401k Plan data: EDWARD C. BUSH, M.D. PROFIT SHARING PLAN plan

EDWARD C. BUSH, M.D. PROFIT SHARING PLAN 401k Plan overview

Plan Name	EDWARD C. BUSH, M.D. PROFIT SHARING PLAN
Plan identification number	002

EDWARD C. BUSH, M.D. PROFIT SHARING PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
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.
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

EDWARD C. BUSH, M.D. has sponsored the creation of one or more 401k plans.

Company Name: EDWARD C. BUSH, M.D.

Employer identification number (EIN): 382511079

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EDWARD C. BUSH, M.D. PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2022-01-01
002 2021-01-01
002 2020-01-01
002 2019-01-01
002 2018-01-01
002 2017-01-01 EDWARD C. BUSH, M.D. EDWARD C. BUSH, M.D. 2018-10-06
002 2016-01-01 EDWARD C. BUSH, M.D. EDWARD C. BUSH, M.D. 2017-06-18
002 2015-01-01 EDWARD C. BUSH, M.D. EDWARD C. BUSH, M.D. 2016-10-14
002 2015-01-01 2016-10-14
002 2015-01-01 2016-10-14
002 2015-01-01 2016-10-14
002 2014-01-01 EDWARD C. BUSH, MD EDWARD C. BUSH, MD 2015-05-09
002 2013-01-01 EDWARD C. BUSH EDWARD C. BUSH 2014-09-22
002 2012-01-01 EDWARD C. BUSH EDWARD C. BUSH 2013-10-07
002 2011-01-01 EDWARD C. BUSH
002 2010-01-01 EDWARD C. BUSH 2011-05-02

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2022-01-01
002	2021-01-01
002	2020-01-01
002	2019-01-01
002	2018-01-01
002	2017-01-01	EDWARD C. BUSH, M.D.		EDWARD C. BUSH, M.D.	2018-10-06
002	2016-01-01	EDWARD C. BUSH, M.D.		EDWARD C. BUSH, M.D.	2017-06-18
002	2015-01-01	EDWARD C. BUSH, M.D.		EDWARD C. BUSH, M.D.	2016-10-14
002	2015-01-01		2016-10-14
002	2015-01-01		2016-10-14
002	2015-01-01		2016-10-14
002	2014-01-01	EDWARD C. BUSH, MD		EDWARD C. BUSH, MD	2015-05-09
002	2013-01-01	EDWARD C. BUSH		EDWARD C. BUSH	2014-09-22
002	2012-01-01	EDWARD C. BUSH		EDWARD C. BUSH	2013-10-07
002	2011-01-01	EDWARD C. BUSH
002	2010-01-01	EDWARD C. BUSH	2011-05-02

Plan Statistics for EDWARD C. BUSH, M.D. PROFIT SHARING PLAN

401k plan membership statisitcs for EDWARD C. BUSH, M.D. PROFIT SHARING PLAN

Measure Date Value
2022: EDWARD C. BUSH, M.D. PROFIT SHARING PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 6
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 5
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 1
Total of all active and inactive participants 2022-01-01 6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 6
Number of participants with account balances 2022-01-01 6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: EDWARD C. BUSH, M.D. PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 5
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 4
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 1
Total of all active and inactive participants 2021-01-01 5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 5
Number of participants with account balances 2021-01-01 5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: EDWARD C. BUSH, M.D. PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 4
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
Number of participants with account balances 2020-01-01 4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: EDWARD C. BUSH, M.D. PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 4
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 3
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 1
Total of all active and inactive participants 2019-01-01 4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 4
Number of participants with account balances 2019-01-01 4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: EDWARD C. BUSH, M.D. PROFIT SHARING PLAN 2018 401k membership
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 3
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 1
Total of all active and inactive participants 2018-01-01 4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 4
Number of participants with account balances 2018-01-01 4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: EDWARD C. BUSH, M.D. PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 5
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 3
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 1
Total of all active and inactive participants 2017-01-01 4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 4
Number of participants with account balances 2017-01-01 4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: EDWARD C. BUSH, M.D. PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 5
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 3
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 2
Total of all active and inactive participants 2016-01-01 5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 5
Number of participants with account balances 2016-01-01 5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: EDWARD C. BUSH, M.D. PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 6
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 4
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 1
Total of all active and inactive participants 2015-01-01 5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 5
Number of participants with account balances 2015-01-01 4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: EDWARD C. BUSH, M.D. PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 7
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 4
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 2
Total of all active and inactive participants 2014-01-01 6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 6
Number of participants with account balances 2014-01-01 6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: EDWARD C. BUSH, M.D. PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 6
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 6
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 1
Total of all active and inactive participants 2013-01-01 7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 7
Number of participants with account balances 2013-01-01 6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: EDWARD C. BUSH, M.D. PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 6
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 5
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 1
Total of all active and inactive participants 2012-01-01 6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 6
Number of participants with account balances 2012-01-01 6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: EDWARD C. BUSH, M.D. PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 6
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 5
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 1
Total of all active and inactive participants 2011-01-01 6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 6
Number of participants with account balances 2011-01-01 6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0

