401k Plan data: EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS PLAN plan

EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS PLAN 401k Plan overview

Plan Name	EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS PLAN
Plan identification number	001

EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS 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

EAST LAKELAND OB-GYN ASSOCIATES, PA has sponsored the creation of one or more 401k plans.

Company Name: EAST LAKELAND OB-GYN ASSOCIATES, PA

Employer identification number (EIN): 640821400

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2021-10-01 GINNY LLOYD 2023-07-10
001 2020-10-01 GINNY LLOYD 2022-06-13
001 2019-10-01 GINNY LLOYD 2021-04-14
001 2019-01-01 GINNY LLOYD 2020-07-09
001 2018-01-01 GINNY LLOYD 2019-10-07
001 2017-01-01
001 2016-01-01 GINNY LLOYD
001 2015-01-01 GINNY LLOYD
001 2014-01-01 GINNY LLOYD
001 2013-01-01 GINNY LLOYD
001 2012-01-01 GINNY LLOYD
001 2011-01-01 GINNY LLOYD
001 2009-01-01 GINNY LLOYD

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2021-10-01	GINNY LLOYD	2023-07-10
001	2020-10-01	GINNY LLOYD	2022-06-13
001	2019-10-01	GINNY LLOYD	2021-04-14
001	2019-01-01	GINNY LLOYD	2020-07-09
001	2018-01-01	GINNY LLOYD	2019-10-07
001	2017-01-01
001	2016-01-01	GINNY LLOYD
001	2015-01-01	GINNY LLOYD
001	2014-01-01	GINNY LLOYD
001	2013-01-01	GINNY LLOYD
001	2012-01-01	GINNY LLOYD
001	2011-01-01	GINNY LLOYD
001	2009-01-01	GINNY LLOYD

Plan Statistics for EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS PLAN

401k plan membership statisitcs for EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS PLAN

Measure Date Value
2021: EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS PLAN 2021 401k membership
Total participants, beginning-of-year 2021-10-01 46
Total number of active participants reported on line 7a of the Form 5500 2021-10-01 32
Number of retired or separated participants receiving benefits 2021-10-01 2
Number of other retired or separated participants entitled to future benefits 2021-10-01 11
Total of all active and inactive participants 2021-10-01 45
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-10-01 1
Total participants 2021-10-01 46
Number of participants with account balances 2021-10-01 46
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-10-01 2
2020: EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS PLAN 2020 401k membership
Total participants, beginning-of-year 2020-10-01 54
Total number of active participants reported on line 7a of the Form 5500 2020-10-01 34
Number of retired or separated participants receiving benefits 2020-10-01 2
Number of other retired or separated participants entitled to future benefits 2020-10-01 10
Total of all active and inactive participants 2020-10-01 46
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-10-01 0
Total participants 2020-10-01 46
Number of participants with account balances 2020-10-01 44
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-10-01 2
2019: EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS PLAN 2019 401k membership
Total participants, beginning-of-year 2019-10-01 58
Total number of active participants reported on line 7a of the Form 5500 2019-10-01 35
Number of retired or separated participants receiving benefits 2019-10-01 6
Number of other retired or separated participants entitled to future benefits 2019-10-01 11
Total of all active and inactive participants 2019-10-01 52
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-10-01 0
Total participants 2019-10-01 52
Number of participants with account balances 2019-10-01 51
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-10-01 2
Total participants, beginning-of-year 2019-01-01 62
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 35
Number of retired or separated participants receiving benefits 2019-01-01 4
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 57
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 57
Number of participants with account balances 2019-01-01 57
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 1
2018: EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 58
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 34
Number of retired or separated participants receiving benefits 2018-01-01 4
Number of other retired or separated participants entitled to future benefits 2018-01-01 20
Total of all active and inactive participants 2018-01-01 58
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 58
Number of participants with account balances 2018-01-01 57
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 7
2017: EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 61
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 42
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 63
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 63
Number of participants with account balances 2017-01-01 63
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 5
2016: EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 58
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 46
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 9
Total of all active and inactive participants 2016-01-01 56
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 56
Number of participants with account balances 2016-01-01 56
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 3
2015: EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 55
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 40
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 9
Total of all active and inactive participants 2015-01-01 50
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 50
Number of participants with account balances 2015-01-01 50
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 61
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 40
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 11
Total of all active and inactive participants 2014-01-01 52
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 52
Number of participants with account balances 2014-01-01 52
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 5
2013: EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 59
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 45
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 11
Total of all active and inactive participants 2013-01-01 56
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 56
Number of participants with account balances 2013-01-01 56
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 1
2012: EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 63
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 47
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 12
Total of all active and inactive participants 2012-01-01 59
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 59
Number of participants with account balances 2012-01-01 59
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 8
2011: EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 63
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 52
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 8
Total of all active and inactive participants 2011-01-01 60
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 60
Number of participants with account balances 2011-01-01 60
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 67
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 54
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 8
Total of all active and inactive participants 2009-01-01 62
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 62
Number of participants with account balances 2009-01-01 62
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 2

Measure	Date	Value
2021: EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS PLAN 2021 401k membership
Total participants, beginning-of-year	2021-10-01	46
Total number of active participants reported on line 7a of the Form 5500	2021-10-01	32
Number of retired or separated participants receiving benefits	2021-10-01	2
Number of other retired or separated participants entitled to future benefits	2021-10-01	11
Total of all active and inactive participants	2021-10-01	45
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-10-01	1
Total participants	2021-10-01	46
Number of participants with account balances	2021-10-01	46
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-10-01	2
2020: EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS PLAN 2020 401k membership
Total participants, beginning-of-year	2020-10-01	54
Total number of active participants reported on line 7a of the Form 5500	2020-10-01	34
Number of retired or separated participants receiving benefits	2020-10-01	2
Number of other retired or separated participants entitled to future benefits	2020-10-01	10
Total of all active and inactive participants	2020-10-01	46
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-10-01	0
Total participants	2020-10-01	46
Number of participants with account balances	2020-10-01	44
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-10-01	2
2019: EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS PLAN 2019 401k membership
Total participants, beginning-of-year	2019-10-01	58
Total number of active participants reported on line 7a of the Form 5500	2019-10-01	35
Number of retired or separated participants receiving benefits	2019-10-01	6
Number of other retired or separated participants entitled to future benefits	2019-10-01	11
Total of all active and inactive participants	2019-10-01	52
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-10-01	0
Total participants	2019-10-01	52
Number of participants with account balances	2019-10-01	51
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-10-01	2
Total participants, beginning-of-year	2019-01-01	62
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	35
Number of retired or separated participants receiving benefits	2019-01-01	4
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	57
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	57
Number of participants with account balances	2019-01-01	57
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	1
2018: EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	58
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	34
Number of retired or separated participants receiving benefits	2018-01-01	4
Number of other retired or separated participants entitled to future benefits	2018-01-01	20
Total of all active and inactive participants	2018-01-01	58
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	58
Number of participants with account balances	2018-01-01	57
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	7
2017: EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	61
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	42
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	63
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	63
Number of participants with account balances	2017-01-01	63
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	5
2016: EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	58
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	46
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	9
Total of all active and inactive participants	2016-01-01	56
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	56
Number of participants with account balances	2016-01-01	56
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	3
2015: EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	55
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	40
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	9
Total of all active and inactive participants	2015-01-01	50
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	50
Number of participants with account balances	2015-01-01	50
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	61
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	40
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	11
Total of all active and inactive participants	2014-01-01	52
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	52
Number of participants with account balances	2014-01-01	52
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	5
2013: EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	59
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	45
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	11
Total of all active and inactive participants	2013-01-01	56
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	56
Number of participants with account balances	2013-01-01	56
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	1
2012: EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	63
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	47
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	12
Total of all active and inactive participants	2012-01-01	59
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	59
Number of participants with account balances	2012-01-01	59
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	8
2011: EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	63
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	52
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	8
Total of all active and inactive participants	2011-01-01	60
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	60
Number of participants with account balances	2011-01-01	60
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	67
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	54
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	8
Total of all active and inactive participants	2009-01-01	62
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	62
Number of participants with account balances	2009-01-01	62
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	2

Financial Data on EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS PLAN

Measure	Date	Value
2022 : EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS PLAN 2022 401k financial data
Total income from all sources	2022-09-30	$-1,260,723
Expenses. Total of all expenses incurred	2022-09-30	$373,874
Benefits paid (including direct rollovers)	2022-09-30	$331,196
Total plan assets at end of year	2022-09-30	$10,068,955
Total plan assets at beginning of year	2022-09-30	$11,703,552
Value of fidelity bond covering the plan	2022-09-30	$500,000
Total contributions received or receivable from participants	2022-09-30	$147,017
Other income received	2022-09-30	$-1,701,485
Net income (gross income less expenses)	2022-09-30	$-1,634,597
Net plan assets at end of year (total assets less liabilities)	2022-09-30	$10,068,955
Net plan assets at beginning of year (total assets less liabilities)	2022-09-30	$11,703,552
Assets. Value of participant loans	2022-09-30	$69,796
Assets. Value of assets in partnership/joint-venture interests	2022-09-30	$490,975
Total contributions received or receivable from employer(s)	2022-09-30	$293,745
Value of certain deemed distributions of participant loans	2022-09-30	$884
Expenses. Administrative service providers (salaries,fees and commissions)	2022-09-30	$41,794
2021 : EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS PLAN 2021 401k financial data
Total plan liabilities at beginning of year	2021-09-30	$1,538
Total income from all sources	2021-09-30	$2,383,603
Expenses. Total of all expenses incurred	2021-09-30	$657,820
Benefits paid (including direct rollovers)	2021-09-30	$611,322
Total plan assets at end of year	2021-09-30	$11,703,552
Total plan assets at beginning of year	2021-09-30	$9,979,307
Value of fidelity bond covering the plan	2021-09-30	$500,000
Total contributions received or receivable from participants	2021-09-30	$154,199
Other income received	2021-09-30	$1,941,563
Net income (gross income less expenses)	2021-09-30	$1,725,783
Net plan assets at end of year (total assets less liabilities)	2021-09-30	$11,703,552
Net plan assets at beginning of year (total assets less liabilities)	2021-09-30	$9,977,769
Assets. Value of participant loans	2021-09-30	$88,034
Assets. Value of assets in partnership/joint-venture interests	2021-09-30	$506,770
Total contributions received or receivable from employer(s)	2021-09-30	$287,841
Value of certain deemed distributions of participant loans	2021-09-30	$8,243
Expenses. Administrative service providers (salaries,fees and commissions)	2021-09-30	$38,255
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-09-30	$0
2020 : EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS PLAN 2020 401k financial data
Total plan liabilities at end of year	2020-09-30	$1,538
Total plan liabilities at beginning of year	2020-09-30	$8,161
Total income from all sources	2020-09-30	$1,192,016
Expenses. Total of all expenses incurred	2020-09-30	$1,039,502
Benefits paid (including direct rollovers)	2020-09-30	$1,006,252
Total plan assets at end of year	2020-09-30	$9,940,369
Total plan assets at beginning of year	2020-09-30	$9,794,478
Value of fidelity bond covering the plan	2020-09-30	$1,000,000
Total contributions received or receivable from participants	2020-09-30	$146,613
Contributions received from other sources (not participants or employers)	2020-09-30	$0
Other income received	2020-09-30	$803,039
Noncash contributions received	2020-09-30	$0
Net income (gross income less expenses)	2020-09-30	$152,514
Net plan assets at end of year (total assets less liabilities)	2020-09-30	$9,938,831
Net plan assets at beginning of year (total assets less liabilities)	2020-09-30	$9,786,317
Assets. Value of participant loans	2020-09-30	$103,931
Assets. Value of assets in partnership/joint-venture interests	2020-09-30	$403,728
Total contributions received or receivable from employer(s)	2020-09-30	$242,364
Expenses. Administrative service providers (salaries,fees and commissions)	2020-09-30	$33,250
2019 : EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS PLAN 2019 401k financial data
Total plan liabilities at end of year	2019-09-30	$8,161
Total income from all sources	2019-09-30	$1,700,764
Expenses. Total of all expenses incurred	2019-09-30	$3,673,560
Benefits paid (including direct rollovers)	2019-09-30	$3,637,779
Total plan assets at end of year	2019-09-30	$9,794,478
Total plan assets at beginning of year	2019-09-30	$11,759,113
Value of fidelity bond covering the plan	2019-09-30	$1,000,000
Total contributions received or receivable from participants	2019-09-30	$105,709
Other income received	2019-09-30	$1,388,692
Net income (gross income less expenses)	2019-09-30	$-1,972,796
Net plan assets at end of year (total assets less liabilities)	2019-09-30	$9,786,317
Net plan assets at beginning of year (total assets less liabilities)	2019-09-30	$11,759,113
Assets. Value of participant loans	2019-09-30	$104,890
Assets. Value of assets in partnership/joint-venture interests	2019-09-30	$515,310
Total contributions received or receivable from employer(s)	2019-09-30	$206,363
Value of certain deemed distributions of participant loans	2019-09-30	$10,442
Expenses. Administrative service providers (salaries,fees and commissions)	2019-09-30	$25,339
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-09-30	$0
2018 : EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS PLAN 2018 401k financial data
Total income from all sources	2018-12-31	$-130,002
Expenses. Total of all expenses incurred	2018-12-31	$1,124,166
Benefits paid (including direct rollovers)	2018-12-31	$1,079,429
Total plan assets at end of year	2018-12-31	$11,759,113
Total plan assets at beginning of year	2018-12-31	$13,013,281
Value of fidelity bond covering the plan	2018-12-31	$1,000,000
Total contributions received or receivable from participants	2018-12-31	$192,672
Other income received	2018-12-31	$-725,792
Net income (gross income less expenses)	2018-12-31	$-1,254,168
Net plan assets at end of year (total assets less liabilities)	2018-12-31	$11,759,113
Net plan assets at beginning of year (total assets less liabilities)	2018-12-31	$13,013,281
Assets. Value of participant loans	2018-12-31	$142,957
Assets. Value of assets in partnership/joint-venture interests	2018-12-31	$515,785
Total contributions received or receivable from employer(s)	2018-12-31	$403,118
Expenses. Administrative service providers (salaries,fees and commissions)	2018-12-31	$44,737
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
2017 : EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS PLAN 2017 401k financial data
Total income from all sources	2017-12-31	$2,097,092
Expenses. Total of all expenses incurred	2017-12-31	$393,291
Benefits paid (including direct rollovers)	2017-12-31	$351,829
Total plan assets at end of year	2017-12-31	$13,013,281
Total plan assets at beginning of year	2017-12-31	$11,309,480
Value of fidelity bond covering the plan	2017-12-31	$1,000,000
Total contributions received or receivable from participants	2017-12-31	$199,779
Other income received	2017-12-31	$1,475,615
Net income (gross income less expenses)	2017-12-31	$1,703,801
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$13,013,281
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$11,309,480
Assets. Value of participant loans	2017-12-31	$148,332
Assets. Value of assets in partnership/joint-venture interests	2017-12-31	$690,720
Total contributions received or receivable from employer(s)	2017-12-31	$421,698
Expenses. Administrative service providers (salaries,fees and commissions)	2017-12-31	$41,462
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
2016 : EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS PLAN 2016 401k financial data
Total income from all sources	2016-12-31	$1,206,567
Expenses. Total of all expenses incurred	2016-12-31	$105,782
Benefits paid (including direct rollovers)	2016-12-31	$105,782
Total plan assets at end of year	2016-12-31	$11,309,480
Total plan assets at beginning of year	2016-12-31	$10,208,695
Value of fidelity bond covering the plan	2016-12-31	$1,000,000
Total contributions received or receivable from participants	2016-12-31	$211,286
Other income received	2016-12-31	$555,409
Net income (gross income less expenses)	2016-12-31	$1,100,785
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$11,309,480
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$10,208,695
Assets. Value of participant loans	2016-12-31	$111,535
Assets. Value of assets in partnership/joint-venture interests	2016-12-31	$592,798
Total contributions received or receivable from employer(s)	2016-12-31	$439,872
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
2015 : EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS PLAN 2015 401k financial data
Total income from all sources	2015-12-31	$412,406
Expenses. Total of all expenses incurred	2015-12-31	$638,410
Benefits paid (including direct rollovers)	2015-12-31	$638,410
Total plan assets at end of year	2015-12-31	$10,208,695
Total plan assets at beginning of year	2015-12-31	$10,434,699
Value of fidelity bond covering the plan	2015-12-31	$1,000,000
Total contributions received or receivable from participants	2015-12-31	$202,176
