401k Plan data: HOMETOWN URGENT CARE 401(K) PLAN plan

HOMETOWN URGENT CARE 401(K) PLAN 401k Plan overview

Plan Name	HOMETOWN URGENT CARE 401(K) PLAN
Plan identification number	002

HOMETOWN URGENT CARE 401(K) PLAN 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.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

URGENT CARE SPECIALISTS, LLC has sponsored the creation of one or more 401k plans.

Company Name: URGENT CARE SPECIALISTS, LLC

Employer identification number (EIN): 203587332

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HOMETOWN URGENT CARE 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2022-01-01 CORY ROSE 2023-10-16
002 2021-01-01
002 2020-01-01
002 2019-01-01
002 2018-01-01

Plan Statistics for HOMETOWN URGENT CARE 401(K) PLAN

401k plan membership statisitcs for HOMETOWN URGENT CARE 401(K) PLAN

Measure Date Value
2022: HOMETOWN URGENT CARE 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 575
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 146
Number of retired or separated participants receiving benefits 2022-01-01 21
Number of other retired or separated participants entitled to future benefits 2022-01-01 330
Total of all active and inactive participants 2022-01-01 497
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 497
Number of participants with account balances 2022-01-01 468
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: HOMETOWN URGENT CARE 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 597
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 239
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 330
Total of all active and inactive participants 2021-01-01 569
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 569
Number of participants with account balances 2021-01-01 532
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: HOMETOWN URGENT CARE 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 412
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 357
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 196
Total of all active and inactive participants 2020-01-01 553
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 553
Number of participants with account balances 2020-01-01 461
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: HOMETOWN URGENT CARE 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 294
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 309
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 87
Total of all active and inactive participants 2019-01-01 396
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 396
Number of participants with account balances 2019-01-01 363
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: HOMETOWN URGENT CARE 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 236
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 253
Number of retired or separated participants receiving benefits 2018-01-01 3
Number of other retired or separated participants entitled to future benefits 2018-01-01 33
Total of all active and inactive participants 2018-01-01 289
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 289
Number of participants with account balances 2018-01-01 247
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0

Measure	Date	Value
2022: HOMETOWN URGENT CARE 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	575
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	146
Number of retired or separated participants receiving benefits	2022-01-01	21
Number of other retired or separated participants entitled to future benefits	2022-01-01	330
Total of all active and inactive participants	2022-01-01	497
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	497
Number of participants with account balances	2022-01-01	468
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: HOMETOWN URGENT CARE 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	597
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	239
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	330
Total of all active and inactive participants	2021-01-01	569
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	569
Number of participants with account balances	2021-01-01	532
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: HOMETOWN URGENT CARE 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	412
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	357
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	196
Total of all active and inactive participants	2020-01-01	553
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	553
Number of participants with account balances	2020-01-01	461
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: HOMETOWN URGENT CARE 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	294
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	309
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	87
Total of all active and inactive participants	2019-01-01	396
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	396
Number of participants with account balances	2019-01-01	363
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: HOMETOWN URGENT CARE 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	236
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	253
Number of retired or separated participants receiving benefits	2018-01-01	3
Number of other retired or separated participants entitled to future benefits	2018-01-01	33
Total of all active and inactive participants	2018-01-01	289
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	289
Number of participants with account balances	2018-01-01	247
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0

