401k Plan data: ONE PEDIATRICS, PLLC 401(K) RETIREMENT SAVINGS PLAN plan

ONE PEDIATRICS, PLLC 401(K) RETIREMENT SAVINGS PLAN 401k Plan overview

Plan Name	ONE PEDIATRICS, PLLC 401(K) RETIREMENT SAVINGS PLAN
Plan identification number	001

ONE PEDIATRICS, PLLC 401(K) RETIREMENT SAVINGS PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Participant-directed brokerage accounts provided as an investment option under the plan.
Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
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

ONE PEDIATRICS LLC has sponsored the creation of one or more 401k plans.

Company Name: ONE PEDIATRICS LLC

Employer identification number (EIN): 300774617

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ONE PEDIATRICS, PLLC 401(K) RETIREMENT SAVINGS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01 KARA SAMMONS 2023-10-04
001 2021-01-01 KARA SAMMONS 2022-10-12
001 2020-01-01 KARA SAMMONS 2021-10-13
001 2019-01-01 STEPHEN CHURCH, MD 2020-10-13
001 2018-01-01 STEPHEN CHURCH, MD 2019-10-04
001 2017-01-01
001 2016-01-01
001 2015-01-01
001 2014-01-01 STEPHEN CHURCH, MD 2015-10-15

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2022-01-01	KARA SAMMONS	2023-10-04
001	2021-01-01	KARA SAMMONS	2022-10-12
001	2020-01-01	KARA SAMMONS	2021-10-13
001	2019-01-01	STEPHEN CHURCH, MD	2020-10-13
001	2018-01-01	STEPHEN CHURCH, MD	2019-10-04
001	2017-01-01
001	2016-01-01
001	2015-01-01
001	2014-01-01	STEPHEN CHURCH, MD	2015-10-15

Plan Statistics for ONE PEDIATRICS, PLLC 401(K) RETIREMENT SAVINGS PLAN

401k plan membership statisitcs for ONE PEDIATRICS, PLLC 401(K) RETIREMENT SAVINGS PLAN

Measure Date Value
2022: ONE PEDIATRICS, PLLC 401(K) RETIREMENT SAVINGS PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 275
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 137
Number of retired or separated participants receiving benefits 2022-01-01 26
Number of other retired or separated participants entitled to future benefits 2022-01-01 94
Total of all active and inactive participants 2022-01-01 257
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 257
Number of participants with account balances 2022-01-01 257
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 21
2021: ONE PEDIATRICS, PLLC 401(K) RETIREMENT SAVINGS PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 249
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 142
Number of retired or separated participants receiving benefits 2021-01-01 41
Number of other retired or separated participants entitled to future benefits 2021-01-01 91
Total of all active and inactive participants 2021-01-01 274
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 274
Number of participants with account balances 2021-01-01 274
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 10
2020: ONE PEDIATRICS, PLLC 401(K) RETIREMENT SAVINGS PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 292
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 140
Number of retired or separated participants receiving benefits 2020-01-01 35
Number of other retired or separated participants entitled to future benefits 2020-01-01 74
Total of all active and inactive participants 2020-01-01 249
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 249
Number of participants with account balances 2020-01-01 249
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 21
2019: ONE PEDIATRICS, PLLC 401(K) RETIREMENT SAVINGS PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 242
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 191
Number of retired or separated participants receiving benefits 2019-01-01 14
Number of other retired or separated participants entitled to future benefits 2019-01-01 87
Total of all active and inactive participants 2019-01-01 292
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 292
Number of participants with account balances 2019-01-01 291
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 18
2018: ONE PEDIATRICS, PLLC 401(K) RETIREMENT SAVINGS PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 343
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 161
Number of retired or separated participants receiving benefits 2018-01-01 9
Number of other retired or separated participants entitled to future benefits 2018-01-01 71
Total of all active and inactive participants 2018-01-01 241
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 241
Number of participants with account balances 2018-01-01 240
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 15
2017: ONE PEDIATRICS, PLLC 401(K) RETIREMENT SAVINGS PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 279
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 204
Number of retired or separated participants receiving benefits 2017-01-01 30
Number of other retired or separated participants entitled to future benefits 2017-01-01 105
Total of all active and inactive participants 2017-01-01 339
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 1
Total participants 2017-01-01 340
Number of participants with account balances 2017-01-01 339
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 39
2016: ONE PEDIATRICS, PLLC 401(K) RETIREMENT SAVINGS PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 191
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 200
Number of retired or separated participants receiving benefits 2016-01-01 1
Number of other retired or separated participants entitled to future benefits 2016-01-01 73
Total of all active and inactive participants 2016-01-01 274
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 274
Number of participants with account balances 2016-01-01 272
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 7

