401k Plan data: GEORGIA KIDNEY ASSOCIATES, INC. PROFIT SHARING PLAN plan

GEORGIA KIDNEY ASSOCIATES, INC. PROFIT SHARING PLAN 401k Plan overview

Plan Name	GEORGIA KIDNEY ASSOCIATES, INC. PROFIT SHARING PLAN
Plan identification number	001

GEORGIA KIDNEY ASSOCIATES, INC. PROFIT SHARING PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

GEORGIA KIDNEY ASSOCIATES, INC. has sponsored the creation of one or more 401k plans.

Company Name: GEORGIA KIDNEY ASSOCIATES, INC.

Employer identification number (EIN): 581397948

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GEORGIA KIDNEY ASSOCIATES, INC. PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01 LISA MAAS 2023-07-26
001 2021-01-01 KRISTA MINEWEASER 2022-07-18
001 2020-01-01 KRISTA MINEWEASER 2021-07-12
001 2019-01-01
001 2018-01-01
001 2017-01-01
001 2016-01-01
001 2015-01-01
001 2014-01-01 EDWARD D. HIMOT, MD
001 2013-01-01 EDWARD D. HIMOT, MD
001 2012-01-01 EDWARD D. HIMOT, MD
001 2011-01-01 EDWARD H. HIMOT, MD
001 2010-01-01 EDWARD H. HIMOT, MD 2011-10-15
001 2009-01-01 EDWARD H. HIMOT, MD

Plan Statistics for GEORGIA KIDNEY ASSOCIATES, INC. PROFIT SHARING PLAN

401k plan membership statisitcs for GEORGIA KIDNEY ASSOCIATES, INC. PROFIT SHARING PLAN

Measure Date Value
2014: GEORGIA KIDNEY ASSOCIATES, INC. PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 40
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 40
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 3
Total of all active and inactive participants 2014-01-01 43
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 43
Number of participants with account balances 2014-01-01 43
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 1
2013: GEORGIA KIDNEY ASSOCIATES, INC. PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 41
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 33
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 7
Total of all active and inactive participants 2013-01-01 40
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 40
Number of participants with account balances 2013-01-01 40
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 5
2012: GEORGIA KIDNEY ASSOCIATES, INC. PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 39
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 38
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 3
Total of all active and inactive participants 2012-01-01 41
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 41
Number of participants with account balances 2012-01-01 41
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 1
2011: GEORGIA KIDNEY ASSOCIATES, INC. PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 39
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 33
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 6
Total of all active and inactive participants 2011-01-01 39
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 39
Number of participants with account balances 2011-01-01 39
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 4
2009: GEORGIA KIDNEY ASSOCIATES, INC. PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 37
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 30
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 8
Total of all active and inactive participants 2009-01-01 38
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 38
Number of participants with account balances 2009-01-01 38
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 3

Measure	Date	Value
2014: GEORGIA KIDNEY ASSOCIATES, INC. PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	40
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	40
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	3
Total of all active and inactive participants	2014-01-01	43
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	43
Number of participants with account balances	2014-01-01	43
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	1
2013: GEORGIA KIDNEY ASSOCIATES, INC. PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	41
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	33
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	7
Total of all active and inactive participants	2013-01-01	40
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	40
Number of participants with account balances	2013-01-01	40
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	5
2012: GEORGIA KIDNEY ASSOCIATES, INC. PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	39
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	38
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	3
Total of all active and inactive participants	2012-01-01	41
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	41
Number of participants with account balances	2012-01-01	41
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	1
2011: GEORGIA KIDNEY ASSOCIATES, INC. PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	39
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	33
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	6
Total of all active and inactive participants	2011-01-01	39
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	39
Number of participants with account balances	2011-01-01	39
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	4
2009: GEORGIA KIDNEY ASSOCIATES, INC. PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	37
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	30
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	8
Total of all active and inactive participants	2009-01-01	38
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	38
Number of participants with account balances	2009-01-01	38
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	3

