401k Plan data: PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA plan

PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 401k Plan overview

Plan Name	PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA
Plan identification number	001

PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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.
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.
Plan not intended to be qualified - A plan not intended to be qualified under Code sections 401, 403, or 408.
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.
U.S.-based plan that covers residents of Puerto Rico and is qualified under both Code section 401 and section 1165 of the Puerto Rico Code.

401k Sponsoring company profile

SALUD INTEGRAL EN LA MONTANA, INC. has sponsored the creation of one or more 401k plans.

Company Name: SALUD INTEGRAL EN LA MONTANA, INC.

Employer identification number (EIN): 660329532

NAIC Classification: 623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-07-01
001 2021-07-01
001 2020-07-01
001 2019-07-01
001 2018-07-01
001 2017-07-01
001 2016-07-01 GLORIA AMADOR
001 2015-07-01 ANGEL VEGA ANGEL VEGA 2017-04-13
001 2014-07-01 GLORIA AMADOR GLORIA AMADOR 2016-04-15
001 2013-07-01 GLORIA AMADOR GLORIA AMADOR 2015-04-15
001 2012-07-01 GLORIA AMADOR GLORIA AMADOR 2014-04-14
001 2011-07-01 GLORIA AMADOR
001 2010-07-01 SANDRA GARCIA SANDRA GARCIA 2012-01-30
001 2009-07-01 SANDRA GARCIA SANDRA GARCIA 2011-01-28
001 2009-07-01 SANDRA GARCIA SANDRA GARCIA 2011-01-28

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2022-07-01
001	2021-07-01
001	2020-07-01
001	2019-07-01
001	2018-07-01
001	2017-07-01
001	2016-07-01	GLORIA AMADOR
001	2015-07-01	ANGEL VEGA	ANGEL VEGA	2017-04-13
001	2014-07-01	GLORIA AMADOR	GLORIA AMADOR	2016-04-15
001	2013-07-01	GLORIA AMADOR	GLORIA AMADOR	2015-04-15
001	2012-07-01	GLORIA AMADOR	GLORIA AMADOR	2014-04-14
001	2011-07-01	GLORIA AMADOR
001	2010-07-01	SANDRA GARCIA	SANDRA GARCIA	2012-01-30
001	2009-07-01	SANDRA GARCIA	SANDRA GARCIA	2011-01-28
001	2009-07-01	SANDRA GARCIA	SANDRA GARCIA	2011-01-28

Plan Statistics for PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA

401k plan membership statisitcs for PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA

Measure Date Value
2022: PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2022 401k membership
Total participants, beginning-of-year 2022-07-01 577
Total number of active participants reported on line 7a of the Form 5500 2022-07-01 758
Number of retired or separated participants receiving benefits 2022-07-01 0
Number of other retired or separated participants entitled to future benefits 2022-07-01 0
Total of all active and inactive participants 2022-07-01 758
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-07-01 0
Total participants 2022-07-01 758
Number of participants with account balances 2022-07-01 758
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-07-01 0
2021: PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2021 401k membership
Total participants, beginning-of-year 2021-07-01 550
Total number of active participants reported on line 7a of the Form 5500 2021-07-01 577
Number of retired or separated participants receiving benefits 2021-07-01 0
Number of other retired or separated participants entitled to future benefits 2021-07-01 0
Total of all active and inactive participants 2021-07-01 577
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-07-01 0
Total participants 2021-07-01 577
Number of participants with account balances 2021-07-01 577
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-07-01 0
2020: PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2020 401k membership
Total participants, beginning-of-year 2020-07-01 515
Total number of active participants reported on line 7a of the Form 5500 2020-07-01 550
Number of retired or separated participants receiving benefits 2020-07-01 0
Number of other retired or separated participants entitled to future benefits 2020-07-01 0
Total of all active and inactive participants 2020-07-01 550
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-07-01 0
Total participants 2020-07-01 550
Number of participants with account balances 2020-07-01 550
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-07-01 0
2019: PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2019 401k membership
Total participants, beginning-of-year 2019-07-01 460
Total number of active participants reported on line 7a of the Form 5500 2019-07-01 515
Number of retired or separated participants receiving benefits 2019-07-01 0
Number of other retired or separated participants entitled to future benefits 2019-07-01 0
Total of all active and inactive participants 2019-07-01 515
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-07-01 0
Total participants 2019-07-01 515
Number of participants with account balances 2019-07-01 515
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-07-01 0
2018: PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2018 401k membership
Total participants, beginning-of-year 2018-07-01 400
Total number of active participants reported on line 7a of the Form 5500 2018-07-01 460
Number of retired or separated participants receiving benefits 2018-07-01 0
Number of other retired or separated participants entitled to future benefits 2018-07-01 0
Total of all active and inactive participants 2018-07-01 460
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-07-01 0
Total participants 2018-07-01 460
Number of participants with account balances 2018-07-01 460
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-07-01 0
2017: PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2017 401k membership
Total participants, beginning-of-year 2017-07-01 383
Total number of active participants reported on line 7a of the Form 5500 2017-07-01 400
Number of retired or separated participants receiving benefits 2017-07-01 0
Number of other retired or separated participants entitled to future benefits 2017-07-01 0
Total of all active and inactive participants 2017-07-01 400
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-07-01 0
Total participants 2017-07-01 400
Number of participants with account balances 2017-07-01 400
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-07-01 0
2016: PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2016 401k membership
Total participants, beginning-of-year 2016-07-01 341
Total number of active participants reported on line 7a of the Form 5500 2016-07-01 383
Number of retired or separated participants receiving benefits 2016-07-01 0
Number of other retired or separated participants entitled to future benefits 2016-07-01 0
Total of all active and inactive participants 2016-07-01 383
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-07-01 0
Total participants 2016-07-01 383
Number of participants with account balances 2016-07-01 383
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-07-01 0
2015: PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2015 401k membership
Total participants, beginning-of-year 2015-07-01 313
Total number of active participants reported on line 7a of the Form 5500 2015-07-01 341
Number of retired or separated participants receiving benefits 2015-07-01 0
Number of other retired or separated participants entitled to future benefits 2015-07-01 0
Total of all active and inactive participants 2015-07-01 341
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-07-01 0
Total participants 2015-07-01 341
Number of participants with account balances 2015-07-01 341
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-07-01 0
2014: PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2014 401k membership
Total participants, beginning-of-year 2014-07-01 303
Total number of active participants reported on line 7a of the Form 5500 2014-07-01 313
Number of retired or separated participants receiving benefits 2014-07-01 0
Number of other retired or separated participants entitled to future benefits 2014-07-01 0
Total of all active and inactive participants 2014-07-01 313
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-07-01 0
Total participants 2014-07-01 313
Number of participants with account balances 2014-07-01 313
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-07-01 0
2013: PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2013 401k membership
Total participants, beginning-of-year 2013-07-01 293
Total number of active participants reported on line 7a of the Form 5500 2013-07-01 303
Number of retired or separated participants receiving benefits 2013-07-01 0
Number of other retired or separated participants entitled to future benefits 2013-07-01 0
Total of all active and inactive participants 2013-07-01 303
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-07-01 0
Total participants 2013-07-01 303
Number of participants with account balances 2013-07-01 303
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-07-01 0
2012: PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2012 401k membership
Total participants, beginning-of-year 2012-07-01 298
Total number of active participants reported on line 7a of the Form 5500 2012-07-01 293
Number of retired or separated participants receiving benefits 2012-07-01 0
Number of other retired or separated participants entitled to future benefits 2012-07-01 0
Total of all active and inactive participants 2012-07-01 293
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-07-01 0
Total participants 2012-07-01 293
Number of participants with account balances 2012-07-01 293
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-07-01 0
2011: PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2011 401k membership
Total participants, beginning-of-year 2011-07-01 321
Total number of active participants reported on line 7a of the Form 5500 2011-07-01 298
Number of retired or separated participants receiving benefits 2011-07-01 0
Number of other retired or separated participants entitled to future benefits 2011-07-01 0
Total of all active and inactive participants 2011-07-01 298
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-07-01 0
Total participants 2011-07-01 298
Number of participants with account balances 2011-07-01 298
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-07-01 0
2010: PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2010 401k membership
Total participants, beginning-of-year 2010-07-01 351
Total number of active participants reported on line 7a of the Form 5500 2010-07-01 321
Number of retired or separated participants receiving benefits 2010-07-01 0
Number of other retired or separated participants entitled to future benefits 2010-07-01 0
Total of all active and inactive participants 2010-07-01 321
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-07-01 0
Total participants 2010-07-01 321
Number of participants with account balances 2010-07-01 321
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-07-01 0
2009: PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2009 401k membership
Total participants, beginning-of-year 2009-07-01 415
Total number of active participants reported on line 7a of the Form 5500 2009-07-01 457
Number of retired or separated participants receiving benefits 2009-07-01 0
Number of other retired or separated participants entitled to future benefits 2009-07-01 0
Total of all active and inactive participants 2009-07-01 457
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-07-01 0
Total participants 2009-07-01 457
Number of participants with account balances 2009-07-01 351
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-07-01 39

