401k Plan data: TAX DEFERRED ANNUITY PLAN FOR CERTAIN EMPLOYEES OF CENTRAL FLORIDA LIONS EYE & TISSUE BANK, INC. plan

TAX DEFERRED ANNUITY PLAN FOR CERTAIN EMPLOYEES OF CENTRAL FLORIDA LIONS EYE & TISSUE BANK, INC. 401k Plan overview

Plan Name	TAX DEFERRED ANNUITY PLAN FOR CERTAIN EMPLOYEES OF CENTRAL FLORIDA LIONS EYE & TISSUE BANK, INC.
Plan identification number	001

TAX DEFERRED ANNUITY PLAN FOR CERTAIN EMPLOYEES OF CENTRAL FLORIDA LIONS EYE & TISSUE BANK, INC. 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 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
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

LIONS EYE INSTITUTE FOR TRANSPLANT AND RESEARCH, INC. has sponsored the creation of one or more 401k plans.

Company Name: LIONS EYE INSTITUTE FOR TRANSPLANT AND RESEARCH, INC.

Employer identification number (EIN): 591458151

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TAX DEFERRED ANNUITY PLAN FOR CERTAIN EMPLOYEES OF CENTRAL FLORIDA LIONS EYE & TISSUE BANK, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01
001 2022-01-01
001 2021-01-01
001 2021-01-01
001 2020-01-01
001 2019-01-01
001 2018-01-01
001 2017-01-01 AHARON YOKI 2018-07-31 AHARON YOKI 2018-07-31
001 2016-01-01 AHARON YOKI 2017-06-02 AHARON YOKI 2017-06-02
001 2015-01-01 AHARON YOKI 2016-06-09 AHARON YOKI 2016-06-09
001 2014-01-01 RYANN IREDELL 2015-06-18 AHARON YOKI 2015-06-18
001 2013-01-01 AHARON YOKI 2015-10-27
001 2012-01-01 AHARON YOKI 2014-07-02
001 2011-01-01 DONALD SCHLEICHER 2012-07-26
001 2010-01-01 DONALD SCHLEICHER 2011-07-28

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2022-01-01
001	2022-01-01
001	2021-01-01
001	2021-01-01
001	2020-01-01
001	2019-01-01
001	2018-01-01
001	2017-01-01	AHARON YOKI	2018-07-31	AHARON YOKI	2018-07-31
001	2016-01-01	AHARON YOKI	2017-06-02	AHARON YOKI	2017-06-02
001	2015-01-01	AHARON YOKI	2016-06-09	AHARON YOKI	2016-06-09
001	2014-01-01	RYANN IREDELL	2015-06-18	AHARON YOKI	2015-06-18
001	2013-01-01	AHARON YOKI	2015-10-27
001	2012-01-01	AHARON YOKI	2014-07-02
001	2011-01-01	DONALD SCHLEICHER	2012-07-26
001	2010-01-01	DONALD SCHLEICHER	2011-07-28

Plan Statistics for TAX DEFERRED ANNUITY PLAN FOR CERTAIN EMPLOYEES OF CENTRAL FLORIDA LIONS EYE & TISSUE BANK, INC.

401k plan membership statisitcs for TAX DEFERRED ANNUITY PLAN FOR CERTAIN EMPLOYEES OF CENTRAL FLORIDA LIONS EYE & TISSUE BANK, INC.

