401k Plan data: CHILDREN'S HEALTH CENTER, LLC CASH BALANCE PLAN plan

CHILDREN'S HEALTH CENTER, LLC CASH BALANCE PLAN 401k Plan overview

Plan Name	CHILDREN'S HEALTH CENTER, LLC CASH BALANCE PLAN
Plan identification number	002

CHILDREN'S HEALTH CENTER, LLC CASH BALANCE PLAN Benefits

401k Plan Type

Defined Benefit Pension

Plan Features/Benefits

Benefits are primarily flat dollar (includes dollars per year of service)
Cash balance or similar plan - Plan has a "cash balance" formula. For this purpose, a "cash balance" formula is a benefit formula in a defined benefit plan by whatever name (for example, personal account plan, pension equity plan, life cycle plan, cash account plan, etc.) that rather than, or in addition to, expressing the accrued benefit as a life annuity commencing at normal retirement age, defines benefits for each employee in terms more common to a defined contribution plan such as a single sum distribution amount (for example, 10 percent of final average pay times years of service, or the amount of the employee's hypothetical account balance).
Plan covering Self-Employed individuals.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

CHILDREN'S HEALTH CENTER, LLC has sponsored the creation of one or more 401k plans.

Company Name: CHILDREN'S HEALTH CENTER, LLC

Employer identification number (EIN): 300404864

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CHILDREN'S HEALTH CENTER, LLC CASH BALANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2022-01-01 NANCY DENICOLA 2023-05-11
002 2021-01-01 NANCY DENICOLA 2022-06-08
002 2020-01-01
002 2019-01-01
002 2018-01-01
002 2017-01-01 NANCY DENICOLA

Plan Statistics for CHILDREN'S HEALTH CENTER, LLC CASH BALANCE PLAN

401k plan membership statisitcs for CHILDREN'S HEALTH CENTER, LLC CASH BALANCE PLAN