Measure	Date	Value
2022: PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2022 401k membership
Total participants, beginning-of-year	2022-07-01	577
Total number of active participants reported on line 7a of the Form 5500	2022-07-01	758
Number of retired or separated participants receiving benefits	2022-07-01	0
Number of other retired or separated participants entitled to future benefits	2022-07-01	0
Total of all active and inactive participants	2022-07-01	758
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-07-01	0
Total participants	2022-07-01	758
Number of participants with account balances	2022-07-01	758
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-07-01	0
2021: PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2021 401k membership
Total participants, beginning-of-year	2021-07-01	550
Total number of active participants reported on line 7a of the Form 5500	2021-07-01	577
Number of retired or separated participants receiving benefits	2021-07-01	0
Number of other retired or separated participants entitled to future benefits	2021-07-01	0
Total of all active and inactive participants	2021-07-01	577
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-07-01	0
Total participants	2021-07-01	577
Number of participants with account balances	2021-07-01	577
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-07-01	0
2020: PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2020 401k membership
Total participants, beginning-of-year	2020-07-01	515
Total number of active participants reported on line 7a of the Form 5500	2020-07-01	550
Number of retired or separated participants receiving benefits	2020-07-01	0
Number of other retired or separated participants entitled to future benefits	2020-07-01	0
Total of all active and inactive participants	2020-07-01	550
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-07-01	0
Total participants	2020-07-01	550
Number of participants with account balances	2020-07-01	550
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-07-01	0
2019: PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2019 401k membership
Total participants, beginning-of-year	2019-07-01	460
Total number of active participants reported on line 7a of the Form 5500	2019-07-01	515
Number of retired or separated participants receiving benefits	2019-07-01	0
Number of other retired or separated participants entitled to future benefits	2019-07-01	0
Total of all active and inactive participants	2019-07-01	515
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-07-01	0
Total participants	2019-07-01	515
Number of participants with account balances	2019-07-01	515
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-07-01	0
2018: PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2018 401k membership
Total participants, beginning-of-year	2018-07-01	400
Total number of active participants reported on line 7a of the Form 5500	2018-07-01	460
Number of retired or separated participants receiving benefits	2018-07-01	0
Number of other retired or separated participants entitled to future benefits	2018-07-01	0
Total of all active and inactive participants	2018-07-01	460
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-07-01	0
Total participants	2018-07-01	460
Number of participants with account balances	2018-07-01	460
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-07-01	0
2017: PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2017 401k membership
Total participants, beginning-of-year	2017-07-01	383
Total number of active participants reported on line 7a of the Form 5500	2017-07-01	400
Number of retired or separated participants receiving benefits	2017-07-01	0
Number of other retired or separated participants entitled to future benefits	2017-07-01	0
Total of all active and inactive participants	2017-07-01	400
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-07-01	0
Total participants	2017-07-01	400
Number of participants with account balances	2017-07-01	400
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-07-01	0
2016: PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2016 401k membership
Total participants, beginning-of-year	2016-07-01	341
Total number of active participants reported on line 7a of the Form 5500	2016-07-01	383
Number of retired or separated participants receiving benefits	2016-07-01	0
Number of other retired or separated participants entitled to future benefits	2016-07-01	0
Total of all active and inactive participants	2016-07-01	383
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-07-01	0
Total participants	2016-07-01	383
Number of participants with account balances	2016-07-01	383
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-07-01	0
2015: PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2015 401k membership
Total participants, beginning-of-year	2015-07-01	313
Total number of active participants reported on line 7a of the Form 5500	2015-07-01	341
Number of retired or separated participants receiving benefits	2015-07-01	0
Number of other retired or separated participants entitled to future benefits	2015-07-01	0
Total of all active and inactive participants	2015-07-01	341
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-07-01	0
Total participants	2015-07-01	341
Number of participants with account balances	2015-07-01	341
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-07-01	0
2014: PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2014 401k membership
Total participants, beginning-of-year	2014-07-01	303
Total number of active participants reported on line 7a of the Form 5500	2014-07-01	313
Number of retired or separated participants receiving benefits	2014-07-01	0
Number of other retired or separated participants entitled to future benefits	2014-07-01	0
Total of all active and inactive participants	2014-07-01	313
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-07-01	0
Total participants	2014-07-01	313
Number of participants with account balances	2014-07-01	313
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-07-01	0
2013: PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2013 401k membership
Total participants, beginning-of-year	2013-07-01	293
Total number of active participants reported on line 7a of the Form 5500	2013-07-01	303
Number of retired or separated participants receiving benefits	2013-07-01	0
Number of other retired or separated participants entitled to future benefits	2013-07-01	0
Total of all active and inactive participants	2013-07-01	303
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-07-01	0
Total participants	2013-07-01	303
Number of participants with account balances	2013-07-01	303
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-07-01	0
2012: PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2012 401k membership
Total participants, beginning-of-year	2012-07-01	298
Total number of active participants reported on line 7a of the Form 5500	2012-07-01	293
Number of retired or separated participants receiving benefits	2012-07-01	0
Number of other retired or separated participants entitled to future benefits	2012-07-01	0
Total of all active and inactive participants	2012-07-01	293
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-07-01	0
Total participants	2012-07-01	293
Number of participants with account balances	2012-07-01	293
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-07-01	0
2011: PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2011 401k membership
Total participants, beginning-of-year	2011-07-01	321
Total number of active participants reported on line 7a of the Form 5500	2011-07-01	298
Number of retired or separated participants receiving benefits	2011-07-01	0
Number of other retired or separated participants entitled to future benefits	2011-07-01	0
Total of all active and inactive participants	2011-07-01	298
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-07-01	0
Total participants	2011-07-01	298
Number of participants with account balances	2011-07-01	298
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-07-01	0
2010: PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2010 401k membership
Total participants, beginning-of-year	2010-07-01	351
Total number of active participants reported on line 7a of the Form 5500	2010-07-01	321
Number of retired or separated participants receiving benefits	2010-07-01	0
Number of other retired or separated participants entitled to future benefits	2010-07-01	0
Total of all active and inactive participants	2010-07-01	321
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-07-01	0
Total participants	2010-07-01	321
Number of participants with account balances	2010-07-01	321
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-07-01	0
2009: PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2009 401k membership
Total participants, beginning-of-year	2009-07-01	415
Total number of active participants reported on line 7a of the Form 5500	2009-07-01	457
Number of retired or separated participants receiving benefits	2009-07-01	0
Number of other retired or separated participants entitled to future benefits	2009-07-01	0
Total of all active and inactive participants	2009-07-01	457
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-07-01	0
Total participants	2009-07-01	457
Number of participants with account balances	2009-07-01	351
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-07-01	39