Measure Date Value
2022: TAX DEFERRED ANNUITY PLAN FOR CERTAIN EMPLOYEES OF CENTRAL FLORIDA LIONS EYE & TISSUE BANK, INC. 2022 401k membership
Total participants, beginning-of-year 2022-01-01 179
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 110
Number of retired or separated participants receiving benefits 2022-01-01 2
Number of other retired or separated participants entitled to future benefits 2022-01-01 80
Total of all active and inactive participants 2022-01-01 192
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 192
Number of participants with account balances 2022-01-01 191
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 2
2021: TAX DEFERRED ANNUITY PLAN FOR CERTAIN EMPLOYEES OF CENTRAL FLORIDA LIONS EYE & TISSUE BANK, INC. 2021 401k membership
Total participants, beginning-of-year 2021-01-01 170
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 100
Number of retired or separated participants receiving benefits 2021-01-01 2
Number of other retired or separated participants entitled to future benefits 2021-01-01 77
Total of all active and inactive participants 2021-01-01 179
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 179
Number of participants with account balances 2021-01-01 178
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 1
2020: TAX DEFERRED ANNUITY PLAN FOR CERTAIN EMPLOYEES OF CENTRAL FLORIDA LIONS EYE & TISSUE BANK, INC. 2020 401k membership
Total participants, beginning-of-year 2020-01-01 139
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 95
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 75
Total of all active and inactive participants 2020-01-01 170
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 170
Number of participants with account balances 2020-01-01 166
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: TAX DEFERRED ANNUITY PLAN FOR CERTAIN EMPLOYEES OF CENTRAL FLORIDA LIONS EYE & TISSUE BANK, INC. 2019 401k membership
Total participants, beginning-of-year 2019-01-01 138
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 83
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 56
Total of all active and inactive participants 2019-01-01 139
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 139
Number of participants with account balances 2019-01-01 137
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: TAX DEFERRED ANNUITY PLAN FOR CERTAIN EMPLOYEES OF CENTRAL FLORIDA LIONS EYE & TISSUE BANK, INC. 2018 401k membership
Total participants, beginning-of-year 2018-01-01 182
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 129
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 9
Total of all active and inactive participants 2018-01-01 138
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 138
Number of participants with account balances 2018-01-01 109
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: TAX DEFERRED ANNUITY PLAN FOR CERTAIN EMPLOYEES OF CENTRAL FLORIDA LIONS EYE & TISSUE BANK, INC. 2022 401k membership
Total participants, beginning-of-year	2022-01-01	179
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	110
Number of retired or separated participants receiving benefits	2022-01-01	2
Number of other retired or separated participants entitled to future benefits	2022-01-01	80
Total of all active and inactive participants	2022-01-01	192
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	192
Number of participants with account balances	2022-01-01	191
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	2
2021: TAX DEFERRED ANNUITY PLAN FOR CERTAIN EMPLOYEES OF CENTRAL FLORIDA LIONS EYE & TISSUE BANK, INC. 2021 401k membership
Total participants, beginning-of-year	2021-01-01	170
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	100
Number of retired or separated participants receiving benefits	2021-01-01	2
Number of other retired or separated participants entitled to future benefits	2021-01-01	77
Total of all active and inactive participants	2021-01-01	179
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	179
Number of participants with account balances	2021-01-01	178
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	1
2020: TAX DEFERRED ANNUITY PLAN FOR CERTAIN EMPLOYEES OF CENTRAL FLORIDA LIONS EYE & TISSUE BANK, INC. 2020 401k membership
Total participants, beginning-of-year	2020-01-01	139
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	95
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	75
Total of all active and inactive participants	2020-01-01	170
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	170
Number of participants with account balances	2020-01-01	166
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: TAX DEFERRED ANNUITY PLAN FOR CERTAIN EMPLOYEES OF CENTRAL FLORIDA LIONS EYE & TISSUE BANK, INC. 2019 401k membership
Total participants, beginning-of-year	2019-01-01	138
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	83
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	56
Total of all active and inactive participants	2019-01-01	139
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	139
Number of participants with account balances	2019-01-01	137
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: TAX DEFERRED ANNUITY PLAN FOR CERTAIN EMPLOYEES OF CENTRAL FLORIDA LIONS EYE & TISSUE BANK, INC. 2018 401k membership
Total participants, beginning-of-year	2018-01-01	182
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	129
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	9
Total of all active and inactive participants	2018-01-01	138
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	138
Number of participants with account balances	2018-01-01	109
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0

Financial Data on TAX DEFERRED ANNUITY PLAN FOR CERTAIN EMPLOYEES OF CENTRAL FLORIDA LIONS EYE & TISSUE BANK, INC.

