Policy instance

Insurance contract or identification number	SA 12863
Number of Individuals Covered	0
Insurance policy start date	2014-01-01
Insurance policy end date	2014-02-10
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?	Yes
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

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

809894

Policy instance

Insurance contract or identification number	809894
Number of Individuals Covered	264
Insurance policy start date	2014-02-10
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $28,778
Total amount of fees paid to insurance company	USD $7,195
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 $28,778
Insurance broker organization code?	3
Amount paid for insurance broker fees	7195
Additional information about fees paid to insurance broker	REFERRAL/SERVICE FEE
Insurance broker name	THE ANGELL PENSION GROUP, INC.

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

SA 12863

Policy instance

Insurance contract or identification number	SA 12863
Number of Individuals Covered	269
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
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?	Yes
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

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

SA 12863

Policy instance

Insurance contract or identification number	SA 12863
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
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?	Yes
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

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

SA 12863

Policy instance

Insurance contract or identification number	SA 12863
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
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?	Yes
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

Potentially related plans

Was this data useful?

If you found the data here useful, PLEASE HELP US. We are a start-up and believe in making information freely available. By linking to us, posting on twitter, facebook and linkedin about us and generally spreading the word, you'll help us to grow. Our vision is to provide high quality data about the activities of all the companies in the world and where possible make it free to use and view. Finding and integrating data from thousands of data sources is time consuming and needs lots of effort. By simply spreading the word about us, you will help us. Please use the share buttons. It will only take a few seconds of your time. Thanks for helping

Information Disclaimer

The information provided on this website is not advice, endorsement or recommendation
The information published is supplied by third parties so we make no warranty on the accuracy, completeness etc. This information is provided "as-is". The information is subject to change as we obtain updates and corrections from the primary information sources.
You are free to use the information for your own personal research on the understanding to do so is at your own risk.

See full terms and conditions

Company Name:	MIDWEST HEART LLC
Employer identification number (EIN):	453990246
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)