401k Plan data: BEACON HEALTH ALLIANCE PROFIT SHARING PLAN plan

BEACON HEALTH ALLIANCE PROFIT SHARING PLAN 401k Plan overview

Plan Name	BEACON HEALTH ALLIANCE PROFIT SHARING PLAN
Plan identification number	001

BEACON HEALTH ALLIANCE 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.
Plan sponsor(s) received services of leased employees, as defined in Code section 414(n), during the plan year.
Life insurance

401k Sponsoring company profile

BEACON HEALTH ALLIANCE, P.C. has sponsored the creation of one or more 401k plans.

Company Name: BEACON HEALTH ALLIANCE, P.C.

Employer identification number (EIN): 621587901

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BEACON HEALTH ALLIANCE 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
001 2021-01-01
001 2020-01-01
001 2019-01-01
001 2018-01-01
001 2017-01-01 HEATHER GUNNON
001 2016-01-01 COLLIN CHERRY
001 2015-01-01 COLLIN CHERRY
001 2014-01-01 HEATHER GUNNON
001 2013-01-01 HEATHER GUNNON
001 2012-01-01 COLLIN CHERRY
001 2011-01-01 COLLIN CHERRY
001 2009-01-01 COLLIN CHERRY

Plan Statistics for BEACON HEALTH ALLIANCE PROFIT SHARING PLAN

401k plan membership statisitcs for BEACON HEALTH ALLIANCE PROFIT SHARING PLAN

Measure Date Value
2022: BEACON HEALTH ALLIANCE PROFIT SHARING PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 30
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 24
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 8
Total of all active and inactive participants 2022-01-01 32
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 32
Number of participants with account balances 2022-01-01 31
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: BEACON HEALTH ALLIANCE PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 32
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 23
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 7
Total of all active and inactive participants 2021-01-01 30
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 30
Number of participants with account balances 2021-01-01 30
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 2
2020: BEACON HEALTH ALLIANCE PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 34
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 28
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 4
Total of all active and inactive participants 2020-01-01 32
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 32
Number of participants with account balances 2020-01-01 32
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: BEACON HEALTH ALLIANCE PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 31
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 30
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 4
Total of all active and inactive participants 2019-01-01 34
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 34
Number of participants with account balances 2019-01-01 34
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: BEACON HEALTH ALLIANCE PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 31
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 29
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 2
Total of all active and inactive participants 2018-01-01 31
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 31
Number of participants with account balances 2018-01-01 31
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: BEACON HEALTH ALLIANCE PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 33
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 29
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 2
Total of all active and inactive participants 2017-01-01 31
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 31
Number of participants with account balances 2017-01-01 31
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: BEACON HEALTH ALLIANCE PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 34
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 32
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 1
Total of all active and inactive participants 2016-01-01 33
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 33
Number of participants with account balances 2016-01-01 31
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: BEACON HEALTH ALLIANCE PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 32
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 33
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 1
Total of all active and inactive participants 2015-01-01 34
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 34
Number of participants with account balances 2015-01-01 33
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: BEACON HEALTH ALLIANCE PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 32
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 31
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 1
Total of all active and inactive participants 2014-01-01 32
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 32
Number of participants with account balances 2014-01-01 32
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: BEACON HEALTH ALLIANCE PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 32
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 31
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 1
Total of all active and inactive participants 2013-01-01 32
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 32
Number of participants with account balances 2013-01-01 32
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: BEACON HEALTH ALLIANCE PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 33
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 31
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 1
Total of all active and inactive participants 2012-01-01 32
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 32
Number of participants with account balances 2012-01-01 32
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: BEACON HEALTH ALLIANCE PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 35
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 31
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 1
Total of all active and inactive participants 2011-01-01 32
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 1
Total participants 2011-01-01 33
Number of participants with account balances 2011-01-01 32
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 1
2009: BEACON HEALTH ALLIANCE PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 37
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 34
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 3
Total of all active and inactive participants 2009-01-01 37
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 37
Number of participants with account balances 2009-01-01 37
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2022: BEACON HEALTH ALLIANCE PROFIT SHARING PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	30
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	24
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	8
Total of all active and inactive participants	2022-01-01	32
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	32
Number of participants with account balances	2022-01-01	31
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: BEACON HEALTH ALLIANCE PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	32
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	23
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	7
Total of all active and inactive participants	2021-01-01	30
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	30
Number of participants with account balances	2021-01-01	30
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	2
2020: BEACON HEALTH ALLIANCE PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	34
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	28
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	4
Total of all active and inactive participants	2020-01-01	32
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	32
Number of participants with account balances	2020-01-01	32
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: BEACON HEALTH ALLIANCE PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	31
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	30
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	4
Total of all active and inactive participants	2019-01-01	34
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	34
Number of participants with account balances	2019-01-01	34
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: BEACON HEALTH ALLIANCE PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	31
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	29
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	2
Total of all active and inactive participants	2018-01-01	31
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	31
Number of participants with account balances	2018-01-01	31
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: BEACON HEALTH ALLIANCE PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	33
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	29
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	2
Total of all active and inactive participants	2017-01-01	31
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	31
Number of participants with account balances	2017-01-01	31
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: BEACON HEALTH ALLIANCE PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	34
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	32
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	1
Total of all active and inactive participants	2016-01-01	33
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	33
Number of participants with account balances	2016-01-01	31
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: BEACON HEALTH ALLIANCE PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	32
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	33
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	1
Total of all active and inactive participants	2015-01-01	34
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	34
Number of participants with account balances	2015-01-01	33
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: BEACON HEALTH ALLIANCE PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	32
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	31
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	1
Total of all active and inactive participants	2014-01-01	32
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	32
Number of participants with account balances	2014-01-01	32
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: BEACON HEALTH ALLIANCE PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	32
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	31
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	1
Total of all active and inactive participants	2013-01-01	32
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	32
Number of participants with account balances	2013-01-01	32
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: BEACON HEALTH ALLIANCE PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	33
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	31
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	1
Total of all active and inactive participants	2012-01-01	32
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	32
Number of participants with account balances	2012-01-01	32
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: BEACON HEALTH ALLIANCE PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	35
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	31
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	1
Total of all active and inactive participants	2011-01-01	32
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	1
Total participants	2011-01-01	33
Number of participants with account balances	2011-01-01	32
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	1
2009: BEACON HEALTH ALLIANCE PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	37
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	34
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	3
Total of all active and inactive participants	2009-01-01	37
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	37
Number of participants with account balances	2009-01-01	37
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on BEACON HEALTH ALLIANCE PROFIT SHARING PLAN

