401k Plan data: PATIENT HOME MONITORING 401(K) PLAN plan

PATIENT HOME MONITORING 401(K) PLAN 401k Plan overview

Plan Name	PATIENT HOME MONITORING 401(K) PLAN
Plan identification number	001

PATIENT HOME MONITORING 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

PATIENT HOME MONITORING has sponsored the creation of one or more 401k plans.

Company Name: PATIENT HOME MONITORING

Employer identification number (EIN): 271139562

NAIC Classification: 621610
NAIC Description: Home Health Care Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PATIENT HOME MONITORING 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2018-01-01
001 2017-01-01 KIMBERLY CHILDERS
001 2016-01-01 CHRIS WEEKS
001 2015-01-01 JOHN WEEKS 2017-01-23
001 2014-01-01 HECTOR RIVERA 2015-09-23
001 2013-01-01 HECTOR RIVERA 2014-08-28
001 2012-01-01 HECTOR RIVERA 2014-08-28

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2018-01-01
001	2017-01-01	KIMBERLY CHILDERS
001	2016-01-01	CHRIS WEEKS
001	2015-01-01	JOHN WEEKS	2017-01-23
001	2014-01-01	HECTOR RIVERA	2015-09-23
001	2013-01-01	HECTOR RIVERA	2014-08-28
001	2012-01-01	HECTOR RIVERA	2014-08-28

Plan Statistics for PATIENT HOME MONITORING 401(K) PLAN

401k plan membership statisitcs for PATIENT HOME MONITORING 401(K) PLAN

Measure Date Value
2018: PATIENT HOME MONITORING 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 443
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 374
Number of retired or separated participants receiving benefits 2018-01-01 5
Number of other retired or separated participants entitled to future benefits 2018-01-01 22
Total of all active and inactive participants 2018-01-01 401
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 401
Number of participants with account balances 2018-01-01 147
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 1
2017: PATIENT HOME MONITORING 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 392
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 351
Number of retired or separated participants receiving benefits 2017-01-01 3
Number of other retired or separated participants entitled to future benefits 2017-01-01 25
Total of all active and inactive participants 2017-01-01 379
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 379
Number of participants with account balances 2017-01-01 237
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 2
2016: PATIENT HOME MONITORING 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 250
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 207
Number of retired or separated participants receiving benefits 2016-01-01 3
Number of other retired or separated participants entitled to future benefits 2016-01-01 48
Total of all active and inactive participants 2016-01-01 258
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 258
Number of participants with account balances 2016-01-01 258
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 3

Measure	Date	Value
2018: PATIENT HOME MONITORING 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	443
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	374
Number of retired or separated participants receiving benefits	2018-01-01	5
Number of other retired or separated participants entitled to future benefits	2018-01-01	22
Total of all active and inactive participants	2018-01-01	401
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	401
Number of participants with account balances	2018-01-01	147
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	1
2017: PATIENT HOME MONITORING 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	392
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	351
Number of retired or separated participants receiving benefits	2017-01-01	3
Number of other retired or separated participants entitled to future benefits	2017-01-01	25
Total of all active and inactive participants	2017-01-01	379
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	379
Number of participants with account balances	2017-01-01	237
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	2
2016: PATIENT HOME MONITORING 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	250
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	207
Number of retired or separated participants receiving benefits	2016-01-01	3
Number of other retired or separated participants entitled to future benefits	2016-01-01	48
Total of all active and inactive participants	2016-01-01	258
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	258
Number of participants with account balances	2016-01-01	258
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	3