Measure	Date	Value
2022: EDWARD C. BUSH, M.D. PROFIT SHARING PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	6
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	5
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	1
Total of all active and inactive participants	2022-01-01	6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	6
Number of participants with account balances	2022-01-01	6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: EDWARD C. BUSH, M.D. PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	5
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	4
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	1
Total of all active and inactive participants	2021-01-01	5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	5
Number of participants with account balances	2021-01-01	5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: EDWARD C. BUSH, M.D. PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	4
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
Number of participants with account balances	2020-01-01	4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: EDWARD C. BUSH, M.D. PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	4
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	3
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	1
Total of all active and inactive participants	2019-01-01	4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	4
Number of participants with account balances	2019-01-01	4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: EDWARD C. BUSH, M.D. PROFIT SHARING PLAN 2018 401k membership
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	3
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	1
Total of all active and inactive participants	2018-01-01	4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	4
Number of participants with account balances	2018-01-01	4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: EDWARD C. BUSH, M.D. PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	5
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	3
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	1
Total of all active and inactive participants	2017-01-01	4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	4
Number of participants with account balances	2017-01-01	4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: EDWARD C. BUSH, M.D. PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	5
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	3
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	2
Total of all active and inactive participants	2016-01-01	5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	5
Number of participants with account balances	2016-01-01	5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: EDWARD C. BUSH, M.D. PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	6
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	4
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	1
Total of all active and inactive participants	2015-01-01	5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	5
Number of participants with account balances	2015-01-01	4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: EDWARD C. BUSH, M.D. PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	7
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	4
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	2
Total of all active and inactive participants	2014-01-01	6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	6
Number of participants with account balances	2014-01-01	6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: EDWARD C. BUSH, M.D. PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	6
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	6
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	1
Total of all active and inactive participants	2013-01-01	7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	7
Number of participants with account balances	2013-01-01	6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: EDWARD C. BUSH, M.D. PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	6
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	5
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	1
Total of all active and inactive participants	2012-01-01	6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	6
Number of participants with account balances	2012-01-01	6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: EDWARD C. BUSH, M.D. PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	6
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	5
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	1
Total of all active and inactive participants	2011-01-01	6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	6
Number of participants with account balances	2011-01-01	6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0