Financial Data on HOMETOWN URGENT CARE 401(K) PLAN

Measure	Date	Value
2022 : HOMETOWN URGENT CARE 401(K) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total income from all sources (including contributions)	2022-12-31	$-677,519
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$517,311
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$500,547
Expenses. Certain deemed distributions of participant loans	2022-12-31	$5,614
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$0
Value of total assets at end of year	2022-12-31	$2,611,482
Value of total assets at beginning of year	2022-12-31	$3,806,312
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$11,150
Total interest from all sources	2022-12-31	$1,099
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$500,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Participant contributions at end of year	2022-12-31	$7,782
Participant contributions at beginning of year	2022-12-31	$40,291
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$-1,194,830
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$2,611,482
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$3,806,312
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Investment advisory and management fees	2022-12-31	$11,150
Value of interest in pooled separate accounts at end of year	2022-12-31	$2,566,059
Value of interest in pooled separate accounts at beginning of year	2022-12-31	$3,728,740
Interest on participant loans	2022-12-31	$1,099
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$37,641
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$37,281
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-678,618
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$500,547
Did the plan have assets held for investment	2022-12-31	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	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Disclaimer
Accountancy firm name	2022-12-31	SWINDON, SPRINGER & CO. CPA'S
Accountancy firm EIN	2022-12-31	311339842
2021 : HOMETOWN URGENT CARE 401(K) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$1,038,165
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$914,101
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$901,426
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$470,025
Value of total assets at end of year	2021-12-31	$3,806,312
Value of total assets at beginning of year	2021-12-31	$3,682,248
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$12,675
Total interest from all sources	2021-12-31	$3,971
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$372,640
Participant contributions at end of year	2021-12-31	$40,291
Participant contributions at beginning of year	2021-12-31	$65,477
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$97,385
Other income not declared elsewhere	2021-12-31	$395
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$124,064
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$3,806,312
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$3,682,248
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Investment advisory and management fees	2021-12-31	$12,675
Interest on participant loans	2021-12-31	$3,971
Value of interest in master investment trust accounts at end of year	2021-12-31	$3,728,740
Value of interest in master investment trust accounts at beginning of year	2021-12-31	$3,580,652
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$37,281
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$36,119
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$563,774
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$901,426
Did the plan have assets held for investment	2021-12-31	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	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Disclaimer
Accountancy firm name	2021-12-31	SWINDON, SPRINGER & CO. CPA'S
Accountancy firm EIN	2021-12-31	311339842
2020 : HOMETOWN URGENT CARE 401(K) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$1,203,238
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$303,079
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$296,229
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$714,510
Value of total assets at end of year	2020-12-31	$3,682,248
Value of total assets at beginning of year	2020-12-31	$2,782,089
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$6,850
Total interest from all sources	2020-12-31	$5,173
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Was this plan covered by a fidelity bond	2020-12-31	No
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$690,077
Participant contributions at end of year	2020-12-31	$65,477
Participant contributions at beginning of year	2020-12-31	$66,936
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$24,433
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$900,159
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$3,682,248
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$2,782,089
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Investment advisory and management fees	2020-12-31	$6,850
Interest on participant loans	2020-12-31	$5,173
Value of interest in master investment trust accounts at end of year	2020-12-31	$3,580,652
Value of interest in master investment trust accounts at beginning of year	2020-12-31	$2,690,305
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$36,119
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$24,848
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$296,229
Did the plan have assets held for investment	2020-12-31	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	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	SWINDON, SPRINGER & CO. CPA'S
Accountancy firm EIN	2020-12-31	311339842
2019 : HOMETOWN URGENT CARE 401(K) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$1,170,480
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$104,527
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$90,395
Expenses. Certain deemed distributions of participant loans	2019-12-31	$0
Value of total corrective distributions	2019-12-31	$6,567
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$735,424
Value of total assets at end of year	2019-12-31	$2,782,089
Value of total assets at beginning of year	2019-12-31	$1,716,136
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$7,565
Total interest from all sources	2019-12-31	$5,578
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Was this plan covered by a fidelity bond	2019-12-31	No
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$612,315
Participant contributions at end of year	2019-12-31	$66,936
Participant contributions at beginning of year	2019-12-31	$52,796
Participant contributions at end of year	2019-12-31	$0
Participant contributions at beginning of year	2019-12-31	$2,418
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$123,109
Other income not declared elsewhere	2019-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$1,065,953
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$2,782,089
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$1,716,136
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$0
Value of interest in pooled separate accounts at end of year	2019-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$0
Interest on participant loans	2019-12-31	$5,578
Value of interest in master investment trust accounts at end of year	2019-12-31	$2,690,305
Value of interest in master investment trust accounts at beginning of year	2019-12-31	$1,639,312
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$24,848
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$21,610
Net investment gain/loss from pooled separate accounts	2019-12-31	$429,478
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$90,395
Contract administrator fees	2019-12-31	$7,565
Liabilities. Value of benefit claims payable at end of year	2019-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2019-12-31	$0
Did the plan have assets held for investment	2019-12-31	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	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	SWINDON, SPRINGER & CO. CPA'S
Accountancy firm EIN	2019-12-31	311339842
2018 : HOMETOWN URGENT CARE 401(K) PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total transfer of assets to this plan	2018-12-31	$1,565,926
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$163,407
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$13,197
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$8,922
Expenses. Certain deemed distributions of participant loans	2018-12-31	$1,625
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$351,735
Value of total assets at end of year	2018-12-31	$1,716,136
Value of total assets at beginning of year	2018-12-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$2,650
Total interest from all sources	2018-12-31	$1,412
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Administrative expenses professional fees incurred	2018-12-31	$2,650
Was this plan covered by a fidelity bond	2018-12-31	No
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$280,180
Participant contributions at end of year	2018-12-31	$52,796
Participant contributions at beginning of year	2018-12-31	$0
Participant contributions at end of year	2018-12-31	$2,418
Participant contributions at beginning of year	2018-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$71,555
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$150,210
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$1,716,136
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in pooled separate accounts at end of year	2018-12-31	$21,610
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$0
Interest on participant loans	2018-12-31	$1,412
Value of interest in master investment trust accounts at end of year	2018-12-31	$1,639,312
Value of interest in master investment trust accounts at beginning of year	2018-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-189,740
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$8,922
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2018-12-31	No
Liabilities. Value of benefit claims payable at end of year	2018-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2018-12-31	$0
Did the plan have assets held for investment	2018-12-31	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	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	SWINDON, SPRINGER & CO. CPA'S
Accountancy firm EIN	2018-12-31	311339842

