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MILLER-DWAN MEDICAL CENTER, INC. TAX SHELTERED ANNUITY/403(B) PLAN 401k Plan overview

Plan NameMILLER-DWAN MEDICAL CENTER, INC. TAX SHELTERED ANNUITY/403(B) PLAN
Plan identification number 002

MILLER-DWAN MEDICAL CENTER, INC. TAX SHELTERED ANNUITY/403(B) PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • 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 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

SMDC MEDICAL CENTER has sponsored the creation of one or more 401k plans.

Company Name:SMDC MEDICAL CENTER
Employer identification number (EIN):411878730
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MILLER-DWAN MEDICAL CENTER, INC. TAX SHELTERED ANNUITY/403(B) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0022022-01-01DIANE T. DAVIDSON2023-10-13
0022021-01-01DIANE T. DAVIDSON2022-10-17
0022020-01-01DIANE T. DAVIDSON2021-10-06
0022019-01-01DIANE T. DAVIDSON2020-10-12
0022018-01-01DIANE T. DAVIDSON2019-10-09
0022017-01-01
0022016-01-01
0022015-01-01
0022014-01-01
0022013-01-01
0022012-01-01DIANE T. DAVIDSON
0022011-01-01DIANE T. DAVIDSON
0022010-01-01DIANE T. DAVIDSON
0022009-01-01DIANE T DAVIDSON DIANE T DAVIDSON2011-05-16
0022009-01-01DIANE T DAVIDSON DIANE T DAVIDSON2010-10-15

Plan Statistics for MILLER-DWAN MEDICAL CENTER, INC. TAX SHELTERED ANNUITY/403(B) PLAN

401k plan membership statisitcs for MILLER-DWAN MEDICAL CENTER, INC. TAX SHELTERED ANNUITY/403(B) PLAN

Measure Date Value
2022: MILLER-DWAN MEDICAL CENTER, INC. TAX SHELTERED ANNUITY/403(B) PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01145
Total number of active participants reported on line 7a of the Form 55002022-01-0179
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-0158
Total of all active and inactive participants2022-01-01137
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01137
Number of participants with account balances2022-01-01137
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010
2021: MILLER-DWAN MEDICAL CENTER, INC. TAX SHELTERED ANNUITY/403(B) PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01158
Total number of active participants reported on line 7a of the Form 55002021-01-0184
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-0161
Total of all active and inactive participants2021-01-01145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01145
Number of participants with account balances2021-01-01145
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: MILLER-DWAN MEDICAL CENTER, INC. TAX SHELTERED ANNUITY/403(B) PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01173
Total number of active participants reported on line 7a of the Form 55002020-01-0199
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-0159
Total of all active and inactive participants2020-01-01158
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01158
Number of participants with account balances2020-01-01158
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: MILLER-DWAN MEDICAL CENTER, INC. TAX SHELTERED ANNUITY/403(B) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01177
Total number of active participants reported on line 7a of the Form 55002019-01-01105
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-0168
Total of all active and inactive participants2019-01-01173
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01173
Number of participants with account balances2019-01-01173
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: MILLER-DWAN MEDICAL CENTER, INC. TAX SHELTERED ANNUITY/403(B) PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01184
Total number of active participants reported on line 7a of the Form 55002018-01-01110
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-0167
Total of all active and inactive participants2018-01-01177
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01177
Number of participants with account balances2018-01-01177
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: MILLER-DWAN MEDICAL CENTER, INC. TAX SHELTERED ANNUITY/403(B) PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01229
Total number of active participants reported on line 7a of the Form 55002017-01-01121
Number of retired or separated participants receiving benefits2017-01-0163
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01184
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-01184
Number of participants with account balances2017-01-01184
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: MILLER-DWAN MEDICAL CENTER, INC. TAX SHELTERED ANNUITY/403(B) PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01241
Total number of active participants reported on line 7a of the Form 55002016-01-01144
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-0185
Total of all active and inactive participants2016-01-01229
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-01229
Number of participants with account balances2016-01-01229
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: MILLER-DWAN MEDICAL CENTER, INC. TAX SHELTERED ANNUITY/403(B) PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01249
Total number of active participants reported on line 7a of the Form 55002015-01-01154
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-0187
Total of all active and inactive participants2015-01-01241
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-01241
Number of participants with account balances2015-01-01241
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: MILLER-DWAN MEDICAL CENTER, INC. TAX SHELTERED ANNUITY/403(B) PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01275
Total number of active participants reported on line 7a of the Form 55002014-01-01155
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-0194
Total of all active and inactive participants2014-01-01249
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-01249
Number of participants with account balances2014-01-01249
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: MILLER-DWAN MEDICAL CENTER, INC. TAX SHELTERED ANNUITY/403(B) PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01303