Financial Data on GEORGIA KIDNEY ASSOCIATES, INC. PROFIT SHARING PLAN

Measure	Date	Value
2014 : GEORGIA KIDNEY ASSOCIATES, INC. PROFIT SHARING PLAN 2014 401k financial data
Transfers to/from the plan	2014-12-31	$0
Total plan liabilities at end of year	2014-12-31	$0
Total plan liabilities at beginning of year	2014-12-31	$0
Total income from all sources	2014-12-31	$568,727
Expenses. Total of all expenses incurred	2014-12-31	$139,549
Benefits paid (including direct rollovers)	2014-12-31	$91,951
Total plan assets at end of year	2014-12-31	$7,801,806
Total plan assets at beginning of year	2014-12-31	$7,372,628
Value of fidelity bond covering the plan	2014-12-31	$550,000
Total contributions received or receivable from participants	2014-12-31	$0
Expenses. Other expenses not covered elsewhere	2014-12-31	$0
Contributions received from other sources (not participants or employers)	2014-12-31	$0
Other income received	2014-12-31	$259,749
Noncash contributions received	2014-12-31	$0
Net income (gross income less expenses)	2014-12-31	$429,178
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$7,801,806
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$7,372,628
Assets. Value of participant loans	2014-12-31	$81,871
Assets. Value of assets in partnership/joint-venture interests	2014-12-31	$373
Total contributions received or receivable from employer(s)	2014-12-31	$308,978
Value of certain deemed distributions of participant loans	2014-12-31	$0
Value of corrective distributions	2014-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2014-12-31	$47,598
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
2013 : GEORGIA KIDNEY ASSOCIATES, INC. PROFIT SHARING PLAN 2013 401k financial data
Transfers to/from the plan	2013-12-31	$0
Total plan liabilities at end of year	2013-12-31	$0
Total plan liabilities at beginning of year	2013-12-31	$0
Total income from all sources	2013-12-31	$1,522,398
Expenses. Total of all expenses incurred	2013-12-31	$69,233
Benefits paid (including direct rollovers)	2013-12-31	$22,773
Total plan assets at end of year	2013-12-31	$7,372,628
Total plan assets at beginning of year	2013-12-31	$5,919,463
Value of fidelity bond covering the plan	2013-12-31	$55,000
Total contributions received or receivable from participants	2013-12-31	$0
Expenses. Other expenses not covered elsewhere	2013-12-31	$0
Contributions received from other sources (not participants or employers)	2013-12-31	$0
Other income received	2013-12-31	$1,144,434
Noncash contributions received	2013-12-31	$0
Net income (gross income less expenses)	2013-12-31	$1,453,165
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$7,372,628
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$5,919,463
Assets. Value of participant loans	2013-12-31	$63,280
Assets. Value of assets in partnership/joint-venture interests	2013-12-31	$1,687
Total contributions received or receivable from employer(s)	2013-12-31	$377,964
Value of certain deemed distributions of participant loans	2013-12-31	$0
Value of corrective distributions	2013-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2013-12-31	$46,460
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
2012 : GEORGIA KIDNEY ASSOCIATES, INC. PROFIT SHARING PLAN 2012 401k financial data
Transfers to/from the plan	2012-12-31	$0
Total plan liabilities at end of year	2012-12-31	$0
Total plan liabilities at beginning of year	2012-12-31	$0
Total income from all sources	2012-12-31	$844,974
Expenses. Total of all expenses incurred	2012-12-31	$176,481
Benefits paid (including direct rollovers)	2012-12-31	$176,260
Total plan assets at end of year	2012-12-31	$5,919,463
Total plan assets at beginning of year	2012-12-31	$5,250,970
Value of fidelity bond covering the plan	2012-12-31	$550,000
Total contributions received or receivable from participants	2012-12-31	$0
Expenses. Other expenses not covered elsewhere	2012-12-31	$0
Contributions received from other sources (not participants or employers)	2012-12-31	$0
Other income received	2012-12-31	$479,139
Noncash contributions received	2012-12-31	$0
Net income (gross income less expenses)	2012-12-31	$668,493
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$5,919,463
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$5,250,970
Assets. Value of participant loans	2012-12-31	$62,897
Assets. Value of assets in partnership/joint-venture interests	2012-12-31	$2,694
Total contributions received or receivable from employer(s)	2012-12-31	$365,835
Value of certain deemed distributions of participant loans	2012-12-31	$0
Value of corrective distributions	2012-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2012-12-31	$221
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
2011 : GEORGIA KIDNEY ASSOCIATES, INC. PROFIT SHARING PLAN 2011 401k financial data
Transfers to/from the plan	2011-12-31	$0
Total plan liabilities at end of year	2011-12-31	$0
Total plan liabilities at beginning of year	2011-12-31	$3,046
Total income from all sources	2011-12-31	$663,225
Expenses. Total of all expenses incurred	2011-12-31	$21,079
Benefits paid (including direct rollovers)	2011-12-31	$19,528
Total plan assets at end of year	2011-12-31	$5,250,970
Total plan assets at beginning of year	2011-12-31	$4,611,870
Value of fidelity bond covering the plan	2011-12-31	$550,000
Total contributions received or receivable from participants	2011-12-31	$0
Contributions received from other sources (not participants or employers)	2011-12-31	$0
Other income received	2011-12-31	$308,853
Noncash contributions received	2011-12-31	$0
Net income (gross income less expenses)	2011-12-31	$642,146
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$5,250,970
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$4,608,824
Assets. Value of participant loans	2011-12-31	$27,789
Assets. Value of assets in partnership/joint-venture interests	2011-12-31	$5,991
Total contributions received or receivable from employer(s)	2011-12-31	$354,372
Value of certain deemed distributions of participant loans	2011-12-31	$1,466
Value of corrective distributions	2011-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$85
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
2009 : GEORGIA KIDNEY ASSOCIATES, INC. PROFIT SHARING PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for GEORGIA KIDNEY ASSOCIATES, INC. PROFIT SHARING PLAN

2014: GEORGIA KIDNEY ASSOCIATES, INC. PROFIT SHARING PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: GEORGIA KIDNEY ASSOCIATES, INC. PROFIT SHARING PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: GEORGIA KIDNEY ASSOCIATES, INC. PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: GEORGIA KIDNEY ASSOCIATES, INC. PROFIT SHARING PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: GEORGIA KIDNEY ASSOCIATES, INC. PROFIT SHARING PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

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

Policy contract number

6279941

Policy instance

Insurance contract or identification number	6279941
Number of Individuals Covered	1
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Are there contracts with allocated funds for individual policies?	Yes
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Insurance broker organization code?	3
Insurance broker name	HENRY W MCCRAY JR

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

Policy contract number

6279941

Policy instance

Insurance contract or identification number	6279941
Number of Individuals Covered	1
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Are there contracts with allocated funds for individual policies?	Yes
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Insurance broker organization code?	3
Insurance broker name	HENRY W MCCRAY JR

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

Policy contract number

6279941

Policy instance

Insurance contract or identification number	6279941
Number of Individuals Covered	1
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Are there contracts with allocated funds for individual policies?	Yes
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Insurance broker organization code?	3
Insurance broker name	MCQUAID, WILLIAM J

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

Policy contract number

6279941

Policy instance

Insurance contract or identification number	6279941
Number of Individuals Covered	1
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Are there contracts with allocated funds for individual policies?	Yes
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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GEORGIA KIDNEY CONSULTANTS MEDOVA LIFESTYLE HEALTH PLAN [EIN = 272108685]

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The information provided on this website is not advice, endorsement or recommendation
The information published is supplied by third parties so we make no warranty on the accuracy, completeness etc. This information is provided "as-is". The information is subject to change as we obtain updates and corrections from the primary information sources.
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See full terms and conditions

Company Name:	GEORGIA KIDNEY ASSOCIATES, INC.
Employer identification number (EIN):	581397948
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2022-01-01	LISA MAAS	2023-07-26
001	2021-01-01	KRISTA MINEWEASER	2022-07-18
001	2020-01-01	KRISTA MINEWEASER	2021-07-12
001	2019-01-01
001	2018-01-01
001	2017-01-01
001	2016-01-01
001	2015-01-01
001	2014-01-01	EDWARD D. HIMOT, MD
001	2013-01-01	EDWARD D. HIMOT, MD
001	2012-01-01	EDWARD D. HIMOT, MD
001	2011-01-01	EDWARD H. HIMOT, MD
001	2010-01-01	EDWARD H. HIMOT, MD	2011-10-15
001	2009-01-01	EDWARD H. HIMOT, MD