401k Plan data: THE UROLOGY TEAM 401(K) PLAN plan

THE UROLOGY TEAM 401(K) PLAN 401k Plan overview

Plan Name	THE UROLOGY TEAM 401(K) PLAN
Plan identification number	001

THE UROLOGY TEAM 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.
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.
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

THE UROLOGY TEAM, P.A. has sponsored the creation of one or more 401k plans.

Company Name: THE UROLOGY TEAM, P.A.

Employer identification number (EIN): 742837301

NAIC Classification: 621399
NAIC Description: Offices of All Other Miscellaneous Health Practitioners

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE UROLOGY TEAM 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2019-01-01 JENNIFER CRANE 2020-06-22
001 2018-01-01 JENNIFER CRANE 2019-10-01
001 2017-01-01 ALYSSA M RODGERS ALYSSA M RODGERS 2018-10-10
001 2016-01-01 RICHARD CHOPP MD RICHARD CHOPP MD 2017-10-16
001 2015-01-01 RICHARD CHOPP MD RICHARD CHOPP MD 2016-06-21
001 2014-01-01 RICHARD CHOPP, MD
001 2013-01-01 RICHARD CHOPP MD
001 2012-01-01 RICHARD CHOPP MD RICHARD CHOPP MD 2013-07-01
001 2011-01-01 ADA JACOBS 2012-09-28 ADA JACOBS 2012-09-28
001 2010-01-01 ADA JACOBS 2011-10-17

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2019-01-01	JENNIFER CRANE	2020-06-22
001	2018-01-01	JENNIFER CRANE	2019-10-01
001	2017-01-01	ALYSSA M RODGERS		ALYSSA M RODGERS	2018-10-10
001	2016-01-01	RICHARD CHOPP MD		RICHARD CHOPP MD	2017-10-16
001	2015-01-01	RICHARD CHOPP MD		RICHARD CHOPP MD	2016-06-21
001	2014-01-01	RICHARD CHOPP, MD
001	2013-01-01	RICHARD CHOPP MD
001	2012-01-01	RICHARD CHOPP MD		RICHARD CHOPP MD	2013-07-01
001	2011-01-01	ADA JACOBS	2012-09-28	ADA JACOBS	2012-09-28
001	2010-01-01	ADA JACOBS	2011-10-17

Plan Statistics for THE UROLOGY TEAM 401(K) PLAN

401k plan membership statisitcs for THE UROLOGY TEAM 401(K) PLAN

Measure Date Value
2017: THE UROLOGY TEAM 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 46
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 57
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 5
Total of all active and inactive participants 2017-01-01 62
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 62
Number of participants with account balances 2017-01-01 58
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 2
2016: THE UROLOGY TEAM 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 45
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 41
Number of retired or separated participants receiving benefits 2016-01-01 0
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 45
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 45
Number of participants with account balances 2016-01-01 45
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 2
2015: THE UROLOGY TEAM 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 44
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 39
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 6
Total of all active and inactive participants 2015-01-01 45
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 45
Number of participants with account balances 2015-01-01 43
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 2
2014: THE UROLOGY TEAM 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 39
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 36
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 7
Total of all active and inactive participants 2014-01-01 43
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 43
Number of participants with account balances 2014-01-01 43
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: THE UROLOGY TEAM 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 44
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 33
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 6
Total of all active and inactive participants 2013-01-01 39
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 39
Number of participants with account balances 2013-01-01 39
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 4
2012: THE UROLOGY TEAM 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 46
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 38
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 6
Total of all active and inactive participants 2012-01-01 44
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 44
Number of participants with account balances 2012-01-01 44
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 6

Measure	Date	Value
2017: THE UROLOGY TEAM 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	46
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	57
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	5
Total of all active and inactive participants	2017-01-01	62
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	62
Number of participants with account balances	2017-01-01	58
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	2
2016: THE UROLOGY TEAM 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	45
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	41
Number of retired or separated participants receiving benefits	2016-01-01	0
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	45
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	45
Number of participants with account balances	2016-01-01	45
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	2
2015: THE UROLOGY TEAM 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	44
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	39
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	6
Total of all active and inactive participants	2015-01-01	45
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	45
Number of participants with account balances	2015-01-01	43
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	2
2014: THE UROLOGY TEAM 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	39
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	36
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	7
Total of all active and inactive participants	2014-01-01	43
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	43
Number of participants with account balances	2014-01-01	43
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: THE UROLOGY TEAM 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	44
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	33
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	6
Total of all active and inactive participants	2013-01-01	39
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	39
Number of participants with account balances	2013-01-01	39
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	4
2012: THE UROLOGY TEAM 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	46
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	38
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	6
Total of all active and inactive participants	2012-01-01	44
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	44
Number of participants with account balances	2012-01-01	44
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	6