Measure	Date	Value
2022 : BEACON HEALTH ALLIANCE PROFIT SHARING PLAN 2022 401k financial data
Transfers to/from the plan	2022-12-31	$0
Total plan liabilities at end of year	2022-12-31	$0
Total plan liabilities at beginning of year	2022-12-31	$0
Total income from all sources	2022-12-31	$-4,041,482
Expenses. Total of all expenses incurred	2022-12-31	$0
Benefits paid (including direct rollovers)	2022-12-31	$0
Total plan assets at end of year	2022-12-31	$17,694,338
Total plan assets at beginning of year	2022-12-31	$21,735,820
Value of fidelity bond covering the plan	2022-12-31	$500,000
Total contributions received or receivable from participants	2022-12-31	$569,305
Expenses. Other expenses not covered elsewhere	2022-12-31	$0
Contributions received from other sources (not participants or employers)	2022-12-31	$0
Other income received	2022-12-31	$-4,722,427
Noncash contributions received	2022-12-31	$0
Net income (gross income less expenses)	2022-12-31	$-4,041,482
Net plan assets at end of year (total assets less liabilities)	2022-12-31	$17,694,338
Net plan assets at beginning of year (total assets less liabilities)	2022-12-31	$21,735,820
Assets. Value of participant loans	2022-12-31	$0
Total contributions received or receivable from employer(s)	2022-12-31	$111,640
Value of certain deemed distributions of participant loans	2022-12-31	$0
Value of corrective distributions	2022-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2022-12-31	$0
2021 : BEACON HEALTH ALLIANCE PROFIT SHARING PLAN 2021 401k financial data
Transfers to/from the plan	2021-12-31	$0
Total plan liabilities at end of year	2021-12-31	$0
Total plan liabilities at beginning of year	2021-12-31	$0
Total income from all sources	2021-12-31	$3,056,766
Expenses. Total of all expenses incurred	2021-12-31	$3,919,888
Benefits paid (including direct rollovers)	2021-12-31	$3,919,713
Total plan assets at end of year	2021-12-31	$21,735,820
Total plan assets at beginning of year	2021-12-31	$22,598,942
Value of fidelity bond covering the plan	2021-12-31	$500,000
Total contributions received or receivable from participants	2021-12-31	$650,624
Expenses. Other expenses not covered elsewhere	2021-12-31	$0
Contributions received from other sources (not participants or employers)	2021-12-31	$0
Other income received	2021-12-31	$2,380,622
Noncash contributions received	2021-12-31	$0
Net income (gross income less expenses)	2021-12-31	$-863,122
Net plan assets at end of year (total assets less liabilities)	2021-12-31	$21,735,820
Net plan assets at beginning of year (total assets less liabilities)	2021-12-31	$22,598,942
Assets. Value of participant loans	2021-12-31	$19,447
Total contributions received or receivable from employer(s)	2021-12-31	$25,520
Value of certain deemed distributions of participant loans	2021-12-31	$0
Value of corrective distributions	2021-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2021-12-31	$175
2020 : BEACON HEALTH ALLIANCE PROFIT SHARING PLAN 2020 401k financial data
Transfers to/from the plan	2020-12-31	$0
Total plan liabilities at end of year	2020-12-31	$0
Total plan liabilities at beginning of year	2020-12-31	$0
Total income from all sources	2020-12-31	$4,513,866
Expenses. Total of all expenses incurred	2020-12-31	$5,752
Benefits paid (including direct rollovers)	2020-12-31	$5,752
Total plan assets at end of year	2020-12-31	$22,598,942
Total plan assets at beginning of year	2020-12-31	$18,090,828
Value of fidelity bond covering the plan	2020-12-31	$500,000
Total contributions received or receivable from participants	2020-12-31	$718,506
Expenses. Other expenses not covered elsewhere	2020-12-31	$0
Contributions received from other sources (not participants or employers)	2020-12-31	$440
Other income received	2020-12-31	$3,587,611
Noncash contributions received	2020-12-31	$0
Net income (gross income less expenses)	2020-12-31	$4,508,114
Net plan assets at end of year (total assets less liabilities)	2020-12-31	$22,598,942
Net plan assets at beginning of year (total assets less liabilities)	2020-12-31	$18,090,828
Total contributions received or receivable from employer(s)	2020-12-31	$207,309
Value of certain deemed distributions of participant loans	2020-12-31	$0
Value of corrective distributions	2020-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2020-12-31	$0
2019 : BEACON HEALTH ALLIANCE PROFIT SHARING PLAN 2019 401k financial data
Transfers to/from the plan	2019-12-31	$0
Total plan liabilities at end of year	2019-12-31	$0
Total plan liabilities at beginning of year	2019-12-31	$0
Total income from all sources	2019-12-31	$4,135,437
Expenses. Total of all expenses incurred	2019-12-31	$998,840
Benefits paid (including direct rollovers)	2019-12-31	$998,815
Total plan assets at end of year	2019-12-31	$18,090,828
Total plan assets at beginning of year	2019-12-31	$14,954,231
Value of fidelity bond covering the plan	2019-12-31	$500,000
Total contributions received or receivable from participants	2019-12-31	$599,529
Expenses. Other expenses not covered elsewhere	2019-12-31	$0
Contributions received from other sources (not participants or employers)	2019-12-31	$124,138
Other income received	2019-12-31	$3,226,671
Noncash contributions received	2019-12-31	$0
Net income (gross income less expenses)	2019-12-31	$3,136,597
Net plan assets at end of year (total assets less liabilities)	2019-12-31	$18,090,828
Net plan assets at beginning of year (total assets less liabilities)	2019-12-31	$14,954,231
Total contributions received or receivable from employer(s)	2019-12-31	$185,099
Value of certain deemed distributions of participant loans	2019-12-31	$0
Value of corrective distributions	2019-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2019-12-31	$25
2018 : BEACON HEALTH ALLIANCE PROFIT SHARING PLAN 2018 401k financial data
Transfers to/from the plan	2018-12-31	$0
Total plan liabilities at end of year	2018-12-31	$0
Total plan liabilities at beginning of year	2018-12-31	$0
Total income from all sources	2018-12-31	$-140,289
Expenses. Total of all expenses incurred	2018-12-31	$1,578,096
Benefits paid (including direct rollovers)	2018-12-31	$1,578,096
Total plan assets at end of year	2018-12-31	$14,954,231
Total plan assets at beginning of year	2018-12-31	$16,672,616
Value of fidelity bond covering the plan	2018-12-31	$500,000
Total contributions received or receivable from participants	2018-12-31	$476,745
Expenses. Other expenses not covered elsewhere	2018-12-31	$0
Contributions received from other sources (not participants or employers)	2018-12-31	$122,428
Other income received	2018-12-31	$-927,970
Noncash contributions received	2018-12-31	$0
Net income (gross income less expenses)	2018-12-31	$-1,718,385
Net plan assets at end of year (total assets less liabilities)	2018-12-31	$14,954,231
Net plan assets at beginning of year (total assets less liabilities)	2018-12-31	$16,672,616
Assets. Value of participant loans	2018-12-31	$0
Total contributions received or receivable from employer(s)	2018-12-31	$188,508
Value of certain deemed distributions of participant loans	2018-12-31	$0
Value of corrective distributions	2018-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2018-12-31	$0
2017 : BEACON HEALTH ALLIANCE PROFIT SHARING PLAN 2017 401k financial data
Transfers to/from the plan	2017-12-31	$0
Total plan liabilities at end of year	2017-12-31	$0
Total plan liabilities at beginning of year	2017-12-31	$0
Total income from all sources	2017-12-31	$2,916,559
Expenses. Total of all expenses incurred	2017-12-31	$1,157,015
Benefits paid (including direct rollovers)	2017-12-31	$1,157,015
Total plan assets at end of year	2017-12-31	$16,672,616
Total plan assets at beginning of year	2017-12-31	$14,913,072
Value of fidelity bond covering the plan	2017-12-31	$500,000
Total contributions received or receivable from participants	2017-12-31	$463,187
Expenses. Other expenses not covered elsewhere	2017-12-31	$0
Contributions received from other sources (not participants or employers)	2017-12-31	$0
Other income received	2017-12-31	$2,223,528
Noncash contributions received	2017-12-31	$0
Net income (gross income less expenses)	2017-12-31	$1,759,544
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$16,672,616
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$14,913,072
Assets. Value of participant loans	2017-12-31	$3,265
Total contributions received or receivable from employer(s)	2017-12-31	$229,844
Value of certain deemed distributions of participant loans	2017-12-31	$0
Value of corrective distributions	2017-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2017-12-31	$0
2016 : BEACON HEALTH ALLIANCE PROFIT SHARING PLAN 2016 401k financial data
Transfers to/from the plan	2016-12-31	$0
Total plan liabilities at end of year	2016-12-31	$0
Total plan liabilities at beginning of year	2016-12-31	$0
Total income from all sources	2016-12-31	$2,074,083
Expenses. Total of all expenses incurred	2016-12-31	$639,929
Benefits paid (including direct rollovers)	2016-12-31	$639,929
Total plan assets at end of year	2016-12-31	$14,913,072
Total plan assets at beginning of year	2016-12-31	$13,478,918
Value of fidelity bond covering the plan	2016-12-31	$500,000
Total contributions received or receivable from participants	2016-12-31	$483,508
Expenses. Other expenses not covered elsewhere	2016-12-31	$0
Contributions received from other sources (not participants or employers)	2016-12-31	$0
Other income received	2016-12-31	$847,700
Noncash contributions received	2016-12-31	$0
Net income (gross income less expenses)	2016-12-31	$1,434,154
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$14,913,072
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$13,478,918
Assets. Value of participant loans	2016-12-31	$7,320
Total contributions received or receivable from employer(s)	2016-12-31	$742,875
Value of certain deemed distributions of participant loans	2016-12-31	$0
Value of corrective distributions	2016-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2016-12-31	$0
2015 : BEACON HEALTH ALLIANCE PROFIT SHARING PLAN 2015 401k financial data
Transfers to/from the plan	2015-12-31	$0
Total plan liabilities at end of year	2015-12-31	$0
Total plan liabilities at beginning of year	2015-12-31	$0
Total income from all sources	2015-12-31	$818,743
Expenses. Total of all expenses incurred	2015-12-31	$268,842
Benefits paid (including direct rollovers)	2015-12-31	$268,125
Total plan assets at end of year	2015-12-31	$13,478,918
Total plan assets at beginning of year	2015-12-31	$12,929,017
Value of fidelity bond covering the plan	2015-12-31	$500,000
Total contributions received or receivable from participants	2015-12-31	$465,905
Expenses. Other expenses not covered elsewhere	2015-12-31	$0
Contributions received from other sources (not participants or employers)	2015-12-31	$150,726
Other income received	2015-12-31	$1,556
Noncash contributions received	2015-12-31	$0
Net income (gross income less expenses)	2015-12-31	$549,901
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$13,478,918
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$12,929,017
Assets. Value of participant loans	2015-12-31	$12,484
Total contributions received or receivable from employer(s)	2015-12-31	$200,556
Value of certain deemed distributions of participant loans	2015-12-31	$0
Value of corrective distributions	2015-12-31	$692
Expenses. Administrative service providers (salaries,fees and commissions)	2015-12-31	$25
2014 : BEACON HEALTH ALLIANCE PROFIT SHARING PLAN 2014 401k financial data
Transfers to/from the plan	2014-12-31	$0
Total plan liabilities at end of year	2014-12-31	$0
Total plan liabilities at beginning of year	2014-12-31	$0
Total income from all sources	2014-12-31	$1,364,160
Expenses. Total of all expenses incurred	2014-12-31	$0
Benefits paid (including direct rollovers)	2014-12-31	$0
Total plan assets at end of year	2014-12-31	$12,929,017
Total plan assets at beginning of year	2014-12-31	$11,564,857
Value of fidelity bond covering the plan	2014-12-31	$500,000
Total contributions received or receivable from participants	2014-12-31	$424,054
Expenses. Other expenses not covered elsewhere	2014-12-31	$0
Contributions received from other sources (not participants or employers)	2014-12-31	$0
Other income received	2014-12-31	$729,829
Noncash contributions received	2014-12-31	$0
Net income (gross income less expenses)	2014-12-31	$1,364,160
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$12,929,017
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$11,564,857
Assets. Value of participant loans	2014-12-31	$17,383
Total contributions received or receivable from employer(s)	2014-12-31	$210,277
Value of certain deemed distributions of participant loans	2014-12-31	$0
Value of corrective distributions	2014-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2014-12-31	$0
2013 : BEACON HEALTH ALLIANCE PROFIT SHARING PLAN 2013 401k financial data
Transfers to/from the plan	2013-12-31	$0
Total plan liabilities at end of year	2013-12-31	$0