Financial Data on EDWARD C. BUSH, M.D. PROFIT SHARING PLAN

Measure	Date	Value
2022 : EDWARD C. BUSH, M.D. PROFIT SHARING PLAN 2022 401k financial data
Total plan liabilities at end of year	2022-12-31	$0
Total plan liabilities at beginning of year	2022-12-31	$0
Total income from all sources	2022-12-31	$-783,682
Expenses. Total of all expenses incurred	2022-12-31	$44,379
Benefits paid (including direct rollovers)	2022-12-31	$0
Total plan assets at end of year	2022-12-31	$4,674,975
Total plan assets at beginning of year	2022-12-31	$5,503,036
Value of fidelity bond covering the plan	2022-12-31	$150,000
Total contributions received or receivable from participants	2022-12-31	$54,000
Expenses. Other expenses not covered elsewhere	2022-12-31	$423
Contributions received from other sources (not participants or employers)	2022-12-31	$0
Other income received	2022-12-31	$-889,852
Noncash contributions received	2022-12-31	$0
Net income (gross income less expenses)	2022-12-31	$-828,061
Net plan assets at end of year (total assets less liabilities)	2022-12-31	$4,674,975
Net plan assets at beginning of year (total assets less liabilities)	2022-12-31	$5,503,036
Total contributions received or receivable from employer(s)	2022-12-31	$52,170
Value of certain deemed distributions of participant loans	2022-12-31	$0
Value of corrective distributions	2022-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2022-12-31	$43,956
2021 : EDWARD C. BUSH, M.D. PROFIT SHARING PLAN 2021 401k financial data
Total plan liabilities at end of year	2021-12-31	$0
Total plan liabilities at beginning of year	2021-12-31	$0
Total income from all sources	2021-12-31	$967,619
Expenses. Total of all expenses incurred	2021-12-31	$48,264
Benefits paid (including direct rollovers)	2021-12-31	$0
Total plan assets at end of year	2021-12-31	$5,503,036
Total plan assets at beginning of year	2021-12-31	$4,583,681
Value of fidelity bond covering the plan	2021-12-31	$150,000
Total contributions received or receivable from participants	2021-12-31	$52,000
Expenses. Other expenses not covered elsewhere	2021-12-31	$0
Contributions received from other sources (not participants or employers)	2021-12-31	$0
Other income received	2021-12-31	$870,542
Noncash contributions received	2021-12-31	$0
Net income (gross income less expenses)	2021-12-31	$919,355
Net plan assets at end of year (total assets less liabilities)	2021-12-31	$5,503,036
Net plan assets at beginning of year (total assets less liabilities)	2021-12-31	$4,583,681
Total contributions received or receivable from employer(s)	2021-12-31	$45,077
Value of certain deemed distributions of participant loans	2021-12-31	$0
Value of corrective distributions	2021-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2021-12-31	$48,264
2020 : EDWARD C. BUSH, M.D. PROFIT SHARING PLAN 2020 401k financial data
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	$912,827
Expenses. Total of all expenses incurred	2020-12-31	$35,771
Benefits paid (including direct rollovers)	2020-12-31	$0
Total plan assets at end of year	2020-12-31	$4,583,681
Total plan assets at beginning of year	2020-12-31	$3,706,625
Value of fidelity bond covering the plan	2020-12-31	$150,000
Total contributions received or receivable from participants	2020-12-31	$43,129
Contributions received from other sources (not participants or employers)	2020-12-31	$0
Other income received	2020-12-31	$817,698
Noncash contributions received	2020-12-31	$0
Net income (gross income less expenses)	2020-12-31	$877,056
Net plan assets at end of year (total assets less liabilities)	2020-12-31	$4,583,681
Net plan assets at beginning of year (total assets less liabilities)	2020-12-31	$3,706,625
Total contributions received or receivable from employer(s)	2020-12-31	$52,000
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	$35,771
2019 : EDWARD C. BUSH, M.D. PROFIT SHARING PLAN 2019 401k financial data
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	$758,310
Expenses. Total of all expenses incurred	2019-12-31	$27,887
Benefits paid (including direct rollovers)	2019-12-31	$0
Total plan assets at end of year	2019-12-31	$3,706,625
Total plan assets at beginning of year	2019-12-31	$2,976,202
Value of fidelity bond covering the plan	2019-12-31	$150,000
Total contributions received or receivable from participants	2019-12-31	$49,000
Expenses. Other expenses not covered elsewhere	2019-12-31	$92
Contributions received from other sources (not participants or employers)	2019-12-31	$0
Other income received	2019-12-31	$664,698
Noncash contributions received	2019-12-31	$0
Net income (gross income less expenses)	2019-12-31	$730,423
Net plan assets at end of year (total assets less liabilities)	2019-12-31	$3,706,625
Net plan assets at beginning of year (total assets less liabilities)	2019-12-31	$2,976,202
Total contributions received or receivable from employer(s)	2019-12-31	$44,612
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	$27,795
2018 : EDWARD C. BUSH, M.D. PROFIT SHARING PLAN 2018 401k financial data
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	$-90,712
Expenses. Total of all expenses incurred	2018-12-31	$869
Benefits paid (including direct rollovers)	2018-12-31	$0
Total plan assets at end of year	2018-12-31	$2,976,202
Total plan assets at beginning of year	2018-12-31	$3,067,783
Value of fidelity bond covering the plan	2018-12-31	$150,000
Total contributions received or receivable from participants	2018-12-31	$48,000
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	$-186,052
Noncash contributions received	2018-12-31	$0
Net income (gross income less expenses)	2018-12-31	$-91,581
Net plan assets at end of year (total assets less liabilities)	2018-12-31	$2,976,202
Net plan assets at beginning of year (total assets less liabilities)	2018-12-31	$3,067,783
Total contributions received or receivable from employer(s)	2018-12-31	$47,340
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	$869
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
2017 : EDWARD C. BUSH, M.D. PROFIT SHARING PLAN 2017 401k financial data
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	$644,684
Expenses. Total of all expenses incurred	2017-12-31	$31,432
Benefits paid (including direct rollovers)	2017-12-31	$31,349
Total plan assets at end of year	2017-12-31	$3,067,783
Total plan assets at beginning of year	2017-12-31	$2,454,531
Value of fidelity bond covering the plan	2017-12-31	$150,000
Total contributions received or receivable from participants	2017-12-31	$48,000
Contributions received from other sources (not participants or employers)	2017-12-31	$156,908
Other income received	2017-12-31	$395,119
Noncash contributions received	2017-12-31	$0
Net income (gross income less expenses)	2017-12-31	$613,252
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$3,067,783
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$2,454,531
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2017-12-31	$23,000
Total contributions received or receivable from employer(s)	2017-12-31	$44,657
Value of certain deemed distributions of participant loans	2017-12-31	$30
Value of corrective distributions	2017-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2017-12-31	$53
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
2016 : EDWARD C. BUSH, M.D. PROFIT SHARING PLAN 2016 401k financial data
Total plan liabilities at end of year	2016-12-31	$0
Total plan liabilities at beginning of year	2016-12-31	$0
Total income from all sources	2016-12-31	$296,152
Expenses. Total of all expenses incurred	2016-12-31	$50,015
Benefits paid (including direct rollovers)	2016-12-31	$50,000
Total plan assets at end of year	2016-12-31	$2,454,531
Total plan assets at beginning of year	2016-12-31	$2,208,394
Value of fidelity bond covering the plan	2016-12-31	$150,000
Total contributions received or receivable from participants	2016-12-31	$48,000
Expenses. Other expenses not covered elsewhere	2016-12-31	$0
Contributions received from other sources (not participants or employers)	2016-12-31	$0
Other income received	2016-12-31	$199,050
Noncash contributions received	2016-12-31	$0
Net income (gross income less expenses)	2016-12-31	$246,137
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$2,454,531
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$2,208,394
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2016-12-31	$23,000
Total contributions received or receivable from employer(s)	2016-12-31	$49,102
Value of certain deemed distributions of participant loans	2016-12-31	$0
Value of corrective distributions	2016-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2016-12-31	$15
2015 : EDWARD C. BUSH, M.D. PROFIT SHARING PLAN 2015 401k financial data
Total plan liabilities at end of year	2015-12-31	$0
Total plan liabilities at beginning of year	2015-12-31	$0
Total income from all sources	2015-12-31	$72,980
Expenses. Total of all expenses incurred	2015-12-31	$75,806
Benefits paid (including direct rollovers)	2015-12-31	$75,806
Total plan assets at end of year	2015-12-31	$2,208,394
Total plan assets at beginning of year	2015-12-31	$2,211,220
Value of fidelity bond covering the plan	2015-12-31	$150,000
Total contributions received or receivable from participants	2015-12-31	$47,000
Expenses. Other expenses not covered elsewhere	2015-12-31	$0
Contributions received from other sources (not participants or employers)	2015-12-31	$0
Other income received	2015-12-31	$-17,637
Noncash contributions received	2015-12-31	$0
Net income (gross income less expenses)	2015-12-31	$-2,826
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$2,208,394
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$2,211,220
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2015-12-31	$23,000
Total contributions received or receivable from employer(s)	2015-12-31	$43,617
Value of certain deemed distributions of participant loans	2015-12-31	$0
Value of corrective distributions	2015-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2015-12-31	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
2014 : EDWARD C. BUSH, M.D. PROFIT SHARING PLAN 2014 401k financial data
Total plan liabilities at end of year	2014-12-31	$0
Total plan liabilities at beginning of year	2014-12-31	$0
Total income from all sources	2014-12-31	$215,914
Expenses. Total of all expenses incurred	2014-12-31	$0
Benefits paid (including direct rollovers)	2014-12-31	$0
Total plan assets at end of year	2014-12-31	$2,211,220
Total plan assets at beginning of year	2014-12-31	$1,995,306
Value of fidelity bond covering the plan	2014-12-31	$150,000
Total contributions received or receivable from participants	2014-12-31	$45,640
Expenses. Other expenses not covered elsewhere	2014-12-31	$0
Contributions received from other sources (not participants or employers)	2014-12-31	$0
Other income received	2014-12-31	$124,274
Noncash contributions received	2014-12-31	$0
Net income (gross income less expenses)	2014-12-31	$215,914
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$2,211,220
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$1,995,306
Total contributions received or receivable from employer(s)	2014-12-31	$46,000
Value of certain deemed distributions of participant loans	2014-12-31	$0
Value of corrective distributions	2014-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2014-12-31	$0
2013 : EDWARD C. BUSH, M.D. PROFIT SHARING PLAN 2013 401k financial data
Transfers to/from the plan	2013-12-31	$0
Total plan liabilities at end of year	2013-12-31	$0
Total plan liabilities at beginning of year	2013-12-31	$0
Total income from all sources	2013-12-31	$409,003
Expenses. Total of all expenses incurred	2013-12-31	$0
Benefits paid (including direct rollovers)	2013-12-31	$0
Total plan assets at end of year	2013-12-31	$1,995,306
Total plan assets at beginning of year	2013-12-31	$1,586,303
Value of fidelity bond covering the plan	2013-12-31	$150,000
Total contributions received or receivable from participants	2013-12-31	$46,000
Expenses. Other expenses not covered elsewhere	2013-12-31	$0
Contributions received from other sources (not participants or employers)	2013-12-31	$7,250
Other income received	2013-12-31	$312,027
Noncash contributions received	2013-12-31	$0
Net income (gross income less expenses)	2013-12-31	$409,003
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$1,995,306
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$1,586,303
Total contributions received or receivable from employer(s)	2013-12-31	$43,726
Value of certain deemed distributions of participant loans	2013-12-31	$0
Value of corrective distributions	2013-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2013-12-31	$0
2012 : EDWARD C. BUSH, M.D. PROFIT SHARING PLAN 2012 401k financial data
Total plan liabilities at end of year	2012-12-31	$0
Total plan liabilities at beginning of year	2012-12-31	$0
Total income from all sources	2012-12-31	$233,621
Total plan assets at end of year	2012-12-31	$1,586,303
Total plan assets at beginning of year	2012-12-31	$1,352,682
Value of fidelity bond covering the plan	2012-12-31	$150,000
Total contributions received or receivable from participants	2012-12-31	$45,000
Other income received	2012-12-31	$143,842
Noncash contributions received	2012-12-31	$1,125
Net income (gross income less expenses)	2012-12-31	$233,621
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$1,586,303
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$1,352,682
Total contributions received or receivable from employer(s)	2012-12-31	$43,654
2011 : EDWARD C. BUSH, M.D. PROFIT SHARING PLAN 2011 401k financial data
Total plan liabilities at end of year	2011-12-31	$0
Total plan liabilities at beginning of year	2011-12-31	$0
Total income from all sources	2011-12-31	$82,166
Expenses. Total of all expenses incurred	2011-12-31	$100,000
Benefits paid (including direct rollovers)	2011-12-31	$100,000
Total plan assets at end of year	2011-12-31	$1,352,682
Total plan assets at beginning of year	2011-12-31	$1,370,516
Value of fidelity bond covering the plan	2011-12-31	$150,000
Total contributions received or receivable from participants	2011-12-31	$44,000
Other income received	2011-12-31	$-4,240
Net income (gross income less expenses)	2011-12-31	$-17,834
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$1,352,682
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$1,370,516
Total contributions received or receivable from employer(s)	2011-12-31	$42,406