Measure	Date	Value
2022 : TAX DEFERRED ANNUITY PLAN FOR CERTAIN EMPLOYEES OF CENTRAL FLORIDA LIONS EYE & TISSUE BANK, INC. 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	$12,847
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$185,180
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$155,556
Expenses. Certain deemed distributions of participant loans	2022-12-31	$4,471
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$749,881
Value of total assets at end of year	2022-12-31	$4,346,933
Value of total assets at beginning of year	2022-12-31	$4,519,266
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$25,153
Total interest from all sources	2022-12-31	$7,512
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$96,445
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-12-31	$96,445
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
Contributions received from participants	2022-12-31	$379,929
Participant contributions at end of year	2022-12-31	$53,359
Participant contributions at beginning of year	2022-12-31	$9,059
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$42,039
Other income not declared elsewhere	2022-12-31	$247
Administrative expenses (other) incurred	2022-12-31	$25,153
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	$-172,333
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$4,346,933
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$4,519,266
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$3,631,967
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$3,894,379
Interest on participant loans	2022-12-31	$1,142
Interest earned on other investments	2022-12-31	$6,370
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$661,607
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$615,828
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-841,238
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
Contributions received in cash from employer	2022-12-31	$327,913
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$155,556
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	Unqualified
Accountancy firm name	2022-12-31	CLIFTONLARSONALLEN LLP
Accountancy firm EIN	2022-12-31	410746749
2021 : TAX DEFERRED ANNUITY PLAN FOR CERTAIN EMPLOYEES OF CENTRAL FLORIDA LIONS EYE & TISSUE BANK, INC. 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	$1,174,246
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$589,448
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$563,050
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$628,782
Value of total assets at end of year	2021-12-31	$4,519,266
Value of total assets at beginning of year	2021-12-31	$3,934,468
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$26,398
Total interest from all sources	2021-12-31	$12,031
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$105,785
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2021-12-31	$105,785
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
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$342,452
Participant contributions at end of year	2021-12-31	$9,059
Participant contributions at beginning of year	2021-12-31	$2,233
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$175
Other income not declared elsewhere	2021-12-31	$69
Administrative expenses (other) incurred	2021-12-31	$26,398
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	$584,798
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$4,519,266
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$3,934,468
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$3,894,379
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$3,062,335
Interest on participant loans	2021-12-31	$314
Interest earned on other investments	2021-12-31	$11,717
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$615,828
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$869,900
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$416,463
Net investment gain/loss from pooled separate accounts	2021-12-31	$11,116
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
Contributions received in cash from employer	2021-12-31	$286,155
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$563,050
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	Unqualified
Accountancy firm name	2021-12-31	CLIFTONLARSONALLEN LLP
Accountancy firm EIN	2021-12-31	410746749
2020 : TAX DEFERRED ANNUITY PLAN FOR CERTAIN EMPLOYEES OF CENTRAL FLORIDA LIONS EYE & TISSUE BANK, INC. 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	$1,020,885
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$584,246
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$562,074
Expenses. Certain deemed distributions of participant loans	2020-12-31	$2,068
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$557,453
Value of total assets at end of year	2020-12-31	$3,934,468
Value of total assets at beginning of year	2020-12-31	$3,497,829
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$20,104
Total interest from all sources	2020-12-31	$16,237
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$58,757
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-31	$58,757
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
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	$302,660
Participant contributions at end of year	2020-12-31	$2,233
Participant contributions at beginning of year	2020-12-31	$10,098
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$29,037
Other income not declared elsewhere	2020-12-31	$56
Administrative expenses (other) incurred	2020-12-31	$20,104
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	$436,639
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$3,934,468
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$3,497,829
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$3,062,335
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$2,347,164
Interest on participant loans	2020-12-31	$248
Interest earned on other investments	2020-12-31	$15,989
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$869,900
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$1,140,567
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$388,382
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	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$225,756
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$562,074
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	CLIFTONLARSONALLEN LLP
Accountancy firm EIN	2020-12-31	410746749
2019 : TAX DEFERRED ANNUITY PLAN FOR CERTAIN EMPLOYEES OF CENTRAL FLORIDA LIONS EYE & TISSUE BANK, INC. 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	$1,174,256
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$503,249
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$487,375
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$688,799
Value of total assets at end of year	2019-12-31	$3,497,829
Value of total assets at beginning of year	2019-12-31	$2,826,822
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$15,874
Total interest from all sources	2019-12-31	$11,140
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$65,876
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$65,876
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$282,407
Participant contributions at end of year	2019-12-31	$10,098
Participant contributions at beginning of year	2019-12-31	$102,719
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$175,345
Other income not declared elsewhere	2019-12-31	$2,206
Administrative expenses (other) incurred	2019-12-31	$15,874
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	$671,007
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$3,497,829
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$2,826,822
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	$2,578,558
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$1,692,186
Interest on participant loans	2019-12-31	$3,166
Interest earned on other investments	2019-12-31	$7,974
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$909,173
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$1,031,917
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$406,235
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
Contributions received in cash from employer	2019-12-31	$231,047
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$487,375
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	CLIFTONLARSONALLEN, LLP
Accountancy firm EIN	2019-12-31	410746749
2018 : TAX DEFERRED ANNUITY PLAN FOR CERTAIN EMPLOYEES OF CENTRAL FLORIDA LIONS EYE & TISSUE BANK, INC. 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
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	$279,494
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$89,542
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$88,947
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$415,343
Value of total assets at end of year	2018-12-31	$2,826,822
Value of total assets at beginning of year	2018-12-31	$2,636,870
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$595
Total interest from all sources	2018-12-31	$13,489
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$33,456
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2018-12-31	$33,456
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$250,000
If this is an individual account plan, was there a blackout period	2018-12-31	Yes
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$186,723
Participant contributions at end of year	2018-12-31	$102,719
Participant contributions at beginning of year	2018-12-31	$82,297
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$113,818
Other income not declared elsewhere	2018-12-31	$2,338
Administrative expenses (other) incurred	2018-12-31	$595
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	$189,952
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$2,826,822
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$2,636,870
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 registered invesment companies (eg mutual funds) at end of year	2018-12-31	$1,692,186
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$2,463,870
Interest on participant loans	2018-12-31	$6,789
Interest earned on other investments	2018-12-31	$6,700
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$1,031,917
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$90,703
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-185,132
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	Yes
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$114,802
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$88,947
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	Yes
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	CLIFTONLARSONALLEN, LLP
Accountancy firm EIN	2018-12-31	410746749

