401k Plan data: ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN plan

ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN 401k Plan overview

Plan Name	ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN
Plan identification number	001

ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Participant-directed brokerage accounts provided as an investment option under the plan.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. has sponsored the creation of one or more 401k plans.

Company Name: ORTHOPEDIC SURGEONS OF WISCONSIN, S.C.

Employer identification number (EIN): 200217581

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01 JAMES W. STONE, M.D. 2023-10-03
001 2021-01-01 JAMES W. STONE, M.D. 2022-10-14
001 2020-01-01 JAMES W. STONE, M.D. 2021-09-20
001 2019-01-01 STEVEN R. TRINKL, M.D. 2020-07-16
001 2018-01-01 STEVEN R. TRINKL, M.D. 2019-09-12
001 2017-01-01
001 2016-01-01
001 2015-01-01
001 2014-01-01 JAMES W. STONE, M.D.
001 2013-01-01 JAMES W. STONE, M.D.
001 2012-01-01 BINDU BAMRAH
001 2011-01-01 JAMES W. STONE, M.D.
001 2010-01-01 JAMES W. STONE, M.D. 2011-10-13

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2022-01-01	JAMES W. STONE, M.D.	2023-10-03
001	2021-01-01	JAMES W. STONE, M.D.	2022-10-14
001	2020-01-01	JAMES W. STONE, M.D.	2021-09-20
001	2019-01-01	STEVEN R. TRINKL, M.D.	2020-07-16
001	2018-01-01	STEVEN R. TRINKL, M.D.	2019-09-12
001	2017-01-01
001	2016-01-01
001	2015-01-01
001	2014-01-01	JAMES W. STONE, M.D.
001	2013-01-01	JAMES W. STONE, M.D.
001	2012-01-01	BINDU BAMRAH
001	2011-01-01	JAMES W. STONE, M.D.
001	2010-01-01	JAMES W. STONE, M.D.	2011-10-13

Plan Statistics for ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN

401k plan membership statisitcs for ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN

Measure Date Value
2022: ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 134
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 96
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 41
Total of all active and inactive participants 2022-01-01 137
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 137
Number of participants with account balances 2022-01-01 136
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 6
2021: ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 136
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 97
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 35
Total of all active and inactive participants 2021-01-01 132
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 132
Number of participants with account balances 2021-01-01 132
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 10
2020: ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 139
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 100
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 33
Total of all active and inactive participants 2020-01-01 133
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 133
Number of participants with account balances 2020-01-01 133
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 4
2019: ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 136
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 101
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 35
Total of all active and inactive participants 2019-01-01 136
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 136
Number of participants with account balances 2019-01-01 136
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 8
2018: ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 148
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 97
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 38
Total of all active and inactive participants 2018-01-01 135
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 135
Number of participants with account balances 2018-01-01 135
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 10
2017: ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 164
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 96
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 48
Total of all active and inactive participants 2017-01-01 144
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 144
Number of participants with account balances 2017-01-01 143
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 6
2016: ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 173
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 92
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 71
Total of all active and inactive participants 2016-01-01 163
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 163
Number of participants with account balances 2016-01-01 163
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 12
2015: ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 178
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 120
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 53
Total of all active and inactive participants 2015-01-01 173
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 173
Number of participants with account balances 2015-01-01 173
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 5
2014: ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 171
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 127
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 46
Total of all active and inactive participants 2014-01-01 173
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 173
Number of participants with account balances 2014-01-01 173
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 14
2013: ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 192
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 130
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 41
Total of all active and inactive participants 2013-01-01 171
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 171
Number of participants with account balances 2013-01-01 171
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 11
2012: ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 169
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 136
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 50
Total of all active and inactive participants 2012-01-01 186
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 186
Number of participants with account balances 2012-01-01 186
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 16
2011: ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 149
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 128
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 40
Total of all active and inactive participants 2011-01-01 168
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 1
Total participants 2011-01-01 169
Number of participants with account balances 2011-01-01 169
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 17