Financial Data on PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA

Measure	Date	Value
2022 : PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-06-30	$31,878
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-06-30	$33,800
Total income from all sources (including contributions)	2022-06-30	$3,381,806
Total loss/gain on sale of assets	2022-06-30	$0
Total of all expenses incurred	2022-06-30	$373,391
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-06-30	$356,416
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-06-30	$4,102,511
Value of total assets at end of year	2022-06-30	$10,519,347
Value of total assets at beginning of year	2022-06-30	$7,512,854
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-06-30	$16,975
Total interest from all sources	2022-06-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2022-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-06-30	No
Was this plan covered by a fidelity bond	2022-06-30	Yes
Value of fidelity bond cover	2022-06-30	$342,000
If this is an individual account plan, was there a blackout period	2022-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2022-06-30	No
Contributions received from participants	2022-06-30	$662,988
Participant contributions at end of year	2022-06-30	$104,566
Participant contributions at beginning of year	2022-06-30	$41,294
Participant contributions at end of year	2022-06-30	$26,640
Income. Received or receivable in cash from other sources (including rollovers)	2022-06-30	$8,935
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2022-06-30	$31,878
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2022-06-30	$33,800
Administrative expenses (other) incurred	2022-06-30	$16,975
Total non interest bearing cash at end of year	2022-06-30	$50,723
Total non interest bearing cash at beginning of year	2022-06-30	$43,937
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-06-30	No
Value of net income/loss	2022-06-30	$3,008,415
Value of net assets at end of year (total assets less liabilities)	2022-06-30	$10,487,469
Value of net assets at beginning of year (total assets less liabilities)	2022-06-30	$7,479,054
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-06-30	No
Were any leases to which the plan was party in default or uncollectible	2022-06-30	No
Value of interest in pooled separate accounts at end of year	2022-06-30	$7,078,682
Value of interest in pooled separate accounts at beginning of year	2022-06-30	$5,073,560
Net investment gain/loss from pooled separate accounts	2022-06-30	$-720,705
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-06-30	No
Was there a failure to transmit to the plan any participant contributions	2022-06-30	No
Has the plan failed to provide any benefit when due under the plan	2022-06-30	No
Contributions received in cash from employer	2022-06-30	$3,430,588
Employer contributions (assets) at end of year	2022-06-30	$3,258,736
Employer contributions (assets) at beginning of year	2022-06-30	$2,354,063
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-06-30	$356,416
Did the plan have assets held for investment	2022-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-06-30	No
Opinion of an independent qualified public accountant for this plan	2022-06-30	Unqualified
Accountancy firm name	2022-06-30	RRC CPA GROUP, PSC
Accountancy firm EIN	2022-06-30	660701886
2021 : PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-06-30	$33,800
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-06-30	$33,800
Total income from all sources (including contributions)	2021-06-30	$3,542,267
Total loss/gain on sale of assets	2021-06-30	$0
Total of all expenses incurred	2021-06-30	$884,443
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-06-30	$884,443
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-06-30	$2,961,991
Value of total assets at end of year	2021-06-30	$7,512,854
Value of total assets at beginning of year	2021-06-30	$4,855,030
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-06-30	$0
Total interest from all sources	2021-06-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2021-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-06-30	No
Was this plan covered by a fidelity bond	2021-06-30	Yes
Value of fidelity bond cover	2021-06-30	$342,000
If this is an individual account plan, was there a blackout period	2021-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2021-06-30	No
Contributions received from participants	2021-06-30	$476,766
Participant contributions at end of year	2021-06-30	$41,294
Participant contributions at beginning of year	2021-06-30	$62,366
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2021-06-30	$27,276
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2021-06-30	$33,800
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2021-06-30	$33,800
Other income not declared elsewhere	2021-06-30	$3,030
Total non interest bearing cash at end of year	2021-06-30	$43,937
Total non interest bearing cash at beginning of year	2021-06-30	$33,885
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-06-30	No
Value of net income/loss	2021-06-30	$2,657,824
Value of net assets at end of year (total assets less liabilities)	2021-06-30	$7,479,054
Value of net assets at beginning of year (total assets less liabilities)	2021-06-30	$4,821,230
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-06-30	No
Were any leases to which the plan was party in default or uncollectible	2021-06-30	No
Value of interest in pooled separate accounts at end of year	2021-06-30	$5,073,560
Value of interest in pooled separate accounts at beginning of year	2021-06-30	$3,413,089
Net investment gain/loss from pooled separate accounts	2021-06-30	$577,246
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-06-30	No
Was there a failure to transmit to the plan any participant contributions	2021-06-30	No
Has the plan failed to provide any benefit when due under the plan	2021-06-30	No
Contributions received in cash from employer	2021-06-30	$2,485,225
Employer contributions (assets) at end of year	2021-06-30	$2,354,063
Employer contributions (assets) at beginning of year	2021-06-30	$1,345,690
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-06-30	$857,167
Did the plan have assets held for investment	2021-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-06-30	No
Opinion of an independent qualified public accountant for this plan	2021-06-30	Disclaimer
Accountancy firm name	2021-06-30	RRC CPA GROUP, PSC
Accountancy firm EIN	2021-06-30	660701886
2020 : PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-06-30	$33,800
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-06-30	$50,535
Total income from all sources (including contributions)	2020-06-30	$2,076,265
Total loss/gain on sale of assets	2020-06-30	$0
Total of all expenses incurred	2020-06-30	$1,870,823
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-06-30	$1,870,823
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-06-30	$1,856,316
Value of total assets at end of year	2020-06-30	$4,855,030
Value of total assets at beginning of year	2020-06-30	$4,666,323
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-06-30	$0
Total interest from all sources	2020-06-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2020-06-30	$0
Was this plan covered by a fidelity bond	2020-06-30	Yes
Value of fidelity bond cover	2020-06-30	$342,000
If this is an individual account plan, was there a blackout period	2020-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2020-06-30	No
Contributions received from participants	2020-06-30	$401,017
Participant contributions at end of year	2020-06-30	$62,366
Participant contributions at beginning of year	2020-06-30	$44,037
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2020-06-30	$19,419
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2020-06-30	$33,800
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2020-06-30	$50,535
Other income not declared elsewhere	2020-06-30	$3,503
Total non interest bearing cash at end of year	2020-06-30	$33,885
Total non interest bearing cash at beginning of year	2020-06-30	$50,535
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-06-30	No
Value of net income/loss	2020-06-30	$205,442
Value of net assets at end of year (total assets less liabilities)	2020-06-30	$4,821,230
Value of net assets at beginning of year (total assets less liabilities)	2020-06-30	$4,615,788
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-06-30	No
Were any leases to which the plan was party in default or uncollectible	2020-06-30	No
Value of interest in pooled separate accounts at end of year	2020-06-30	$3,413,089
Value of interest in pooled separate accounts at beginning of year	2020-06-30	$3,919,017
Net investment gain/loss from pooled separate accounts	2020-06-30	$216,446
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-06-30	No