Total number of active participants reported on line 7a of the Form 55002013-01-01179
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-0196
Total of all active and inactive participants2013-01-01275
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-01275
Number of participants with account balances2013-01-01275
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: MILLER-DWAN MEDICAL CENTER, INC. TAX SHELTERED ANNUITY/403(B) PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01206
Total number of active participants reported on line 7a of the Form 55002012-01-01203
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-01100
Total of all active and inactive participants2012-01-01303
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-01303
Number of participants with account balances2012-01-01303
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: MILLER-DWAN MEDICAL CENTER, INC. TAX SHELTERED ANNUITY/403(B) PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01380
Total number of active participants reported on line 7a of the Form 55002011-01-01206
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-01103
Total of all active and inactive participants2011-01-01309
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-01309
Number of participants with account balances2011-01-01309
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2010: MILLER-DWAN MEDICAL CENTER, INC. TAX SHELTERED ANNUITY/403(B) PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01449
Total number of active participants reported on line 7a of the Form 55002010-01-01270
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-01110
Total of all active and inactive participants2010-01-01380
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-01380
Number of participants with account balances2010-01-01380
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-010
2009: MILLER-DWAN MEDICAL CENTER, INC. TAX SHELTERED ANNUITY/403(B) PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01517
Total number of active participants reported on line 7a of the Form 55002009-01-01308
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-01141
Total of all active and inactive participants2009-01-01449
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-01449
Number of participants with account balances2009-01-01449
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on MILLER-DWAN MEDICAL CENTER, INC. TAX SHELTERED ANNUITY/403(B) PLAN

Measure Date Value
2022 : MILLER-DWAN MEDICAL CENTER, INC. TAX SHELTERED ANNUITY/403(B) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$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$0
Total income from all sources (including contributions)2022-12-31$-1,274,404
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$267,207
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$266,882
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$0
Value of total assets at end of year2022-12-31$5,669,235
Value of total assets at beginning of year2022-12-31$7,210,846
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$325
Total interest from all sources2022-12-31$24,750
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$5,000,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-1,541,611
Value of net assets at end of year (total assets less liabilities)2022-12-31$5,669,235
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$7,210,846
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$4,864,192
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$6,380,181
Interest earned on other investments2022-12-31$24,750
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$805,043
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$830,665
Net investment gain/loss from pooled separate accounts2022-12-31$-1,299,154
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$266,882
Contract administrator fees2022-12-31$325
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Disclaimer
Accountancy firm name2022-12-31RSM US LLP
Accountancy firm EIN2022-12-31420714325
2021 : MILLER-DWAN MEDICAL CENTER, INC. TAX SHELTERED ANNUITY/403(B) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total income from all sources (including contributions)2021-12-31$1,192,635
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$1,113,498
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$1,113,138
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$0
Value of total assets at end of year2021-12-31$7,210,846
Value of total assets at beginning of year2021-12-31$7,131,709
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$360
Total interest from all sources2021-12-31$31,824
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$5,000,000
If this is an individual account plan, was there a blackout period2021-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$79,137
Value of net assets at end of year (total assets less liabilities)2021-12-31$7,210,846
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$7,131,709
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$6,380,181
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$6,278,287
Interest earned on other investments2021-12-31$31,824
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$830,665
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$853,422
Net investment gain/loss from pooled separate accounts2021-12-31$1,160,811
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$1,113,138
Contract administrator fees2021-12-31$360
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Disclaimer
Accountancy firm name2021-12-31RSM US LLP
Accountancy firm EIN2021-12-31420714325
2020 : MILLER-DWAN MEDICAL CENTER, INC. TAX SHELTERED ANNUITY/403(B) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total transfer of assets from this plan2020-12-31$121,245
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total income from all sources (including contributions)2020-12-31$1,035,991
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$831,818
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$831,391