Form 5500 Responses for TAX DEFERRED ANNUITY PLAN FOR CERTAIN EMPLOYEES OF CENTRAL FLORIDA LIONS EYE & TISSUE BANK, INC.

2022: TAX DEFERRED ANNUITY PLAN FOR CERTAIN EMPLOYEES OF CENTRAL FLORIDA LIONS EYE & TISSUE BANK, INC. 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
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: TAX DEFERRED ANNUITY PLAN FOR CERTAIN EMPLOYEES OF CENTRAL FLORIDA LIONS EYE & TISSUE BANK, INC. 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: TAX DEFERRED ANNUITY PLAN FOR CERTAIN EMPLOYEES OF CENTRAL FLORIDA LIONS EYE & TISSUE BANK, INC. 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: TAX DEFERRED ANNUITY PLAN FOR CERTAIN EMPLOYEES OF CENTRAL FLORIDA LIONS EYE & TISSUE BANK, INC. 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: TAX DEFERRED ANNUITY PLAN FOR CERTAIN EMPLOYEES OF CENTRAL FLORIDA LIONS EYE & TISSUE BANK, INC. 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

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

Policy contract number

664F22

Policy instance

Insurance contract or identification number	664F22
Number of Individuals Covered	192
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
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?	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

C.M. LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93432 )

Policy contract number

ART0115110EE

Policy instance

Insurance contract or identification number	ART0115110EE
Number of Individuals Covered	14
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
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?	1
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

C.M. LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93432 )

Policy contract number

ART0105912EE

Policy instance

Insurance contract or identification number	ART0105912EE
Number of Individuals Covered	14
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
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?	1
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

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

Policy contract number

664F22

Policy instance

Insurance contract or identification number	664F22
Number of Individuals Covered	179
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $2,118
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 $2,118
Insurance broker organization code?	3

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

Policy contract number

664F22

Policy instance

Insurance contract or identification number	664F22
Number of Individuals Covered	136
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $15,896
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 $15,896
Insurance broker organization code?	3

C.M. LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93432 )

Policy contract number

ART0105912EE

Policy instance

Insurance contract or identification number	ART0105912EE
Number of Individuals Covered	19
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
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?	1
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

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

Policy contract number

664F22

Policy instance

Insurance contract or identification number	664F22
Number of Individuals Covered	136
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $14,203
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 $14,203
Insurance broker organization code?	3

C.M. LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93432 )

Policy contract number

ART0105912EE

Policy instance

Insurance contract or identification number	ART0105912EE
Number of Individuals Covered	19
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
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?	1
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

C.M. LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93432 )

Policy contract number

SE2445274

Policy instance

Insurance contract or identification number	SE2445274
Number of Individuals Covered	21
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
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?	1
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

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

Policy contract number

664F22

Policy instance

Insurance contract or identification number	664F22
Number of Individuals Covered	138
Insurance policy start date	2018-10-31
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $1,031
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 $1,031
Insurance broker organization code?	3

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Company Name:	LIONS EYE INSTITUTE FOR TRANSPLANT AND RESEARCH, INC.
Employer identification number (EIN):	591458151
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)