Measure	Date	Value
2022: ONE PEDIATRICS, PLLC 401(K) RETIREMENT SAVINGS PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	275
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	137
Number of retired or separated participants receiving benefits	2022-01-01	26
Number of other retired or separated participants entitled to future benefits	2022-01-01	94
Total of all active and inactive participants	2022-01-01	257
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	257
Number of participants with account balances	2022-01-01	257
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	21
2021: ONE PEDIATRICS, PLLC 401(K) RETIREMENT SAVINGS PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	249
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	142
Number of retired or separated participants receiving benefits	2021-01-01	41
Number of other retired or separated participants entitled to future benefits	2021-01-01	91
Total of all active and inactive participants	2021-01-01	274
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	274
Number of participants with account balances	2021-01-01	274
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	10
2020: ONE PEDIATRICS, PLLC 401(K) RETIREMENT SAVINGS PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	292
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	140
Number of retired or separated participants receiving benefits	2020-01-01	35
Number of other retired or separated participants entitled to future benefits	2020-01-01	74
Total of all active and inactive participants	2020-01-01	249
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	249
Number of participants with account balances	2020-01-01	249
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	21
2019: ONE PEDIATRICS, PLLC 401(K) RETIREMENT SAVINGS PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	242
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	191
Number of retired or separated participants receiving benefits	2019-01-01	14
Number of other retired or separated participants entitled to future benefits	2019-01-01	87
Total of all active and inactive participants	2019-01-01	292
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	292
Number of participants with account balances	2019-01-01	291
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	18
2018: ONE PEDIATRICS, PLLC 401(K) RETIREMENT SAVINGS PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	343
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	161
Number of retired or separated participants receiving benefits	2018-01-01	9
Number of other retired or separated participants entitled to future benefits	2018-01-01	71
Total of all active and inactive participants	2018-01-01	241
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	241
Number of participants with account balances	2018-01-01	240
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	15
2017: ONE PEDIATRICS, PLLC 401(K) RETIREMENT SAVINGS PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	279
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	204
Number of retired or separated participants receiving benefits	2017-01-01	30
Number of other retired or separated participants entitled to future benefits	2017-01-01	105
Total of all active and inactive participants	2017-01-01	339
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	1
Total participants	2017-01-01	340
Number of participants with account balances	2017-01-01	339
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	39
2016: ONE PEDIATRICS, PLLC 401(K) RETIREMENT SAVINGS PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	191
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	200
Number of retired or separated participants receiving benefits	2016-01-01	1
Number of other retired or separated participants entitled to future benefits	2016-01-01	73
Total of all active and inactive participants	2016-01-01	274
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	274
Number of participants with account balances	2016-01-01	272
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	7