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$0
Value of total assets at end of year2020-12-31$7,131,709
Value of total assets at beginning of year2020-12-31$7,048,781
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$427
Total interest from all sources2020-12-31$25,752
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$5,000,000
If this is an individual account plan, was there a blackout period2020-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$204,173
Value of net assets at end of year (total assets less liabilities)2020-12-31$7,131,709
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$7,048,781
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$6,278,287
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$6,172,648
Interest earned on other investments2020-12-31$25,752
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$853,422
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$876,133
Net investment gain/loss from pooled separate accounts2020-12-31$1,010,239
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$831,391
Contract administrator fees2020-12-31$427
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Disclaimer
Accountancy firm name2020-12-31RSM US LLP
Accountancy firm EIN2020-12-31420714325
2019 : MILLER-DWAN MEDICAL CENTER, INC. TAX SHELTERED ANNUITY/403(B) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total transfer of assets from this plan2019-12-31$298,923
Total transfer of assets from this plan2019-12-31$298,923
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total income from all sources (including contributions)2019-12-31$1,320,538
Total income from all sources (including contributions)2019-12-31$1,320,538
Total loss/gain on sale of assets2019-12-31$0
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$227,624
Total of all expenses incurred2019-12-31$227,624
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$227,144
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$227,144
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$0
Value of total assets at end of year2019-12-31$7,048,781
Value of total assets at end of year2019-12-31$7,048,781
Value of total assets at beginning of year2019-12-31$6,254,790
Value of total assets at beginning of year2019-12-31$6,254,790
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$480
Total interest from all sources2019-12-31$25,287
Total interest from all sources2019-12-31$25,287
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31Yes
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$5,000,000
Value of fidelity bond cover2019-12-31$5,000,000
If this is an individual account plan, was there a blackout period2019-12-31No
If this is an individual account plan, was there a blackout period2019-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$1,092,914
Value of net income/loss2019-12-31$1,092,914
Value of net assets at end of year (total assets less liabilities)2019-12-31$7,048,781
Value of net assets at end of year (total assets less liabilities)2019-12-31$7,048,781
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$6,254,790
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$6,254,790
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$6,172,648
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$6,172,648
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$5,403,899
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$5,403,899
Interest earned on other investments2019-12-31$25,287
Interest earned on other investments2019-12-31$25,287
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$876,133
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$876,133
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$850,891
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$850,891
Net investment gain/loss from pooled separate accounts2019-12-31$1,295,251
Net investment gain/loss from pooled separate accounts2019-12-31$1,295,251
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$227,144
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$227,144
Contract administrator fees2019-12-31$480
Contract administrator fees2019-12-31$480
Did the plan have assets held for investment2019-12-31Yes
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31RSM US LLP
Accountancy firm name2019-12-31RSM US LLP
Accountancy firm EIN2019-12-31420714325
Accountancy firm EIN2019-12-31420714325
2018 : MILLER-DWAN MEDICAL CENTER, INC. TAX SHELTERED ANNUITY/403(B) PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total transfer of assets from this plan2018-12-31$247,890
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total income from all sources (including contributions)2018-12-31$-389,064
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$403,286
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$402,774
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$0
Value of total assets at end of year2018-12-31$6,254,790
Value of total assets at beginning of year2018-12-31$7,295,030
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$512
Total interest from all sources2018-12-31$24,688
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$5,000,000
If this is an individual account plan, was there a blackout period2018-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$-792,350
Value of net assets at end of year (total assets less liabilities)2018-12-31$6,254,790
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$7,295,030
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$5,403,899
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$6,460,771
Interest earned on other investments2018-12-31$24,688
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$850,891
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$834,259
Net investment gain/loss from pooled separate accounts2018-12-31$-413,752
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$402,774
Contract administrator fees2018-12-31$512
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31RSM US LLP
Accountancy firm EIN2018-12-31420714325
