TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF CHESHIRE MEDICAL CENTER 401k Plan overview

Plan Name	TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF CHESHIRE MEDICAL CENTER
Plan identification number	002

TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF CHESHIRE MEDICAL CENTER Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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(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. Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations. Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations. Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

CHESHIRE MEDICAL CENTER has sponsored the creation of one or more 401k plans.

Company Name:	CHESHIRE MEDICAL CENTER
Employer identification number (EIN):	020354549
NAIC Classification:	622000
NAIC Description:	Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF CHESHIRE MEDICAL CENTER

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2022-01-01
002	2021-01-01
002	2020-01-01
002	2019-01-01
002	2018-01-01
002	2017-01-01	CHRISTINE SCHON
002	2016-01-01	CHRISTINE SCHON
002	2015-01-01
002	2014-01-01	ROBERT COCHRANE
002	2013-01-01	ROBERT COCHRANE
002	2012-01-01	JILL BATTY
002	2011-01-01	JILL BATTY
002	2009-01-01	MARILYN LEHTO
002	2009-01-01	MARILYN LEHTO

Plan Statistics for TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF CHESHIRE MEDICAL CENTER

401k plan membership statisitcs for TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF CHESHIRE MEDICAL CENTER

Measure	Date	Value
2022: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF CHESHIRE MEDICAL CENTER 2022 401k membership
Total participants, beginning-of-year	2022-01-01	2,269
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	1,046
Number of retired or separated participants receiving benefits	2022-01-01	43
Number of other retired or separated participants entitled to future benefits	2022-01-01	1,349
Total of all active and inactive participants	2022-01-01	2,438
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	6
Total participants	2022-01-01	2,444
Number of participants with account balances	2022-01-01	2,444
2021: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF CHESHIRE MEDICAL CENTER 2021 401k membership
Total participants, beginning-of-year	2021-01-01	2,324
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	1,097
Number of retired or separated participants receiving benefits	2021-01-01	35
Number of other retired or separated participants entitled to future benefits	2021-01-01	1,130
Total of all active and inactive participants	2021-01-01	2,262
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	7
Total participants	2021-01-01	2,269
Number of participants with account balances	2021-01-01	2,252
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	125
2020: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF CHESHIRE MEDICAL CENTER 2020 401k membership
Total participants, beginning-of-year	2020-01-01	2,143
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	1,068
Number of retired or separated participants receiving benefits	2020-01-01	18
Number of other retired or separated participants entitled to future benefits	2020-01-01	1,230
Total of all active and inactive participants	2020-01-01	2,316
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	8
Total participants	2020-01-01	2,324
Number of participants with account balances	2020-01-01	2,324
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	86
2019: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF CHESHIRE MEDICAL CENTER 2019 401k membership
Total participants, beginning-of-year	2019-01-01	1,839
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	1,786
Number of retired or separated participants receiving benefits	2019-01-01	23
Number of other retired or separated participants entitled to future benefits	2019-01-01	327
Total of all active and inactive participants	2019-01-01	2,136
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	7
Total participants	2019-01-01	2,143
Number of participants with account balances	2019-01-01	2,018
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF CHESHIRE MEDICAL CENTER 2018 401k membership
Total participants, beginning-of-year	2018-01-01	1,918
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	1,011
Number of retired or separated participants receiving benefits	2018-01-01	23
Number of other retired or separated participants entitled to future benefits	2018-01-01	802
Total of all active and inactive participants	2018-01-01	1,836
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	3
Total participants	2018-01-01	1,839
Number of participants with account balances	2018-01-01	1,839
2017: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF CHESHIRE MEDICAL CENTER 2017 401k membership
Total participants, beginning-of-year	2017-01-01	1,865
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	1,106
Number of retired or separated participants receiving benefits	2017-01-01	33
Number of other retired or separated participants entitled to future benefits	2017-01-01	778
Total of all active and inactive participants	2017-01-01	1,917
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	1
Total participants	2017-01-01	1,918
Number of participants with account balances	2017-01-01	1,917
2016: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF CHESHIRE MEDICAL CENTER 2016 401k membership
Total participants, beginning-of-year	2016-01-01	1,699
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	1,125
Number of retired or separated participants receiving benefits	2016-01-01	22
Number of other retired or separated participants entitled to future benefits	2016-01-01	716
Total of all active and inactive participants	2016-01-01	1,863
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	2
Total participants	2016-01-01	1,865
Number of participants with account balances	2016-01-01	1,827
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	46
2015: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF CHESHIRE MEDICAL CENTER 2015 401k membership
Total participants, beginning-of-year	2015-01-01	1,618
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	1,073
Number of retired or separated participants receiving benefits	2015-01-01	22
Number of other retired or separated participants entitled to future benefits	2015-01-01	602
Total of all active and inactive participants	2015-01-01	1,697
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	2
Total participants	2015-01-01	1,699
Number of participants with account balances	2015-01-01	1,625
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	23
2014: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF CHESHIRE MEDICAL CENTER 2014 401k membership
Total participants, beginning-of-year	2014-01-01	1,543
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	1,088
Number of retired or separated participants receiving benefits	2014-01-01	11
Number of other retired or separated participants entitled to future benefits	2014-01-01	518
Total of all active and inactive participants	2014-01-01	1,617
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	1
Total participants	2014-01-01	1,618
Number of participants with account balances	2014-01-01	1,436
2013: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF CHESHIRE MEDICAL CENTER 2013 401k membership
Total participants, beginning-of-year	2013-01-01	1,510
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	1,006
Number of retired or separated participants receiving benefits	2013-01-01	9
Number of other retired or separated participants entitled to future benefits	2013-01-01	526
Total of all active and inactive participants	2013-01-01	1,541
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	2
Total participants	2013-01-01	1,543
Number of participants with account balances	2013-01-01	1,387
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	1
2012: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF CHESHIRE MEDICAL CENTER 2012 401k membership
Total participants, beginning-of-year	2012-01-01	1,439
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	1,040
Number of retired or separated participants receiving benefits	2012-01-01	95
Number of other retired or separated participants entitled to future benefits	2012-01-01	375
Total of all active and inactive participants	2012-01-01	1,510
Total participants	2012-01-01	1,510
Number of participants with account balances	2012-01-01	1,140
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	2
2011: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF CHESHIRE MEDICAL CENTER 2011 401k membership
Total participants, beginning-of-year	2011-01-01	1,287
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	1,001
Number of retired or separated participants receiving benefits	2011-01-01	2
Number of other retired or separated participants entitled to future benefits	2011-01-01	435
Total of all active and inactive participants	2011-01-01	1,438
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	1
Total participants	2011-01-01	1,439
Number of participants with account balances	2011-01-01	1,294
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF CHESHIRE MEDICAL CENTER 2009 401k membership
Total participants, beginning-of-year	2009-01-01	1,099
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	1,074
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	74
Total of all active and inactive participants	2009-01-01	1,148
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	1,148
Number of participants with account balances	2009-01-01	984
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF CHESHIRE MEDICAL CENTER

Measure	Date	Value
2022 : TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF CHESHIRE MEDICAL CENTER 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	$-10,965,493
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$9,550,044
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$9,337,635
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$9,158,098
Value of total assets at end of year	2022-12-31	$101,974,689
Value of total assets at beginning of year	2022-12-31	$122,490,226
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$212,409
Total interest from all sources	2022-12-31	$119,344
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$2,184,028
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-12-31	$2,184,028
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	$5,219,172
Participant contributions at end of year	2022-12-31	$1,053,854
Participant contributions at beginning of year	2022-12-31	$1,104,357
Assets. Other investments not covered elsewhere at end of year	2022-12-31	$77,758
Assets. Other investments not covered elsewhere at beginning of year	2022-12-31	$82,474
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$186,244
Other income not declared elsewhere	2022-12-31	$27,749
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
Value of net income/loss	2022-12-31	$-20,515,537
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$101,974,689
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$122,490,226
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
Investment advisory and management fees	2022-12-31	$212,409
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$93,251,688
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$114,288,584
Interest on participant loans	2022-12-31	$51,743
Interest earned on other investments	2022-12-31	$67,433
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2022-12-31	$150,275
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2022-12-31	$64,280
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2022-12-31	$64,280
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2022-12-31	$168
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$7,441,114
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$6,950,531
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-22,454,712
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	$3,752,682
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$9,337,635
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	CARON & BLETZER, PLLC
Accountancy firm EIN	2022-12-31	043499945
2021 : TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF CHESHIRE MEDICAL CENTER 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	$23,890,106
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$12,599,905
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$12,370,099
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$8,922,179
Value of total assets at end of year	2021-12-31	$122,490,226
Value of total assets at beginning of year	2021-12-31	$111,200,025
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$229,806
Total interest from all sources	2021-12-31	$127,632
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$3,034,808
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2021-12-31	$3,034,808
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	$4,893,432
Participant contributions at end of year	2021-12-31	$1,104,357
Participant contributions at beginning of year	2021-12-31	$1,008,328
Assets. Other investments not covered elsewhere at end of year	2021-12-31	$82,474
Assets. Other investments not covered elsewhere at beginning of year	2021-12-31	$120,556
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$538,971
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	$11,290,201
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$122,490,226
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$111,200,025
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	$229,806
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$114,288,584
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$100,568,423
Interest on participant loans	2021-12-31	$52,074
Interest earned on other investments	2021-12-31	$75,557
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2021-12-31	$64,280
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2021-12-31	$109,404
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2021-12-31	$109,404
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2021-12-31	$1
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$6,950,531
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$9,393,314
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$11,805,487
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	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$3,489,776
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$12,370,099
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	CARON & BLETZER, PLLC
Accountancy firm EIN	2021-12-31	043499945
2020 : TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF CHESHIRE MEDICAL CENTER 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$23,242,370
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$6,838,880
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$6,649,461
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$8,568,869
Value of total assets at end of year	2020-12-31	$111,200,025
Value of total assets at beginning of year	2020-12-31	$94,796,535
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$189,419
Total interest from all sources	2020-12-31	$280,100
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$1,888,894
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-31	$1,888,894
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$4,533,679
Participant contributions at end of year	2020-12-31	$1,008,328
Participant contributions at beginning of year	2020-12-31	$1,070,888
Assets. Other investments not covered elsewhere at end of year	2020-12-31	$120,556
Assets. Other investments not covered elsewhere at beginning of year	2020-12-31	$49,229
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$165,487
Administrative expenses (other) incurred	2020-12-31	$186,482
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$16,403,490
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$111,200,025
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$94,796,535
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Investment advisory and management fees	2020-12-31	$2,937
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$100,568,423
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$85,204,431
Value of interest in pooled separate accounts at end of year	2020-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$2,110,060
Interest on participant loans	2020-12-31	$59,252
Interest earned on other investments	2020-12-31	$220,580
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2020-12-31	$109,404
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2020-12-31	$93,788
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2020-12-31	$93,788
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2020-12-31	$268
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$9,393,314
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$6,231,503
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$12,086,727
Net investment gain/loss from pooled separate accounts	2020-12-31	$417,780
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$3,869,703
Employer contributions (assets) at end of year	2020-12-31	$0
Employer contributions (assets) at beginning of year	2020-12-31	$36,636
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$6,649,461
Did the plan have assets held for investment	2020-12-31	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	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Unqualified
Accountancy firm name	2020-12-31	CARON & BLETZER, PLLC
Accountancy firm EIN	2020-12-31	043499945
2019 : TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF CHESHIRE MEDICAL CENTER 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$23,212,281
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$10,990,239
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$10,722,900
Expenses. Certain deemed distributions of participant loans	2019-12-31	$16,954
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$6,297,511
Value of total assets at end of year	2019-12-31	$94,796,535
Value of total assets at beginning of year	2019-12-31	$82,574,493
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$250,385
Total interest from all sources	2019-12-31	$129,818
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$1,740,517
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$1,740,517
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$3,651,507
Participant contributions at end of year	2019-12-31	$1,070,888
Participant contributions at beginning of year	2019-12-31	$1,060,089
Assets. Other investments not covered elsewhere at end of year	2019-12-31	$49,229
Assets. Other investments not covered elsewhere at beginning of year	2019-12-31	$494,882
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$340,841
Other income not declared elsewhere	2019-12-31	$-25,816
Administrative expenses (other) incurred	2019-12-31	$247,097
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$12,222,042
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$94,796,535
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$82,574,493
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Investment advisory and management fees	2019-12-31	$3,288
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$85,204,431
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$70,974,277
Value of interest in pooled separate accounts at end of year	2019-12-31	$2,110,060
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$7,778,927
Interest on participant loans	2019-12-31	$55,744
Interest earned on other investments	2019-12-31	$72,921
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2019-12-31	$93,788
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2019-12-31	$104,192
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2019-12-31	$104,192
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-31	$1,153
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$6,231,503
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$2,105,600
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$14,602,651
Net investment gain/loss from pooled separate accounts	2019-12-31	$467,600
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$2,305,163
Employer contributions (assets) at end of year	2019-12-31	$36,636
Employer contributions (assets) at beginning of year	2019-12-31	$56,526
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$10,722,900
Did the plan have assets held for investment	2019-12-31	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	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	CARON & BLETZER, PLLC
Accountancy firm EIN	2019-12-31	043499945
2018 : TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF CHESHIRE MEDICAL CENTER 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$1,929,257
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$9,992,615
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$9,730,639
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$5,911,754
Value of total assets at end of year	2018-12-31	$82,574,493
Value of total assets at beginning of year	2018-12-31	$90,637,851
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$261,976
Total interest from all sources	2018-12-31	$127,122
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$1,807,609
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2018-12-31	$1,807,609
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$500,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$3,483,922
Participant contributions at end of year	2018-12-31	$1,060,089
Participant contributions at beginning of year	2018-12-31	$1,002,882
Assets. Other investments not covered elsewhere at end of year	2018-12-31	$494,882
Assets. Other investments not covered elsewhere at beginning of year	2018-12-31	$526,956
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$60,655
Administrative expenses (other) incurred	2018-12-31	$257,497
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$-8,063,358
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$82,574,493
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$90,637,851
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Investment advisory and management fees	2018-12-31	$4,479
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$70,974,277
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$79,336,240
Value of interest in pooled separate accounts at end of year	2018-12-31	$7,778,927
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$7,496,317
Interest on participant loans	2018-12-31	$47,016
Interest earned on other investments	2018-12-31	$79,596
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2018-12-31	$104,192
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2018-12-31	$66,574
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2018-12-31	$66,574
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2018-12-31	$510
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$2,105,600
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$2,170,083
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-5,820,981
Net investment gain/loss from pooled separate accounts	2018-12-31	$-96,247
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$2,367,177
Employer contributions (assets) at end of year	2018-12-31	$56,526
Employer contributions (assets) at beginning of year	2018-12-31	$38,799
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$9,730,639
Did the plan have assets held for investment	2018-12-31	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	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	CARON & BLETZER, PLLC
Accountancy firm EIN	2018-12-31	043499945
2017 : TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF CHESHIRE MEDICAL CENTER 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$19,032,521
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$6,844,031
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$6,591,940
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$6,072,620
Value of total assets at end of year	2017-12-31	$90,637,851
Value of total assets at beginning of year	2017-12-31	$78,449,361
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$252,091
Total interest from all sources	2017-12-31	$125,427
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$1,606,736
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$1,606,736
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$500,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$3,370,309
Participant contributions at end of year	2017-12-31	$1,002,882
Participant contributions at beginning of year	2017-12-31	$1,009,779
Assets. Other investments not covered elsewhere at end of year	2017-12-31	$526,956
Assets. Other investments not covered elsewhere at beginning of year	2017-12-31	$387,800
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$309,966
Other income not declared elsewhere	2017-12-31	$259,901
Total non interest bearing cash at end of year	2017-12-31	$66,574
Total non interest bearing cash at beginning of year	2017-12-31	$42,374
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$12,188,490
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$90,637,851
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$78,449,361
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Investment advisory and management fees	2017-12-31	$252,091
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$79,336,239
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$67,108,699
Value of interest in pooled separate accounts at end of year	2017-12-31	$7,496,317
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$7,456,553
Interest on participant loans	2017-12-31	$120,884
Interest earned on other investments	2017-12-31	$4,543
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$2,170,084
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$2,370,992
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$10,580,678
Net investment gain/loss from pooled separate accounts	2017-12-31	$387,159
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$2,392,345
Employer contributions (assets) at end of year	2017-12-31	$38,799
Employer contributions (assets) at beginning of year	2017-12-31	$73,164
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$6,591,940
Did the plan have assets held for investment	2017-12-31	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	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	CARON & BLETZER, PLLC
Accountancy firm EIN	2017-12-31	043499945
2016 : TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF CHESHIRE MEDICAL CENTER 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$11,376,436
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$5,303,419
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$5,072,948
Expenses. Certain deemed distributions of participant loans	2016-12-31	$613
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$6,281,970
Value of total assets at end of year	2016-12-31	$78,449,361
Value of total assets at beginning of year	2016-12-31	$72,376,344
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$229,858
Total interest from all sources	2016-12-31	$130,302
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$1,142,590
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$1,142,590
Administrative expenses professional fees incurred	2016-12-31	$8,750
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$500,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$3,184,204
Participant contributions at end of year	2016-12-31	$1,009,779
Participant contributions at beginning of year	2016-12-31	$950,116
Participant contributions at end of year	2016-12-31	$0
Participant contributions at beginning of year	2016-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2016-12-31	$387,800
Assets. Other investments not covered elsewhere at beginning of year	2016-12-31	$600,116
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$548,714
Value of other receiveables (less allowance for doubtful accounts) at end of year	2016-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2016-12-31	$0
Administrative expenses (other) incurred	2016-12-31	$164,708
Total non interest bearing cash at end of year	2016-12-31	$42,374
Total non interest bearing cash at beginning of year	2016-12-31	$31,195
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$6,073,017
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$78,449,361
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$72,376,344
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Investment advisory and management fees	2016-12-31	$56,400
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$67,108,699
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$60,365,009
Value of interest in pooled separate accounts at end of year	2016-12-31	$7,456,553
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$7,901,889
Interest on participant loans	2016-12-31	$39,204
Interest earned on other investments	2016-12-31	$90,878
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2016-12-31	$220
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$2,370,992
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$2,491,583
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$3,702,388
Net investment gain/loss from pooled separate accounts	2016-12-31	$119,186
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$2,549,052
Employer contributions (assets) at end of year	2016-12-31	$73,164
Employer contributions (assets) at beginning of year	2016-12-31	$36,436
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$5,072,948
Did the plan have assets held for investment	2016-12-31	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	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	CARON & BLETZER, PLLC
Accountancy firm EIN	2016-12-31	043499945
2015 : TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF CHESHIRE MEDICAL CENTER 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	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$6,130,117
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$5,152,287
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$4,936,835
Expenses. Certain deemed distributions of participant loans	2015-12-31	$7,741
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$5,825,056
Value of total assets at end of year	2015-12-31	$72,376,344
Value of total assets at beginning of year	2015-12-31	$71,398,514
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$207,711
Total interest from all sources	2015-12-31	$36,985
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$1,068,681
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$1,068,681
Administrative expenses professional fees incurred	2015-12-31	$13,515
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$500,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
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
Contributions received from participants	2015-12-31	$3,034,029
Participant contributions at end of year	2015-12-31	$950,116
Participant contributions at beginning of year	2015-12-31	$917,359
Assets. Other investments not covered elsewhere at end of year	2015-12-31	$600,116
Assets. Other investments not covered elsewhere at beginning of year	2015-12-31	$430,502
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$395,248
Other income not declared elsewhere	2015-12-31	$93,031
Administrative expenses (other) incurred	2015-12-31	$172,250
Total non interest bearing cash at end of year	2015-12-31	$31,195
Total non interest bearing cash at beginning of year	2015-12-31	$14,435
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	$977,830
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$72,376,344
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$71,398,514
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
Investment advisory and management fees	2015-12-31	$16,500
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$60,365,009
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$59,542,751
Value of interest in pooled separate accounts at end of year	2015-12-31	$7,901,889
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$7,349,070
Interest on participant loans	2015-12-31	$36,893
Interest earned on other investments	2015-12-31	$31
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2015-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2015-12-31	$200,578
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2015-12-31	$200,578
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2015-12-31	$61
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$2,491,583
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$2,530,873
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-927,309
Net investment gain/loss from pooled separate accounts	2015-12-31	$33,673
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
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	$2,395,779
Employer contributions (assets) at end of year	2015-12-31	$36,436
Employer contributions (assets) at beginning of year	2015-12-31	$412,946
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$4,936,835
Contract administrator fees	2015-12-31	$5,446
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	CARON & BLETZER, PLLC
Accountancy firm EIN	2015-12-31	043499945
2014 : TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF CHESHIRE MEDICAL CENTER 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	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$9,643,116
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$4,115,266
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$4,026,177
Expenses. Certain deemed distributions of participant loans	2014-12-31	$10,004
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$5,920,251
Value of total assets at end of year	2014-12-31	$71,398,514
Value of total assets at beginning of year	2014-12-31	$65,870,664
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$79,085
Total interest from all sources	2014-12-31	$36,661
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$3,072,597
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$3,072,597
Administrative expenses professional fees incurred	2014-12-31	$27,775
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$500,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
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
Contributions received from participants	2014-12-31	$2,827,689
Participant contributions at end of year	2014-12-31	$917,359
Participant contributions at beginning of year	2014-12-31	$834,680
Assets. Other investments not covered elsewhere at end of year	2014-12-31	$430,502
Assets. Other investments not covered elsewhere at beginning of year	2014-12-31	$371,129
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$359,803
Other income not declared elsewhere	2014-12-31	$417,821
Administrative expenses (other) incurred	2014-12-31	$25,159
Total non interest bearing cash at end of year	2014-12-31	$14,435
Total non interest bearing cash at beginning of year	2014-12-31	$8,196
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	$5,527,850
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$71,398,514
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$65,870,664
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	$20,584
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$59,542,751
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$54,072,369
Value of interest in pooled separate accounts at end of year	2014-12-31	$7,349,070
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$7,144,646
Interest on participant loans	2014-12-31	$36,581
Interest earned on other investments	2014-12-31	$22
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2014-12-31	$200,578
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2014-12-31	$426,338
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2014-12-31	$426,338
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2014-12-31	$58
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$2,530,873
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$2,555,762
Net investment gain/loss from pooled separate accounts	2014-12-31	$195,786
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
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
Contributions received in cash from employer	2014-12-31	$2,732,759
Employer contributions (assets) at end of year	2014-12-31	$412,946
Employer contributions (assets) at beginning of year	2014-12-31	$457,544
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$4,026,177
Contract administrator fees	2014-12-31	$5,567
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	CARON & BLETZER, PLLC
Accountancy firm EIN	2014-12-31	043499945
2013 : TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF CHESHIRE MEDICAL CENTER 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	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$15,358,251
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$4,419,039
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$4,341,266
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$5,762,663
Value of total assets at end of year	2013-12-31	$65,870,664
Value of total assets at beginning of year	2013-12-31	$54,931,452
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$77,773
Total interest from all sources	2013-12-31	$33,242
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$942,354
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-12-31	$942,354
Administrative expenses professional fees incurred	2013-12-31	$9,061
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$500,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
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
Contributions received from participants	2013-12-31	$2,776,484
Participant contributions at end of year	2013-12-31	$834,680
Participant contributions at beginning of year	2013-12-31	$764,455
Participant contributions at end of year	2013-12-31	$0
Participant contributions at beginning of year	2013-12-31	$105,448
Assets. Other investments not covered elsewhere at end of year	2013-12-31	$371,129
Assets. Other investments not covered elsewhere at beginning of year	2013-12-31	$295,778
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$212,964
Other income not declared elsewhere	2013-12-31	$145,292
Administrative expenses (other) incurred	2013-12-31	$40,216
Total non interest bearing cash at end of year	2013-12-31	$8,196
Total non interest bearing cash at beginning of year	2013-12-31	$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	2013-12-31	No
Value of net income/loss	2013-12-31	$10,939,212
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$65,870,664
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$54,931,452
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
Investment advisory and management fees	2013-12-31	$22,000
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$54,072,369
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$43,488,897
Value of interest in pooled separate accounts at end of year	2013-12-31	$7,144,646
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$7,136,718
Interest on participant loans	2013-12-31	$33,166
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2013-12-31	$426,338
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2013-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2013-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2013-12-31	$76
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$2,555,762
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$2,608,316
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$7,845,412
Net investment gain/loss from pooled separate accounts	2013-12-31	$629,288
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
Contributions received in cash from employer	2013-12-31	$2,773,215
Employer contributions (assets) at end of year	2013-12-31	$457,544
Employer contributions (assets) at beginning of year	2013-12-31	$531,840
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$4,341,266
Contract administrator fees	2013-12-31	$6,496
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	CARON & BLETZER, PLLC
Accountancy firm EIN	2013-12-31	043499945
2012 : TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF CHESHIRE MEDICAL CENTER 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	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$11,669,743
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$4,049,785
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$3,982,303
Expenses. Certain deemed distributions of participant loans	2012-12-31	$5,464
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$6,017,177
Value of total assets at end of year	2012-12-31	$54,931,452
Value of total assets at beginning of year	2012-12-31	$47,311,494
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$62,018
Total interest from all sources	2012-12-31	$35,196
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$880,077
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-12-31	$880,077
Administrative expenses professional fees incurred	2012-12-31	$1,963
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$500,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
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
Contributions received from participants	2012-12-31	$2,805,843
Participant contributions at end of year	2012-12-31	$764,455
Participant contributions at beginning of year	2012-12-31	$645,413
Participant contributions at end of year	2012-12-31	$105,448
Participant contributions at beginning of year	2012-12-31	$103,672
Assets. Other investments not covered elsewhere at end of year	2012-12-31	$295,778
Assets. Other investments not covered elsewhere at beginning of year	2012-12-31	$255,003
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$507,473
Other income not declared elsewhere	2012-12-31	$118,527
Administrative expenses (other) incurred	2012-12-31	$33,410
Total non interest bearing cash at end of year	2012-12-31	$0
Total non interest bearing cash at beginning of year	2012-12-31	$153,030
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	$7,619,958
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$54,931,452
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$47,311,494
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
Investment advisory and management fees	2012-12-31	$20,000
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$43,488,897
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$36,588,454
Value of interest in pooled separate accounts at end of year	2012-12-31	$7,136,718
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$6,765,682
Interest on participant loans	2012-12-31	$34,971
Interest earned on other investments	2012-12-31	$10
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-12-31	$215
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$2,608,316
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$2,629,397
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$4,322,823
Net investment gain/loss from pooled separate accounts	2012-12-31	$295,943
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
Contributions received in cash from employer	2012-12-31	$2,703,861
Employer contributions (assets) at end of year	2012-12-31	$531,840
Employer contributions (assets) at beginning of year	2012-12-31	$170,843
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$3,982,303
Contract administrator fees	2012-12-31	$6,645
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	CARON & BLETZER, PLLC
Accountancy firm EIN	2012-12-31	043499945
2011 : TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF CHESHIRE MEDICAL CENTER 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total transfer of assets to this plan	2011-12-31	$347,816
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
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	$5,144,916
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$4,325,833
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$4,304,302
Expenses. Certain deemed distributions of participant loans	2011-12-31	$6,787
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$5,732,149
Value of total assets at end of year	2011-12-31	$47,311,494
Value of total assets at beginning of year	2011-12-31	$46,144,595
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$14,744
Total interest from all sources	2011-12-31	$30,547
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$716,589
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2011-12-31	$716,589
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$500,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
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
Contributions received from participants	2011-12-31	$2,879,038
Participant contributions at end of year	2011-12-31	$645,413
Participant contributions at beginning of year	2011-12-31	$670,019
Participant contributions at end of year	2011-12-31	$103,672
Participant contributions at beginning of year	2011-12-31	$110,860
Assets. Other investments not covered elsewhere at end of year	2011-12-31	$255,003
Assets. Other investments not covered elsewhere at beginning of year	2011-12-31	$176,585
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$43,938
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-12-31	$0
Other income not declared elsewhere	2011-12-31	$-619
Administrative expenses (other) incurred	2011-12-31	$14,744
Total non interest bearing cash at end of year	2011-12-31	$153,030
Total non interest bearing cash at beginning of year	2011-12-31	$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	2011-12-31	No
Value of net income/loss	2011-12-31	$819,083
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$47,311,494
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$46,144,595
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 registered invesment companies (eg mutual funds) at end of year	2011-12-31	$36,588,454
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$35,492,860
Value of interest in pooled separate accounts at end of year	2011-12-31	$6,765,682
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$6,722,487
Interest on participant loans	2011-12-31	$30,383
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-12-31	$164
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$2,629,397
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$2,837,825
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-1,399,025
Net investment gain/loss from pooled separate accounts	2011-12-31	$65,275
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
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	$2,809,173
Employer contributions (assets) at end of year	2011-12-31	$170,843
Employer contributions (assets) at beginning of year	2011-12-31	$133,959
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$4,304,302
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	CARON & BLETZER, PLLC
Accountancy firm EIN	2011-12-31	043499945
2010 : TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF CHESHIRE MEDICAL CENTER 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total income from all sources (including contributions)	2010-12-31	$11,335,306
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$1,838,731
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$1,790,282
Expenses. Certain deemed distributions of participant loans	2010-12-31	$974
Value of total corrective distributions	2010-12-31	$64
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$6,580,928
Value of total assets at end of year	2010-12-31	$46,144,595
Value of total assets at beginning of year	2010-12-31	$36,648,020
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$47,411
Total interest from all sources	2010-12-31	$128,483
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$684,501
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2010-12-31	$684,501
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$500,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$3,066,226
Participant contributions at end of year	2010-12-31	$670,019
Participant contributions at beginning of year	2010-12-31	$536,009
Participant contributions at end of year	2010-12-31	$110,860
Participant contributions at beginning of year	2010-12-31	$107,746
Assets. Other investments not covered elsewhere at end of year	2010-12-31	$176,585
Assets. Other investments not covered elsewhere at beginning of year	2010-12-31	$32,145
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$136,546
Other income not declared elsewhere	2010-12-31	$14,314
Administrative expenses (other) incurred	2010-12-31	$47,411
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$9,496,575
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$46,144,595
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$36,648,020
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$35,492,860
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$27,325,347
Value of interest in pooled separate accounts at end of year	2010-12-31	$6,722,487
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$5,740,287
Interest on participant loans	2010-12-31	$27,234
Interest earned on other investments	2010-12-31	$101,249
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$2,837,825
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$2,652,277
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$3,380,944
Net investment gain/loss from pooled separate accounts	2010-12-31	$546,136
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$3,378,156
Employer contributions (assets) at end of year	2010-12-31	$133,959
Employer contributions (assets) at beginning of year	2010-12-31	$254,209
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$1,790,282
Did the plan have assets held for investment	2010-12-31	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	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	CARON & BLETZER, PLLC
Accountancy firm EIN	2010-12-31	043499945

Form 5500 Responses for TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF CHESHIRE MEDICAL CENTER

2022: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF CHESHIRE MEDICAL CENTER 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 - Trust	Yes
2021: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF CHESHIRE MEDICAL CENTER 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF CHESHIRE MEDICAL CENTER 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF CHESHIRE MEDICAL CENTER 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF CHESHIRE MEDICAL CENTER 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF CHESHIRE MEDICAL CENTER 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 - Trust	Yes
2016: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF CHESHIRE MEDICAL CENTER 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 - Trust	Yes
2015: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF CHESHIRE MEDICAL CENTER 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 - Trust	Yes
2014: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF CHESHIRE MEDICAL CENTER 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 - Trust	Yes
2013: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF CHESHIRE MEDICAL CENTER 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 - Trust	Yes
2012: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF CHESHIRE MEDICAL CENTER 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 - Trust	Yes
2011: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF CHESHIRE MEDICAL CENTER 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 - Trust	Yes
2009: TAX SHELTERED ANNUITY PLAN FOR EMPLOYEES OF CHESHIRE MEDICAL CENTER 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )
Policy contract number	TT069281
Policy instance	4
Insurance contract or identification number TT069281 Number of Individuals Covered 2267 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 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? Yes 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
SUN AMERICA/CAL FARM (National Association of Insurance Commissioners NAIC id number: 60941 )
Policy contract number	949A
Policy instance	3
Insurance contract or identification number 949A Number of Individuals Covered 14 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 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? Yes 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 Other information about contract 403 (B)
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number	45729
Policy instance	2
Insurance contract or identification number 45729 Number of Individuals Covered 97 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Total amount of commissions paid to insurance broker USD $270 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 1 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 $172 Insurance broker organization code? 3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	1071186
Policy instance	1
Insurance contract or identification number 1071186 Number of Individuals Covered 12 Insurance policy start date 2022-01-01 Insurance policy end date 2022-12-31 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? Yes 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
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	1071186
Policy instance	1
Insurance contract or identification number 1071186 Number of Individuals Covered 12 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? Yes 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
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number	45729
Policy instance	2
Insurance contract or identification number 45729 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 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 1 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
SUN AMERICA/CAL FARM (National Association of Insurance Commissioners NAIC id number: 60941 )
Policy contract number	949A
Policy instance	3
Insurance contract or identification number 949A Number of Individuals Covered 15 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 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
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number	TT 069281
Policy instance	4
Insurance contract or identification number TT 069281 Insurance policy start date 2021-01-01 Insurance policy end date 2021-12-31 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? Yes 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
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	1071186
Policy instance	1
Insurance contract or identification number 1071186 Number of Individuals Covered 14 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? Yes 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
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number	45729
Policy instance	2
Insurance contract or identification number 45729 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 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 1 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
SUN AMERICA/CAL FARM (National Association of Insurance Commissioners NAIC id number: 60941 )
Policy contract number	949A
Policy instance	3
Insurance contract or identification number 949A Number of Individuals Covered 15 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 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
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number	TT 069281
Policy instance	4
Insurance contract or identification number TT 069281 Insurance policy start date 2020-01-01 Insurance policy end date 2020-12-31 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? Yes 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
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	1071186
Policy instance	1
Insurance contract or identification number 1071186 Number of Individuals Covered 16 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? Yes 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
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number	45729
Policy instance	2
Insurance contract or identification number 45729 Number of Individuals Covered 44 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 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 1 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
SUN AMERICA/CAL FARM (National Association of Insurance Commissioners NAIC id number: 60941 )
Policy contract number	949A
Policy instance	3
Insurance contract or identification number 949A Number of Individuals Covered 15 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 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
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number	TT 069281
Policy instance	4
Insurance contract or identification number TT 069281 Insurance policy start date 2019-01-01 Insurance policy end date 2019-12-31 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? Yes 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
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	1071186
Policy instance	1
Insurance contract or identification number 1071186 Number of Individuals Covered 19 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? Yes 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
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number	TT069281
Policy instance	2
Insurance contract or identification number TT069281 Number of Individuals Covered 1769 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 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
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number	45729
Policy instance	3
Insurance contract or identification number 45729 Number of Individuals Covered 377 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 Total amount of commissions paid to insurance broker USD $377 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 1 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 $377 Insurance broker organization code? 3
SUN AMERICA/CAL FARM (National Association of Insurance Commissioners NAIC id number: 60941 )
Policy contract number	949A
Policy instance	4
Insurance contract or identification number 949A Number of Individuals Covered 15 Insurance policy start date 2018-01-01 Insurance policy end date 2018-12-31 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
SUN AMERICA/CAL FARM (National Association of Insurance Commissioners NAIC id number: 60941 )
Policy contract number	949A
Policy instance	4
Insurance contract or identification number 949A Number of Individuals Covered 17 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 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
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number	45729
Policy instance	3
Insurance contract or identification number 45729 Number of Individuals Covered 128 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Total amount of commissions paid to insurance broker USD $377 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 1 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 $377 Insurance broker organization code? 3 Insurance broker name MULTIPLE VALIC AGENTS
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number	TT069281
Policy instance	2
Insurance contract or identification number TT069281 Number of Individuals Covered 1769 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 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
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	1071186
Policy instance	1
Insurance contract or identification number 1071186 Number of Individuals Covered 21 Insurance policy start date 2017-01-01 Insurance policy end date 2017-12-31 Are there contracts with allocated funds for individual policies? 0 Are there contracts with allocated funds for group deferred annuity? Yes 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
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	1071186
Policy instance	1
Insurance contract or identification number 1071186 Number of Individuals Covered 24 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? Yes 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
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number	TT069281
Policy instance	2
Insurance contract or identification number TT069281 Number of Individuals Covered 1451 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 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 1 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? Yes 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
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number	45729
Policy instance	3
Insurance contract or identification number 45729 Number of Individuals Covered 142 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 Total amount of commissions paid to insurance broker USD $352 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 1 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 $352 Insurance broker organization code? 3 Insurance broker name MULTIPLE VALIC AGENTS
SUN AMERICA/CAL FARM (National Association of Insurance Commissioners NAIC id number: 60941 )
Policy contract number	949A
Policy instance	4
Insurance contract or identification number 949A Number of Individuals Covered 20 Insurance policy start date 2015-01-01 Insurance policy end date 2015-12-31 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
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number	45729
Policy instance	3
Insurance contract or identification number 45729 Number of Individuals Covered 153 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Total amount of commissions paid to insurance broker USD $713 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 1 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 $713 Insurance broker organization code? 3 Insurance broker name MULTIPLE VALIC AGENTS
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	1071186
Policy instance	1
Insurance contract or identification number 1071186 Number of Individuals Covered 25 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? Yes 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
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number	TT069281
Policy instance	2
Insurance contract or identification number TT069281 Number of Individuals Covered 1279 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 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 1 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? Yes 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
SUN AMERICA/CAL FARM (National Association of Insurance Commissioners NAIC id number: 60941 )
Policy contract number	949A
Policy instance	4
Insurance contract or identification number 949A Number of Individuals Covered 21 Insurance policy start date 2014-01-01 Insurance policy end date 2014-12-31 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
SUN AMERICA/CAL FARM (National Association of Insurance Commissioners NAIC id number: 60941 )
Policy contract number	949A
Policy instance	4
Insurance contract or identification number 949A Number of Individuals Covered 21 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
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	1071186
Policy instance	1
Insurance contract or identification number 1071186 Number of Individuals Covered 29 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? Yes 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
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number	TT069281
Policy instance	2
Insurance contract or identification number TT069281 Number of Individuals Covered 1196 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? Yes 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
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number	45729
Policy instance	3
Insurance contract or identification number 45729 Number of Individuals Covered 161 Insurance policy start date 2013-01-01 Insurance policy end date 2013-12-31 Total amount of commissions paid to insurance broker USD $577 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 1 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 $577 Insurance broker organization code? 3 Insurance broker name MULTIPLE VALIC AGENTS
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number	TT069281
Policy instance	2
Insurance contract or identification number TT069281 Number of Individuals Covered 1140 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 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? Yes 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
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number	45729
Policy instance	3
Insurance contract or identification number 45729 Number of Individuals Covered 175 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Total amount of commissions paid to insurance broker USD $145 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 1 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 $145 Insurance broker organization code? 3 Insurance broker name MULTIPLE VALIC AGENTS
SUN AMERICA/CAL FARM (National Association of Insurance Commissioners NAIC id number: 60941 )
Policy contract number	949A
Policy instance	4
Insurance contract or identification number 949A Number of Individuals Covered 23 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 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
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	1071186
Policy instance	1
Insurance contract or identification number 1071186 Number of Individuals Covered 31 Insurance policy start date 2012-01-01 Insurance policy end date 2012-12-31 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? Yes 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
SUN AMERICA/CAL FARM (National Association of Insurance Commissioners NAIC id number: 60941 )
Policy contract number	949A
Policy instance	4
Insurance contract or identification number 949A Number of Individuals Covered 29 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 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
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number	45729
Policy instance	3
Insurance contract or identification number 45729 Number of Individuals Covered 186 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Total amount of commissions paid to insurance broker USD $571 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 1 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
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number	TT069281
Policy instance	2
Insurance contract or identification number TT069281 Number of Individuals Covered 1088 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 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? Yes 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
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	1071186
Policy instance	1
Insurance contract or identification number 1071186 Number of Individuals Covered 32 Insurance policy start date 2011-01-01 Insurance policy end date 2011-12-31 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? Yes 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
VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )
Policy contract number	45729
Policy instance	3
Insurance contract or identification number 45729 Number of Individuals Covered 212 Insurance policy start date 2010-01-01 Insurance policy end date 2010-12-31 Total amount of commissions paid to insurance broker USD $2,471 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 1 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 $2,471 Insurance broker organization code? 3 Insurance broker name MULTIPLE VALIC AGENTS
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )
Policy contract number	TT069281
Policy instance	2
Insurance contract or identification number TT069281 Number of Individuals Covered 1068 Insurance policy start date 2010-01-01 Insurance policy end date 2010-12-31 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? Yes 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
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	1071186
Policy instance	1
Insurance contract or identification number 1071186 Number of Individuals Covered 32 Insurance policy start date 2010-01-01 Insurance policy end date 2010-12-31 Are there contracts with allocated funds for individual policies? No Are there contracts with allocated funds for group deferred annuity? Yes 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

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