Form 5500 Responses for EDWARD C. BUSH, M.D. PROFIT SHARING PLAN

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

OSL24705509

Policy instance

Insurance contract or identification number	OSL24705509
Number of Individuals Covered	0
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	1
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No

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

Policy contract number

OSL24705509

Policy instance

Insurance contract or identification number	OSL24705509
Number of Individuals Covered	1
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 $0
Are there contracts with allocated funds for individual policies?	1
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

OSL24705509

Policy instance

Insurance contract or identification number	OSL24705509
Number of Individuals Covered	1
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	1
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Insurance broker organization code?	3

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

Policy contract number

OSL24705509

Policy instance

Insurance contract or identification number	OSL24705509
Number of Individuals Covered	1
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	1
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Insurance broker organization code?	3

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

Policy contract number

OSL24705509

Policy instance

Insurance contract or identification number	OSL24705509
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	1
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Insurance broker organization code?	3
Insurance broker name

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

Policy contract number

OSL24705509

Policy instance

Insurance contract or identification number	OSL24705509
Number of Individuals Covered	1
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No

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

Policy contract number

OSL24705509

Policy instance

Insurance contract or identification number	OSL24705509
Number of Individuals Covered	1
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No

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

Policy contract number

OSL24705509

Policy instance

Insurance contract or identification number	OSL24705509
Number of Individuals Covered	1
Insurance policy start date	2013-03-29
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No

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

Policy contract number

OSL24705509

Policy instance

Insurance contract or identification number	OSL24705509
Number of Individuals Covered	1
Insurance policy start date	2012-03-29
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No

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

Policy contract number

OSL24705509

Policy instance

Insurance contract or identification number	OSL24705509
Number of Individuals Covered	1
Insurance policy start date	2011-03-29
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No

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Company Name:	EDWARD C. BUSH, M.D.
Employer identification number (EIN):	382511079
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)