2017 : MILLER-DWAN MEDICAL CENTER, INC. TAX SHELTERED ANNUITY/403(B) PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total transfer of assets from this plan2017-12-31$153,589
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total income from all sources (including contributions)2017-12-31$1,014,765
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$374,897
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$374,380
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$0
Value of total assets at end of year2017-12-31$7,295,030
Value of total assets at beginning of year2017-12-31$6,808,751
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$517
Total interest from all sources2017-12-31$25,987
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$5,000,000
If this is an individual account plan, was there a blackout period2017-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$639,868
Value of net assets at end of year (total assets less liabilities)2017-12-31$7,295,030
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$6,808,751
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$6,460,771
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$5,951,333
Interest earned on other investments2017-12-31$25,987
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-12-31$834,259
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-12-31$857,418
Net investment gain/loss from pooled separate accounts2017-12-31$988,778
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$374,380
Contract administrator fees2017-12-31$517
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31RSM US LLP
Accountancy firm EIN2017-12-31420714325
2016 : MILLER-DWAN MEDICAL CENTER, INC. TAX SHELTERED ANNUITY/403(B) PLAN 2016 401k financial data
Total transfer of assets from this plan2016-12-31$68,336
Total income from all sources (including contributions)2016-12-31$453,988
Total of all expenses incurred2016-12-31$1,429,634
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$1,429,067
Value of total assets at end of year2016-12-31$6,808,751
Value of total assets at beginning of year2016-12-31$7,852,733
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$567
Total interest from all sources2016-12-31$29,746
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$5,000,000
If this is an individual account plan, was there a blackout period2016-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Participant contributions at end of year2016-12-31$0
Participant contributions at beginning of year2016-12-31$14,094
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$-975,646
Value of net assets at end of year (total assets less liabilities)2016-12-31$6,808,751
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$7,852,733
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-31$5,951,333
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$6,795,517
Interest on participant loans2016-12-31$45
Interest earned on other investments2016-12-31$29,701
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-12-31$857,418
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-12-31$1,043,122
Net investment gain/loss from pooled separate accounts2016-12-31$424,242
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$1,429,067
Contract administrator fees2016-12-31$567
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31RSM US LLP
Accountancy firm EIN2016-12-31420714325
2015 : MILLER-DWAN MEDICAL CENTER, INC. TAX SHELTERED ANNUITY/403(B) PLAN 2015 401k financial data
Total transfer of assets from this plan2015-12-31$138,014
Total income from all sources (including contributions)2015-12-31$-75,341
Total of all expenses incurred2015-12-31$427,141
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$426,422
Value of total assets at end of year2015-12-31$7,852,733
Value of total assets at beginning of year2015-12-31$8,493,229
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$719
Total interest from all sources2015-12-31$32,693
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$5,000,000
If this is an individual account plan, was there a blackout period2015-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Participant contributions at end of year2015-12-31$14,094
Participant contributions at beginning of year2015-12-31$13,684
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$-502,482
Value of net assets at end of year (total assets less liabilities)2015-12-31$7,852,733
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$8,493,229
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$6,795,517
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$7,340,977
Interest on participant loans2015-12-31$411
Interest earned on other investments2015-12-31$32,282
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-12-31$1,043,122
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-12-31$1,138,568
Net investment gain/loss from pooled separate accounts2015-12-31$-108,034
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$426,422
Contract administrator fees2015-12-31$719
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31RSM US LLP
Accountancy firm EIN2015-12-31420714325
2014 : MILLER-DWAN MEDICAL CENTER, INC. TAX SHELTERED ANNUITY/403(B) PLAN 2014 401k financial data
Total transfer of assets from this plan2014-12-31$78,978
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total income from all sources (including contributions)2014-12-31$474,317
Total of all expenses incurred2014-12-31$937,649
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$936,733
Value of total assets at end of year2014-12-31$8,493,229
Value of total assets at beginning of year2014-12-31$9,035,539
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$916
Total interest from all sources2014-12-31$36,162
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$5,000,000
If this is an individual account plan, was there a blackout period2014-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Participant contributions at end of year2014-12-31$13,684
Participant contributions at beginning of year2014-12-31$13,285
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$-463,332
Value of net assets at end of year (total assets less liabilities)2014-12-31$8,493,229
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$9,035,539
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$7,340,977
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$7,701,198
Interest on participant loans2014-12-31$399
Interest earned on other investments2014-12-31$35,763
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-12-31$1,138,568
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-12-31$1,321,056
Net investment gain/loss from pooled separate accounts2014-12-31$438,155
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$936,733
Contract administrator fees2014-12-31$916
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31MCGLADREY LLP
Accountancy firm EIN2014-12-31420714325
2013 : MILLER-DWAN MEDICAL CENTER, INC. TAX SHELTERED ANNUITY/403(B) PLAN 2013 401k financial data
Total transfer of assets from this plan2013-12-31$186,435
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total income from all sources (including contributions)2013-12-31$1,375,977
Total of all expenses incurred2013-12-31$870,843
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$869,678
Value of total assets at end of year2013-12-31$9,035,539
Value of total assets at beginning of year2013-12-31$8,716,840
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$1,165
Total interest from all sources2013-12-31$39,564
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$5,000,000
If this is an individual account plan, was there a blackout period2013-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Participant contributions at end of year2013-12-31$13,285
Participant contributions at beginning of year2013-12-31$15,580
Administrative expenses (other) incurred2013-12-31$1,165
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$505,134
Value of net assets at end of year (total assets less liabilities)2013-12-31$9,035,539
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$8,716,840
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-12-31$7,701,198
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$7,389,463
Interest on participant loans2013-12-31$392
Interest earned on other investments2013-12-31$39,172
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-12-31$1,321,056
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-12-31$1,311,797
Net investment gain/loss from pooled separate accounts2013-12-31$1,336,413
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$869,678
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31No
Opinion of an independent qualified public accountant for this plan2013-12-31Disclaimer
Accountancy firm name2013-12-31MCGLADREY LLP
Accountancy firm EIN2013-12-31420714325
2012 : MILLER-DWAN MEDICAL CENTER, INC. TAX SHELTERED ANNUITY/403(B) PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-12-31$0
Total transfer of assets from this plan2012-12-31$142,364
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total income from all sources (including contributions)2012-12-31$944,905
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$1,002,804
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$1,001,486
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$0
Value of total assets at end of year2012-12-31$8,716,840
Value of total assets at beginning of year2012-12-31$8,917,103
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$1,318
Total interest from all sources2012-12-31$42,403
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Administrative expenses professional fees incurred2012-12-31$1,318
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$5,000,000
If this is an individual account plan, was there a blackout period2012-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-12-31$0
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Participant contributions at end of year2012-12-31$15,580
Participant contributions at beginning of year2012-12-31$31,788
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$-57,899
Value of net assets at end of year (total assets less liabilities)2012-12-31$8,716,840
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$8,917,103
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-12-31$7,389,463
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$7,419,949
Interest on participant loans2012-12-31$358
Interest earned on other investments2012-12-31$42,045
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-12-31$1,311,797
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-12-31$1,465,366
Net investment gain/loss from pooled separate accounts2012-12-31$902,502
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$1,001,486
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31Yes
Opinion of an independent qualified public accountant for this plan2012-12-31Disclaimer
Accountancy firm name2012-12-31MCGLADREY LLP
Accountancy firm EIN2012-12-31420714325
2011 : MILLER-DWAN MEDICAL CENTER, INC. TAX SHELTERED ANNUITY/403(B) PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-12-31$0
Total transfer of assets from this plan2011-12-31$345,630
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$20,355
Total income from all sources (including contributions)2011-12-31$-135,059
Total loss/gain on sale of assets2011-12-31$0
Total of all expenses incurred2011-12-31$1,137,996
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$1,136,672
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$0
Value of total assets at end of year2011-12-31$8,917,103
Value of total assets at beginning of year2011-12-31$10,556,143
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$1,324
Total interest from all sources2011-12-31$50,936
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$5,000,000
If this is an individual account plan, was there a blackout period2011-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Participant contributions at end of year2011-12-31$31,788
Participant contributions at beginning of year2011-12-31$104,229
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-1,273,055
Value of net assets at end of year (total assets less liabilities)2011-12-31$8,917,103
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$10,535,788
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-12-31$7,419,949
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-12-31$8,722,712
Interest on participant loans2011-12-31$1,753
Interest earned on other investments2011-12-31$49,183
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-12-31$1,465,366
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-12-31$1,729,202
Net investment gain/loss from pooled separate accounts2011-12-31$-185,995
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$1,136,672
Contract administrator fees2011-12-31$1,324
Liabilities. Value of benefit claims payable at beginning of year2011-12-31$20,355
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31MCGLADREY LLP
Accountancy firm EIN2011-12-31420714325
2010 : MILLER-DWAN MEDICAL CENTER, INC. TAX SHELTERED ANNUITY/403(B) PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets2010-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$20,355
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$6,047
Total income from all sources (including contributions)2010-12-31$1,088,343
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$1,469,277
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$1,467,751
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$0
Value of total assets at end of year2010-12-31$10,556,143
Value of total assets at beginning of year2010-12-31$10,922,769
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$1,526
Total interest from all sources2010-12-31$62,352
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$5,000,000
If this is an individual account plan, was there a blackout period2010-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Participant contributions at end of year2010-12-31$104,229
Participant contributions at beginning of year2010-12-31$139,674
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2010-12-31$6,047
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$-380,934
Value of net assets at end of year (total assets less liabilities)2010-12-31$10,535,788
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$10,916,722
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2010-12-31$8,722,712
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$8,743,831
Interest on participant loans2010-12-31$3,239
Interest earned on other investments2010-12-31$59,113
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$1,729,202
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$2,039,264
Net investment gain/loss from pooled separate accounts2010-12-31$1,025,991
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$1,467,751
Contract administrator fees2010-12-31$1,526
Liabilities. Value of benefit claims payable at end of year2010-12-31$20,355
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31MCGLADREY & PULLEN, LLP
Accountancy firm EIN2010-12-31420714325
2009 : MILLER-DWAN MEDICAL CENTER, INC. TAX SHELTERED ANNUITY/403(B) PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2009-12-31$0

Form 5500 Responses for MILLER-DWAN MEDICAL CENTER, INC. TAX SHELTERED ANNUITY/403(B) PLAN

2022: MILLER-DWAN MEDICAL CENTER, INC. TAX SHELTERED ANNUITY/403(B) PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planYes
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: MILLER-DWAN MEDICAL CENTER, INC. TAX SHELTERED ANNUITY/403(B) PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planYes
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: MILLER-DWAN MEDICAL CENTER, INC. TAX SHELTERED ANNUITY/403(B) PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planYes
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: MILLER-DWAN MEDICAL CENTER, INC. TAX SHELTERED ANNUITY/403(B) PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planYes
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: MILLER-DWAN MEDICAL CENTER, INC. TAX SHELTERED ANNUITY/403(B) PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planYes
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: MILLER-DWAN MEDICAL CENTER, INC. TAX SHELTERED ANNUITY/403(B) PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planYes
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: MILLER-DWAN MEDICAL CENTER, INC. TAX SHELTERED ANNUITY/403(B) PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planYes
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: MILLER-DWAN MEDICAL CENTER, INC. TAX SHELTERED ANNUITY/403(B) PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planYes
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: MILLER-DWAN MEDICAL CENTER, INC. TAX SHELTERED ANNUITY/403(B) PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planYes
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: MILLER-DWAN MEDICAL CENTER, INC. TAX SHELTERED ANNUITY/403(B) PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planYes
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: MILLER-DWAN MEDICAL CENTER, INC. TAX SHELTERED ANNUITY/403(B) PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: MILLER-DWAN MEDICAL CENTER, INC. TAX SHELTERED ANNUITY/403(B) PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2010: MILLER-DWAN MEDICAL CENTER, INC. TAX SHELTERED ANNUITY/403(B) PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes
2009: MILLER-DWAN MEDICAL CENTER, INC. TAX SHELTERED ANNUITY/403(B) PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedYes
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )
Policy contract number778253
Policy instance 4
Insurance contract or identification number778253
Number of Individuals Covered52
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract numberVF6136
Policy instance 3
Insurance contract or identification numberVF6136
Number of Individuals Covered75
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $3,174
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 BrokerUSD $1,492
Insurance broker organization code?3
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberA010062017