Financial Data on ONE PEDIATRICS, PLLC 401(K) RETIREMENT SAVINGS PLAN

Measure	Date	Value
2022 : ONE PEDIATRICS, PLLC 401(K) RETIREMENT SAVINGS 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	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$462
Total income from all sources (including contributions)	2022-12-31	$-2,808,256
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$794,576
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$750,727
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$1,143,846
Value of total assets at end of year	2022-12-31	$15,516,968
Value of total assets at beginning of year	2022-12-31	$19,120,262
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$43,849
Total interest from all sources	2022-12-31	$246
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$624,310
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	$624,310
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	$483,603
Participant contributions at end of year	2022-12-31	$5,779
Participant contributions at beginning of year	2022-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$61,823
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2022-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2022-12-31	$462
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
Income. Non cash contributions	2022-12-31	$0
Value of net income/loss	2022-12-31	$-3,602,832
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$15,516,968
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$19,119,800
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$14,424,711
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$17,717,939
Interest on participant loans	2022-12-31	$246
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$735,865
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$1,079,489
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-4,576,658
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	Yes
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	$598,420
Employer contributions (assets) at end of year	2022-12-31	$350,613
Employer contributions (assets) at beginning of year	2022-12-31	$322,834
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$750,727
Contract administrator fees	2022-12-31	$43,849
Did the plan have assets held for investment	2022-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	MATHER & COMPANY CPAS, LLC
Accountancy firm EIN	2022-12-31	611210177
2021 : ONE PEDIATRICS, PLLC 401(K) RETIREMENT SAVINGS 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	$462
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$861
Total income from all sources (including contributions)	2021-12-31	$4,212,902
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$11,398,601
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$11,333,580
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$1,022,887
Value of total assets at end of year	2021-12-31	$19,120,262
Value of total assets at beginning of year	2021-12-31	$26,306,360
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$65,021
Total interest from all sources	2021-12-31	$236
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$1,373,353
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	$1,373,353
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$492,155
Participant contributions at end of year	2021-12-31	$0
Participant contributions at beginning of year	2021-12-31	$15,316
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$4,112
Assets. Loans (other than to participants) at end of year	2021-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2021-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2021-12-31	$462
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2021-12-31	$861
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
Income. Non cash contributions	2021-12-31	$0
Value of net income/loss	2021-12-31	$-7,185,699
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$19,119,800
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$26,305,499
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$17,717,939
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$24,680,419
Interest on participant loans	2021-12-31	$236
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$1,079,489
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$1,298,524
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$1,816,426
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	Yes
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	$526,620
Employer contributions (assets) at end of year	2021-12-31	$322,834
Employer contributions (assets) at beginning of year	2021-12-31	$312,101
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$11,333,580
Contract administrator fees	2021-12-31	$65,021
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	MATHER & COMPANY CPAS, LLC
Accountancy firm EIN	2021-12-31	611210177
2020 : ONE PEDIATRICS, PLLC 401(K) RETIREMENT SAVINGS PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total transfer of assets from this plan	2020-12-31	$11,935,952
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$861
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$48
Total income from all sources (including contributions)	2020-12-31	$4,715,012
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$501,996
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$400,315
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$1,131,697
Value of total assets at end of year	2020-12-31	$26,306,360
Value of total assets at beginning of year	2020-12-31	$34,028,483
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$101,681
Total interest from all sources	2020-12-31	$236
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$853,934
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-31	$853,934
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	Yes
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	$528,568
Participant contributions at end of year	2020-12-31	$15,316
Participant contributions at beginning of year	2020-12-31	$16
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$30,335
Assets. Loans (other than to participants) at end of year	2020-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2020-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2020-12-31	$861
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2020-12-31	$48
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	$4,213,016
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$26,305,499
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$34,028,435
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$24,680,419
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$33,374,629
Interest on participant loans	2020-12-31	$236
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$1,298,524
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$267,403
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$2,729,145
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	Yes
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	$572,794
Employer contributions (assets) at end of year	2020-12-31	$312,101
Employer contributions (assets) at beginning of year	2020-12-31	$386,435
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$400,315
Contract administrator fees	2020-12-31	$101,681
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	2020-12-31	Yes
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	Disclaimer
Accountancy firm name	2020-12-31	MATHER & COMPANY CPAS, LLC
Accountancy firm EIN	2020-12-31	611210177
2019 : ONE PEDIATRICS, PLLC 401(K) RETIREMENT SAVINGS 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	$48
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$2,492
Total income from all sources (including contributions)	2019-12-31	$7,551,768
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$562,512
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$464,593
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$1,295,076
Value of total assets at end of year	2019-12-31	$34,028,483
Value of total assets at beginning of year	2019-12-31	$27,041,671
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$97,919
Total interest from all sources	2019-12-31	$864
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$1,201,229
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$1,201,229
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	$578,185
Participant contributions at end of year	2019-12-31	$16
Participant contributions at beginning of year	2019-12-31	$28