Measure	Date	Value
2022: ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	134
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	96
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	41
Total of all active and inactive participants	2022-01-01	137
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	137
Number of participants with account balances	2022-01-01	136
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	6
2021: ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	136
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	97
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	35
Total of all active and inactive participants	2021-01-01	132
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	132
Number of participants with account balances	2021-01-01	132
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	10
2020: ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	139
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	100
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	33
Total of all active and inactive participants	2020-01-01	133
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	133
Number of participants with account balances	2020-01-01	133
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	4
2019: ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	136
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	101
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	35
Total of all active and inactive participants	2019-01-01	136
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	136
Number of participants with account balances	2019-01-01	136
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	8
2018: ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	148
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	97
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	38
Total of all active and inactive participants	2018-01-01	135
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	135
Number of participants with account balances	2018-01-01	135
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	10
2017: ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	164
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	96
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	48
Total of all active and inactive participants	2017-01-01	144
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	144
Number of participants with account balances	2017-01-01	143
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	6
2016: ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	173
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	92
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	71
Total of all active and inactive participants	2016-01-01	163
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	163
Number of participants with account balances	2016-01-01	163
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	12
2015: ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	178
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	120
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	53
Total of all active and inactive participants	2015-01-01	173
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	173
Number of participants with account balances	2015-01-01	173
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	5
2014: ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	171
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	127
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	46
Total of all active and inactive participants	2014-01-01	173
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	173
Number of participants with account balances	2014-01-01	173
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	14
2013: ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	192
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	130
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	41
Total of all active and inactive participants	2013-01-01	171
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	171
Number of participants with account balances	2013-01-01	171
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	11
2012: ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	169
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	136
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	50
Total of all active and inactive participants	2012-01-01	186
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	186
Number of participants with account balances	2012-01-01	186
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	16
2011: ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	149
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	128
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	40
Total of all active and inactive participants	2011-01-01	168
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	1
Total participants	2011-01-01	169
Number of participants with account balances	2011-01-01	169
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	17

