401k Plan data: EAR, NOSE & THROAT SPECIALISTS 401K PROFIT SHARING PLAN plan

EAR, NOSE & THROAT SPECIALISTS 401K PROFIT SHARING PLAN 401k Plan overview

Plan Name	EAR, NOSE & THROAT SPECIALISTS 401K PROFIT SHARING PLAN
Plan identification number	001

EAR, NOSE & THROAT SPECIALISTS 401K PROFIT SHARING 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

EAR, NOSE & THROAT SPECIALISTS OF NORTHERN VIRGINIA has sponsored the creation of one or more 401k plans.

Company Name: EAR, NOSE & THROAT SPECIALISTS OF NORTHERN VIRGINIA

Employer identification number (EIN): 540982265

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EAR, NOSE & THROAT SPECIALISTS 401K PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01 CAROLYN HISEY 2023-07-25
001 2021-01-01 CAROLYN HISEY 2022-07-22 CAROLYN HISEY 2022-07-22
001 2020-01-01 CAROLYN HISEY 2021-06-24
001 2019-01-01 CAROLYN I HISEY 2020-06-01
001 2018-01-01 CAROLYN HISEY 2019-07-30
001 2017-01-01 CAROLYN HISEY 2018-08-03 CAROLYN HISEY 2018-08-03
001 2016-01-01 CAROLYN HISEY 2017-07-12
001 2015-01-01 CAROLYN HISEY
001 2014-01-01 CAROLYN HISEY
001 2013-01-01 NANCI PANOS NANCI PANOS 2014-07-31
001 2012-01-01 NANCI PANOS
001 2011-01-01 ELLEN BALDY
001 2009-01-01 ELLEN BALDY

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2022-01-01	CAROLYN HISEY	2023-07-25
001	2021-01-01	CAROLYN HISEY	2022-07-22	CAROLYN HISEY	2022-07-22
001	2020-01-01	CAROLYN HISEY	2021-06-24
001	2019-01-01	CAROLYN I HISEY	2020-06-01
001	2018-01-01	CAROLYN HISEY	2019-07-30
001	2017-01-01	CAROLYN HISEY	2018-08-03	CAROLYN HISEY	2018-08-03
001	2016-01-01	CAROLYN HISEY	2017-07-12
001	2015-01-01	CAROLYN HISEY
001	2014-01-01	CAROLYN HISEY
001	2013-01-01	NANCI PANOS		NANCI PANOS	2014-07-31
001	2012-01-01	NANCI PANOS
001	2011-01-01	ELLEN BALDY
001	2009-01-01	ELLEN BALDY

Plan Statistics for EAR, NOSE & THROAT SPECIALISTS 401K PROFIT SHARING PLAN

401k plan membership statisitcs for EAR, NOSE & THROAT SPECIALISTS 401K PROFIT SHARING PLAN

Measure Date Value
2015: EAR, NOSE & THROAT SPECIALISTS 401K PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 73
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 51
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 13
Total of all active and inactive participants 2015-01-01 64
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 64
Number of participants with account balances 2015-01-01 62
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 1
2014: EAR, NOSE & THROAT SPECIALISTS 401K PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 75
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 58
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 14
Total of all active and inactive participants 2014-01-01 72
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 1
Total participants 2014-01-01 73
Number of participants with account balances 2014-01-01 70
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: EAR, NOSE & THROAT SPECIALISTS 401K PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 85
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 61
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 14
Total of all active and inactive participants 2013-01-01 75
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 75
Number of participants with account balances 2013-01-01 67
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: EAR, NOSE & THROAT SPECIALISTS 401K PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 73
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 55
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 26
Total of all active and inactive participants 2012-01-01 81
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 1
Total participants 2012-01-01 82
Number of participants with account balances 2012-01-01 75
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: EAR, NOSE & THROAT SPECIALISTS 401K PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 72
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 48
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 24
Total of all active and inactive participants 2011-01-01 72
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 1
Total participants 2011-01-01 73
Number of participants with account balances 2011-01-01 70
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 2
2009: EAR, NOSE & THROAT SPECIALISTS 401K PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 65
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 61
Number of retired or separated participants receiving benefits 2009-01-01 1
Number of other retired or separated participants entitled to future benefits 2009-01-01 17
Total of all active and inactive participants 2009-01-01 79
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 1
Total participants 2009-01-01 80
Number of participants with account balances 2009-01-01 71
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 4

