401k Plan data: ABC PEDIATRICS, INC. ABC PEDIATRICS 401(K) AND PROFIT SHARING PLAN plan

ABC PEDIATRICS, INC. ABC PEDIATRICS 401(K) AND PROFIT SHARING PLAN 401k Plan overview

Plan Name	ABC PEDIATRICS, INC. ABC PEDIATRICS 401(K) AND PROFIT SHARING PLAN
Plan identification number	001

ABC PEDIATRICS, INC. ABC PEDIATRICS 401(K) AND 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.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Participant-directed brokerage accounts provided as an investment option under the plan.
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

ABC PEDIATRICS PC has sponsored the creation of one or more 401k plans.

Company Name: ABC PEDIATRICS PC

Employer identification number (EIN): 582209024

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ABC PEDIATRICS, INC. ABC PEDIATRICS 401(K) AND PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2023-01-01 ALBERO BOOTO 2024-05-22
001 2022-01-01 TEREASA BALLAY 2023-09-11
001 2021-01-01 TEREASA BALLAY 2022-06-28 TEREASA BALLAY 2022-06-28
001 2020-01-01 ERIC HOFFLER 2021-08-05 ERIC HOFFLER 2021-08-05
001 2019-01-01 ERIC HOFFLER 2020-06-24 ERIC HOFFLER 2020-06-24
001 2018-01-01 ERIC HOFFLER 2019-10-11 ERIC HOFFLER 2019-10-11
001 2017-01-01
001 2016-01-01
001 2015-01-01 ERIC HOFFLER 2016-04-28
001 2014-01-01 ERIC HOFFLER 2015-04-27
001 2013-01-01 ERIC HOFFLER 2014-06-12

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2023-01-01	ALBERO BOOTO	2024-05-22
001	2022-01-01	TEREASA BALLAY	2023-09-11
001	2021-01-01	TEREASA BALLAY	2022-06-28	TEREASA BALLAY	2022-06-28
001	2020-01-01	ERIC HOFFLER	2021-08-05	ERIC HOFFLER	2021-08-05
001	2019-01-01	ERIC HOFFLER	2020-06-24	ERIC HOFFLER	2020-06-24
001	2018-01-01	ERIC HOFFLER	2019-10-11	ERIC HOFFLER	2019-10-11
001	2017-01-01
001	2016-01-01
001	2015-01-01	ERIC HOFFLER	2016-04-28
001	2014-01-01	ERIC HOFFLER	2015-04-27
001	2013-01-01	ERIC HOFFLER	2014-06-12

Plan Statistics for ABC PEDIATRICS, INC. ABC PEDIATRICS 401(K) AND PROFIT SHARING PLAN

401k plan membership statisitcs for ABC PEDIATRICS, INC. ABC PEDIATRICS 401(K) AND PROFIT SHARING PLAN

Measure Date Value
2021: ABC PEDIATRICS, INC. ABC PEDIATRICS 401(K) AND PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 24
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 12
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 3
Total of all active and inactive participants 2021-01-01 15
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 15
Number of participants with account balances 2021-01-01 15
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 3
2020: ABC PEDIATRICS, INC. ABC PEDIATRICS 401(K) AND PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 22
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 12
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 10
Total of all active and inactive participants 2020-01-01 22
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 22
Number of participants with account balances 2020-01-01 22
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 1
2019: ABC PEDIATRICS, INC. ABC PEDIATRICS 401(K) AND PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 20
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 12
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 10
Total of all active and inactive participants 2019-01-01 22
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 22
Number of participants with account balances 2019-01-01 22
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 2
2018: ABC PEDIATRICS, INC. ABC PEDIATRICS 401(K) AND PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 21
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 13
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 7
Total of all active and inactive participants 2018-01-01 20
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 20
Number of participants with account balances 2018-01-01 20
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 1
2017: ABC PEDIATRICS, INC. ABC PEDIATRICS 401(K) AND PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 17
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 15
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 6
Total of all active and inactive participants 2017-01-01 21
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 21
Number of participants with account balances 2017-01-01 21
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 1
2016: ABC PEDIATRICS, INC. ABC PEDIATRICS 401(K) AND PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 19
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 12
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 5
Total of all active and inactive participants 2016-01-01 17
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 17
Number of participants with account balances 2016-01-01 17
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 2