Financial Data on ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN

Measure	Date	Value
2022 : ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$26,000
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total income from all sources (including contributions)	2022-12-31	$-2,225,343
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$434,755
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$263,133
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$1,819,671
Value of total assets at end of year	2022-12-31	$26,808,607
Value of total assets at beginning of year	2022-12-31	$29,442,705
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$171,622
Total interest from all sources	2022-12-31	$14,450
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$666,059
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	$666,059
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	$802,868
Participant contributions at end of year	2022-12-31	$224,353
Participant contributions at beginning of year	2022-12-31	$153,620
Participant contributions at end of year	2022-12-31	$7,451
Participant contributions at beginning of year	2022-12-31	$4,808
Assets. Other investments not covered elsewhere at end of year	2022-12-31	$19,312,756
Assets. Other investments not covered elsewhere at beginning of year	2022-12-31	$21,560,674
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$75,814
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2022-12-31	$26,000
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2022-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$-2,660,098
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$26,782,607
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$29,442,705
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	$163,867
Value of interest in pooled separate accounts at end of year	2022-12-31	$6,696,074
Value of interest in pooled separate accounts at beginning of year	2022-12-31	$7,228,769
Interest on participant loans	2022-12-31	$9,902
Interest earned on other investments	2022-12-31	$4,548
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$456,618
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$375,932
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-3,437,205
Net investment gain/loss from pooled separate accounts	2022-12-31	$-1,288,318
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	$940,989
Employer contributions (assets) at end of year	2022-12-31	$111,355
Employer contributions (assets) at beginning of year	2022-12-31	$118,902
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$263,133
Contract administrator fees	2022-12-31	$7,755
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	Qualified
Accountancy firm name	2022-12-31	VRAKAS, S.C.
Accountancy firm EIN	2022-12-31	391453055
2021 : ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$4,709,324
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$1,269,812
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$1,094,467
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$1,606,202
Value of total assets at end of year	2021-12-31	$29,442,705
Value of total assets at beginning of year	2021-12-31	$26,003,193
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$175,345
Total interest from all sources	2021-12-31	$9,228
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$666,948
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	$666,948
Administrative expenses professional fees incurred	2021-12-31	$2,830
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	Yes
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	$706,313
Participant contributions at end of year	2021-12-31	$153,620
Participant contributions at beginning of year	2021-12-31	$192,630
Participant contributions at end of year	2021-12-31	$4,808
Participant contributions at beginning of year	2021-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2021-12-31	$21,560,674
Assets. Other investments not covered elsewhere at beginning of year	2021-12-31	$17,563,705
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$24,511
Other income not declared elsewhere	2021-12-31	$7,117
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	$3,439,512
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$29,442,705
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$26,003,193
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	$170,720
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$0
Value of interest in pooled separate accounts at end of year	2021-12-31	$7,228,769
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$7,834,528
Interest on participant loans	2021-12-31	$9,228
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$375,932
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$328,456
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$2,419,829
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	$875,378
Employer contributions (assets) at end of year	2021-12-31	$118,902
Employer contributions (assets) at beginning of year	2021-12-31	$83,874
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$1,094,467
Contract administrator fees	2021-12-31	$1,795
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2021-12-31	Yes
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	Qualified
Accountancy firm name	2021-12-31	VRAKAS, S.C.
Accountancy firm EIN	2021-12-31	391453055
2020 : ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN 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	$4,666,720
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$575,110
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$428,334
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$1,528,008
Value of total assets at end of year	2020-12-31	$26,003,193
Value of total assets at beginning of year	2020-12-31	$21,911,583
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$146,776
Total interest from all sources	2020-12-31	$10,070
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
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	$685,292
Participant contributions at end of year	2020-12-31	$192,630
Participant contributions at beginning of year	2020-12-31	$166,177
Participant contributions at end of year	2020-12-31	$0
Participant contributions at beginning of year	2020-12-31	$2,057
Assets. Other investments not covered elsewhere at end of year	2020-12-31	$17,563,705
Assets. Other investments not covered elsewhere at beginning of year	2020-12-31	$14,960,978
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$13,638
Other income not declared elsewhere	2020-12-31	$1,854,688
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	$4,091,610
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$26,003,193
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$21,911,583
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	$141,627
Value of interest in pooled separate accounts at end of year	2020-12-31	$7,834,528
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$6,355,964
Interest on participant loans	2020-12-31	$10,070
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$328,456
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$360,681
Net investment gain/loss from pooled separate accounts	2020-12-31	$1,273,954
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	$829,078
Employer contributions (assets) at end of year	2020-12-31	$83,874
Employer contributions (assets) at beginning of year	2020-12-31	$65,726
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$428,334