Financial Data on THE UROLOGY TEAM 401(K) PLAN

Measure	Date	Value
2017 : THE UROLOGY TEAM 401(K) PLAN 2017 401k financial data
Total income from all sources	2017-12-31	$2,036,421
Expenses. Total of all expenses incurred	2017-12-31	$38,034
Benefits paid (including direct rollovers)	2017-12-31	$37,189
Total plan assets at end of year	2017-12-31	$8,834,180
Total plan assets at beginning of year	2017-12-31	$6,835,793
Value of fidelity bond covering the plan	2017-12-31	$500,000
Total contributions received or receivable from participants	2017-12-31	$213,636
Expenses. Other expenses not covered elsewhere	2017-12-31	$125
Contributions received from other sources (not participants or employers)	2017-12-31	$0
Other income received	2017-12-31	$1,356,334
Net income (gross income less expenses)	2017-12-31	$1,998,387
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$8,834,180
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$6,835,793
Assets. Value of participant loans	2017-12-31	$55,354
Total contributions received or receivable from employer(s)	2017-12-31	$466,451
Value of certain deemed distributions of participant loans	2017-12-31	$0
Value of corrective distributions	2017-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2017-12-31	$720
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
2016 : THE UROLOGY TEAM 401(K) PLAN 2016 401k financial data
Total income from all sources	2016-12-31	$690,771
Expenses. Total of all expenses incurred	2016-12-31	$202,846
Benefits paid (including direct rollovers)	2016-12-31	$201,681
Total plan assets at end of year	2016-12-31	$6,835,793
Total plan assets at beginning of year	2016-12-31	$6,347,868
Total contributions received or receivable from participants	2016-12-31	$182,073
Expenses. Other expenses not covered elsewhere	2016-12-31	$300
Contributions received from other sources (not participants or employers)	2016-12-31	$36,666
Other income received	2016-12-31	$132,668
Net income (gross income less expenses)	2016-12-31	$487,925
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$6,835,793
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$6,347,868
Assets. Value of participant loans	2016-12-31	$53,280
Total contributions received or receivable from employer(s)	2016-12-31	$339,364
Value of certain deemed distributions of participant loans	2016-12-31	$0
Value of corrective distributions	2016-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2016-12-31	$865
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
2015 : THE UROLOGY TEAM 401(K) PLAN 2015 401k financial data
Total income from all sources	2015-12-31	$361,013
Expenses. Total of all expenses incurred	2015-12-31	$45,129
Benefits paid (including direct rollovers)	2015-12-31	$44,729
Total plan assets at end of year	2015-12-31	$6,347,868
Total plan assets at beginning of year	2015-12-31	$6,031,984
Value of fidelity bond covering the plan	2015-12-31	$1,000,000
Total contributions received or receivable from participants	2015-12-31	$197,251
Expenses. Other expenses not covered elsewhere	2015-12-31	$-300
Contributions received from other sources (not participants or employers)	2015-12-31	$0
Other income received	2015-12-31	$-158,241
Net income (gross income less expenses)	2015-12-31	$315,884
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$6,347,868
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$6,031,984
Assets. Value of participant loans	2015-12-31	$62,818
Total contributions received or receivable from employer(s)	2015-12-31	$322,003
Value of certain deemed distributions of participant loans	2015-12-31	$0
Value of corrective distributions	2015-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2015-12-31	$700
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
2014 : THE UROLOGY TEAM 401(K) PLAN 2014 401k financial data
Total income from all sources	2014-12-31	$627,397
Expenses. Total of all expenses incurred	2014-12-31	$53,291
Benefits paid (including direct rollovers)	2014-12-31	$52,236
Total plan assets at end of year	2014-12-31	$6,031,984
Total plan assets at beginning of year	2014-12-31	$5,457,878
Total contributions received or receivable from participants	2014-12-31	$189,283
Expenses. Other expenses not covered elsewhere	2014-12-31	$0
Contributions received from other sources (not participants or employers)	2014-12-31	$3,707
Other income received	2014-12-31	$112,198
Net income (gross income less expenses)	2014-12-31	$574,106
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$6,031,984
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$5,457,878
Assets. Value of participant loans	2014-12-31	$84,394
Total contributions received or receivable from employer(s)	2014-12-31	$322,209
Value of certain deemed distributions of participant loans	2014-12-31	$0
Value of corrective distributions	2014-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2014-12-31	$1,055
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
2013 : THE UROLOGY TEAM 401(K) PLAN 2013 401k financial data
Total income from all sources	2013-12-31	$1,318,946
Expenses. Total of all expenses incurred	2013-12-31	$90,199
Benefits paid (including direct rollovers)	2013-12-31	$88,452
Total plan assets at end of year	2013-12-31	$5,457,878
Total plan assets at beginning of year	2013-12-31	$4,229,131
Value of fidelity bond covering the plan	2013-12-31	$1,000,000
Total contributions received or receivable from participants	2013-12-31	$177,904
Expenses. Other expenses not covered elsewhere	2013-12-31	$0
Contributions received from other sources (not participants or employers)	2013-12-31	$0
Other income received	2013-12-31	$878,021
Net income (gross income less expenses)	2013-12-31	$1,228,747
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$5,457,878
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$4,229,131
Assets. Value of participant loans	2013-12-31	$55,895
Total contributions received or receivable from employer(s)	2013-12-31	$263,021
Value of certain deemed distributions of participant loans	2013-12-31	$0
Value of corrective distributions	2013-12-31	$282
Expenses. Administrative service providers (salaries,fees and commissions)	2013-12-31	$1,465
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
2012 : THE UROLOGY TEAM 401(K) PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$1,076,199
Expenses. Total of all expenses incurred	2012-12-31	$1,059,455
Benefits paid (including direct rollovers)	2012-12-31	$1,058,580
Total plan assets at end of year	2012-12-31	$4,229,131
Total plan assets at beginning of year	2012-12-31	$4,212,387
Total contributions received or receivable from participants	2012-12-31	$175,926
Expenses. Other expenses not covered elsewhere	2012-12-31	$10
Contributions received from other sources (not participants or employers)	2012-12-31	$1,479
Other income received	2012-12-31	$581,509
Net income (gross income less expenses)	2012-12-31	$16,744
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$4,229,131
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$4,212,387
Assets. Value of participant loans	2012-12-31	$38,117
Total contributions received or receivable from employer(s)	2012-12-31	$317,285
Value of certain deemed distributions of participant loans	2012-12-31	$0
Value of corrective distributions	2012-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2012-12-31	$865
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0