Was there a failure to transmit to the plan any participant contributions	2020-06-30	No
Has the plan failed to provide any benefit when due under the plan	2020-06-30	No
Contributions received in cash from employer	2020-06-30	$1,455,299
Employer contributions (assets) at end of year	2020-06-30	$1,345,690
Employer contributions (assets) at beginning of year	2020-06-30	$652,734
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-06-30	$1,851,404
Did the plan have assets held for investment	2020-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2020-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2020-06-30	Disclaimer
Accountancy firm name	2020-06-30	RRC CPA GROUP, PSC
Accountancy firm EIN	2020-06-30	660701886
2019 : PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-06-30	$50,535
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-06-30	$63,146
Total income from all sources (including contributions)	2019-06-30	$1,329,222
Total loss/gain on sale of assets	2019-06-30	$0
Total of all expenses incurred	2019-06-30	$338,037
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-06-30	$306,650
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-06-30	$1,178,927
Value of total assets at end of year	2019-06-30	$4,666,323
Value of total assets at beginning of year	2019-06-30	$3,687,749
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-06-30	$31,387
Total interest from all sources	2019-06-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2019-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-06-30	No
Was this plan covered by a fidelity bond	2019-06-30	Yes
Value of fidelity bond cover	2019-06-30	$100,000
If this is an individual account plan, was there a blackout period	2019-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2019-06-30	No
Contributions received from participants	2019-06-30	$397,667
Participant contributions at end of year	2019-06-30	$44,037
Participant contributions at beginning of year	2019-06-30	$29,105
Income. Received or receivable in cash from other sources (including rollovers)	2019-06-30	$20,099
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2019-06-30	$2,066
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2019-06-30	$50,535
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2019-06-30	$63,146
Other income not declared elsewhere	2019-06-30	$2,417
Administrative expenses (other) incurred	2019-06-30	$31,387
Total non interest bearing cash at end of year	2019-06-30	$50,535
Total non interest bearing cash at beginning of year	2019-06-30	$63,146
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-06-30	No
Value of net income/loss	2019-06-30	$991,185
Value of net assets at end of year (total assets less liabilities)	2019-06-30	$4,615,788
Value of net assets at beginning of year (total assets less liabilities)	2019-06-30	$3,624,603
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-06-30	No
Were any leases to which the plan was party in default or uncollectible	2019-06-30	No
Value of interest in pooled separate accounts at end of year	2019-06-30	$3,919,017
Value of interest in pooled separate accounts at beginning of year	2019-06-30	$2,566,177
Net investment gain/loss from pooled separate accounts	2019-06-30	$147,878
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-06-30	No
Was there a failure to transmit to the plan any participant contributions	2019-06-30	No
Has the plan failed to provide any benefit when due under the plan	2019-06-30	No
Contributions received in cash from employer	2019-06-30	$761,161
Employer contributions (assets) at end of year	2019-06-30	$652,734
Employer contributions (assets) at beginning of year	2019-06-30	$1,029,321
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-06-30	$304,584
Did the plan have assets held for investment	2019-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2019-06-30	Disclaimer
Accountancy firm name	2019-06-30	RRC CPA GROUP, PSC
Accountancy firm EIN	2019-06-30	660701886
2018 : PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-06-30	$63,146
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-06-30	$73,607
Total income from all sources (including contributions)	2018-06-30	$1,557,698
Total loss/gain on sale of assets	2018-06-30	$0
Total of all expenses incurred	2018-06-30	$357,567
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-06-30	$321,843
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-06-30	$1,477,156
Value of total assets at end of year	2018-06-30	$3,687,749
Value of total assets at beginning of year	2018-06-30	$2,498,079
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-06-30	$35,724
Total interest from all sources	2018-06-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2018-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-06-30	No
Was this plan covered by a fidelity bond	2018-06-30	Yes
Value of fidelity bond cover	2018-06-30	$100,000
If this is an individual account plan, was there a blackout period	2018-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2018-06-30	No
Contributions received from participants	2018-06-30	$350,850
Participant contributions at end of year	2018-06-30	$29,105
Participant contributions at end of year	2018-06-30	$0
Participant contributions at beginning of year	2018-06-30	$0
Assets. Loans (other than to participants) at beginning of year	2018-06-30	$971
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2018-06-30	$63,146
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2018-06-30	$73,607
Other income not declared elsewhere	2018-06-30	$181
Administrative expenses (other) incurred	2018-06-30	$35,724
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-06-30	No
Value of net income/loss	2018-06-30	$1,200,131
Value of net assets at end of year (total assets less liabilities)	2018-06-30	$3,624,603
Value of net assets at beginning of year (total assets less liabilities)	2018-06-30	$2,424,472
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-06-30	No
Were any leases to which the plan was party in default or uncollectible	2018-06-30	No
Value of interest in pooled separate accounts at end of year	2018-06-30	$2,629,323
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-06-30	$2,362,879
Net investment gain or loss from common/collective trusts	2018-06-30	$80,361
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-06-30	No
Was there a failure to transmit to the plan any participant contributions	2018-06-30	No
Has the plan failed to provide any benefit when due under the plan	2018-06-30	No
Contributions received in cash from employer	2018-06-30	$1,126,306
Employer contributions (assets) at end of year	2018-06-30	$1,029,321
Employer contributions (assets) at beginning of year	2018-06-30	$134,229
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-06-30	$321,843
Did the plan have assets held for investment	2018-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2018-06-30	Disclaimer
Accountancy firm name	2018-06-30	JUAN REYES RAMIS CPA GROUP, PSC
Accountancy firm EIN	2018-06-30	660701886
2017 : PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-06-30	$73,607
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-06-30	$58,994
Total income from all sources (including contributions)	2017-06-30	$544,453
Total loss/gain on sale of assets	2017-06-30	$0
Total of all expenses incurred	2017-06-30	$103,837
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-06-30	$63,002
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-06-30	$442,698
Value of total assets at end of year	2017-06-30	$2,498,079
Value of total assets at beginning of year	2017-06-30	$2,042,850
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-06-30	$40,835
Total interest from all sources	2017-06-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2017-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-06-30	No
Was this plan covered by a fidelity bond	2017-06-30	Yes
Value of fidelity bond cover	2017-06-30	$1,000,000
If this is an individual account plan, was there a blackout period	2017-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2017-06-30	No
Contributions received from participants	2017-06-30	$241,398
Participant contributions at beginning of year	2017-06-30	$3,026
Assets. Loans (other than to participants) at end of year	2017-06-30	$971
Assets. Loans (other than to participants) at beginning of year	2017-06-30	$1,660
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2017-06-30	$73,607
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2017-06-30	$58,994
Other income not declared elsewhere	2017-06-30	$55
Administrative expenses (other) incurred	2017-06-30	$40,835
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-06-30	No
Value of net income/loss	2017-06-30	$440,616
Value of net assets at end of year (total assets less liabilities)	2017-06-30	$2,424,472
Value of net assets at beginning of year (total assets less liabilities)	2017-06-30	$1,983,856