Measure Date Value
2022: CHILDREN'S HEALTH CENTER, LLC CASH BALANCE PLAN 2022 401k membership
Market value of plan assets 2022-12-31 337,860
Acturial value of plan assets 2022-12-31 337,860
Funding target for retired participants and beneficiaries receiving payment 2022-12-31 0
Number of terminated vested participants 2022-12-31 1
Fundng target for terminated vested participants 2022-12-31 799
Active participant vested funding target 2022-12-31 277,975
Number of active participants 2022-12-31 7
Total funding liabilities for active participants 2022-12-31 278,325
Total participant count 2022-12-31 8
Total funding target for all participants 2022-12-31 279,124
Balance at beginning of prior year after applicable adjustments 2022-12-31 0
Prefunding balance at beginning of prior year after applicable adjustments 2022-12-31 7,018
Carryover balanced portion elected for use to offset prior years funding requirement 2022-12-31 0
Prefunding balanced used to offset prior years funding requirement 2022-12-31 0
Amount remaining of carryover balance 2022-12-31 0
Amount remaining of prefunding balance 2022-12-31 7,018
Present value of excess contributions 2022-12-31 8,073
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance 2022-12-31 8,462
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance 2022-12-31 8,462
Reductions in caryover balances due to elections or deemed elections 2022-12-31 0
Reductions in prefunding balances due to elections or deemed elections 2022-12-31 0
Balance of carryovers at beginning of current year 2022-12-31 0
Balance of prefunding at beginning of current year 2022-12-31 16,803
Total employer contributions 2022-12-31 54,508
Total employee contributions 2022-12-31 0
Contributions allocated toward unpaid minimum require contributions from prior years 2022-12-31 0
Contributions made to avoid restrictions adjusted to valuation date 2022-12-31 0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date 2022-12-31 51,065
Unpaid minimum required contributions for all prior years 2022-12-31 0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years 2022-12-31 0
Remaining amount of unpaid minimum required contributions 2022-12-31 0
Minimum required contributions for current year target normal cost 2022-12-31 50,317
Net shortfall amortization installment of oustanding balance 2022-12-31 0
Waiver amortization installment 2022-12-31 0
Total funding amount beforereflecting carryover/prefunding balances 2022-12-31 8,384
Carryover balance elected to use to offset funding requirement 2022-12-31 0
Prefunding balance elected to use to offset funding requirement 2022-12-31 0
Additional cash requirement 2022-12-31 8,384
Contributions allocatedtoward minimum required contributions for current year 2022-12-31 51,065
Unpaid minimum required contributions for current year 2022-12-31 0
Unpaid minimum required contributions for all years 2022-12-31 0
2021: CHILDREN'S HEALTH CENTER, LLC CASH BALANCE PLAN 2021 401k membership
Market value of plan assets 2021-12-31 240,301
Acturial value of plan assets 2021-12-31 240,301
Funding target for retired participants and beneficiaries receiving payment 2021-12-31 0
Number of terminated vested participants 2021-12-31 1
Fundng target for terminated vested participants 2021-12-31 887
Active participant vested funding target 2021-12-31 220,746
Number of active participants 2021-12-31 5
Total funding liabilities for active participants 2021-12-31 223,952
Total participant count 2021-12-31 6
Total funding target for all participants 2021-12-31 224,839
Balance at beginning of prior year after applicable adjustments 2021-12-31 0
Prefunding balance at beginning of prior year after applicable adjustments 2021-12-31 5,211
Carryover balanced portion elected for use to offset prior years funding requirement 2021-12-31 0
Prefunding balanced used to offset prior years funding requirement 2021-12-31 0
Amount remaining of carryover balance 2021-12-31 0
Amount remaining of prefunding balance 2021-12-31 5,211
Present value of excess contributions 2021-12-31 830
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance 2021-12-31 873
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance 2021-12-31 873
Reductions in caryover balances due to elections or deemed elections 2021-12-31 0
Reductions in prefunding balances due to elections or deemed elections 2021-12-31 0
Balance of carryovers at beginning of current year 2021-12-31 0
Balance of prefunding at beginning of current year 2021-12-31 7,018
Total employer contributions 2021-12-31 54,825
Total employee contributions 2021-12-31 0
Contributions allocated toward unpaid minimum require contributions from prior years 2021-12-31 0
Contributions made to avoid restrictions adjusted to valuation date 2021-12-31 0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date 2021-12-31 51,604
Unpaid minimum required contributions for all prior years 2021-12-31 0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years 2021-12-31 0
Remaining amount of unpaid minimum required contributions 2021-12-31 0
Minimum required contributions for current year target normal cost 2021-12-31 51,975
Net shortfall amortization installment of oustanding balance 2021-12-31 0
Waiver amortization installment 2021-12-31 0
Total funding amount beforereflecting carryover/prefunding balances 2021-12-31 43,531
Carryover balance elected to use to offset funding requirement 2021-12-31 0
Prefunding balance elected to use to offset funding requirement 2021-12-31 0
Additional cash requirement 2021-12-31 43,531
Contributions allocatedtoward minimum required contributions for current year 2021-12-31 51,604
Unpaid minimum required contributions for current year 2021-12-31 0
Unpaid minimum required contributions for all years 2021-12-31 0
2020: CHILDREN'S HEALTH CENTER, LLC CASH BALANCE PLAN 2020 401k membership
Market value of plan assets 2020-12-31 164,057
Acturial value of plan assets 2020-12-31 164,057
Funding target for retired participants and beneficiaries receiving payment 2020-12-31 0