Contract administrator fees	2020-12-31	$5,149
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	Qualified
Accountancy firm name	2020-12-31	VRAKAS, S.C.
Accountancy firm EIN	2020-12-31	391453055
2019 : ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN 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	$4,944,373
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$700,180
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$568,300
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$1,438,478
Value of total assets at end of year	2019-12-31	$21,911,583
Value of total assets at beginning of year	2019-12-31	$17,667,390
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$131,880
Total interest from all sources	2019-12-31	$7,607
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
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	$622,700
Participant contributions at end of year	2019-12-31	$166,177
Participant contributions at beginning of year	2019-12-31	$73,401
Participant contributions at end of year	2019-12-31	$2,057
Participant contributions at beginning of year	2019-12-31	$9,924
Assets. Other investments not covered elsewhere at end of year	2019-12-31	$14,960,978
Assets. Other investments not covered elsewhere at beginning of year	2019-12-31	$12,205,568
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$12,331
Other income not declared elsewhere	2019-12-31	$2,325,655
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	$4,244,193
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$21,911,583
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$17,667,390
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	$130,504
Value of interest in pooled separate accounts at end of year	2019-12-31	$6,355,964
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$5,000,881
Interest on participant loans	2019-12-31	$7,607
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$360,681
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$317,518
Net investment gain/loss from pooled separate accounts	2019-12-31	$1,172,633
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	$803,447
Employer contributions (assets) at end of year	2019-12-31	$65,726
Employer contributions (assets) at beginning of year	2019-12-31	$60,098
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$568,300
Contract administrator fees	2019-12-31	$1,376
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	No
Opinion of an independent qualified public accountant for this plan	2019-12-31	Qualified
Accountancy firm name	2019-12-31	VRAKAS, S.C.
Accountancy firm EIN	2019-12-31	391453055
2018 : ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN 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	$140,505
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$313,500
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$194,296
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$1,293,873
Value of total assets at end of year	2018-12-31	$17,667,390
Value of total assets at beginning of year	2018-12-31	$17,840,385
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$119,204
Total interest from all sources	2018-12-31	$3,758
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
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	$557,244
Participant contributions at end of year	2018-12-31	$73,401
Participant contributions at beginning of year	2018-12-31	$70,980
Participant contributions at end of year	2018-12-31	$9,924
Participant contributions at beginning of year	2018-12-31	$4,438
Assets. Other investments not covered elsewhere at end of year	2018-12-31	$12,205,568
Assets. Other investments not covered elsewhere at beginning of year	2018-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$5,150
Other income not declared elsewhere	2018-12-31	$-663,347
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	$-172,995
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$17,667,390
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$17,840,385
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	$117,978
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$11,535,388
Value of interest in pooled separate accounts at end of year	2018-12-31	$5,000,881
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$5,874,544
Interest on participant loans	2018-12-31	$3,758
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$317,518
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$306,132
Net investment gain/loss from pooled separate accounts	2018-12-31	$-493,779
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	$731,479
Employer contributions (assets) at end of year	2018-12-31	$60,098
Employer contributions (assets) at beginning of year	2018-12-31	$48,903
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$194,296
Contract administrator fees	2018-12-31	$1,226
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	No
Opinion of an independent qualified public accountant for this plan	2018-12-31	Qualified
Accountancy firm name	2018-12-31	VRAKAS, S.C.
Accountancy firm EIN	2018-12-31	391453055
2017 : ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN 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	$4,485,022
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$545,463
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$434,328
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$2,429,927
Value of total assets at end of year	2017-12-31	$17,840,385
Value of total assets at beginning of year	2017-12-31	$13,900,826
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$111,135
Total interest from all sources	2017-12-31	$2,453
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
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	$523,477
Participant contributions at end of year	2017-12-31	$70,980
Participant contributions at beginning of year	2017-12-31	$51,664
Participant contributions at end of year	2017-12-31	$4,438
Participant contributions at beginning of year	2017-12-31	$679
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$1,191,586
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	$3,939,559
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$17,840,385
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$13,900,826
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	$108,065
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$11,535,388
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$8,662,496
Value of interest in pooled separate accounts at end of year	2017-12-31	$5,874,544
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$4,883,389
Interest on participant loans	2017-12-31	$2,453
Value of interest in common/collective trusts at end of year	2017-12-31	$0
Value of interest in common/collective trusts at beginning of year	2017-12-31	$247,024
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$306,132
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$1,212,833
Net investment gain/loss from pooled separate accounts	2017-12-31	$838,431
Net investment gain or loss from common/collective trusts	2017-12-31	$1,378
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	$714,864
Employer contributions (assets) at end of year	2017-12-31	$48,903
Employer contributions (assets) at beginning of year	2017-12-31	$55,574
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$434,328
Contract administrator fees	2017-12-31	$3,070
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	No
Opinion of an independent qualified public accountant for this plan	2017-12-31	Unqualified