Measure	Date	Value
2015: EAR, NOSE & THROAT SPECIALISTS 401K PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	73
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	51
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	13
Total of all active and inactive participants	2015-01-01	64
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	64
Number of participants with account balances	2015-01-01	62
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	1
2014: EAR, NOSE & THROAT SPECIALISTS 401K PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	75
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	58
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	14
Total of all active and inactive participants	2014-01-01	72
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	1
Total participants	2014-01-01	73
Number of participants with account balances	2014-01-01	70
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: EAR, NOSE & THROAT SPECIALISTS 401K PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	85
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	61
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	14
Total of all active and inactive participants	2013-01-01	75
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	75
Number of participants with account balances	2013-01-01	67
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: EAR, NOSE & THROAT SPECIALISTS 401K PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	73
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	55
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	26
Total of all active and inactive participants	2012-01-01	81
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	1
Total participants	2012-01-01	82
Number of participants with account balances	2012-01-01	75
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: EAR, NOSE & THROAT SPECIALISTS 401K PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	72
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	48
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	24
Total of all active and inactive participants	2011-01-01	72
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	1
Total participants	2011-01-01	73
Number of participants with account balances	2011-01-01	70
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	2
2009: EAR, NOSE & THROAT SPECIALISTS 401K PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	65
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	61
Number of retired or separated participants receiving benefits	2009-01-01	1
Number of other retired or separated participants entitled to future benefits	2009-01-01	17
Total of all active and inactive participants	2009-01-01	79
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	1
Total participants	2009-01-01	80
Number of participants with account balances	2009-01-01	71
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	4

Financial Data on EAR, NOSE & THROAT SPECIALISTS 401K PROFIT SHARING PLAN

Measure	Date	Value
2015 : EAR, NOSE & THROAT SPECIALISTS 401K PROFIT SHARING PLAN 2015 401k financial data
Total income from all sources	2015-12-31	$455,031
Expenses. Total of all expenses incurred	2015-12-31	$2,981,562
Benefits paid (including direct rollovers)	2015-12-31	$2,979,512
Total plan assets at end of year	2015-12-31	$8,062,549
Total plan assets at beginning of year	2015-12-31	$10,589,080
Value of fidelity bond covering the plan	2015-12-31	$500,000
Total contributions received or receivable from participants	2015-12-31	$230,075
Other income received	2015-12-31	$-124,467
Net income (gross income less expenses)	2015-12-31	$-2,526,531
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$8,062,549
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$10,589,080
Assets. Value of participant loans	2015-12-31	$77,264
Total contributions received or receivable from employer(s)	2015-12-31	$349,423
Expenses. Administrative service providers (salaries,fees and commissions)	2015-12-31	$2,050
2014 : EAR, NOSE & THROAT SPECIALISTS 401K PROFIT SHARING PLAN 2014 401k financial data
Total income from all sources	2014-12-31	$1,560,118
Expenses. Total of all expenses incurred	2014-12-31	$5,011,105
Benefits paid (including direct rollovers)	2014-12-31	$5,009,805
Total plan assets at end of year	2014-12-31	$10,589,080
Total plan assets at beginning of year	2014-12-31	$14,040,067
Value of fidelity bond covering the plan	2014-12-31	$500,000
Total contributions received or receivable from participants	2014-12-31	$267,730
Contributions received from other sources (not participants or employers)	2014-12-31	$123,047
Other income received	2014-12-31	$840,154
Net income (gross income less expenses)	2014-12-31	$-3,450,987
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$10,589,080
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$14,040,067
Assets. Value of participant loans	2014-12-31	$95,026
Total contributions received or receivable from employer(s)	2014-12-31	$329,187
Expenses. Administrative service providers (salaries,fees and commissions)	2014-12-31	$1,300
2013 : EAR, NOSE & THROAT SPECIALISTS 401K PROFIT SHARING PLAN 2013 401k financial data
Total income from all sources	2013-12-31	$2,352,637
Expenses. Total of all expenses incurred	2013-12-31	$524,500
Benefits paid (including direct rollovers)	2013-12-31	$418,788
Total plan assets at end of year	2013-12-31	$14,040,067
Total plan assets at beginning of year	2013-12-31	$12,211,930
Value of fidelity bond covering the plan	2013-12-31	$500,000
Total contributions received or receivable from participants	2013-12-31	$248,366
Expenses. Other expenses not covered elsewhere	2013-12-31	$105,712
Other income received	2013-12-31	$1,954,384
Net income (gross income less expenses)	2013-12-31	$1,828,137
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$14,040,067
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$12,211,930
Assets. Value of participant loans	2013-12-31	$100,327
Total contributions received or receivable from employer(s)	2013-12-31	$149,887
2012 : EAR, NOSE & THROAT SPECIALISTS 401K PROFIT SHARING PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$1,771,456
Expenses. Total of all expenses incurred	2012-12-31	$43,490
Benefits paid (including direct rollovers)	2012-12-31	$43,237
Total plan assets at end of year	2012-12-31	$12,211,930
Total plan assets at beginning of year	2012-12-31	$10,483,964
Value of fidelity bond covering the plan	2012-12-31	$500,000
Total contributions received or receivable from participants	2012-12-31	$284,474
Other income received	2012-12-31	$1,204,424
Net income (gross income less expenses)	2012-12-31	$1,727,966
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$12,211,930
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$10,483,964
Assets. Value of participant loans	2012-12-31	$26,828
Total contributions received or receivable from employer(s)	2012-12-31	$282,558
Expenses. Administrative service providers (salaries,fees and commissions)	2012-12-31	$253
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
2011 : EAR, NOSE & THROAT SPECIALISTS 401K PROFIT SHARING PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$263,529
Expenses. Total of all expenses incurred	2011-12-31	$86,529
Benefits paid (including direct rollovers)	2011-12-31	$85,750
Total plan assets at end of year	2011-12-31	$10,483,964
Total plan assets at beginning of year	2011-12-31	$10,306,964
Value of fidelity bond covering the plan	2011-12-31	$500,000
Total contributions received or receivable from participants	2011-12-31	$237,497
Contributions received from other sources (not participants or employers)	2011-12-31	$1,606
Other income received	2011-12-31	$-257,801
Net income (gross income less expenses)	2011-12-31	$177,000
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$10,483,964
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$10,306,964
Assets. Value of participant loans	2011-12-31	$46,428
Total contributions received or receivable from employer(s)	2011-12-31	$282,227
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$779
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
2010 : EAR, NOSE & THROAT SPECIALISTS 401K PROFIT SHARING PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$1,877,984
Expenses. Total of all expenses incurred	2010-12-31	$519,521
Benefits paid (including direct rollovers)	2010-12-31	$519,173
Total plan assets at end of year	2010-12-31	$10,306,964
Total plan assets at beginning of year	2010-12-31	$8,948,501
Value of fidelity bond covering the plan	2010-12-31	$500,000
Total contributions received or receivable from participants	2010-12-31	$292,519
Other income received	2010-12-31	$1,260,851
Net income (gross income less expenses)	2010-12-31	$1,358,463
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$10,306,964
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$8,948,501
Assets. Value of participant loans	2010-12-31	$25,523
Total contributions received or receivable from employer(s)	2010-12-31	$324,614
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$348
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
2009 : EAR, NOSE & THROAT SPECIALISTS 401K PROFIT SHARING PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for EAR, NOSE & THROAT SPECIALISTS 401K PROFIT SHARING PLAN

2015: EAR, NOSE & THROAT SPECIALISTS 401K PROFIT SHARING PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: EAR, NOSE & THROAT SPECIALISTS 401K PROFIT SHARING PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: EAR, NOSE & THROAT SPECIALISTS 401K PROFIT SHARING PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: EAR, NOSE & THROAT SPECIALISTS 401K PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: EAR, NOSE & THROAT SPECIALISTS 401K PROFIT SHARING PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: EAR, NOSE & THROAT SPECIALISTS 401K PROFIT SHARING PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	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

ZH9759

Policy instance

Insurance contract or identification number	ZH9759
Number of Individuals Covered	64
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $29,598
Total amount of fees paid to insurance company	USD $0
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $29,598
Insurance broker organization code?	3
Insurance broker name	MORGAN STANLEY SMITH BARNEY LLC

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

Policy contract number

ZH9759

Policy instance

Insurance contract or identification number	ZH9759
Number of Individuals Covered	73
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $37,980
Total amount of fees paid to insurance company	USD $0
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $37,980
Insurance broker organization code?	3
Insurance broker name	MORGAN STANLEY SMITH BARNEY LLC

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

Policy contract number

ZH9759

Policy instance

Insurance contract or identification number	ZH9759
Number of Individuals Covered	75
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	EAR, NOSE & THROAT SPECIALISTS OF NORTHERN VIRGINIA
Employer identification number (EIN):	540982265
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)