Number of terminated vested participants 2020-12-31 0
Fundng target for terminated vested participants 2020-12-31 0
Active participant vested funding target 2020-12-31 154,049
Number of active participants 2020-12-31 7
Total funding liabilities for active participants 2020-12-31 154,049
Total participant count 2020-12-31 7
Total funding target for all participants 2020-12-31 154,049
Balance at beginning of prior year after applicable adjustments 2020-12-31 0
Prefunding balance at beginning of prior year after applicable adjustments 2020-12-31 5,650
Carryover balanced portion elected for use to offset prior years funding requirement 2020-12-31 0
Prefunding balanced used to offset prior years funding requirement 2020-12-31 1,565
Amount remaining of carryover balance 2020-12-31 0
Amount remaining of prefunding balance 2020-12-31 4,085
Present value of excess contributions 2020-12-31 0
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance 2020-12-31 0
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance 2020-12-31 0
Reductions in caryover balances due to elections or deemed elections 2020-12-31 0
Reductions in prefunding balances due to elections or deemed elections 2020-12-31 0
Balance of carryovers at beginning of current year 2020-12-31 0
Balance of prefunding at beginning of current year 2020-12-31 5,211
Total employer contributions 2020-12-31 50,000
Total employee contributions 2020-12-31 0
Contributions allocated toward unpaid minimum require contributions from prior years 2020-12-31 0
Contributions made to avoid restrictions adjusted to valuation date 2020-12-31 0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date 2020-12-31 46,351
Unpaid minimum required contributions for all prior years 2020-12-31 0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years 2020-12-31 0
Remaining amount of unpaid minimum required contributions 2020-12-31 0
Minimum required contributions for current year target normal cost 2020-12-31 50,318
Net shortfall amortization installment of oustanding balance 2020-12-31 0
Waiver amortization installment 2020-12-31 0
Total funding amount beforereflecting carryover/prefunding balances 2020-12-31 45,521
Carryover balance elected to use to offset funding requirement 2020-12-31 0
Prefunding balance elected to use to offset funding requirement 2020-12-31 0
Additional cash requirement 2020-12-31 45,521
Contributions allocatedtoward minimum required contributions for current year 2020-12-31 46,351
Unpaid minimum required contributions for current year 2020-12-31 0
Unpaid minimum required contributions for all years 2020-12-31 0
Total participants, beginning-of-year 2020-01-01 2
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 4
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 1
Total of all active and inactive participants 2020-01-01 5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 1
2019: CHILDREN'S HEALTH CENTER, LLC CASH BALANCE PLAN 2019 401k membership
Market value of plan assets 2019-12-31 95,590
Acturial value of plan assets 2019-12-31 95,590
Funding target for retired participants and beneficiaries receiving payment 2019-12-31 0
Number of terminated vested participants 2019-12-31 0
Fundng target for terminated vested participants 2019-12-31 0
Active participant vested funding target 2019-12-31 0
Number of active participants 2019-12-31 6
Total funding liabilities for active participants 2019-12-31 98,098
Total participant count 2019-12-31 6
Total funding target for all participants 2019-12-31 98,098
Balance at beginning of prior year after applicable adjustments 2019-12-31 0
Prefunding balance at beginning of prior year after applicable adjustments 2019-12-31 3,310
Carryover balanced portion elected for use to offset prior years funding requirement 2019-12-31 0
Prefunding balanced used to offset prior years funding requirement 2019-12-31 0
Amount remaining of carryover balance 2019-12-31 0
Amount remaining of prefunding balance 2019-12-31 3,310
Present value of excess contributions 2019-12-31 2,510
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance 2019-12-31 2,649
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance 2019-12-31 2,649
Reductions in caryover balances due to elections or deemed elections 2019-12-31 0
Reductions in prefunding balances due to elections or deemed elections 2019-12-31 0
Balance of carryovers at beginning of current year 2019-12-31 0
Balance of prefunding at beginning of current year 2019-12-31 5,650
Total employer contributions 2019-12-31 50,000
Total employee contributions 2019-12-31 0
Contributions allocated toward unpaid minimum require contributions from prior years 2019-12-31 0
Contributions made to avoid restrictions adjusted to valuation date 2019-12-31 0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date 2019-12-31 46,442
Unpaid minimum required contributions for all prior years 2019-12-31 0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years 2019-12-31 0
Remaining amount of unpaid minimum required contributions 2019-12-31 0
Minimum required contributions for current year target normal cost 2019-12-31 46,681
Net shortfall amortization installment of oustanding balance 2019-12-31 8,158
Waiver amortization installment 2019-12-31 0
Total funding amount beforereflecting carryover/prefunding balances 2019-12-31 48,007
Carryover balance elected to use to offset funding requirement 2019-12-31 0
Prefunding balance elected to use to offset funding requirement 2019-12-31 1,565
Additional cash requirement 2019-12-31 46,442
Contributions allocatedtoward minimum required contributions for current year 2019-12-31 46,442
Unpaid minimum required contributions for current year 2019-12-31 0
Unpaid minimum required contributions for all years 2019-12-31 0
Total participants, beginning-of-year 2019-01-01 5
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 2
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 0
Total of all active and inactive participants 2019-01-01 2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: CHILDREN'S HEALTH CENTER, LLC CASH BALANCE PLAN 2018 401k membership