Measure	Date	Value
2021: ABC PEDIATRICS, INC. ABC PEDIATRICS 401(K) AND PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	24
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	12
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	3
Total of all active and inactive participants	2021-01-01	15
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	15
Number of participants with account balances	2021-01-01	15
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	3
2020: ABC PEDIATRICS, INC. ABC PEDIATRICS 401(K) AND PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	22
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	12
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	10
Total of all active and inactive participants	2020-01-01	22
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	22
Number of participants with account balances	2020-01-01	22
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	1
2019: ABC PEDIATRICS, INC. ABC PEDIATRICS 401(K) AND PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	20
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	12
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	10
Total of all active and inactive participants	2019-01-01	22
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	22
Number of participants with account balances	2019-01-01	22
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	2
2018: ABC PEDIATRICS, INC. ABC PEDIATRICS 401(K) AND PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	21
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	13
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	7
Total of all active and inactive participants	2018-01-01	20
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	20
Number of participants with account balances	2018-01-01	20
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	1
2017: ABC PEDIATRICS, INC. ABC PEDIATRICS 401(K) AND PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	17
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	15
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	6
Total of all active and inactive participants	2017-01-01	21
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	21
Number of participants with account balances	2017-01-01	21
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	1
2016: ABC PEDIATRICS, INC. ABC PEDIATRICS 401(K) AND PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	19
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	12
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	5
Total of all active and inactive participants	2016-01-01	17
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	17
Number of participants with account balances	2016-01-01	17
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	2

Financial Data on ABC PEDIATRICS, INC. ABC PEDIATRICS 401(K) AND PROFIT SHARING PLAN

Measure	Date	Value
2021 : ABC PEDIATRICS, INC. ABC PEDIATRICS 401(K) AND PROFIT SHARING PLAN 2021 401k financial data
Total income from all sources	2021-12-31	$423,738
Expenses. Total of all expenses incurred	2021-12-31	$23,927
Benefits paid (including direct rollovers)	2021-12-31	$21,481
Total plan assets at end of year	2021-12-31	$1,629,598
Total plan assets at beginning of year	2021-12-31	$1,229,787
Value of fidelity bond covering the plan	2021-12-31	$500,000
Total contributions received or receivable from participants	2021-12-31	$86,332
Other income received	2021-12-31	$231,545
Net income (gross income less expenses)	2021-12-31	$399,811
Net plan assets at end of year (total assets less liabilities)	2021-12-31	$1,629,598
Net plan assets at beginning of year (total assets less liabilities)	2021-12-31	$1,229,787
Assets. Value of participant loans	2021-12-31	$4,435
Total contributions received or receivable from employer(s)	2021-12-31	$105,861
Expenses. Administrative service providers (salaries,fees and commissions)	2021-12-31	$2,446
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
2020 : ABC PEDIATRICS, INC. ABC PEDIATRICS 401(K) AND PROFIT SHARING PLAN 2020 401k financial data
Total income from all sources	2020-12-31	$46,893
Expenses. Total of all expenses incurred	2020-12-31	$24,134
Benefits paid (including direct rollovers)	2020-12-31	$21,734
Total plan assets at end of year	2020-12-31	$1,229,787
Total plan assets at beginning of year	2020-12-31	$1,207,028
Value of fidelity bond covering the plan	2020-12-31	$500,000
Total contributions received or receivable from participants	2020-12-31	$72,172
Expenses. Other expenses not covered elsewhere	2020-12-31	$0
Contributions received from other sources (not participants or employers)	2020-12-31	$0
Other income received	2020-12-31	$-136,765
Net income (gross income less expenses)	2020-12-31	$22,759
Net plan assets at end of year (total assets less liabilities)	2020-12-31	$1,229,787
Net plan assets at beginning of year (total assets less liabilities)	2020-12-31	$1,207,028
Assets. Value of participant loans	2020-12-31	$6,150
Total contributions received or receivable from employer(s)	2020-12-31	$111,486
Expenses. Administrative service providers (salaries,fees and commissions)	2020-12-31	$2,400
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
2019 : ABC PEDIATRICS, INC. ABC PEDIATRICS 401(K) AND PROFIT SHARING PLAN 2019 401k financial data
Total income from all sources	2019-12-31	$288,718
Expenses. Total of all expenses incurred	2019-12-31	$2,675
Total plan assets at end of year	2019-12-31	$1,207,028
Total plan assets at beginning of year	2019-12-31	$920,985
Value of fidelity bond covering the plan	2019-12-31	$500,000
Total contributions received or receivable from participants	2019-12-31	$79,952
Other income received	2019-12-31	$96,276
Net income (gross income less expenses)	2019-12-31	$286,043
Net plan assets at end of year (total assets less liabilities)	2019-12-31	$1,207,028
Net plan assets at beginning of year (total assets less liabilities)	2019-12-31	$920,985
Assets. Value of participant loans	2019-12-31	$7,765
Total contributions received or receivable from employer(s)	2019-12-31	$112,490
Expenses. Administrative service providers (salaries,fees and commissions)	2019-12-31	$2,675
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
2018 : ABC PEDIATRICS, INC. ABC PEDIATRICS 401(K) AND PROFIT SHARING PLAN 2018 401k financial data
Total income from all sources	2018-12-31	$128,084
Expenses. Total of all expenses incurred	2018-12-31	$195,858
Benefits paid (including direct rollovers)	2018-12-31	$193,127
Total plan assets at end of year	2018-12-31	$920,985
Total plan assets at beginning of year	2018-12-31	$988,759
Value of fidelity bond covering the plan	2018-12-31	$500,000
Total contributions received or receivable from participants	2018-12-31	$70,931
Other income received	2018-12-31	$-51,762
Net income (gross income less expenses)	2018-12-31	$-67,774
Net plan assets at end of year (total assets less liabilities)	2018-12-31	$920,985
Net plan assets at beginning of year (total assets less liabilities)	2018-12-31	$988,759
Total contributions received or receivable from employer(s)	2018-12-31	$108,915
Expenses. Administrative service providers (salaries,fees and commissions)	2018-12-31	$2,731
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
2017 : ABC PEDIATRICS, INC. ABC PEDIATRICS 401(K) AND PROFIT SHARING PLAN 2017 401k financial data
Total income from all sources	2017-12-31	$260,072
Expenses. Total of all expenses incurred	2017-12-31	$18,866
Benefits paid (including direct rollovers)	2017-12-31	$16,277
Total plan assets at end of year	2017-12-31	$988,759
Total plan assets at beginning of year	2017-12-31	$747,553
Value of fidelity bond covering the plan	2017-12-31	$500,000
Total contributions received or receivable from participants	2017-12-31	$68,078
Other income received	2017-12-31	$130,607
Net income (gross income less expenses)	2017-12-31	$241,206
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$988,759
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$747,553
Assets. Value of participant loans	2017-12-31	$1,088
Total contributions received or receivable from employer(s)	2017-12-31	$61,387
Expenses. Administrative service providers (salaries,fees and commissions)	2017-12-31	$2,589
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
2016 : ABC PEDIATRICS, INC. ABC PEDIATRICS 401(K) AND PROFIT SHARING PLAN 2016 401k financial data
Total income from all sources	2016-12-31	$260,324
Expenses. Total of all expenses incurred	2016-12-31	$10,112
Benefits paid (including direct rollovers)	2016-12-31	$7,414
Total plan assets at end of year	2016-12-31	$747,553
Total plan assets at beginning of year	2016-12-31	$497,341
Value of fidelity bond covering the plan	2016-12-31	$500,000
Total contributions received or receivable from participants	2016-12-31	$69,620
Other income received	2016-12-31	$25,788
Net income (gross income less expenses)	2016-12-31	$250,212
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$747,553
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$497,341
Total contributions received or receivable from employer(s)	2016-12-31	$164,916
Expenses. Administrative service providers (salaries,fees and commissions)	2016-12-31	$2,698