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-06-30	No
Were any leases to which the plan was party in default or uncollectible	2017-06-30	No
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-06-30	$2,362,879
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-06-30	$1,598,719
Net investment gain or loss from common/collective trusts	2017-06-30	$101,700
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-06-30	No
Was there a failure to transmit to the plan any participant contributions	2017-06-30	No
Has the plan failed to provide any benefit when due under the plan	2017-06-30	No
Contributions received in cash from employer	2017-06-30	$201,300
Employer contributions (assets) at end of year	2017-06-30	$134,229
Employer contributions (assets) at beginning of year	2017-06-30	$439,445
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-06-30	$63,002
Did the plan have assets held for investment	2017-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2017-06-30	Disclaimer
Accountancy firm name	2017-06-30	JOSE E. ROSARIO & CO., CPA, PSC
Accountancy firm EIN	2017-06-30	660687714
2016 : PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-06-30	$58,994
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-06-30	$40,601
Total income from all sources (including contributions)	2016-06-30	$586,014
Total loss/gain on sale of assets	2016-06-30	$0
Total of all expenses incurred	2016-06-30	$153,805
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-06-30	$127,386
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-06-30	$587,525
Value of total assets at end of year	2016-06-30	$2,042,850
Value of total assets at beginning of year	2016-06-30	$1,592,248
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-06-30	$26,419
Total interest from all sources	2016-06-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2016-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-06-30	No
Was this plan covered by a fidelity bond	2016-06-30	Yes
Value of fidelity bond cover	2016-06-30	$100,000
If this is an individual account plan, was there a blackout period	2016-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2016-06-30	No
Contributions received from participants	2016-06-30	$115,435
Participant contributions at end of year	2016-06-30	$3,026
Participant contributions at beginning of year	2016-06-30	$3,220
Assets. Loans (other than to participants) at end of year	2016-06-30	$1,660
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2016-06-30	$58,994
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2016-06-30	$40,601
Administrative expenses (other) incurred	2016-06-30	$26,419
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-06-30	No
Value of net income/loss	2016-06-30	$432,209
Value of net assets at end of year (total assets less liabilities)	2016-06-30	$1,983,856
Value of net assets at beginning of year (total assets less liabilities)	2016-06-30	$1,551,647
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-06-30	No
Were any leases to which the plan was party in default or uncollectible	2016-06-30	No
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-06-30	$1,598,719
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-06-30	$1,189,546
Net investment gain/loss from pooled separate accounts	2016-06-30	$-1,511
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-06-30	No
Was there a failure to transmit to the plan any participant contributions	2016-06-30	No
Has the plan failed to provide any benefit when due under the plan	2016-06-30	No
Contributions received in cash from employer	2016-06-30	$472,090
Employer contributions (assets) at end of year	2016-06-30	$439,445
Employer contributions (assets) at beginning of year	2016-06-30	$399,482
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-06-30	$127,386
Did the plan have assets held for investment	2016-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2016-06-30	Disclaimer
Accountancy firm name	2016-06-30	JOSE E. ROSARIO & CO., CPA, P.S.C.
Accountancy firm EIN	2016-06-30	660687714
2015 : PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-06-30	$40,601
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-06-30	$21,281
Total income from all sources (including contributions)	2015-06-30	$522,332
Total loss/gain on sale of assets	2015-06-30	$0
Total of all expenses incurred	2015-06-30	$78,194
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-06-30	$55,244
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-06-30	$536,369
Value of total assets at end of year	2015-06-30	$1,592,248
Value of total assets at beginning of year	2015-06-30	$1,128,790
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-06-30	$22,950
Total interest from all sources	2015-06-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2015-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-06-30	No
Was this plan covered by a fidelity bond	2015-06-30	Yes
Value of fidelity bond cover	2015-06-30	$100,000
If this is an individual account plan, was there a blackout period	2015-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2015-06-30	No
Contributions received from participants	2015-06-30	$106,265
Participant contributions at end of year	2015-06-30	$3,220
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2015-06-30	$40,601
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2015-06-30	$21,281
Administrative expenses (other) incurred	2015-06-30	$22,950
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-06-30	No
Value of net income/loss	2015-06-30	$444,138
Value of net assets at end of year (total assets less liabilities)	2015-06-30	$1,551,647
Value of net assets at beginning of year (total assets less liabilities)	2015-06-30	$1,107,509
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-06-30	No
Were any leases to which the plan was party in default or uncollectible	2015-06-30	No
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-06-30	$1,189,546
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-06-30	$867,740
Net investment gain/loss from pooled separate accounts	2015-06-30	$-14,037
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-06-30	No
Was there a failure to transmit to the plan any participant contributions	2015-06-30	No
Has the plan failed to provide any benefit when due under the plan	2015-06-30	No
Contributions received in cash from employer	2015-06-30	$430,104
Employer contributions (assets) at end of year	2015-06-30	$399,482
Employer contributions (assets) at beginning of year	2015-06-30	$261,050
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-06-30	$55,244
Did the plan have assets held for investment	2015-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-06-30	No
Opinion of an independent qualified public accountant for this plan	2015-06-30	Unqualified
Accountancy firm name	2015-06-30	JOSE E. ROSARIO & CO., CPA, P.S.C.
Accountancy firm EIN	2015-06-30	660687714
2014 : PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-06-30	$21,281
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-06-30	$21,281
Total income from all sources (including contributions)	2014-06-30	$321,140
Total loss/gain on sale of assets	2014-06-30	$0
Total of all expenses incurred	2014-06-30	$55,664
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-06-30	$36,582
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-06-30	$261,050
Value of total assets at end of year	2014-06-30	$1,128,790
Value of total assets at beginning of year	2014-06-30	$863,314
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-06-30	$19,082
Total interest from all sources	2014-06-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2014-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-06-30	No
Was this plan covered by a fidelity bond	2014-06-30	Yes
Value of fidelity bond cover	2014-06-30	$100,000
If this is an individual account plan, was there a blackout period	2014-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2014-06-30	No
Contributions received from participants	2014-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2014-06-30	$21,281
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2014-06-30	$21,281
Administrative expenses (other) incurred	2014-06-30	$19,082
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-06-30	No
Value of net income/loss	2014-06-30	$265,476
Value of net assets at end of year (total assets less liabilities)	2014-06-30	$1,107,509
Value of net assets at beginning of year (total assets less liabilities)	2014-06-30	$842,033
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-06-30	No
Were any leases to which the plan was party in default or uncollectible	2014-06-30	No
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-06-30	$867,740
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-06-30	$636,627
Net investment gain/loss from pooled separate accounts	2014-06-30	$60,090
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-06-30	No