Policy instance 2
Insurance contract or identification numberA010062017
Number of Individuals Covered5
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Are there contracts with allocated funds for individual policies?1
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )
Policy contract number924860
Policy instance 1
Insurance contract or identification number924860
Number of Individuals Covered7
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )
Policy contract number924860
Policy instance 1
Insurance contract or identification number924860
Number of Individuals Covered7
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 numberA010062017
Policy instance 2
Insurance contract or identification numberA010062017
Number of Individuals Covered5
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Are there contracts with allocated funds for individual policies?1
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract numberVF6136
Policy instance 3
Insurance contract or identification numberVF6136
Number of Individuals Covered79
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $4,088
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 BrokerUSD $1,708
Insurance broker organization code?3
AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )
Policy contract number778253
Policy instance 4
Insurance contract or identification number778253
Number of Individuals Covered52
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )
Policy contract number018040
Policy instance 5
Insurance contract or identification number018040
Number of Individuals Covered7
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )
Policy contract number778253
Policy instance 4
Insurance contract or identification number778253
Number of Individuals Covered51
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract numberVF6136
Policy instance 3
Insurance contract or identification numberVF6136
Number of Individuals Covered86
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $3,867
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 BrokerUSD $1,431
Insurance broker organization code?3
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract numberA010018140
Policy instance 2
Insurance contract or identification numberA010018140
Number of Individuals Covered1
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Are there contracts with allocated funds for individual policies?1
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )
Policy contract number924860
Policy instance 1
Insurance contract or identification number924860
Number of Individuals Covered10
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 number139023
Policy instance 2
Insurance contract or identification number139023
Number of Individuals Covered5
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Are there contracts with allocated funds for individual policies?1
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )
Policy contract number924860
Policy instance 1
Insurance contract or identification number924860
Number of Individuals Covered10
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract numberVF6136
Policy instance 3
Insurance contract or identification numberVF6136
Number of Individuals Covered91
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $3,968
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 BrokerUSD $1,468
Insurance broker organization code?3
AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )
Policy contract number778253
Policy instance 4
Insurance contract or identification number778253
Number of Individuals Covered54
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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
AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )
Policy contract number778253
Policy instance 4
Insurance contract or identification number778253
Number of Individuals Covered57
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )
Policy contract number924860
Policy instance 1
Insurance contract or identification number924860
Number of Individuals Covered10
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 number139023
Policy instance 2
Insurance contract or identification number139023
Number of Individuals Covered5
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Are there contracts with allocated funds for individual policies?1
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract numberVF6136
Policy instance 3
Insurance contract or identification numberVF6136
Number of Individuals Covered96
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $4,133
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 BrokerUSD $1,529
Insurance broker organization code?3
AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66944 )
Policy contract number778253
Policy instance 4
Insurance contract or identification number778253
Number of Individuals Covered60
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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
VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )
Policy contract numberVF6136
Policy instance 3
Insurance contract or identification numberVF6136
Number of Individuals Covered104
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $3,372
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 BrokerUSD $1,453
Insurance broker organization code?3
Insurance broker nameJEFFERY STEIN
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number139023
Policy instance 2
Insurance contract or identification number139023
Number of Individuals Covered6
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Are there contracts with allocated funds for individual policies?1
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METLIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 87726 )
Policy contract number924860
Policy instance 1
Insurance contract or identification number924860
Number of Individuals Covered11
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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

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