Form 5500 Responses for THE UROLOGY TEAM 401(K) PLAN

2017: THE UROLOGY TEAM 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: THE UROLOGY TEAM 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: THE UROLOGY TEAM 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: THE UROLOGY TEAM 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: THE UROLOGY TEAM 401(K) PLAN 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: THE UROLOGY TEAM 401(K) PLAN 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

Insurance Providers Used on plan

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

Policy contract number

MR 60679

Policy instance

Insurance contract or identification number	MR 60679
Number of Individuals Covered	62
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $18
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?	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
Commission paid to Insurance Broker	USD $18
Insurance broker organization code?	4
Insurance broker name	WELLS FARGO ADVISORS INS AGENCY LLC

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

Policy contract number

MR 60679

Policy instance

Insurance contract or identification number	MR 60679
Number of Individuals Covered	45
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $69
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
Commission paid to Insurance Broker	USD $69
Insurance broker organization code?	4
Insurance broker name	WELLS FARGO ADVISORS INS AGENCY LLC

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

Policy contract number

MR 60679

Policy instance

Insurance contract or identification number	MR 60679
Number of Individuals Covered	43
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $86
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
Commission paid to Insurance Broker	USD $86
Insurance broker organization code?	4
Insurance broker name	WELLS FARGO ADVISORS INS AGENCY, LL

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

Policy contract number

MR 60679

Policy instance

Insurance contract or identification number	MR 60679
Number of Individuals Covered	39
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $68
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
Commission paid to Insurance Broker	USD $68
Insurance broker organization code?	4
Insurance broker name	WELLS FARGO ADVISORS INS AGENCY, LL

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

Policy contract number

MR 60679

Policy instance

Insurance contract or identification number	MR 60679
Number of Individuals Covered	44
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $137
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
Commission paid to Insurance Broker	USD $118
Insurance broker organization code?	4
Insurance broker name	LPL FINANCIAL CORPORATION

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Company Name:	THE UROLOGY TEAM, P.A.
Employer identification number (EIN):	742837301
NAIC Classification:	621399
NAIC Description:	Offices of All Other Miscellaneous Health Practitioners