Was there a failure to transmit to the plan any participant contributions	2014-06-30	No
Has the plan failed to provide any benefit when due under the plan	2014-06-30	No
Contributions received in cash from employer	2014-06-30	$261,050
Employer contributions (assets) at end of year	2014-06-30	$261,050
Employer contributions (assets) at beginning of year	2014-06-30	$226,687
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-06-30	$36,582
Did the plan have assets held for investment	2014-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2014-06-30	Disclaimer
Accountancy firm name	2014-06-30	JOSE E. ROSARIO & CO.,CPA, P.S.C.
Accountancy firm EIN	2014-06-30	660687714
2013 : PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-06-30	$21,281
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-06-30	$21,281
Total income from all sources (including contributions)	2013-06-30	$265,138
Total loss/gain on sale of assets	2013-06-30	$0
Total of all expenses incurred	2013-06-30	$71,674
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-06-30	$54,167
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-06-30	$226,687
Value of total assets at end of year	2013-06-30	$863,314
Value of total assets at beginning of year	2013-06-30	$669,850
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-06-30	$17,507
Total interest from all sources	2013-06-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2013-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-06-30	No
Was this plan covered by a fidelity bond	2013-06-30	Yes
Value of fidelity bond cover	2013-06-30	$500,000
If this is an individual account plan, was there a blackout period	2013-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2013-06-30	No
Contributions received from participants	2013-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2013-06-30	$21,281
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2013-06-30	$21,281
Administrative expenses (other) incurred	2013-06-30	$17,507
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-06-30	No
Value of net income/loss	2013-06-30	$193,464
Value of net assets at end of year (total assets less liabilities)	2013-06-30	$842,033
Value of net assets at beginning of year (total assets less liabilities)	2013-06-30	$648,569
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-06-30	No
Were any leases to which the plan was party in default or uncollectible	2013-06-30	No
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-06-30	$636,627
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-06-30	$596,120
Net investment gain/loss from pooled separate accounts	2013-06-30	$38,451
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-06-30	No
Was there a failure to transmit to the plan any participant contributions	2013-06-30	No
Has the plan failed to provide any benefit when due under the plan	2013-06-30	No
Contributions received in cash from employer	2013-06-30	$226,687
Employer contributions (assets) at end of year	2013-06-30	$226,687
Employer contributions (assets) at beginning of year	2013-06-30	$73,730
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-06-30	$54,167
Did the plan have assets held for investment	2013-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2013-06-30	Disclaimer
Accountancy firm name	2013-06-30	JOSE E. ROSARIO & CO., CPA, P.S.C.
Accountancy firm EIN	2013-06-30	660687714
2012 : PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-06-30	$21,281
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-06-30	$27,284
Total income from all sources (including contributions)	2012-06-30	$76,221
Total loss/gain on sale of assets	2012-06-30	$0
Total of all expenses incurred	2012-06-30	$167,589
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-06-30	$148,206
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-06-30	$73,730
Value of total assets at end of year	2012-06-30	$669,850
Value of total assets at beginning of year	2012-06-30	$767,221
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-06-30	$19,383
Total interest from all sources	2012-06-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2012-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-06-30	No
Was this plan covered by a fidelity bond	2012-06-30	Yes
Value of fidelity bond cover	2012-06-30	$500,000
If this is an individual account plan, was there a blackout period	2012-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2012-06-30	No
Contributions received from participants	2012-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2012-06-30	$21,281
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2012-06-30	$27,284
Administrative expenses (other) incurred	2012-06-30	$19,383
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-06-30	No
Value of net income/loss	2012-06-30	$-91,368
Value of net assets at end of year (total assets less liabilities)	2012-06-30	$648,569
Value of net assets at beginning of year (total assets less liabilities)	2012-06-30	$739,937
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-06-30	No
Were any leases to which the plan was party in default or uncollectible	2012-06-30	No
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-06-30	$596,120
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-06-30	$723,276
Net investment gain/loss from pooled separate accounts	2012-06-30	$2,491
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-06-30	No
Was there a failure to transmit to the plan any participant contributions	2012-06-30	No
Has the plan failed to provide any benefit when due under the plan	2012-06-30	No
Contributions received in cash from employer	2012-06-30	$73,730
Employer contributions (assets) at end of year	2012-06-30	$73,730
Employer contributions (assets) at beginning of year	2012-06-30	$43,945
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-06-30	$148,206
Did the plan have assets held for investment	2012-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2012-06-30	Disclaimer
Accountancy firm name	2012-06-30	JOSE E. ROSARIO & CO., CPA, P.S.C.
Accountancy firm EIN	2012-06-30	660687714
2011 : PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-06-30	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-06-30	$27,284
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-06-30	$27,284
Total income from all sources (including contributions)	2011-06-30	$128,135
Total loss/gain on sale of assets	2011-06-30	$0
Total of all expenses incurred	2011-06-30	$119,481
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-06-30	$98,477
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-06-30	$43,945
Value of total assets at end of year	2011-06-30	$767,221
Value of total assets at beginning of year	2011-06-30	$758,567
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-06-30	$21,004
Total interest from all sources	2011-06-30	$0
Total dividends received (eg from common stock, registered investment company shares)	2011-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-06-30	No
Was this plan covered by a fidelity bond	2011-06-30	Yes
Value of fidelity bond cover	2011-06-30	$500,000
If this is an individual account plan, was there a blackout period	2011-06-30	No
Were there any nonexempt tranactions with any party-in-interest	2011-06-30	No
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2011-06-30	$27,284
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2011-06-30	$27,284
Administrative expenses (other) incurred	2011-06-30	$21,004
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-06-30	No
Value of net income/loss	2011-06-30	$8,654
Value of net assets at end of year (total assets less liabilities)	2011-06-30	$739,937
Value of net assets at beginning of year (total assets less liabilities)	2011-06-30	$731,283
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-06-30	No
Were any leases to which the plan was party in default or uncollectible	2011-06-30	No
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-06-30	$723,276
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-06-30	$714,651
Net investment gain/loss from pooled separate accounts	2011-06-30	$84,190
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-06-30	No
Was there a failure to transmit to the plan any participant contributions	2011-06-30	No
Has the plan failed to provide any benefit when due under the plan	2011-06-30	No
Contributions received in cash from employer	2011-06-30	$43,945
Employer contributions (assets) at end of year	2011-06-30	$43,945
Employer contributions (assets) at beginning of year	2011-06-30	$43,916
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-06-30	$98,477
Did the plan have assets held for investment	2011-06-30	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-06-30	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2011-06-30	Disclaimer
Accountancy firm name	2011-06-30	JOSE E. ROSARIO & CO.,CPA, P.S.C.
Accountancy firm EIN	2011-06-30	660687714