Form 5500 Responses for HOMETOWN URGENT CARE 401(K) PLAN

2022: HOMETOWN URGENT CARE 401(K) PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	Yes
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: HOMETOWN URGENT CARE 401(K) PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: HOMETOWN URGENT CARE 401(K) PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: HOMETOWN URGENT CARE 401(K) PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: HOMETOWN URGENT CARE 401(K) PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	First time form 5500 has been submitted	Yes
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

81A873

Policy instance

Insurance contract or identification number	81A873
Number of Individuals Covered	469
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $9,208
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $9,208
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	CASH COMMISSIONS
Insurance broker organization code?	3

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

81A873

Policy instance

Insurance contract or identification number	81A873
Number of Individuals Covered	533
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $11,805
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $11,805
Insurance broker organization code?	3

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

81A873

Policy instance

Insurance contract or identification number	81A873
Number of Individuals Covered	461
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $8,801
Total amount of fees paid to insurance company	USD $1,395
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $8,801
Insurance broker organization code?	3
Amount paid for insurance broker fees	1070
Additional information about fees paid to insurance broker	VOYA TPA PARTNERSHIP AND ALLIANCE PROGRAMS

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

81A873

Policy instance

Insurance contract or identification number	81A873
Number of Individuals Covered	357
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $7,693
Total amount of fees paid to insurance company	USD $3,590
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $7,693
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	CASH COMMISSIONS
Insurance broker organization code?	3

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

248

Policy instance

Insurance contract or identification number	248
Number of Individuals Covered	81873
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $17,223
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $17,223
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	CASH COMMISSIONS
Insurance broker organization code?	3

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Company Name:	URGENT CARE SPECIALISTS, LLC
Employer identification number (EIN):	203587332
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
002	2022-01-01	CORY ROSE	2023-10-16
002	2021-01-01
002	2020-01-01
002	2019-01-01
002	2018-01-01