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$36,425
Assets. Loans (other than to participants) at end of year	2019-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2019-12-31	$854
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2019-12-31	$48
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2019-12-31	$2,492
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	$6,989,256
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$34,028,435
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$27,039,179
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$33,374,629
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$26,403,043
Interest on participant loans	2019-12-31	$864
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$267,403
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$269,807
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$5,054,599
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	Yes
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	$680,466
Employer contributions (assets) at end of year	2019-12-31	$386,435
Employer contributions (assets) at beginning of year	2019-12-31	$367,939
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$464,593
Contract administrator fees	2019-12-31	$97,919
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	MATHER & COMPANY CPAS, LLC
Accountancy firm EIN	2019-12-31	611210177
2018 : ONE PEDIATRICS, PLLC 401(K) RETIREMENT SAVINGS 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	$1,039,951
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$2,492
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$2,492
Total income from all sources (including contributions)	2018-12-31	$-302,328
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$3,866,099
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$3,755,260
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$1,221,963
Value of total assets at end of year	2018-12-31	$27,041,671
Value of total assets at beginning of year	2018-12-31	$32,250,049
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$110,839
Total interest from all sources	2018-12-31	$78
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$1,403,152
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2018-12-31	$1,403,152
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	$565,000
Participant contributions at end of year	2018-12-31	$28
Participant contributions at beginning of year	2018-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$452
Assets. Loans (other than to participants) at end of year	2018-12-31	$854
Assets. Loans (other than to participants) at beginning of year	2018-12-31	$3,391
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2018-12-31	$2,492
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2018-12-31	$2,492
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	$-4,168,427
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$27,039,179
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$32,247,557
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	$26,403,043
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$31,124,092
Interest on participant loans	2018-12-31	$78
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$269,807
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$738,211
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-2,927,521
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	$656,511
Employer contributions (assets) at end of year	2018-12-31	$367,939
Employer contributions (assets) at beginning of year	2018-12-31	$384,355
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$3,755,260
Contract administrator fees	2018-12-31	$110,839
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	MATHER & COMPANY CPAS, LLC
Accountancy firm EIN	2018-12-31	611210177
2017 : ONE PEDIATRICS, PLLC 401(K) RETIREMENT SAVINGS 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	$2,492
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	$6,436,939
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$1,789,685
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$1,689,276
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$1,323,208
Value of total assets at end of year	2017-12-31	$32,250,049
Value of total assets at beginning of year	2017-12-31	$27,600,303
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$100,409
Total interest from all sources	2017-12-31	$404
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$1,185,352
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$1,185,352
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	$589,204
Participant contributions at end of year	2017-12-31	$0
Participant contributions at beginning of year	2017-12-31	$27,755
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$99
Assets. Loans (other than to participants) at end of year	2017-12-31	$3,391
Assets. Loans (other than to participants) at beginning of year	2017-12-31	$13,495
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2017-12-31	$2,492
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2017-12-31	$0
Administrative expenses (other) incurred	2017-12-31	$7,039
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
Income. Non cash contributions	2017-12-31	$0
Value of net income/loss	2017-12-31	$4,647,254
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$32,247,557
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$27,600,303
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	$31,124,092
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$26,775,542
Interest on participant loans	2017-12-31	$404
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$738,211
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$344,445
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$3,927,975
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	Yes
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	$733,905
Employer contributions (assets) at end of year	2017-12-31	$384,355
Employer contributions (assets) at beginning of year	2017-12-31	$439,066
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$1,689,276
Contract administrator fees	2017-12-31	$93,370
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	MATHER & COMPANY CPAS, LLC
Accountancy firm EIN	2017-12-31	611210177
2016 : ONE PEDIATRICS, PLLC 401(K) RETIREMENT SAVINGS 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	$5,313,077
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$2,133,378
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$2,029,628
Expenses. Certain deemed distributions of participant loans	2016-12-31	$4,641
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$3,093,457
Value of total assets at end of year	2016-12-31	$27,600,303
Value of total assets at beginning of year	2016-12-31	$24,420,604
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$99,109
Total interest from all sources	2016-12-31	$995
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$793,683
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$793,683
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	$672,537
Participant contributions at end of year	2016-12-31	$27,755
Participant contributions at beginning of year	2016-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$1,640,525
Assets. Loans (other than to participants) at end of year	2016-12-31	$13,495
Assets. Loans (other than to participants) at beginning of year	2016-12-31	$30,582
Administrative expenses (other) incurred	2016-12-31	$15,761
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	$3,179,699
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$27,600,303
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$24,420,604
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	$26,775,542
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$23,981,805
Interest on participant loans	2016-12-31	$995
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$344,445
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$165,830
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$1,424,942
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	Yes
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	$780,395
Employer contributions (assets) at end of year	2016-12-31	$439,066
Employer contributions (assets) at beginning of year	2016-12-31	$242,387
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$2,029,628
Contract administrator fees	2016-12-31	$83,348
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	MATHER & COMPANY CPAS, LLC
Accountancy firm EIN	2016-12-31	611210177

Form 5500 Responses for ONE PEDIATRICS, PLLC 401(K) RETIREMENT SAVINGS PLAN

2022: ONE PEDIATRICS, PLLC 401(K) RETIREMENT SAVINGS 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 – Insurance	Yes
2021: ONE PEDIATRICS, PLLC 401(K) RETIREMENT SAVINGS 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 – Insurance	Yes
2020: ONE PEDIATRICS, PLLC 401(K) RETIREMENT SAVINGS 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 – Insurance	Yes
2019: ONE PEDIATRICS, PLLC 401(K) RETIREMENT SAVINGS 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 – Insurance	Yes
2018: ONE PEDIATRICS, PLLC 401(K) RETIREMENT SAVINGS 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
2017: ONE PEDIATRICS, PLLC 401(K) RETIREMENT SAVINGS 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
2016: ONE PEDIATRICS, PLLC 401(K) RETIREMENT SAVINGS 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

Insurance Providers Used on plan

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

370115-01

Policy instance

Insurance contract or identification number	370115-01
Number of Individuals Covered	13
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $922
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $922
Insurance broker organization code?	3

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

370115-01

Policy instance

Insurance contract or identification number	370115-01
Number of Individuals Covered	12
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $2,502
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,502
Insurance broker organization code?	3

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

370115-01

Policy instance

Insurance contract or identification number	370115-01
Number of Individuals Covered	9
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $3,373
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,373
Insurance broker organization code?	3

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

370115-01

Policy instance

Insurance contract or identification number	370115-01
Number of Individuals Covered	8
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $550
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $550
Insurance broker organization code?	3

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

370115-01

Policy instance

Insurance contract or identification number	370115-01
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 $764
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $764
Insurance broker organization code?	3

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

370115-01

Policy instance

Insurance contract or identification number	370115-01
Number of Individuals Covered	15
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $1,701
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,701
Insurance broker organization code?	3
Insurance broker name	ROBERT SPRAWLS

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Company Name:	ONE PEDIATRICS LLC
Employer identification number (EIN):	300774617
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)