Form 5500 Responses for PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA

2022: PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2022 form 5500 responses
2022-07-01	Type of plan entity	Single employer plan
2022-07-01	Submission has been amended	No
2022-07-01	This submission is the final filing	No
2022-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-07-01	Plan is a collectively bargained plan	No
2022-07-01	Plan funding arrangement – Insurance	Yes
2022-07-01	Plan funding arrangement – Trust	Yes
2022-07-01	Plan benefit arrangement – Insurance	Yes
2022-07-01	Plan benefit arrangement - Trust	Yes
2021: PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2021 form 5500 responses
2021-07-01	Type of plan entity	Single employer plan
2021-07-01	Submission has been amended	No
2021-07-01	This submission is the final filing	No
2021-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-07-01	Plan is a collectively bargained plan	No
2021-07-01	Plan funding arrangement – Insurance	Yes
2021-07-01	Plan funding arrangement – Trust	Yes
2021-07-01	Plan benefit arrangement – Insurance	Yes
2021-07-01	Plan benefit arrangement - Trust	Yes
2020: PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2020 form 5500 responses
2020-07-01	Type of plan entity	Single employer plan
2020-07-01	Submission has been amended	No
2020-07-01	This submission is the final filing	No
2020-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-07-01	Plan is a collectively bargained plan	No
2020-07-01	Plan funding arrangement – Insurance	Yes
2020-07-01	Plan funding arrangement – Trust	Yes
2020-07-01	Plan benefit arrangement – Insurance	Yes
2020-07-01	Plan benefit arrangement - Trust	Yes
2019: PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2019 form 5500 responses
2019-07-01	Type of plan entity	Single employer plan
2019-07-01	Submission has been amended	No
2019-07-01	This submission is the final filing	No
2019-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-07-01	Plan is a collectively bargained plan	No
2019-07-01	Plan funding arrangement – Insurance	Yes
2019-07-01	Plan funding arrangement – Trust	Yes
2019-07-01	Plan benefit arrangement – Insurance	Yes
2019-07-01	Plan benefit arrangement - Trust	Yes
2018: PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2018 form 5500 responses
2018-07-01	Type of plan entity	Single employer plan
2018-07-01	Submission has been amended	No
2018-07-01	This submission is the final filing	No
2018-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-07-01	Plan is a collectively bargained plan	No
2018-07-01	Plan funding arrangement – Insurance	Yes
2018-07-01	Plan funding arrangement – Trust	Yes
2018-07-01	Plan benefit arrangement – Insurance	Yes
2018-07-01	Plan benefit arrangement - Trust	Yes
2017: PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2017 form 5500 responses
2017-07-01	Type of plan entity	Single employer plan
2017-07-01	Submission has been amended	No
2017-07-01	This submission is the final filing	No
2017-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-07-01	Plan is a collectively bargained plan	No
2017-07-01	Plan funding arrangement – Insurance	Yes
2017-07-01	Plan funding arrangement – Trust	Yes
2017-07-01	Plan benefit arrangement – Insurance	Yes
2017-07-01	Plan benefit arrangement - Trust	Yes
2016: PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2016 form 5500 responses
2016-07-01	Type of plan entity	Single employer plan
2016-07-01	Submission has been amended	No
2016-07-01	This submission is the final filing	No
2016-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-07-01	Plan is a collectively bargained plan	No
2016-07-01	Plan funding arrangement – Insurance	Yes
2016-07-01	Plan funding arrangement – Trust	Yes
2016-07-01	Plan benefit arrangement – Insurance	Yes
2016-07-01	Plan benefit arrangement - Trust	Yes
2015: PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2015 form 5500 responses
2015-07-01	Type of plan entity	Single employer plan
2015-07-01	Submission has been amended	No
2015-07-01	This submission is the final filing	No
2015-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-07-01	Plan is a collectively bargained plan	No
2015-07-01	Plan funding arrangement – Insurance	Yes
2015-07-01	Plan funding arrangement – Trust	Yes
2015-07-01	Plan benefit arrangement – Insurance	Yes
2015-07-01	Plan benefit arrangement - Trust	Yes
2014: PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2014 form 5500 responses
2014-07-01	Type of plan entity	Single employer plan
2014-07-01	Submission has been amended	No
2014-07-01	This submission is the final filing	No
2014-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-07-01	Plan is a collectively bargained plan	No
2014-07-01	Plan funding arrangement – Insurance	Yes
2014-07-01	Plan funding arrangement – Trust	Yes
2014-07-01	Plan benefit arrangement – Insurance	Yes
2014-07-01	Plan benefit arrangement - Trust	Yes
2013: PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2013 form 5500 responses
2013-07-01	Type of plan entity	Single employer plan
2013-07-01	Submission has been amended	No
2013-07-01	This submission is the final filing	No
2013-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-07-01	Plan is a collectively bargained plan	No
2013-07-01	Plan funding arrangement – Insurance	Yes
2013-07-01	Plan funding arrangement – Trust	Yes
2013-07-01	Plan benefit arrangement – Insurance	Yes
2013-07-01	Plan benefit arrangement - Trust	Yes
2012: PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2012 form 5500 responses
2012-07-01	Type of plan entity	Single employer plan
2012-07-01	Submission has been amended	No
2012-07-01	This submission is the final filing	No
2012-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-07-01	Plan is a collectively bargained plan	No
2012-07-01	Plan funding arrangement – Insurance	Yes
2012-07-01	Plan funding arrangement – Trust	Yes
2012-07-01	Plan benefit arrangement – Insurance	Yes
2012-07-01	Plan benefit arrangement - Trust	Yes
2011: PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2011 form 5500 responses
2011-07-01	Type of plan entity	Single employer plan
2011-07-01	Submission has been amended	No
2011-07-01	This submission is the final filing	No
2011-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-07-01	Plan is a collectively bargained plan	No
2011-07-01	Plan funding arrangement – Insurance	Yes
2011-07-01	Plan funding arrangement – Trust	Yes
2011-07-01	Plan benefit arrangement – Insurance	Yes
2011-07-01	Plan benefit arrangement - Trust	Yes
2010: PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2010 form 5500 responses
2010-07-01	Type of plan entity	Single employer plan
2010-07-01	Submission has been amended	No
2010-07-01	This submission is the final filing	No
2010-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-07-01	Plan is a collectively bargained plan	No
2010-07-01	Plan funding arrangement – Insurance	Yes
2010-07-01	Plan funding arrangement – Trust	Yes
2010-07-01	Plan benefit arrangement – Insurance	Yes
2010-07-01	Plan benefit arrangement - Trust	Yes
2009: PLAN DE RETIRO DE SALUD INTEGRAL EN LA MONTANA 2009 form 5500 responses
2009-07-01	Type of plan entity	Single employer plan
2009-07-01	Submission has been amended	No
2009-07-01	This submission is the final filing	No
2009-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-07-01	Plan is a collectively bargained plan	No
2009-07-01	Plan funding arrangement – Insurance	Yes
2009-07-01	Plan funding arrangement – Trust	Yes
2009-07-01	Plan benefit arrangement – Insurance	Yes
2009-07-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

