401k Plan data: CARDIOTHORACIC & VASCULAR SURGICAL ASSOCIATES, P.A. 401K PLAN plan

CARDIOTHORACIC & VASCULAR SURGICAL ASSOCIATES, P.A. 401K PLAN 401k Plan overview

Plan Name	CARDIOTHORACIC & VASCULAR SURGICAL ASSOCIATES, P.A. 401K PLAN
Plan identification number	001

CARDIOTHORACIC & VASCULAR SURGICAL ASSOCIATES, P.A. 401K 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.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Participant-directed brokerage accounts provided as an investment option under the plan.
Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
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.

401k Sponsoring company profile

CARDIOTHORACIC & VASCULAR SURGICAL ASSOCIATES, P.A. has sponsored the creation of one or more 401k plans.

Company Name: CARDIOTHORACIC & VASCULAR SURGICAL ASSOCIATES, P.A.

Employer identification number (EIN): 593338654

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

Additional information about CARDIOTHORACIC & VASCULAR SURGICAL ASSOCIATES, P.A.

Jurisdiction of Incorporation: Florida Department of State Division of Corporations

Incorporation Date: 1995-10-18

Company Identification Number: P95000080909

Legal Registered Office Address: 1824 KING STREET

JACKSONVILLE

32204

More information about CARDIOTHORACIC & VASCULAR SURGICAL ASSOCIATES, P.A.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CARDIOTHORACIC & VASCULAR SURGICAL ASSOCIATES, P.A. 401K PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2023-01-01 DAVID E. STRAUSS 2024-09-04
001 2022-01-01 BRIAN PADGETT 2023-10-05
001 2021-01-01 MATTHEW P SMOLAREK 2022-10-07
001 2020-01-01
001 2019-01-01
001 2018-01-01
001 2017-01-01
001 2016-01-01
001 2015-01-01
001 2014-01-01
001 2013-01-01
001 2012-01-01 RAYMOND LEE 2013-10-03
001 2011-01-01 RAYMOND LEE 2012-10-08
001 2010-01-01 RAYMOND LEE 2011-09-29

Plan Statistics for CARDIOTHORACIC & VASCULAR SURGICAL ASSOCIATES, P.A. 401K PLAN

401k plan membership statisitcs for CARDIOTHORACIC & VASCULAR SURGICAL ASSOCIATES, P.A. 401K PLAN

Measure Date Value
2023: CARDIOTHORACIC & VASCULAR SURGICAL ASSOCIATES, P.A. 401K PLAN 2023 401k membership
Total participants, beginning-of-year 2023-01-01 384
Total number of active participants reported on line 7a of the Form 5500 2023-01-01 358
Number of retired or separated participants receiving benefits 2023-01-01 10
Number of other retired or separated participants entitled to future benefits 2023-01-01 136
Total of all active and inactive participants 2023-01-01 504
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2023-01-01 0
Total participants 2023-01-01 504
Number of participants with account balances 2023-01-01 503
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2023-01-01 24
2022: CARDIOTHORACIC & VASCULAR SURGICAL ASSOCIATES, P.A. 401K PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 294
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 237
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 72
Total of all active and inactive participants 2022-01-01 309
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 309
Number of participants with account balances 2022-01-01 309
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 28
2021: CARDIOTHORACIC & VASCULAR SURGICAL ASSOCIATES, P.A. 401K PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 213
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 183
Number of retired or separated participants receiving benefits 2021-01-01 6
Number of other retired or separated participants entitled to future benefits 2021-01-01 33
Total of all active and inactive participants 2021-01-01 222
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 222
Number of participants with account balances 2021-01-01 222
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 26

Measure	Date	Value
2023: CARDIOTHORACIC & VASCULAR SURGICAL ASSOCIATES, P.A. 401K PLAN 2023 401k membership
Total participants, beginning-of-year	2023-01-01	384
Total number of active participants reported on line 7a of the Form 5500	2023-01-01	358
Number of retired or separated participants receiving benefits	2023-01-01	10
Number of other retired or separated participants entitled to future benefits	2023-01-01	136
Total of all active and inactive participants	2023-01-01	504
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2023-01-01	0
Total participants	2023-01-01	504
Number of participants with account balances	2023-01-01	503
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2023-01-01	24
2022: CARDIOTHORACIC & VASCULAR SURGICAL ASSOCIATES, P.A. 401K PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	294
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	237
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	72
Total of all active and inactive participants	2022-01-01	309
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	309
Number of participants with account balances	2022-01-01	309
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	28
2021: CARDIOTHORACIC & VASCULAR SURGICAL ASSOCIATES, P.A. 401K PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	213
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	183
Number of retired or separated participants receiving benefits	2021-01-01	6
Number of other retired or separated participants entitled to future benefits	2021-01-01	33
Total of all active and inactive participants	2021-01-01	222
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	222
Number of participants with account balances	2021-01-01	222
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	26

Financial Data on CARDIOTHORACIC & VASCULAR SURGICAL ASSOCIATES, P.A. 401K PLAN

Measure	Date	Value
2023 : CARDIOTHORACIC & VASCULAR SURGICAL ASSOCIATES, P.A. 401K PLAN 2023 401k financial data
Total unrealized appreciation/depreciation of assets	2023-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2023-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2023-12-31	$0
Total income from all sources (including contributions)	2023-12-31	$6,895,380
Total loss/gain on sale of assets	2023-12-31	$0
Total of all expenses incurred	2023-12-31	$2,249,930
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2023-12-31	$2,130,909
Expenses. Certain deemed distributions of participant loans	2023-12-31	$39,815
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2023-12-31	$2,230,461
Value of total assets at end of year	2023-12-31	$28,694,810
Value of total assets at beginning of year	2023-12-31	$24,049,360
Total of administrative expenses incurred including professional, contract, advisory and management fees	2023-12-31	$79,206
Total interest from all sources	2023-12-31	$12,340
Total dividends received (eg from common stock, registered investment company shares)	2023-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2023-12-31	No
Was this plan covered by a fidelity bond	2023-12-31	Yes
Value of fidelity bond cover	2023-12-31	$500,000
If this is an individual account plan, was there a blackout period	2023-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2023-12-31	No
Contributions received from participants	2023-12-31	$1,631,982
Participant contributions at end of year	2023-12-31	$170,727
Participant contributions at beginning of year	2023-12-31	$210,174
Income. Received or receivable in cash from other sources (including rollovers)	2023-12-31	$45,265
Administrative expenses (other) incurred	2023-12-31	$2,400
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2023-12-31	No
Value of net income/loss	2023-12-31	$4,645,450
Value of net assets at end of year (total assets less liabilities)	2023-12-31	$28,694,810
Value of net assets at beginning of year (total assets less liabilities)	2023-12-31	$24,049,360
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2023-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2023-12-31	No
Were any leases to which the plan was party in default or uncollectible	2023-12-31	No
Investment advisory and management fees	2023-12-31	$38,282
Value of interest in registered invesment companies (eg mutual funds) at end of year	2023-12-31	$27,947,610
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2023-12-31	$23,228,431
Interest on participant loans	2023-12-31	$12,340
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2023-12-31	$23,259
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2023-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2023-12-31	$0
Net investment gain/loss from pooled separate accounts	2023-12-31	$4,652,579
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2023-12-31	No
Was there a failure to transmit to the plan any participant contributions	2023-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2023-12-31	No
Contributions received in cash from employer	2023-12-31	$553,214
Employer contributions (assets) at end of year	2023-12-31	$553,214
Employer contributions (assets) at beginning of year	2023-12-31	$610,755
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2023-12-31	$2,130,909
Did the plan have assets held for investment	2023-12-31	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	2023-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2023-12-31	No
Opinion of an independent qualified public accountant for this plan	2023-12-31	Unqualified
Accountancy firm name	2023-12-31	BAKER TILLY US, LLP
Accountancy firm EIN	2023-12-31	301413443
2022 : CARDIOTHORACIC & VASCULAR SURGICAL ASSOCIATES, P.A. 401K PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total income from all sources (including contributions)	2022-12-31	$-2,134,357
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$1,064,551
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$992,527
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$2,975,186
Value of total assets at end of year	2022-12-31	$24,049,360
Value of total assets at beginning of year	2022-12-31	$27,248,268
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$72,024
Total interest from all sources	2022-12-31	$7,065
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$500,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$1,459,704
Participant contributions at end of year	2022-12-31	$210,174
Participant contributions at beginning of year	2022-12-31	$128,741
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$913,117
Administrative expenses (other) incurred	2022-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Income. Non cash contributions	2022-12-31	$0
Value of net income/loss	2022-12-31	$-3,198,908
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$24,049,360
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$27,248,268
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$23,228,431
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$26,643,239
Interest on participant loans	2022-12-31	$7,065
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-5,116,608
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$602,365
Employer contributions (assets) at end of year	2022-12-31	$610,755
Employer contributions (assets) at beginning of year	2022-12-31	$476,288
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$992,527
Contract administrator fees	2022-12-31	$72,024
Did the plan have assets held for investment	2022-12-31	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	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	ASSURANCE DIMENSIONS
Accountancy firm EIN	2022-12-31	263429295
2021 : CARDIOTHORACIC & VASCULAR SURGICAL ASSOCIATES, P.A. 401K PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$7,397,577
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$247,695
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$159,720
Expenses. Certain deemed distributions of participant loans	2021-12-31	$5,108
Value of total corrective distributions	2021-12-31	$2,955
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$3,436,177
Value of total assets at end of year	2021-12-31	$27,248,268
Value of total assets at beginning of year	2021-12-31	$20,098,386
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$79,912
Total interest from all sources	2021-12-31	$6,599
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$1,250,688
Participant contributions at end of year	2021-12-31	$128,741
Participant contributions at beginning of year	2021-12-31	$53,000
Participant contributions at end of year	2021-12-31	$0
Participant contributions at beginning of year	2021-12-31	$1,568
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$1,709,201
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$7,149,882
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$27,248,268
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$20,098,386
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Investment advisory and management fees	2021-12-31	$43,868
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$26,643,239
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$19,727,063
Interest on participant loans	2021-12-31	$4,969
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2021-12-31	$1,630
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$3,954,801
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2021-12-31	Yes
Contributions received in cash from employer	2021-12-31	$476,288
Employer contributions (assets) at end of year	2021-12-31	$476,288
Employer contributions (assets) at beginning of year	2021-12-31	$316,755
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$159,720
Contract administrator fees	2021-12-31	$36,044
Did the plan have assets held for investment	2021-12-31	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	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	ASSURANCE DIMENSIONS
Accountancy firm EIN	2021-12-31	263429295

Form 5500 Responses for CARDIOTHORACIC & VASCULAR SURGICAL ASSOCIATES, P.A. 401K PLAN

2023: CARDIOTHORACIC & VASCULAR SURGICAL ASSOCIATES, P.A. 401K 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: CARDIOTHORACIC & VASCULAR SURGICAL ASSOCIATES, P.A. 401K 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: CARDIOTHORACIC & VASCULAR SURGICAL ASSOCIATES, P.A. 401K 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 – Trust	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

139989

Policy instance

Insurance contract or identification number	139989
Number of Individuals Covered	349
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $15,073
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

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

139989

Policy instance

Insurance contract or identification number	139989
Number of Individuals Covered	297
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $12,041
Total amount of fees paid to insurance company	USD $2,125
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $9,127
Amount paid for insurance broker fees	1600
Additional information about fees paid to insurance broker	TPA FEES
Insurance broker organization code?	5

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

139989

Policy instance

Insurance contract or identification number	139989
Number of Individuals Covered	215
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $13,293
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 $13,293
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	TPA FEES
Insurance broker organization code?	5

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Company Name:	CARDIOTHORACIC & VASCULAR SURGICAL ASSOCIATES, P.A.
Employer identification number (EIN):	593338654
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)

Jurisdiction of Incorporation:	Florida Department of State Division of Corporations
Incorporation Date:	1995-10-18
Company Identification Number:	P95000080909
Legal Registered Office Address:	1824 KING STREET JACKSONVILLE 32204

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2023-01-01	DAVID E. STRAUSS	2024-09-04
001	2022-01-01	BRIAN PADGETT	2023-10-05
001	2021-01-01	MATTHEW P SMOLAREK	2022-10-07
001	2020-01-01
001	2019-01-01
001	2018-01-01
001	2017-01-01
001	2016-01-01
001	2015-01-01
001	2014-01-01
001	2013-01-01
001	2012-01-01	RAYMOND LEE	2013-10-03
001	2011-01-01	RAYMOND LEE	2012-10-08
001	2010-01-01	RAYMOND LEE	2011-09-29