Financial Data on PATIENT HOME MONITORING 401(K) PLAN

Measure	Date	Value
2018 : PATIENT HOME MONITORING 401(K) PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total transfer of assets from this plan	2018-12-31	$2,902,108
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	$493,561
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$180,128
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$167,656
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$658,245
Value of total assets at end of year	2018-12-31	$2,151,202
Value of total assets at beginning of year	2018-12-31	$4,739,877
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$12,472
Total interest from all sources	2018-12-31	$1,427
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$0
Was this plan covered by a fidelity bond	2018-12-31	No
If this is an individual account plan, was there a blackout period	2018-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$359,443
Participant contributions at end of year	2018-12-31	$35,458
Participant contributions at beginning of year	2018-12-31	$99,129
Participant contributions at end of year	2018-12-31	$18,663
Participant contributions at beginning of year	2018-12-31	$12,587
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$57,902
Total non interest bearing cash at end of year	2018-12-31	$975
Total non interest bearing cash at beginning of year	2018-12-31	$1,239
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	$313,433
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$2,151,202
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$4,739,877
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$2,061,309
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$4,576,473
Interest on participant loans	2018-12-31	$1,419
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2018-12-31	$8
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$23,634
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$42,536
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-166,111
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	Yes
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	$240,900
Employer contributions (assets) at end of year	2018-12-31	$11,163
Employer contributions (assets) at beginning of year	2018-12-31	$7,913
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$167,656
Contract administrator fees	2018-12-31	$12,472
Did the plan have assets held for investment	2018-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	BARNES DENNIG & CO LTD
Accountancy firm EIN	2018-12-31	311119890
2017 : PATIENT HOME MONITORING 401(K) PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total transfer of assets to this plan	2017-12-31	$460,560
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	$1,978,857
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$871,740
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$852,286
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$1,407,720
Value of total assets at end of year	2017-12-31	$4,739,877
Value of total assets at beginning of year	2017-12-31	$3,172,200
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$19,454
Total interest from all sources	2017-12-31	$3,380
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
Was this plan covered by a fidelity bond	2017-12-31	No
If this is an individual account plan, was there a blackout period	2017-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$647,593
Participant contributions at end of year	2017-12-31	$99,129
Participant contributions at beginning of year	2017-12-31	$69,592
Participant contributions at end of year	2017-12-31	$12,587
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$330,561
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2017-12-31	$7,387
Total non interest bearing cash at end of year	2017-12-31	$1,239
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	$1,107,117
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$4,739,877
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$3,172,200
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$4,576,473
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$3,069,611
Interest on participant loans	2017-12-31	$3,374
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2017-12-31	$6
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$42,536
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$25,610
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$567,757
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	$429,566
Employer contributions (assets) at end of year	2017-12-31	$7,913
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$852,286
Contract administrator fees	2017-12-31	$19,454
Did the plan have assets held for investment	2017-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	DARNALL, SIKES, & FREDERICK
Accountancy firm EIN	2017-12-31	720738838
2016 : PATIENT HOME MONITORING 401(K) PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total transfer of assets to this plan	2016-12-31	$1,928,711
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	$1,651,281
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$415,179
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$405,239
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$1,373,522
Value of total assets at end of year	2016-12-31	$3,172,200
Value of total assets at beginning of year	2016-12-31	$7,387
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$9,940
Total interest from all sources	2016-12-31	$2,655
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Was this plan covered by a fidelity bond	2016-12-31	No
If this is an individual account plan, was there a blackout period	2016-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$660,063
Participant contributions at end of year	2016-12-31	$69,592
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$251,976
Value of other receiveables (less allowance for doubtful accounts) at end of year	2016-12-31	$7,387
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	$1,236,102
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$3,172,200
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$7,387
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$3,069,611
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$7,387
Interest on participant loans	2016-12-31	$2,652
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2016-12-31	$3
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$25,610
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$275,104
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	$461,483
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$405,239
Contract administrator fees	2016-12-31	$9,940
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	DARNALL, SIKES, GARDES, & FREDERICK
Accountancy firm EIN	2016-12-31	720738838

Form 5500 Responses for PATIENT HOME MONITORING 401(K) PLAN

2018: PATIENT HOME MONITORING 401(K) 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 – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: PATIENT HOME MONITORING 401(K) PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: PATIENT HOME MONITORING 401(K) PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

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

Policy contract number

806690-000

Policy instance

Insurance contract or identification number	806690-000
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $7,688
Total amount of fees paid to insurance company	USD $1,290
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
Commission paid to Insurance Broker	USD $4,821
Insurance broker organization code?	3
Amount paid for insurance broker fees	1290
Additional information about fees paid to insurance broker	TPA FEES

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

Policy contract number

806690-000

Policy instance

Insurance contract or identification number	806690-000
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $11,464
Total amount of fees paid to insurance company	USD $1,924
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
Commission paid to Insurance Broker	USD $11,464
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Additional information about fees paid to insurance broker	TPA FEES
Insurance broker name	RETIREMENT STRATEGIES GROUP

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Company Name:	PATIENT HOME MONITORING
Employer identification number (EIN):	271139562
NAIC Classification:	621610
NAIC Description:	Home Health Care Services