494-80193

Policy instance

Insurance contract or identification number	494-80193
Number of Individuals Covered	577
Insurance policy start date	2021-07-01
Insurance policy end date	2022-06-30
Total amount of commissions paid to insurance broker	USD $3,783
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Commission paid to Insurance Broker	USD $3,783
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

494-80193

Policy instance

Insurance contract or identification number	494-80193
Number of Individuals Covered	506
Insurance policy start date	2020-07-01
Insurance policy end date	2021-06-30
Total amount of commissions paid to insurance broker	USD $1,725
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?	Yes
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
Other information about contract	GROUP ANNUITY
Commission paid to Insurance Broker	USD $1,725
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

494-80193

Policy instance

Insurance contract or identification number	494-80193
Number of Individuals Covered	515
Insurance policy start date	2019-07-01
Insurance policy end date	2020-06-30
Total amount of commissions paid to insurance broker	USD $10,125
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?	Yes
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
Other information about contract	GROUP ANNUITY
Commission paid to Insurance Broker	USD $10,125
Insurance broker organization code?	3

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

Policy contract number

91435

Policy instance

Insurance contract or identification number	91435
Number of Individuals Covered	0
Insurance policy start date	2019-07-01
Insurance policy end date	2020-06-30
Total amount of commissions paid to insurance broker	USD $9,985
Total amount of fees paid to insurance company	USD $15,029
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?	Yes
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
Other information about contract	GROUP ANNUITY
Amount paid for insurance broker fees	1681
Additional information about fees paid to insurance broker	TPA COMPENSATION
Insurance broker organization code?	5
Commission paid to Insurance Broker	USD $9,985

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

Policy contract number

91435

Policy instance

Insurance contract or identification number	91435
Insurance policy start date	2018-07-01
Insurance policy end date	2019-06-30
Total amount of commissions paid to insurance broker	USD $14,956
Total amount of fees paid to insurance company	USD $21,183
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Commission paid to Insurance Broker	USD $14,956
Insurance broker organization code?	3
Amount paid for insurance broker fees	20087
Additional information about fees paid to insurance broker	TPA FEES

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

Policy contract number

91435

Policy instance

Insurance contract or identification number	91435
Number of Individuals Covered	414
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
Total amount of commissions paid to insurance broker	USD $14,956
Total amount of fees paid to insurance company	USD $21,183
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No

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

Policy contract number

91435

Policy instance

Insurance contract or identification number	91435
Insurance policy start date	2015-07-01
Insurance policy end date	2016-06-30
Total amount of commissions paid to insurance broker	USD $7,180
Total amount of fees paid to insurance company	USD $6,689
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Commission paid to Insurance Broker	USD $7,180
Insurance broker organization code?	3
Amount paid for insurance broker fees	6689
Additional information about fees paid to insurance broker	TPA FEES
Insurance broker name	THE 401K COMPANY OF PUERTO RICO

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

Policy contract number

91435

Policy instance

Insurance contract or identification number	91435
Number of Individuals Covered	313
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Total amount of commissions paid to insurance broker	USD $5,375
Total amount of fees paid to insurance company	USD $4,598
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Commission paid to Insurance Broker	USD $5,375
Insurance broker organization code?	3
Amount paid for insurance broker fees	4598
Additional information about fees paid to insurance broker	TPA FEES
Insurance broker name	THE 401K COMPANY OF PUERTO RICO

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

Policy contract number

91435

Policy instance

Insurance contract or identification number	91435
Number of Individuals Covered	326
Insurance policy start date	2013-07-01
Insurance policy end date	2014-06-30
Total amount of commissions paid to insurance broker	USD $3,627
Total amount of fees paid to insurance company	USD $3,674
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Commission paid to Insurance Broker	USD $3,627
Insurance broker organization code?	3
Amount paid for insurance broker fees	3369
Additional information about fees paid to insurance broker	TPA FEES
Insurance broker name	THE 401K COMPANY OF PUERTO RICO, IN

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

Policy contract number

91435

Policy instance

Insurance contract or identification number	91435
Insurance policy start date	2012-07-01
Insurance policy end date	2013-06-30
Total amount of commissions paid to insurance broker	USD $3,475
Total amount of fees paid to insurance company	USD $2,892
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Commission paid to Insurance Broker	USD $3,475
Insurance broker organization code?	3
Amount paid for insurance broker fees	2892
Additional information about fees paid to insurance broker	TPA FEES PAID
Insurance broker name	THE 401K COMPANY OF PUERTO RICO

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

Policy contract number

91435

Policy instance

Insurance contract or identification number	91435
Number of Individuals Covered	298
Insurance policy start date	2011-07-01
Insurance policy end date	2012-06-30
Total amount of commissions paid to insurance broker	USD $4,115
Total amount of fees paid to insurance company	USD $3,136
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No

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

Policy contract number

91435

Policy instance

Insurance contract or identification number	91435
Insurance policy start date	2010-07-01
Insurance policy end date	2011-06-30
Total amount of commissions paid to insurance broker	USD $4,184
Total amount of fees paid to insurance company	USD $3,486
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No

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Company Name:	SALUD INTEGRAL EN LA MONTANA, INC.
Employer identification number (EIN):	660329532
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities