401k Plan data: CHILDREN'S MEDICAL GROUP 401(K) PLAN plan

CHILDREN'S MEDICAL GROUP 401(K) PLAN 401k Plan overview

Plan Name	CHILDREN'S MEDICAL GROUP 401(K) PLAN
Plan identification number	002

CHILDREN'S MEDICAL GROUP 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Participant-directed brokerage accounts provided as an investment option under the plan.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

CHILDREN'S MEDICAL GROUP has sponsored the creation of one or more 401k plans.

Company Name: CHILDREN'S MEDICAL GROUP

Employer identification number (EIN): 640512728

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CHILDREN'S MEDICAL GROUP 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2022-01-01 PAT MALONEY 2023-08-07
002 2021-01-01 PAT MALONEY 2022-06-20
002 2020-01-01
002 2019-01-01
002 2018-01-01
002 2017-01-01 PAT MALONEY
002 2016-01-01 JOANNA M. STOREY
002 2015-01-01 JOANNA STOREY, M.D.
002 2014-01-01 JOANNA STOREY, M.D.
002 2013-01-01 JOANNA STOREY, M.D.
002 2012-01-01 JOANNA STOREY, M.D.
002 2011-01-01 JOANNA STOREY, M.D.
002 2010-01-01 JOANNA STOREY, M.D.

Plan Statistics for CHILDREN'S MEDICAL GROUP 401(K) PLAN

401k plan membership statisitcs for CHILDREN'S MEDICAL GROUP 401(K) PLAN

Measure Date Value
2022: CHILDREN'S MEDICAL GROUP 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 68
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 42
Number of retired or separated participants receiving benefits 2022-01-01 3
Number of other retired or separated participants entitled to future benefits 2022-01-01 20
Total of all active and inactive participants 2022-01-01 65
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 65
Number of participants with account balances 2022-01-01 65
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: CHILDREN'S MEDICAL GROUP 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 73
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 43
Number of retired or separated participants receiving benefits 2021-01-01 3
Number of other retired or separated participants entitled to future benefits 2021-01-01 22
Total of all active and inactive participants 2021-01-01 68
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 68
Number of participants with account balances 2021-01-01 68
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: CHILDREN'S MEDICAL GROUP 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 76
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 47
Number of retired or separated participants receiving benefits 2020-01-01 3
Number of other retired or separated participants entitled to future benefits 2020-01-01 22
Total of all active and inactive participants 2020-01-01 72
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 72
Number of participants with account balances 2020-01-01 72
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: CHILDREN'S MEDICAL GROUP 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 71
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 53
Number of retired or separated participants receiving benefits 2019-01-01 3
Number of other retired or separated participants entitled to future benefits 2019-01-01 18
Total of all active and inactive participants 2019-01-01 74
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 74
Number of participants with account balances 2019-01-01 74
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: CHILDREN'S MEDICAL GROUP 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 70
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 47
Number of retired or separated participants receiving benefits 2018-01-01 3
Number of other retired or separated participants entitled to future benefits 2018-01-01 18
Total of all active and inactive participants 2018-01-01 68
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 68
Number of participants with account balances 2018-01-01 68
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: CHILDREN'S MEDICAL GROUP 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 57
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 48
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 21
Total of all active and inactive participants 2017-01-01 69
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 69
Number of participants with account balances 2017-01-01 69
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: CHILDREN'S MEDICAL GROUP 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 68
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 51
Number of retired or separated participants receiving benefits 2016-01-01 1
Number of other retired or separated participants entitled to future benefits 2016-01-01 11
Total of all active and inactive participants 2016-01-01 63
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 63
Number of participants with account balances 2016-01-01 63
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: CHILDREN'S MEDICAL GROUP 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 71
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 54
Number of retired or separated participants receiving benefits 2015-01-01 1
Number of other retired or separated participants entitled to future benefits 2015-01-01 13
Total of all active and inactive participants 2015-01-01 68
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 68
Number of participants with account balances 2015-01-01 68
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: CHILDREN'S MEDICAL GROUP 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 74
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 57
Number of retired or separated participants receiving benefits 2014-01-01 1
Number of other retired or separated participants entitled to future benefits 2014-01-01 12
Total of all active and inactive participants 2014-01-01 70
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 70
Number of participants with account balances 2014-01-01 70
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: CHILDREN'S MEDICAL GROUP 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 72
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 56
Number of retired or separated participants receiving benefits 2013-01-01 1
Number of other retired or separated participants entitled to future benefits 2013-01-01 13
Total of all active and inactive participants 2013-01-01 70
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 70
Number of participants with account balances 2013-01-01 70
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: CHILDREN'S MEDICAL GROUP 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 70
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 65
Number of retired or separated participants receiving benefits 2012-01-01 1
Number of other retired or separated participants entitled to future benefits 2012-01-01 3
Total of all active and inactive participants 2012-01-01 69
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 69
Number of participants with account balances 2012-01-01 69
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: CHILDREN'S MEDICAL GROUP 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 70
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 55
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 13
Total of all active and inactive participants 2011-01-01 68
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 68
Number of participants with account balances 2011-01-01 68
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: CHILDREN'S MEDICAL GROUP 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 64
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 51
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 15
Total of all active and inactive participants 2010-01-01 66
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 66
Number of participants with account balances 2010-01-01 66
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0

Measure	Date	Value
2022: CHILDREN'S MEDICAL GROUP 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	68
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	42
Number of retired or separated participants receiving benefits	2022-01-01	3
Number of other retired or separated participants entitled to future benefits	2022-01-01	20
Total of all active and inactive participants	2022-01-01	65
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	65
Number of participants with account balances	2022-01-01	65
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: CHILDREN'S MEDICAL GROUP 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	73
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	43
Number of retired or separated participants receiving benefits	2021-01-01	3
Number of other retired or separated participants entitled to future benefits	2021-01-01	22
Total of all active and inactive participants	2021-01-01	68
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	68
Number of participants with account balances	2021-01-01	68
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: CHILDREN'S MEDICAL GROUP 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	76
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	47
Number of retired or separated participants receiving benefits	2020-01-01	3
Number of other retired or separated participants entitled to future benefits	2020-01-01	22
Total of all active and inactive participants	2020-01-01	72
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	72
Number of participants with account balances	2020-01-01	72
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: CHILDREN'S MEDICAL GROUP 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	71
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	53
Number of retired or separated participants receiving benefits	2019-01-01	3
Number of other retired or separated participants entitled to future benefits	2019-01-01	18
Total of all active and inactive participants	2019-01-01	74
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	74
Number of participants with account balances	2019-01-01	74
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: CHILDREN'S MEDICAL GROUP 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	70
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	47
Number of retired or separated participants receiving benefits	2018-01-01	3
Number of other retired or separated participants entitled to future benefits	2018-01-01	18
Total of all active and inactive participants	2018-01-01	68
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	68
Number of participants with account balances	2018-01-01	68
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: CHILDREN'S MEDICAL GROUP 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	57
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	48
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	21
Total of all active and inactive participants	2017-01-01	69
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	69
Number of participants with account balances	2017-01-01	69
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: CHILDREN'S MEDICAL GROUP 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	68
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	51
Number of retired or separated participants receiving benefits	2016-01-01	1
Number of other retired or separated participants entitled to future benefits	2016-01-01	11
Total of all active and inactive participants	2016-01-01	63
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	63
Number of participants with account balances	2016-01-01	63
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: CHILDREN'S MEDICAL GROUP 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	71
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	54
Number of retired or separated participants receiving benefits	2015-01-01	1
Number of other retired or separated participants entitled to future benefits	2015-01-01	13
Total of all active and inactive participants	2015-01-01	68
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	68
Number of participants with account balances	2015-01-01	68
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: CHILDREN'S MEDICAL GROUP 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	74
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	57
Number of retired or separated participants receiving benefits	2014-01-01	1
Number of other retired or separated participants entitled to future benefits	2014-01-01	12
Total of all active and inactive participants	2014-01-01	70
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	70
Number of participants with account balances	2014-01-01	70
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: CHILDREN'S MEDICAL GROUP 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	72
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	56
Number of retired or separated participants receiving benefits	2013-01-01	1
Number of other retired or separated participants entitled to future benefits	2013-01-01	13
Total of all active and inactive participants	2013-01-01	70
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	70
Number of participants with account balances	2013-01-01	70
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: CHILDREN'S MEDICAL GROUP 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	70
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	65
Number of retired or separated participants receiving benefits	2012-01-01	1
Number of other retired or separated participants entitled to future benefits	2012-01-01	3
Total of all active and inactive participants	2012-01-01	69
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	69
Number of participants with account balances	2012-01-01	69
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: CHILDREN'S MEDICAL GROUP 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	70
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	55
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	13
Total of all active and inactive participants	2011-01-01	68
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	68
Number of participants with account balances	2011-01-01	68
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: CHILDREN'S MEDICAL GROUP 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	64
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	51
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	15
Total of all active and inactive participants	2010-01-01	66
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	66
Number of participants with account balances	2010-01-01	66
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0

Financial Data on CHILDREN'S MEDICAL GROUP 401(K) PLAN

Measure	Date	Value
2022 : CHILDREN'S MEDICAL GROUP 401(K) PLAN 2022 401k financial data
Transfers to/from the plan	2022-12-31	$0
Total plan liabilities at end of year	2022-12-31	$125
Total plan liabilities at beginning of year	2022-12-31	$125
Total income from all sources	2022-12-31	$-1,733,461
Expenses. Total of all expenses incurred	2022-12-31	$1,795,501
Benefits paid (including direct rollovers)	2022-12-31	$1,726,597
Total plan assets at end of year	2022-12-31	$14,657,506
Total plan assets at beginning of year	2022-12-31	$18,186,468
Value of fidelity bond covering the plan	2022-12-31	$500,000
Total contributions received or receivable from participants	2022-12-31	$240,339
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	$-2,312,216
Noncash contributions received	2022-12-31	$0
Net income (gross income less expenses)	2022-12-31	$-3,528,962
Net plan assets at end of year (total assets less liabilities)	2022-12-31	$14,657,381
Net plan assets at beginning of year (total assets less liabilities)	2022-12-31	$18,186,343
Assets. Value of participant loans	2022-12-31	$157,179
Total contributions received or receivable from employer(s)	2022-12-31	$338,416
Value of certain deemed distributions of participant loans	2022-12-31	$5,686
Value of corrective distributions	2022-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2022-12-31	$63,218
2021 : CHILDREN'S MEDICAL GROUP 401(K) PLAN 2021 401k financial data
Total plan liabilities at end of year	2021-12-31	$125
Total plan liabilities at beginning of year	2021-12-31	$2,541
Total income from all sources	2021-12-31	$2,376,220
Expenses. Total of all expenses incurred	2021-12-31	$183,641
Benefits paid (including direct rollovers)	2021-12-31	$131,462
Total plan assets at end of year	2021-12-31	$18,186,468
Total plan assets at beginning of year	2021-12-31	$15,996,305
Value of fidelity bond covering the plan	2021-12-31	$500,000
Total contributions received or receivable from participants	2021-12-31	$233,323
Contributions received from other sources (not participants or employers)	2021-12-31	$0
Other income received	2021-12-31	$1,806,389
Noncash contributions received	2021-12-31	$0
Net income (gross income less expenses)	2021-12-31	$2,192,579
Net plan assets at end of year (total assets less liabilities)	2021-12-31	$18,186,343
Net plan assets at beginning of year (total assets less liabilities)	2021-12-31	$15,993,764
Assets. Value of participant loans	2021-12-31	$111,125
Total contributions received or receivable from employer(s)	2021-12-31	$336,508
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	$52,179
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
2020 : CHILDREN'S MEDICAL GROUP 401(K) PLAN 2020 401k financial data
Total plan liabilities at end of year	2020-12-31	$2,541
Total income from all sources	2020-12-31	$2,528,498
Expenses. Total of all expenses incurred	2020-12-31	$1,027,646
Benefits paid (including direct rollovers)	2020-12-31	$971,550
Total plan assets at end of year	2020-12-31	$15,996,305
Total plan assets at beginning of year	2020-12-31	$14,492,912
Value of fidelity bond covering the plan	2020-12-31	$500,000
Total contributions received or receivable from participants	2020-12-31	$234,933
Contributions received from other sources (not participants or employers)	2020-12-31	$53,355
Other income received	2020-12-31	$1,925,531
Net income (gross income less expenses)	2020-12-31	$1,500,852
Net plan assets at end of year (total assets less liabilities)	2020-12-31	$15,993,764
Net plan assets at beginning of year (total assets less liabilities)	2020-12-31	$14,492,912
Assets. Value of participant loans	2020-12-31	$104,648
Assets. Value of assets in partnership/joint-venture interests	2020-12-31	$-7,023
Total contributions received or receivable from employer(s)	2020-12-31	$314,679
Value of certain deemed distributions of participant loans	2020-12-31	$17,166
Expenses. Administrative service providers (salaries,fees and commissions)	2020-12-31	$38,930
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
2019 : CHILDREN'S MEDICAL GROUP 401(K) PLAN 2019 401k financial data
Total income from all sources	2019-12-31	$2,623,137
Expenses. Total of all expenses incurred	2019-12-31	$91,250
Benefits paid (including direct rollovers)	2019-12-31	$54,527
Total plan assets at end of year	2019-12-31	$14,492,912
Total plan assets at beginning of year	2019-12-31	$11,961,025
Value of fidelity bond covering the plan	2019-12-31	$1,000,000
Total contributions received or receivable from participants	2019-12-31	$213,414
Contributions received from other sources (not participants or employers)	2019-12-31	$4,263
Other income received	2019-12-31	$2,087,631
Net income (gross income less expenses)	2019-12-31	$2,531,887
Net plan assets at end of year (total assets less liabilities)	2019-12-31	$14,492,912
Net plan assets at beginning of year (total assets less liabilities)	2019-12-31	$11,961,025
Assets. Value of participant loans	2019-12-31	$117,567
Assets. Value of assets in partnership/joint-venture interests	2019-12-31	$-1,401
Total contributions received or receivable from employer(s)	2019-12-31	$317,829
Expenses. Administrative service providers (salaries,fees and commissions)	2019-12-31	$36,723
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
2018 : CHILDREN'S MEDICAL GROUP 401(K) PLAN 2018 401k financial data
Total income from all sources	2018-12-31	$-43,935
Expenses. Total of all expenses incurred	2018-12-31	$587,669
Benefits paid (including direct rollovers)	2018-12-31	$539,407
Total plan assets at end of year	2018-12-31	$11,961,025
Total plan assets at beginning of year	2018-12-31	$12,592,629
Value of fidelity bond covering the plan	2018-12-31	$1,000,000
Total contributions received or receivable from participants	2018-12-31	$219,752
Other income received	2018-12-31	$-557,481
Net income (gross income less expenses)	2018-12-31	$-631,604
Net plan assets at end of year (total assets less liabilities)	2018-12-31	$11,961,025
Net plan assets at beginning of year (total assets less liabilities)	2018-12-31	$12,592,629
Assets. Value of participant loans	2018-12-31	$104,145
Assets. Value of assets in partnership/joint-venture interests	2018-12-31	$-1,401
Total contributions received or receivable from employer(s)	2018-12-31	$293,794
Expenses. Administrative service providers (salaries,fees and commissions)	2018-12-31	$48,262
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
2017 : CHILDREN'S MEDICAL GROUP 401(K) PLAN 2017 401k financial data
Total income from all sources	2017-12-31	$1,970,001
Expenses. Total of all expenses incurred	2017-12-31	$117,633
Benefits paid (including direct rollovers)	2017-12-31	$70,946
Total plan assets at end of year	2017-12-31	$12,592,629
Total plan assets at beginning of year	2017-12-31	$10,740,261
Value of fidelity bond covering the plan	2017-12-31	$1,000,000
Total contributions received or receivable from participants	2017-12-31	$222,273
Contributions received from other sources (not participants or employers)	2017-12-31	$109,598
Other income received	2017-12-31	$1,314,000
Net income (gross income less expenses)	2017-12-31	$1,852,368
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$12,592,629
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$10,740,261
Assets. Value of participant loans	2017-12-31	$156,572
Assets. Value of assets in partnership/joint-venture interests	2017-12-31	$0
Total contributions received or receivable from employer(s)	2017-12-31	$324,130
Expenses. Administrative service providers (salaries,fees and commissions)	2017-12-31	$46,687
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
2016 : CHILDREN'S MEDICAL GROUP 401(K) PLAN 2016 401k financial data
Total income from all sources	2016-12-31	$1,398,466
Expenses. Total of all expenses incurred	2016-12-31	$2,949,050
Benefits paid (including direct rollovers)	2016-12-31	$2,949,050
Total plan assets at end of year	2016-12-31	$10,740,261
Total plan assets at beginning of year	2016-12-31	$12,290,845
Value of fidelity bond covering the plan	2016-12-31	$500,000
Total contributions received or receivable from participants	2016-12-31	$267,080
Noncash contributions received	2016-12-31	$793,840
Net income (gross income less expenses)	2016-12-31	$-1,550,584
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$10,740,261
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$12,290,845
Assets. Value of participant loans	2016-12-31	$137,376
Assets. Value of assets in partnership/joint-venture interests	2016-12-31	$36,804
Total contributions received or receivable from employer(s)	2016-12-31	$337,546
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
2015 : CHILDREN'S MEDICAL GROUP 401(K) PLAN 2015 401k financial data
Total income from all sources	2015-12-31	$241,042
Expenses. Total of all expenses incurred	2015-12-31	$51,183
Benefits paid (including direct rollovers)	2015-12-31	$51,183
Total plan assets at end of year	2015-12-31	$12,290,845
Total plan assets at beginning of year	2015-12-31	$12,100,986
Value of fidelity bond covering the plan	2015-12-31	$500,000
Total contributions received or receivable from participants	2015-12-31	$298,187
Contributions received from other sources (not participants or employers)	2015-12-31	$2,831
Other income received	2015-12-31	$-415,051
Net income (gross income less expenses)	2015-12-31	$189,859
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$12,290,845
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$12,100,986
Assets. Value of participant loans	2015-12-31	$78,454
Assets. Value of assets in partnership/joint-venture interests	2015-12-31	$34,154
Total contributions received or receivable from employer(s)	2015-12-31	$355,075
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
2014 : CHILDREN'S MEDICAL GROUP 401(K) PLAN 2014 401k financial data
Total income from all sources	2014-12-31	$1,024,601
Expenses. Total of all expenses incurred	2014-12-31	$65,696
Benefits paid (including direct rollovers)	2014-12-31	$65,696
Total plan assets at end of year	2014-12-31	$12,100,986
Total plan assets at beginning of year	2014-12-31	$11,142,081
Value of fidelity bond covering the plan	2014-12-31	$500,000
Total contributions received or receivable from participants	2014-12-31	$276,421
Other income received	2014-12-31	$390,572
Net income (gross income less expenses)	2014-12-31	$958,905
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$12,100,986
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$11,142,081
Assets. Value of participant loans	2014-12-31	$64,947
Assets. Value of assets in partnership/joint-venture interests	2014-12-31	$83,781
Total contributions received or receivable from employer(s)	2014-12-31	$357,608
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
2013 : CHILDREN'S MEDICAL GROUP 401(K) PLAN 2013 401k financial data
Total income from all sources	2013-12-31	$2,178,360
Expenses. Total of all expenses incurred	2013-12-31	$90,996
Benefits paid (including direct rollovers)	2013-12-31	$90,996
Total plan assets at end of year	2013-12-31	$11,142,081
Total plan assets at beginning of year	2013-12-31	$9,054,717
Value of fidelity bond covering the plan	2013-12-31	$500,000
Total contributions received or receivable from participants	2013-12-31	$241,507
Other income received	2013-12-31	$1,610,402
Net income (gross income less expenses)	2013-12-31	$2,087,364
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$11,142,081
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$9,054,717
Assets. Value of participant loans	2013-12-31	$62,089
Assets. Value of assets in partnership/joint-venture interests	2013-12-31	$70,001
Total contributions received or receivable from employer(s)	2013-12-31	$326,451
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
2012 : CHILDREN'S MEDICAL GROUP 401(K) PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$1,518,151
Expenses. Total of all expenses incurred	2012-12-31	$27,013
Benefits paid (including direct rollovers)	2012-12-31	$27,013
Total plan assets at end of year	2012-12-31	$9,054,717
Total plan assets at beginning of year	2012-12-31	$7,563,579
Value of fidelity bond covering the plan	2012-12-31	$500,000
Total contributions received or receivable from participants	2012-12-31	$247,612
Contributions received from other sources (not participants or employers)	2012-12-31	$12,418
Other income received	2012-12-31	$941,798
Net income (gross income less expenses)	2012-12-31	$1,491,138
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$9,054,717
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$7,563,579
Assets. Value of participant loans	2012-12-31	$71,818
Assets. Value of assets in partnership/joint-venture interests	2012-12-31	$70,001
Total contributions received or receivable from employer(s)	2012-12-31	$316,323
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
2011 : CHILDREN'S MEDICAL GROUP 401(K) PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$281,751
Expenses. Total of all expenses incurred	2011-12-31	$65,237
Benefits paid (including direct rollovers)	2011-12-31	$65,237
Total plan assets at end of year	2011-12-31	$7,563,579
Total plan assets at beginning of year	2011-12-31	$7,347,065
Value of fidelity bond covering the plan	2011-12-31	$500,000
Total contributions received or receivable from participants	2011-12-31	$246,817
Contributions received from other sources (not participants or employers)	2011-12-31	$19,295
Other income received	2011-12-31	$-295,289
Net income (gross income less expenses)	2011-12-31	$216,514
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$7,563,579
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$7,347,065
Assets. Value of participant loans	2011-12-31	$47,923
Assets. Value of assets in partnership/joint-venture interests	2011-12-31	$76,646
Total contributions received or receivable from employer(s)	2011-12-31	$310,928
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
2010 : CHILDREN'S MEDICAL GROUP 401(K) PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$1,298,562
Expenses. Total of all expenses incurred	2010-12-31	$1,349,648
Benefits paid (including direct rollovers)	2010-12-31	$1,349,648
Total plan assets at end of year	2010-12-31	$7,347,065
Total plan assets at beginning of year	2010-12-31	$7,398,151
Value of fidelity bond covering the plan	2010-12-31	$500,000
Total contributions received or receivable from participants	2010-12-31	$253,718
Contributions received from other sources (not participants or employers)	2010-12-31	$91,862
Other income received	2010-12-31	$647,652
Net income (gross income less expenses)	2010-12-31	$-51,086
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$7,347,065
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$7,398,151
Assets. Value of participant loans	2010-12-31	$40,647
Assets. Value of assets in partnership/joint-venture interests	2010-12-31	$76,450
Total contributions received or receivable from employer(s)	2010-12-31	$305,330
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0

Form 5500 Responses for CHILDREN'S MEDICAL GROUP 401(K) PLAN

2022: CHILDREN'S MEDICAL GROUP 401(K) 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: CHILDREN'S MEDICAL GROUP 401(K) PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: CHILDREN'S MEDICAL GROUP 401(K) PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: CHILDREN'S MEDICAL GROUP 401(K) PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: CHILDREN'S MEDICAL GROUP 401(K) 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: CHILDREN'S MEDICAL GROUP 401(K) 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: CHILDREN'S MEDICAL GROUP 401(K) 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: CHILDREN'S MEDICAL GROUP 401(K) 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: CHILDREN'S MEDICAL GROUP 401(K) 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 – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: CHILDREN'S MEDICAL GROUP 401(K) 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 – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: CHILDREN'S MEDICAL GROUP 401(K) PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: CHILDREN'S MEDICAL GROUP 401(K) PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: CHILDREN'S MEDICAL GROUP 401(K) PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

374423-01

Policy instance

Insurance contract or identification number	374423-01
Number of Individuals Covered	46
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
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

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

374423-01

Policy instance

Insurance contract or identification number	374423-01
Number of Individuals Covered	48
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
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

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

374423-01

Policy instance

Insurance contract or identification number	374423-01
Number of Individuals Covered	48
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
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

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

374423-01

Policy instance

Insurance contract or identification number	374423-01
Number of Individuals Covered	50
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
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

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

374423-01

Policy instance

Insurance contract or identification number	374423-01
Number of Individuals Covered	47
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $14,647
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 $14,647
Insurance broker organization code?	3
Insurance broker name	CHARLES MARION

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

374423-01

Policy instance

Insurance contract or identification number	374423-01
Number of Individuals Covered	45
Insurance policy start date	2016-01-01
Insurance policy end date	2016-12-31
Total amount of commissions paid to insurance broker	USD $12,471
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $12,471
Insurance broker organization code?	3
Insurance broker name	CHARLES MARION

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

374423-01

Policy instance

Insurance contract or identification number	374423-01
Number of Individuals Covered	45
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $8,809
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $8,809
Insurance broker organization code?	3
Insurance broker name	CHARLES MARION

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Company Name:	CHILDREN'S MEDICAL GROUP
Employer identification number (EIN):	640512728
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
002	2022-01-01	PAT MALONEY	2023-08-07
002	2021-01-01	PAT MALONEY	2022-06-20
002	2020-01-01
002	2019-01-01
002	2018-01-01
002	2017-01-01	PAT MALONEY
002	2016-01-01	JOANNA M. STOREY
002	2015-01-01	JOANNA STOREY, M.D.
002	2014-01-01	JOANNA STOREY, M.D.
002	2013-01-01	JOANNA STOREY, M.D.
002	2012-01-01	JOANNA STOREY, M.D.
002	2011-01-01	JOANNA STOREY, M.D.
002	2010-01-01	JOANNA STOREY, M.D.