Form 5500 Responses for ABC PEDIATRICS, INC. ABC PEDIATRICS 401(K) AND PROFIT SHARING PLAN

2021: ABC PEDIATRICS, INC. ABC PEDIATRICS 401(K) AND PROFIT SHARING PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: ABC PEDIATRICS, INC. ABC PEDIATRICS 401(K) AND PROFIT SHARING PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: ABC PEDIATRICS, INC. ABC PEDIATRICS 401(K) AND PROFIT SHARING PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: ABC PEDIATRICS, INC. ABC PEDIATRICS 401(K) AND PROFIT SHARING PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: ABC PEDIATRICS, INC. ABC PEDIATRICS 401(K) AND PROFIT SHARING PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: ABC PEDIATRICS, INC. ABC PEDIATRICS 401(K) AND PROFIT SHARING PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

113014

Policy instance

Insurance contract or identification number	113014
Number of Individuals Covered	12
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $4,823
Total amount of fees paid to insurance company	USD $646
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,823
Insurance broker organization code?	3
Amount paid for insurance broker fees	646

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

113014

Policy instance

Insurance contract or identification number	113014
Number of Individuals Covered	21
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $3,547
Total amount of fees paid to insurance company	USD $523
Commission paid to Insurance Broker	USD $3,547
Insurance broker organization code?	3
Amount paid for insurance broker fees	523

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

113014

Policy instance

Insurance contract or identification number	113014
Number of Individuals Covered	20
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $2,846
Total amount of fees paid to insurance company	USD $358
Commission paid to Insurance Broker	USD $2,846
Insurance broker organization code?	3
Amount paid for insurance broker fees	358

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

113014

Policy instance

Insurance contract or identification number	113014
Number of Individuals Covered	19
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $2,501
Total amount of fees paid to insurance company	USD $361
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,501
Insurance broker organization code?	3
Amount paid for insurance broker fees	361
Additional information about fees paid to insurance broker	TPA COMPENSATION

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

113014

Policy instance

Insurance contract or identification number	113014
Number of Individuals Covered	18
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $2,289
Total amount of fees paid to insurance company	USD $438
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,289
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Additional information about fees paid to insurance broker	TPA COMPENSATION
Insurance broker name	RETIREMENT PLAN ADMINISTRATORS

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Company Name:	ABC PEDIATRICS PC
Employer identification number (EIN):	582209024
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)