Total income from all sources	2013-12-31	$2,913,254
Expenses. Total of all expenses incurred	2013-12-31	$150
Benefits paid (including direct rollovers)	2013-12-31	$0
Total plan assets at end of year	2013-12-31	$11,564,857
Total plan assets at beginning of year	2013-12-31	$8,651,753
Value of fidelity bond covering the plan	2013-12-31	$500,000
Total contributions received or receivable from participants	2013-12-31	$392,456
Expenses. Other expenses not covered elsewhere	2013-12-31	$0
Contributions received from other sources (not participants or employers)	2013-12-31	$0
Other income received	2013-12-31	$1,998,135
Noncash contributions received	2013-12-31	$0
Net income (gross income less expenses)	2013-12-31	$2,913,104
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$11,564,857
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$8,651,753
Assets. Value of participant loans	2013-12-31	$22,033
Total contributions received or receivable from employer(s)	2013-12-31	$522,663
Value of certain deemed distributions of participant loans	2013-12-31	$0
Value of corrective distributions	2013-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2013-12-31	$150
2012 : BEACON HEALTH ALLIANCE PROFIT SHARING PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$1,877,631
Expenses. Total of all expenses incurred	2012-12-31	$289,199
Benefits paid (including direct rollovers)	2012-12-31	$289,044
Total plan assets at end of year	2012-12-31	$8,651,753
Total plan assets at beginning of year	2012-12-31	$7,063,321
Value of fidelity bond covering the plan	2012-12-31	$500,000
Total contributions received or receivable from participants	2012-12-31	$413,399
Contributions received from other sources (not participants or employers)	2012-12-31	$57,205
Other income received	2012-12-31	$938,633
Net income (gross income less expenses)	2012-12-31	$1,588,432
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$8,651,753
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$7,063,321
Assets. Value of participant loans	2012-12-31	$24,832
Total contributions received or receivable from employer(s)	2012-12-31	$468,394
Expenses. Administrative service providers (salaries,fees and commissions)	2012-12-31	$155
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
2011 : BEACON HEALTH ALLIANCE PROFIT SHARING PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$252,901
Expenses. Total of all expenses incurred	2011-12-31	$167,589
Benefits paid (including direct rollovers)	2011-12-31	$167,439
Total plan assets at end of year	2011-12-31	$7,063,321
Total plan assets at beginning of year	2011-12-31	$6,978,009
Value of fidelity bond covering the plan	2011-12-31	$500,000
Total contributions received or receivable from participants	2011-12-31	$367,513
Other income received	2011-12-31	$-283,321
Net income (gross income less expenses)	2011-12-31	$85,312
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$7,063,321
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$6,978,009
Assets. Value of participant loans	2011-12-31	$3,483
Total contributions received or receivable from employer(s)	2011-12-31	$168,709
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$150
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
2010 : BEACON HEALTH ALLIANCE PROFIT SHARING PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$1,810,196
Expenses. Total of all expenses incurred	2010-12-31	$154,633
Benefits paid (including direct rollovers)	2010-12-31	$154,608
Total plan assets at end of year	2010-12-31	$6,978,009
Total plan assets at beginning of year	2010-12-31	$5,322,446
Value of fidelity bond covering the plan	2010-12-31	$500,000
Total contributions received or receivable from participants	2010-12-31	$380,190
Other income received	2010-12-31	$1,081,005
Net income (gross income less expenses)	2010-12-31	$1,655,563
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$6,978,009
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$5,322,446
Assets. Value of participant loans	2010-12-31	$11,899
Total contributions received or receivable from employer(s)	2010-12-31	$349,001
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$25
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
2009 : BEACON HEALTH ALLIANCE 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 BEACON HEALTH ALLIANCE PROFIT SHARING PLAN