Market value of plan assets 2018-12-31 51,406
Acturial value of plan assets 2018-12-31 51,406
Funding target for retired participants and beneficiaries receiving payment 2018-12-31 0
Number of terminated vested participants 2018-12-31 0
Fundng target for terminated vested participants 2018-12-31 0
Active participant vested funding target 2018-12-31 0
Number of active participants 2018-12-31 6
Total funding liabilities for active participants 2018-12-31 47,021
Total participant count 2018-12-31 6
Total funding target for all participants 2018-12-31 47,021
Balance at beginning of prior year after applicable adjustments 2018-12-31 0
Prefunding balance at beginning of prior year after applicable adjustments 2018-12-31 0
Carryover balanced portion elected for use to offset prior years funding requirement 2018-12-31 0
Prefunding balanced used to offset prior years funding requirement 2018-12-31 0
Amount remaining of carryover balance 2018-12-31 0
Amount remaining of prefunding balance 2018-12-31 0
Present value of excess contributions 2018-12-31 3,130
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance 2018-12-31 3,310
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance 2018-12-31 3,310
Reductions in caryover balances due to elections or deemed elections 2018-12-31 0
Reductions in prefunding balances due to elections or deemed elections 2018-12-31 0
Balance of carryovers at beginning of current year 2018-12-31 0
Balance of prefunding at beginning of current year 2018-12-31 3,310
Total employer contributions 2018-12-31 50,800
Total employee contributions 2018-12-31 0
Contributions allocated toward unpaid minimum require contributions from prior years 2018-12-31 0
Contributions made to avoid restrictions adjusted to valuation date 2018-12-31 0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date 2018-12-31 46,527
Unpaid minimum required contributions for all prior years 2018-12-31 0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years 2018-12-31 0
Remaining amount of unpaid minimum required contributions 2018-12-31 0
Minimum required contributions for current year target normal cost 2018-12-31 45,092
Net shortfall amortization installment of oustanding balance 2018-12-31 0
Waiver amortization installment 2018-12-31 0
Total funding amount beforereflecting carryover/prefunding balances 2018-12-31 44,017
Additional cash requirement 2018-12-31 44,017
Contributions allocatedtoward minimum required contributions for current year 2018-12-31 46,527
Unpaid minimum required contributions for current year 2018-12-31 0
Unpaid minimum required contributions for all years 2018-12-31 0
Total participants, beginning-of-year 2018-01-01 4
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 2
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 0
Total of all active and inactive participants 2018-01-01 2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 2
2017: CHILDREN'S HEALTH CENTER, LLC CASH BALANCE PLAN 2017 401k membership
Market value of plan assets 2017-12-31 0
Acturial value of plan assets 2017-12-31 0
Funding target for retired participants and beneficiaries receiving payment 2017-12-31 0
Number of terminated vested participants 2017-12-31 0
Fundng target for terminated vested participants 2017-12-31 0
Active participant vested funding target 2017-12-31 0
Number of active participants 2017-12-31 7
Total funding liabilities for active participants 2017-12-31 0
Total participant count 2017-12-31 7
Total funding target for all participants 2017-12-31 0
Balance at beginning of prior year after applicable adjustments 2017-12-31 0
Prefunding balance at beginning of prior year after applicable adjustments 2017-12-31 0
Carryover balanced portion elected for use to offset prior years funding requirement 2017-12-31 0
Prefunding balanced used to offset prior years funding requirement 2017-12-31 0
Amount remaining of carryover balance 2017-12-31 0
Amount remaining of prefunding balance 2017-12-31 0
Present value of excess contributions 2017-12-31 0
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance 2017-12-31 0
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance 2017-12-31 0
Reductions in caryover balances due to elections or deemed elections 2017-12-31 0
Reductions in prefunding balances due to elections or deemed elections 2017-12-31 0
Balance of carryovers at beginning of current year 2017-12-31 0
Balance of prefunding at beginning of current year 2017-12-31 0
Total employer contributions 2017-12-31 50,000
Total employee contributions 2017-12-31 0
Contributions allocated toward unpaid minimum require contributions from prior years 2017-12-31 0
Contributions made to avoid restrictions adjusted to valuation date 2017-12-31 0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date 2017-12-31 47,746
Unpaid minimum required contributions for all prior years 2017-12-31 0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years 2017-12-31 0
Remaining amount of unpaid minimum required contributions 2017-12-31 0
Minimum required contributions for current year target normal cost 2017-12-31 44,616
Net shortfall amortization installment of oustanding balance 2017-12-31 0
Waiver amortization installment 2017-12-31 0
Total funding amount beforereflecting carryover/prefunding balances 2017-12-31 44,616
Carryover balance elected to use to offset funding requirement 2017-12-31 0
Prefunding balance elected to use to offset funding requirement 2017-12-31 0
Additional cash requirement 2017-12-31 44,616
Contributions allocatedtoward minimum required contributions for current year 2017-12-31 47,746
Unpaid minimum required contributions for current year 2017-12-31 0
Unpaid minimum required contributions for all years 2017-12-31 0
Total participants, beginning-of-year 2017-01-01 7
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 5
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 0
Total of all active and inactive participants 2017-01-01 5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0