Accountancy firm name	2017-12-31	SCHENCK S.C.
Accountancy firm EIN	2017-12-31	391173131
2016 : ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN 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	$2,299,126
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$1,096,275
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$1,002,133
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$1,243,798
Value of total assets at end of year	2016-12-31	$13,900,826
Value of total assets at beginning of year	2016-12-31	$12,697,975
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$94,142
Total interest from all sources	2016-12-31	$2,639
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
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	$525,372
Participant contributions at end of year	2016-12-31	$51,664
Participant contributions at beginning of year	2016-12-31	$101,040
Participant contributions at end of year	2016-12-31	$679
Participant contributions at beginning of year	2016-12-31	$3,977
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	$1,202,851
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$13,900,826
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$12,697,975
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	$90,207
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$8,662,496
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$7,324,070
Value of interest in pooled separate accounts at end of year	2016-12-31	$4,883,389
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$4,838,851
Interest on participant loans	2016-12-31	$2,639
Value of interest in common/collective trusts at end of year	2016-12-31	$247,024
Value of interest in common/collective trusts at beginning of year	2016-12-31	$347,628
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$686,264
Net investment gain/loss from pooled separate accounts	2016-12-31	$364,597
Net investment gain or loss from common/collective trusts	2016-12-31	$1,828
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	$718,426
Employer contributions (assets) at end of year	2016-12-31	$55,574
Employer contributions (assets) at beginning of year	2016-12-31	$82,409
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$1,002,133
Contract administrator fees	2016-12-31	$3,935
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	No
Opinion of an independent qualified public accountant for this plan	2016-12-31	Unqualified
Accountancy firm name	2016-12-31	WINTER, KLOMAN, MOTER & REPP, S.C.
Accountancy firm EIN	2016-12-31	391275499
2015 : ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN 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	$1,371,223
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$1,573,151
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$1,477,722
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$1,673,054
Value of total assets at end of year	2015-12-31	$12,697,975
Value of total assets at beginning of year	2015-12-31	$12,899,903
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$95,429
Total interest from all sources	2015-12-31	$4,446
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$500,000
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	$646,678
Participant contributions at end of year	2015-12-31	$101,040
Participant contributions at beginning of year	2015-12-31	$99,611
Participant contributions at end of year	2015-12-31	$3,977
Participant contributions at beginning of year	2015-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$118,423
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	$-201,928
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$12,697,975
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$12,899,903
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	$90,081
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$7,324,070
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$8,025,916
Value of interest in pooled separate accounts at end of year	2015-12-31	$4,838,851
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$4,426,093
Interest on participant loans	2015-12-31	$4,446
Value of interest in common/collective trusts at end of year	2015-12-31	$347,628
Value of interest in common/collective trusts at beginning of year	2015-12-31	$293,413
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-184,174
Net investment gain/loss from pooled separate accounts	2015-12-31	$-122,103
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	$907,953
Employer contributions (assets) at end of year	2015-12-31	$82,409
Employer contributions (assets) at beginning of year	2015-12-31	$54,870
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$1,477,722
Contract administrator fees	2015-12-31	$5,348
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	No
Opinion of an independent qualified public accountant for this plan	2015-12-31	Unqualified
Accountancy firm name	2015-12-31	WINTER, KLOMAN, MOTER & REPP, S.C.
Accountancy firm EIN	2015-12-31	391275499
2014 : ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN 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	$2,012,887
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$380,008
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$284,855
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$1,588,825
Value of total assets at end of year	2014-12-31	$12,899,903
Value of total assets at beginning of year	2014-12-31	$11,267,024
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$95,153
Total interest from all sources	2014-12-31	$4,720
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$329,964
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	$329,964
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	$609,940
Participant contributions at end of year	2014-12-31	$99,611
Participant contributions at beginning of year	2014-12-31	$113,448
Participant contributions at end of year	2014-12-31	$0
Participant contributions at beginning of year	2014-12-31	$62
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$80,199
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$1,632,879
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$12,899,903
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$11,267,024
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	$89,790
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$8,025,916
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$6,559,910
Value of interest in pooled separate accounts at end of year	2014-12-31	$4,426,093
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$4,224,839
Interest on participant loans	2014-12-31	$4,720
Value of interest in common/collective trusts at end of year	2014-12-31	$293,413
Value of interest in common/collective trusts at beginning of year	2014-12-31	$311,423
Net investment gain/loss from pooled separate accounts	2014-12-31	$89,378
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	$898,686
Employer contributions (assets) at end of year	2014-12-31	$54,870
Employer contributions (assets) at beginning of year	2014-12-31	$57,342
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$284,855
Contract administrator fees	2014-12-31	$5,363
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	No
Opinion of an independent qualified public accountant for this plan	2014-12-31	Unqualified
Accountancy firm name	2014-12-31	WINTER, KLOMAN, MOTER & REPP, S.C.
Accountancy firm EIN	2014-12-31	391275499
2013 : ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN 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	$2,978,864
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$481,412
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$404,629
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$1,486,304
Value of total assets at end of year	2013-12-31	$11,267,024
Value of total assets at beginning of year	2013-12-31	$8,769,572
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$76,783
Total interest from all sources	2013-12-31	$3,760
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$500,000
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	$584,369
Participant contributions at end of year	2013-12-31	$113,448
Participant contributions at beginning of year	2013-12-31	$68,715
Participant contributions at end of year	2013-12-31	$62
Participant contributions at beginning of year	2013-12-31	$320
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$650
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$2,497,452
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$11,267,024
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$8,769,572
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	$71,404
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$6,559,910
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$5,162,113
Value of interest in pooled separate accounts at end of year	2013-12-31	$4,224,839
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$3,192,187
Interest on participant loans	2013-12-31	$3,752
Interest earned on other investments	2013-12-31	$8
Value of interest in common/collective trusts at end of year	2013-12-31	$311,423
Value of interest in common/collective trusts at beginning of year	2013-12-31	$272,055
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$1,052,017
Net investment gain/loss from pooled separate accounts	2013-12-31	$435,311
Net investment gain or loss from common/collective trusts	2013-12-31	$1,472
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	$901,285
Employer contributions (assets) at end of year	2013-12-31	$57,342
Employer contributions (assets) at beginning of year	2013-12-31	$74,182
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$404,629
Contract administrator fees	2013-12-31	$5,379
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	No
Opinion of an independent qualified public accountant for this plan	2013-12-31	Unqualified
Accountancy firm name	2013-12-31	WINTER, KLOMAN, MOTER & REPP, S.C.
Accountancy firm EIN	2013-12-31	391275499
2012 : ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN 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	$2,144,688
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$1,157,726
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$1,093,534
Value of total corrective distributions	2012-12-31	$627
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$1,376,694
Value of total assets at end of year	2012-12-31	$8,769,572
Value of total assets at beginning of year	2012-12-31	$7,782,610
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$63,565
Total interest from all sources	2012-12-31	$2,163
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
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	$518,875
Participant contributions at end of year	2012-12-31	$68,715
Participant contributions at beginning of year	2012-12-31	$49,089
Participant contributions at end of year	2012-12-31	$320
Participant contributions at beginning of year	2012-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$11,532
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	$986,962
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$8,769,572
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$7,782,610
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	$60,412
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$5,162,113
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$4,128,547
Value of interest in pooled separate accounts at end of year	2012-12-31	$3,192,187
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$3,313,666
Interest on participant loans	2012-12-31	$2,163
Value of interest in common/collective trusts at end of year	2012-12-31	$272,055
Value of interest in common/collective trusts at beginning of year	2012-12-31	$235,313
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$484,060
Net investment gain/loss from pooled separate accounts	2012-12-31	$280,360
Net investment gain or loss from common/collective trusts	2012-12-31	$1,411
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	$846,287
Employer contributions (assets) at end of year	2012-12-31	$74,182
Employer contributions (assets) at beginning of year	2012-12-31	$55,995
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$1,093,534
Contract administrator fees	2012-12-31	$3,153
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	No
Opinion of an independent qualified public accountant for this plan	2012-12-31	Unqualified
Accountancy firm name	2012-12-31	WINTER, KLOMAN, MOTER & REPP, S.C.
Accountancy firm EIN	2012-12-31	391275499
2011 : ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$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	$809,441
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$69,685
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$13,815
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$1,191,683
Value of total assets at end of year	2011-12-31	$7,782,610
Value of total assets at beginning of year	2011-12-31	$7,042,854
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$55,870
Total interest from all sources	2011-12-31	$1,793
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
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	Yes
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	$441,867
Participant contributions at end of year	2011-12-31	$49,089
Participant contributions at beginning of year	2011-12-31	$22,240
Participant contributions at end of year	2011-12-31	$0
Participant contributions at beginning of year	2011-12-31	$705
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$2,445
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	$739,756
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$7,782,610
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$7,042,854
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
Investment advisory and management fees	2011-12-31	$51,273
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$4,128,547
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$7,005,323
Value of interest in pooled separate accounts at end of year	2011-12-31	$3,313,666
Interest on participant loans	2011-12-31	$1,793
Value of interest in common/collective trusts at end of year	2011-12-31	$235,313
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-269,494
Net investment gain/loss from pooled separate accounts	2011-12-31	$-114,541
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	$747,371
Employer contributions (assets) at end of year	2011-12-31	$55,995
Employer contributions (assets) at beginning of year	2011-12-31	$14,586
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$13,815
Contract administrator fees	2011-12-31	$4,597
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2011-12-31	Yes
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	No
Opinion of an independent qualified public accountant for this plan	2011-12-31	Unqualified
Accountancy firm name	2011-12-31	WINTER, KLOMAN, MOTER & REPP, S.C.
Accountancy firm EIN	2011-12-31	391275499