2022: BEACON HEALTH ALLIANCE PROFIT SHARING PLAN 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: BEACON HEALTH ALLIANCE PROFIT SHARING PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	This submission is the final filing	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: BEACON HEALTH ALLIANCE PROFIT SHARING PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	This submission is the final filing	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: BEACON HEALTH ALLIANCE PROFIT SHARING PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: BEACON HEALTH ALLIANCE PROFIT SHARING PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: BEACON HEALTH ALLIANCE PROFIT SHARING PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: BEACON HEALTH ALLIANCE PROFIT SHARING PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: BEACON HEALTH ALLIANCE 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: BEACON HEALTH ALLIANCE 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: BEACON HEALTH ALLIANCE 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: BEACON HEALTH ALLIANCE 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 funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: BEACON HEALTH ALLIANCE 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 funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: BEACON HEALTH ALLIANCE 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 funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

006936893, ETC.

Policy instance

Insurance contract or identification number	006936893, ETC.
Number of Individuals Covered	2
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $41
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
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $41
Insurance broker organization code?	3

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

006936893, ETC.

Policy instance

Insurance contract or identification number	006936893, ETC.
Number of Individuals Covered	2
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $66
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
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $66
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

006936893, ETC.

Policy instance

Insurance contract or identification number	006936893, ETC.
Number of Individuals Covered	2
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $66
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
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $66
Insurance broker organization code?	3

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

006936893, ETC.

Policy instance

Insurance contract or identification number	006936893, ETC.
Number of Individuals Covered	2
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	Yes
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

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

006936893, ETC.

Policy instance

Insurance contract or identification number	006936893, ETC.
Number of Individuals Covered	2
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
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	Yes
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
Welfare Benefit Premiums Paid to Carrier	USD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	SINKS ROBERT TIMOTHY

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

006936893, ETC.

Policy instance

Insurance contract or identification number	006936893, ETC.
Number of Individuals Covered	2
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Are there contracts with allocated funds for individual policies?	Yes
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	Yes
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

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

006936893, ETC.

Policy instance

Insurance contract or identification number	006936893, ETC.
Number of Individuals Covered	2
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $0
Are there contracts with allocated funds for individual policies?	Yes
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 $0
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	SINKS ROBERT TIMOTHY

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

006936893, ETC.

Policy instance

Insurance contract or identification number	006936893, ETC.
Number of Individuals Covered	2
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $68
Are there contracts with allocated funds for individual policies?	Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $68
Insurance broker organization code?	3
Insurance broker name	SMITH, CHARLES G

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

006936893

Policy instance

Insurance contract or identification number	006936893
Number of Individuals Covered	2
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $69
Are there contracts with allocated funds for individual policies?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Insurance broker name	CHARLES G. SMITH

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

006936893, ETC.

Policy instance

Insurance contract or identification number	006936893, ETC.
Number of Individuals Covered	2
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $69
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

006936893 ETC

Policy instance

Insurance contract or identification number	006936893 ETC
Number of Individuals Covered	2
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $139
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $69
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	JAMES A DAVIS

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Company Name:	BEACON HEALTH ALLIANCE, P.C.
Employer identification number (EIN):	621587901
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)