Measure	Date	Value
2022: CHILDREN'S HEALTH CENTER, LLC CASH BALANCE PLAN 2022 401k membership
Market value of plan assets	2022-12-31	337,860
Acturial value of plan assets	2022-12-31	337,860
Funding target for retired participants and beneficiaries receiving payment	2022-12-31	0
Number of terminated vested participants	2022-12-31	1
Fundng target for terminated vested participants	2022-12-31	799
Active participant vested funding target	2022-12-31	277,975
Number of active participants	2022-12-31	7
Total funding liabilities for active participants	2022-12-31	278,325
Total participant count	2022-12-31	8
Total funding target for all participants	2022-12-31	279,124
Balance at beginning of prior year after applicable adjustments	2022-12-31	0
Prefunding balance at beginning of prior year after applicable adjustments	2022-12-31	7,018
Carryover balanced portion elected for use to offset prior years funding requirement	2022-12-31	0
Prefunding balanced used to offset prior years funding requirement	2022-12-31	0
Amount remaining of carryover balance	2022-12-31	0
Amount remaining of prefunding balance	2022-12-31	7,018
Present value of excess contributions	2022-12-31	8,073
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance	2022-12-31	8,462
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance	2022-12-31	8,462
Reductions in caryover balances due to elections or deemed elections	2022-12-31	0
Reductions in prefunding balances due to elections or deemed elections	2022-12-31	0
Balance of carryovers at beginning of current year	2022-12-31	0
Balance of prefunding at beginning of current year	2022-12-31	16,803
Total employer contributions	2022-12-31	54,508
Total employee contributions	2022-12-31	0
Contributions allocated toward unpaid minimum require contributions from prior years	2022-12-31	0
Contributions made to avoid restrictions adjusted to valuation date	2022-12-31	0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date	2022-12-31	51,065
Unpaid minimum required contributions for all prior years	2022-12-31	0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years	2022-12-31	0
Remaining amount of unpaid minimum required contributions	2022-12-31	0
Minimum required contributions for current year target normal cost	2022-12-31	50,317
Net shortfall amortization installment of oustanding balance	2022-12-31	0
Waiver amortization installment	2022-12-31	0
Total funding amount beforereflecting carryover/prefunding balances	2022-12-31	8,384
Carryover balance elected to use to offset funding requirement	2022-12-31	0
Prefunding balance elected to use to offset funding requirement	2022-12-31	0
Additional cash requirement	2022-12-31	8,384
Contributions allocatedtoward minimum required contributions for current year	2022-12-31	51,065
Unpaid minimum required contributions for current year	2022-12-31	0
Unpaid minimum required contributions for all years	2022-12-31	0
2021: CHILDREN'S HEALTH CENTER, LLC CASH BALANCE PLAN 2021 401k membership
Market value of plan assets	2021-12-31	240,301
Acturial value of plan assets	2021-12-31	240,301
Funding target for retired participants and beneficiaries receiving payment	2021-12-31	0
Number of terminated vested participants	2021-12-31	1
Fundng target for terminated vested participants	2021-12-31	887
Active participant vested funding target	2021-12-31	220,746
Number of active participants	2021-12-31	5
Total funding liabilities for active participants	2021-12-31	223,952
Total participant count	2021-12-31	6
Total funding target for all participants	2021-12-31	224,839
Balance at beginning of prior year after applicable adjustments	2021-12-31	0
Prefunding balance at beginning of prior year after applicable adjustments	2021-12-31	5,211
Carryover balanced portion elected for use to offset prior years funding requirement	2021-12-31	0
Prefunding balanced used to offset prior years funding requirement	2021-12-31	0
Amount remaining of carryover balance	2021-12-31	0
Amount remaining of prefunding balance	2021-12-31	5,211
Present value of excess contributions	2021-12-31	830
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance	2021-12-31	873
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance	2021-12-31	873
Reductions in caryover balances due to elections or deemed elections	2021-12-31	0
Reductions in prefunding balances due to elections or deemed elections	2021-12-31	0
Balance of carryovers at beginning of current year	2021-12-31	0
Balance of prefunding at beginning of current year	2021-12-31	7,018
Total employer contributions	2021-12-31	54,825
Total employee contributions	2021-12-31	0
Contributions allocated toward unpaid minimum require contributions from prior years	2021-12-31	0
Contributions made to avoid restrictions adjusted to valuation date	2021-12-31	0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date	2021-12-31	51,604
Unpaid minimum required contributions for all prior years	2021-12-31	0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years	2021-12-31	0
Remaining amount of unpaid minimum required contributions	2021-12-31	0
Minimum required contributions for current year target normal cost	2021-12-31	51,975
Net shortfall amortization installment of oustanding balance	2021-12-31	0
Waiver amortization installment	2021-12-31	0
Total funding amount beforereflecting carryover/prefunding balances	2021-12-31	43,531
Carryover balance elected to use to offset funding requirement	2021-12-31	0
Prefunding balance elected to use to offset funding requirement	2021-12-31	0
Additional cash requirement	2021-12-31	43,531
Contributions allocatedtoward minimum required contributions for current year	2021-12-31	51,604
Unpaid minimum required contributions for current year	2021-12-31	0
Unpaid minimum required contributions for all years	2021-12-31	0
2020: CHILDREN'S HEALTH CENTER, LLC CASH BALANCE PLAN 2020 401k membership
Market value of plan assets	2020-12-31	164,057
Acturial value of plan assets	2020-12-31	164,057
Funding target for retired participants and beneficiaries receiving payment	2020-12-31	0
Number of terminated vested participants	2020-12-31	0
Fundng target for terminated vested participants	2020-12-31	0
Active participant vested funding target	2020-12-31	154,049
Number of active participants	2020-12-31	7
Total funding liabilities for active participants	2020-12-31	154,049
Total participant count	2020-12-31	7
Total funding target for all participants	2020-12-31	154,049
Balance at beginning of prior year after applicable adjustments	2020-12-31	0
Prefunding balance at beginning of prior year after applicable adjustments	2020-12-31	5,650
Carryover balanced portion elected for use to offset prior years funding requirement	2020-12-31	0
Prefunding balanced used to offset prior years funding requirement	2020-12-31	1,565
Amount remaining of carryover balance	2020-12-31	0
Amount remaining of prefunding balance	2020-12-31	4,085
Present value of excess contributions	2020-12-31	0
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance	2020-12-31	0
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance	2020-12-31	0
Reductions in caryover balances due to elections or deemed elections	2020-12-31	0
Reductions in prefunding balances due to elections or deemed elections	2020-12-31	0
Balance of carryovers at beginning of current year	2020-12-31	0
Balance of prefunding at beginning of current year	2020-12-31	5,211
Total employer contributions	2020-12-31	50,000
Total employee contributions	2020-12-31	0
Contributions allocated toward unpaid minimum require contributions from prior years	2020-12-31	0
Contributions made to avoid restrictions adjusted to valuation date	2020-12-31	0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date	2020-12-31	46,351
Unpaid minimum required contributions for all prior years	2020-12-31	0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years	2020-12-31	0
Remaining amount of unpaid minimum required contributions	2020-12-31	0
Minimum required contributions for current year target normal cost	2020-12-31	50,318
Net shortfall amortization installment of oustanding balance	2020-12-31	0
Waiver amortization installment	2020-12-31	0
Total funding amount beforereflecting carryover/prefunding balances	2020-12-31	45,521
Carryover balance elected to use to offset funding requirement	2020-12-31	0
Prefunding balance elected to use to offset funding requirement	2020-12-31	0
Additional cash requirement	2020-12-31	45,521
Contributions allocatedtoward minimum required contributions for current year	2020-12-31	46,351
Unpaid minimum required contributions for current year	2020-12-31	0
Unpaid minimum required contributions for all years	2020-12-31	0
Total participants, beginning-of-year	2020-01-01	2
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	4
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	1
Total of all active and inactive participants	2020-01-01	5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	1
2019: CHILDREN'S HEALTH CENTER, LLC CASH BALANCE PLAN 2019 401k membership
Market value of plan assets	2019-12-31	95,590
Acturial value of plan assets	2019-12-31	95,590
Funding target for retired participants and beneficiaries receiving payment	2019-12-31	0
Number of terminated vested participants	2019-12-31	0
Fundng target for terminated vested participants	2019-12-31	0
Active participant vested funding target	2019-12-31	0
Number of active participants	2019-12-31	6
Total funding liabilities for active participants	2019-12-31	98,098
Total participant count	2019-12-31	6
Total funding target for all participants	2019-12-31	98,098
Balance at beginning of prior year after applicable adjustments	2019-12-31	0
Prefunding balance at beginning of prior year after applicable adjustments	2019-12-31	3,310
Carryover balanced portion elected for use to offset prior years funding requirement	2019-12-31	0
Prefunding balanced used to offset prior years funding requirement	2019-12-31	0
Amount remaining of carryover balance	2019-12-31	0
Amount remaining of prefunding balance	2019-12-31	3,310
Present value of excess contributions	2019-12-31	2,510
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance	2019-12-31	2,649
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance	2019-12-31	2,649
Reductions in caryover balances due to elections or deemed elections	2019-12-31	0
Reductions in prefunding balances due to elections or deemed elections	2019-12-31	0
Balance of carryovers at beginning of current year	2019-12-31	0
Balance of prefunding at beginning of current year	2019-12-31	5,650
Total employer contributions	2019-12-31	50,000
Total employee contributions	2019-12-31	0
Contributions allocated toward unpaid minimum require contributions from prior years	2019-12-31	0
Contributions made to avoid restrictions adjusted to valuation date	2019-12-31	0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date	2019-12-31	46,442
Unpaid minimum required contributions for all prior years	2019-12-31	0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years	2019-12-31	0
Remaining amount of unpaid minimum required contributions	2019-12-31	0
Minimum required contributions for current year target normal cost	2019-12-31	46,681
Net shortfall amortization installment of oustanding balance	2019-12-31	8,158
Waiver amortization installment	2019-12-31	0
Total funding amount beforereflecting carryover/prefunding balances	2019-12-31	48,007
Carryover balance elected to use to offset funding requirement	2019-12-31	0
Prefunding balance elected to use to offset funding requirement	2019-12-31	1,565
Additional cash requirement	2019-12-31	46,442
Contributions allocatedtoward minimum required contributions for current year	2019-12-31	46,442
Unpaid minimum required contributions for current year	2019-12-31	0
Unpaid minimum required contributions for all years	2019-12-31	0
Total participants, beginning-of-year	2019-01-01	5
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	2
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	0
Total of all active and inactive participants	2019-01-01	2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: CHILDREN'S HEALTH CENTER, LLC CASH BALANCE PLAN 2018 401k membership
Market value of plan assets	2018-12-31	51,406
Acturial value of plan assets	2018-12-31	51,406
Funding target for retired participants and beneficiaries receiving payment	2018-12-31	0
Number of terminated vested participants	2018-12-31	0
Fundng target for terminated vested participants	2018-12-31	0
Active participant vested funding target	2018-12-31	0
Number of active participants	2018-12-31	6
Total funding liabilities for active participants	2018-12-31	47,021
Total participant count	2018-12-31	6
Total funding target for all participants	2018-12-31	47,021
Balance at beginning of prior year after applicable adjustments	2018-12-31	0
Prefunding balance at beginning of prior year after applicable adjustments	2018-12-31	0
Carryover balanced portion elected for use to offset prior years funding requirement	2018-12-31	0
Prefunding balanced used to offset prior years funding requirement	2018-12-31	0
Amount remaining of carryover balance	2018-12-31	0
Amount remaining of prefunding balance	2018-12-31	0
Present value of excess contributions	2018-12-31	3,130
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance	2018-12-31	3,310
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance	2018-12-31	3,310
Reductions in caryover balances due to elections or deemed elections	2018-12-31	0
Reductions in prefunding balances due to elections or deemed elections	2018-12-31	0
Balance of carryovers at beginning of current year	2018-12-31	0
Balance of prefunding at beginning of current year	2018-12-31	3,310
Total employer contributions	2018-12-31	50,800
Total employee contributions	2018-12-31	0
Contributions allocated toward unpaid minimum require contributions from prior years	2018-12-31	0
Contributions made to avoid restrictions adjusted to valuation date	2018-12-31	0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date	2018-12-31	46,527
Unpaid minimum required contributions for all prior years	2018-12-31	0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years	2018-12-31	0
Remaining amount of unpaid minimum required contributions	2018-12-31	0
Minimum required contributions for current year target normal cost	2018-12-31	45,092
Net shortfall amortization installment of oustanding balance	2018-12-31	0
Waiver amortization installment	2018-12-31	0
Total funding amount beforereflecting carryover/prefunding balances	2018-12-31	44,017
Additional cash requirement	2018-12-31	44,017
Contributions allocatedtoward minimum required contributions for current year	2018-12-31	46,527
Unpaid minimum required contributions for current year	2018-12-31	0
Unpaid minimum required contributions for all years	2018-12-31	0
Total participants, beginning-of-year	2018-01-01	4
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	2
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	0
Total of all active and inactive participants	2018-01-01	2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	2
2017: CHILDREN'S HEALTH CENTER, LLC CASH BALANCE PLAN 2017 401k membership
Market value of plan assets	2017-12-31	0
Acturial value of plan assets	2017-12-31	0
Funding target for retired participants and beneficiaries receiving payment	2017-12-31	0
Number of terminated vested participants	2017-12-31	0
Fundng target for terminated vested participants	2017-12-31	0
Active participant vested funding target	2017-12-31	0
Number of active participants	2017-12-31	7
Total funding liabilities for active participants	2017-12-31	0
Total participant count	2017-12-31	7
Total funding target for all participants	2017-12-31	0
Balance at beginning of prior year after applicable adjustments	2017-12-31	0
Prefunding balance at beginning of prior year after applicable adjustments	2017-12-31	0
Carryover balanced portion elected for use to offset prior years funding requirement	2017-12-31	0
Prefunding balanced used to offset prior years funding requirement	2017-12-31	0
Amount remaining of carryover balance	2017-12-31	0
Amount remaining of prefunding balance	2017-12-31	0
Present value of excess contributions	2017-12-31	0
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance	2017-12-31	0
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance	2017-12-31	0
Reductions in caryover balances due to elections or deemed elections	2017-12-31	0
Reductions in prefunding balances due to elections or deemed elections	2017-12-31	0
Balance of carryovers at beginning of current year	2017-12-31	0
Balance of prefunding at beginning of current year	2017-12-31	0
Total employer contributions	2017-12-31	50,000
Total employee contributions	2017-12-31	0
Contributions allocated toward unpaid minimum require contributions from prior years	2017-12-31	0
Contributions made to avoid restrictions adjusted to valuation date	2017-12-31	0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date	2017-12-31	47,746
Unpaid minimum required contributions for all prior years	2017-12-31	0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years	2017-12-31	0
Remaining amount of unpaid minimum required contributions	2017-12-31	0
Minimum required contributions for current year target normal cost	2017-12-31	44,616
Net shortfall amortization installment of oustanding balance	2017-12-31	0
Waiver amortization installment	2017-12-31	0
Total funding amount beforereflecting carryover/prefunding balances	2017-12-31	44,616
Carryover balance elected to use to offset funding requirement	2017-12-31	0
Prefunding balance elected to use to offset funding requirement	2017-12-31	0
Additional cash requirement	2017-12-31	44,616
Contributions allocatedtoward minimum required contributions for current year	2017-12-31	47,746
Unpaid minimum required contributions for current year	2017-12-31	0
Unpaid minimum required contributions for all years	2017-12-31	0
Total participants, beginning-of-year	2017-01-01	7
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	5
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	0
Total of all active and inactive participants	2017-01-01	5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0