Form 5500 Responses for ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN

2022: ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: ORTHOPEDIC SURGEONS OF WISCONSIN, S.C. RETIREMENT PLAN 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

Insurance Providers Used on plan

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

81H811

Policy instance

Insurance contract or identification number	81H811
Number of Individuals Covered	117
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

METLIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60992 )

Policy contract number

3203489487

Policy instance

Insurance contract or identification number	3203489487
Number of Individuals Covered	0
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Are there contracts with allocated funds for individual policies?	1
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?	Yes

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

81H811

Policy instance

Insurance contract or identification number	81H811
Number of Individuals Covered	109
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

METLIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60992 )

Policy contract number

3203489487

Policy instance

Insurance contract or identification number	3203489487
Number of Individuals Covered	1
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Are there contracts with allocated funds for individual policies?	1
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?	Yes

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

801828-000

Policy instance

Insurance contract or identification number	801828-000
Number of Individuals Covered	0
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $2,776
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
Amount paid for insurance broker fees	2776
Additional information about fees paid to insurance broker	TPA FEES
Insurance broker organization code?	5

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

801828-000

Policy instance

Insurance contract or identification number	801828-000
Number of Individuals Covered	116
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $3,409
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
Amount paid for insurance broker fees	3409
Additional information about fees paid to insurance broker	TPA FEES
Insurance broker organization code?	5

METLIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60992 )

Policy contract number

3203489487

Policy instance

Insurance contract or identification number	3203489487
Number of Individuals Covered	1
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Are there contracts with allocated funds for individual policies?	1
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?	Yes

METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )

Policy contract number

3203489487

Policy instance

Insurance contract or identification number	3203489487
Number of Individuals Covered	1
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Are there contracts with allocated funds for individual policies?	1
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?	Yes

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

801828-000

Policy instance

Insurance contract or identification number	801828-000
Number of Individuals Covered	120
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $3,083
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
Amount paid for insurance broker fees	3083
Additional information about fees paid to insurance broker	TPA FEES
Insurance broker organization code?	5

METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )

Policy contract number

3203489487

Policy instance

Insurance contract or identification number	3203489487
Number of Individuals Covered	1
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Are there contracts with allocated funds for individual policies?	1
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?	Yes

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

801828-000

Policy instance

Insurance contract or identification number	801828-000
Number of Individuals Covered	119
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $2,822
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
Amount paid for insurance broker fees	2822
Additional information about fees paid to insurance broker	TPA FEES
Insurance broker organization code?	5

METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )

Policy contract number

3203489487

Policy instance

Insurance contract or identification number	3203489487
Number of Individuals Covered	1
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Are there contracts with allocated funds for individual policies?	1
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?	Yes
Insurance broker name	INFORMATION NOT PROVIDED

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

801828-000

Policy instance

Insurance contract or identification number	801828-000
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 $0
Total amount of fees paid to insurance company	USD $2,683
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
Amount paid for insurance broker fees	2683
Additional information about fees paid to insurance broker	TPA FEES
Insurance broker organization code?	5
Insurance broker name	SIKICH LLP

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

801828-000

Policy instance

Insurance contract or identification number	801828-000
Number of Individuals Covered	158
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $2,373
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
Amount paid for insurance broker fees	1820
Additional information about fees paid to insurance broker	TPA FEES
Insurance broker organization code?	5
Insurance broker name	KOLB&COMPANY RETIREMENT PLAN

METLIFE INVESTORS USA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61050 )

Policy contract number

3203489487

Policy instance

Insurance contract or identification number	3203489487
Number of Individuals Covered	1
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Are there contracts with allocated funds for individual policies?	Yes
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?	Yes
Insurance broker name	INFORMATION NOT PROVIDED

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

801828-000

Policy instance

Insurance contract or identification number	801828-000
Number of Individuals Covered	157
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $2,076
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	2076
Additional information about fees paid to insurance broker	TPA FEES
Insurance broker organization code?	5
Insurance broker name	KOLB&COMPANY RETIREMENT PLAN

METLIFE INVESTORS USA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61050 )

Policy contract number

3203489487

Policy instance

Insurance contract or identification number	3203489487
Number of Individuals Covered	1
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?	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?	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?	Yes
Other information about contract	INDIVIDUAL ANNUITY
Insurance broker name	INFORMATION NOT PROVIDED

METLIFE INVESTORS USA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61050 )

Policy contract number

3203489487

Policy instance

Insurance contract or identification number	3203489487
Number of Individuals Covered	1
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?	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?	Yes
Insurance broker name	INFORMATION NOT PROVIDED

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

801828-000

Policy instance

Insurance contract or identification number	801828-000
Number of Individuals Covered	155
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $1,499
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	1499
Additional information about fees paid to insurance broker	TPA FEES
Insurance broker organization code?	5
Insurance broker name	KOLB&COMPANY RETIREMENT PLAN

THE OHIO NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67172 )

Policy contract number

E1824846

Policy instance

Insurance contract or identification number	E1824846
Number of Individuals Covered	1
Insurance policy start date	2013-01-01
Insurance policy end date	2013-06-10
Total amount of commissions paid to insurance broker	USD $552
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?	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?	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
Other information about contract	INDIVIDUAL ANNUITIES
Commission paid to Insurance Broker	USD $552
Insurance broker organization code?	3
Insurance broker name	JEFFREY LABRI

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

306641762

Policy instance

Insurance contract or identification number	306641762
Number of Individuals Covered	0
Insurance policy start date	2013-01-01
Insurance policy end date	2013-10-25
Total amount of commissions paid to insurance broker	USD $1,316
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,316
Insurance broker organization code?	3
Insurance broker name	JEFFREY LA BRI

THE OHIO NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67172 )

Policy contract number

E1838350

Policy instance

Insurance contract or identification number	E1838350
Number of Individuals Covered	0
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $84
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	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 $84
Insurance broker organization code?	3
Insurance broker name	JEFFREY LABRI

METLIFE INVESTORS USA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61050 )

Policy contract number

3203489487

Policy instance

Insurance contract or identification number	3203489487
Number of Individuals Covered	1
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?	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?	Yes
Insurance broker name	INFORMATION NOT PROVIDED

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

801828-000

Policy instance

Insurance contract or identification number	801828-000
Number of Individuals Covered	172
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $1,049
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	1049
Additional information about fees paid to insurance broker	TPA FEES
Insurance broker organization code?	5
Insurance broker name	KOLB&COMPANY RETIREMENT PLAN

THE OHIO NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67172 )

Policy contract number

E1824846

Policy instance

Insurance contract or identification number	E1824846
Number of Individuals Covered	1
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $3,637
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?	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?	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
Other information about contract	INDIVIDUAL ANNUITIES
Commission paid to Insurance Broker	USD $3,637
Insurance broker organization code?	3
Insurance broker name	JEFFREY LABRI

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

306641762

Policy instance

Insurance contract or identification number	306641762
Number of Individuals Covered	1
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $1,312
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,312
Insurance broker organization code?	3
Insurance broker name	JEFFREY LA BRI

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )

Policy contract number

306641762

Policy instance

Insurance contract or identification number	306641762
Number of Individuals Covered	1
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $1,312
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	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 LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

801828

Policy instance

Insurance contract or identification number	801828
Number of Individuals Covered	152
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $14,627
Total amount of fees paid to insurance company	USD $617
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

METLIFE INVESTORS USA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61050 )

Policy contract number

3203489487

Policy instance

Insurance contract or identification number	3203489487
Number of Individuals Covered	1
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	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?	Yes

THE OHIO NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67172 )

Policy contract number

E1824846

Policy instance

Insurance contract or identification number	E1824846
Number of Individuals Covered	2
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $2,454
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?	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?	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
Other information about contract	INDIVIDUAL ANNUITIES

METLIFE INVESTORS USA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61050 )

Policy contract number

3203377062

Policy instance

Insurance contract or identification number	3203377062
Number of Individuals Covered	1
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	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?	Yes

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Company Name:	ORTHOPEDIC SURGEONS OF WISCONSIN, S.C.
Employer identification number (EIN):	200217581
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)