Financial Data on CHILDREN'S HEALTH CENTER, LLC CASH BALANCE PLAN

Measure	Date	Value
2020 : CHILDREN'S HEALTH CENTER, LLC CASH BALANCE PLAN 2020 401k financial data
Transfers to/from the plan	2020-12-31	$0
Total plan liabilities at end of year	2020-12-31	$0
Total plan liabilities at beginning of year	2020-12-31	$0
Total income from all sources	2020-12-31	$75,898
Expenses. Total of all expenses incurred	2020-12-31	$0
Benefits paid (including direct rollovers)	2020-12-31	$0
Total plan assets at end of year	2020-12-31	$241,024
Total plan assets at beginning of year	2020-12-31	$165,126
Total contributions received or receivable from participants	2020-12-31	$0
Expenses. Other expenses not covered elsewhere	2020-12-31	$0
Contributions received from other sources (not participants or employers)	2020-12-31	$0
Other income received	2020-12-31	$25,898
Noncash contributions received	2020-12-31	$0
Net income (gross income less expenses)	2020-12-31	$75,898
Net plan assets at end of year (total assets less liabilities)	2020-12-31	$241,024
Net plan assets at beginning of year (total assets less liabilities)	2020-12-31	$165,126
Total contributions received or receivable from employer(s)	2020-12-31	$50,000
Value of certain deemed distributions of participant loans	2020-12-31	$0
Value of corrective distributions	2020-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2020-12-31	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
2019 : CHILDREN'S HEALTH CENTER, LLC CASH BALANCE PLAN 2019 401k financial data
Transfers to/from the plan	2019-12-31	$0
Total plan liabilities at end of year	2019-12-31	$0
Total plan liabilities at beginning of year	2019-12-31	$0
Total income from all sources	2019-12-31	$67,799
Expenses. Total of all expenses incurred	2019-12-31	$0
Benefits paid (including direct rollovers)	2019-12-31	$0
Total plan assets at end of year	2019-12-31	$165,126
Total plan assets at beginning of year	2019-12-31	$97,327
Total contributions received or receivable from participants	2019-12-31	$0
Expenses. Other expenses not covered elsewhere	2019-12-31	$0
Contributions received from other sources (not participants or employers)	2019-12-31	$0
Other income received	2019-12-31	$17,799
Noncash contributions received	2019-12-31	$0
Net income (gross income less expenses)	2019-12-31	$67,799
Net plan assets at end of year (total assets less liabilities)	2019-12-31	$165,126
Net plan assets at beginning of year (total assets less liabilities)	2019-12-31	$97,327
Total contributions received or receivable from employer(s)	2019-12-31	$50,000
Value of certain deemed distributions of participant loans	2019-12-31	$0
Value of corrective distributions	2019-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2019-12-31	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
2018 : CHILDREN'S HEALTH CENTER, LLC CASH BALANCE PLAN 2018 401k financial data
Transfers to/from the plan	2018-12-31	$0
Total plan liabilities at end of year	2018-12-31	$0
Total plan liabilities at beginning of year	2018-12-31	$0
Total income from all sources	2018-12-31	$45,921
Expenses. Total of all expenses incurred	2018-12-31	$0
Benefits paid (including direct rollovers)	2018-12-31	$0
Total plan assets at end of year	2018-12-31	$97,327
Total plan assets at beginning of year	2018-12-31	$51,406
Total contributions received or receivable from participants	2018-12-31	$0
Expenses. Other expenses not covered elsewhere	2018-12-31	$0
Contributions received from other sources (not participants or employers)	2018-12-31	$0
Other income received	2018-12-31	$-4,879
Noncash contributions received	2018-12-31	$0
Net income (gross income less expenses)	2018-12-31	$45,921
Net plan assets at end of year (total assets less liabilities)	2018-12-31	$97,327
Net plan assets at beginning of year (total assets less liabilities)	2018-12-31	$51,406
Total contributions received or receivable from employer(s)	2018-12-31	$50,800
Value of certain deemed distributions of participant loans	2018-12-31	$0
Value of corrective distributions	2018-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2018-12-31	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
2017 : CHILDREN'S HEALTH CENTER, LLC CASH BALANCE PLAN 2017 401k financial data
Transfers to/from the plan	2017-12-31	$0
Total plan liabilities at end of year	2017-12-31	$0
Total plan liabilities at beginning of year	2017-12-31	$0
Total income from all sources	2017-12-31	$51,406
Expenses. Total of all expenses incurred	2017-12-31	$0
Benefits paid (including direct rollovers)	2017-12-31	$0
Total plan assets at end of year	2017-12-31	$51,406
Total plan assets at beginning of year	2017-12-31	$0
Total contributions received or receivable from participants	2017-12-31	$0
Expenses. Other expenses not covered elsewhere	2017-12-31	$0
Contributions received from other sources (not participants or employers)	2017-12-31	$0
Other income received	2017-12-31	$1,406
Noncash contributions received	2017-12-31	$0
Net income (gross income less expenses)	2017-12-31	$51,406
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$51,406
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$0
Total contributions received or receivable from employer(s)	2017-12-31	$50,000
Value of certain deemed distributions of participant loans	2017-12-31	$0
Value of corrective distributions	2017-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2017-12-31	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0

Form 5500 Responses for CHILDREN'S HEALTH CENTER, LLC CASH BALANCE PLAN

2020: CHILDREN'S HEALTH CENTER, LLC CASH BALANCE 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 benefit arrangement – Insurance	Yes
2019: CHILDREN'S HEALTH CENTER, LLC CASH BALANCE 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 benefit arrangement – Insurance	Yes
2018: CHILDREN'S HEALTH CENTER, LLC CASH BALANCE 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 benefit arrangement – Insurance	Yes
2017: CHILDREN'S HEALTH CENTER, LLC CASH BALANCE PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	First time form 5500 has been submitted	Yes
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 – Trust	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

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

Policy contract number

GA-841467

Policy instance

Insurance contract or identification number	GA-841467
Number of Individuals Covered	6
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 $561
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	499
Additional information about fees paid to insurance broker	COMMISSIONS
Insurance broker organization code?	3

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

Policy contract number

GA-841467

Policy instance

Insurance contract or identification number	GA-841467
Number of Individuals Covered	2
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $182
Total amount of fees paid to insurance company	USD $29
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $182
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	COMMISSIONS
Insurance broker organization code?	3

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

Policy contract number

GA-841467

Policy instance

Insurance contract or identification number	GA-841467
Number of Individuals Covered	6
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $210
Total amount of fees paid to insurance company	USD $20
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $210
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	COMMISSIONS
Insurance broker organization code?	3

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Company Name:	CHILDREN'S HEALTH CENTER, LLC
Employer identification number (EIN):	300404864
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
002	2022-01-01	NANCY DENICOLA	2023-05-11
002	2021-01-01	NANCY DENICOLA	2022-06-08
002	2020-01-01
002	2019-01-01
002	2018-01-01
002	2017-01-01	NANCY DENICOLA