Other income received	2015-12-31	$-182,714
Net income (gross income less expenses)	2015-12-31	$-226,004
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$10,208,695
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$10,434,699
Assets. Value of participant loans	2015-12-31	$128,457
Assets. Value of assets in partnership/joint-venture interests	2015-12-31	$814,846
Total contributions received or receivable from employer(s)	2015-12-31	$392,944
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
2014 : EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS PLAN 2014 401k financial data
Total income from all sources	2014-12-31	$1,301,673
Expenses. Total of all expenses incurred	2014-12-31	$485,479
Benefits paid (including direct rollovers)	2014-12-31	$485,479
Total plan assets at end of year	2014-12-31	$10,434,699
Total plan assets at beginning of year	2014-12-31	$9,618,505
Value of fidelity bond covering the plan	2014-12-31	$1,000,000
Total contributions received or receivable from participants	2014-12-31	$194,546
Contributions received from other sources (not participants or employers)	2014-12-31	$1,241
Other income received	2014-12-31	$713,382
Net income (gross income less expenses)	2014-12-31	$816,194
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$10,434,699
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$9,618,505
Assets. Value of participant loans	2014-12-31	$172,973
Assets. Value of assets in partnership/joint-venture interests	2014-12-31	$810,526
Total contributions received or receivable from employer(s)	2014-12-31	$392,504
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
2013 : EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS PLAN 2013 401k financial data
Total income from all sources	2013-12-31	$2,073,080
Expenses. Total of all expenses incurred	2013-12-31	$227,416
Benefits paid (including direct rollovers)	2013-12-31	$227,416
Total plan assets at end of year	2013-12-31	$9,618,505
Total plan assets at beginning of year	2013-12-31	$7,772,841
Value of fidelity bond covering the plan	2013-12-31	$500,000
Total contributions received or receivable from participants	2013-12-31	$193,692
Other income received	2013-12-31	$1,487,841
Net income (gross income less expenses)	2013-12-31	$1,845,664
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$9,618,505
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$7,772,841
Assets. Value of participant loans	2013-12-31	$188,546
Assets. Value of assets in partnership/joint-venture interests	2013-12-31	$346,300
Total contributions received or receivable from employer(s)	2013-12-31	$391,547
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
2012 : EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$1,240,547
Expenses. Total of all expenses incurred	2012-12-31	$196,767
Benefits paid (including direct rollovers)	2012-12-31	$196,767
Total plan assets at end of year	2012-12-31	$7,730,557
Total plan assets at beginning of year	2012-12-31	$6,686,777
Value of fidelity bond covering the plan	2012-12-31	$500,000
Total contributions received or receivable from participants	2012-12-31	$193,504
Contributions received from other sources (not participants or employers)	2012-12-31	$1,484
Other income received	2012-12-31	$656,766
Net income (gross income less expenses)	2012-12-31	$1,043,780
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$7,730,557
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$6,686,777
Assets. Value of participant loans	2012-12-31	$128,277
Assets. Value of assets in partnership/joint-venture interests	2012-12-31	$231,672
Total contributions received or receivable from employer(s)	2012-12-31	$388,793
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
2011 : EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$643,187
Expenses. Total of all expenses incurred	2011-12-31	$229,081
Benefits paid (including direct rollovers)	2011-12-31	$229,081
Total plan assets at end of year	2011-12-31	$6,686,777
Total plan assets at beginning of year	2011-12-31	$6,272,671
Value of fidelity bond covering the plan	2011-12-31	$500,000
Total contributions received or receivable from participants	2011-12-31	$193,493
Contributions received from other sources (not participants or employers)	2011-12-31	$147,334
Other income received	2011-12-31	$-100,047
Net income (gross income less expenses)	2011-12-31	$414,106
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$6,686,777
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$6,272,671
Assets. Value of participant loans	2011-12-31	$151,818
Assets. Value of assets in partnership/joint-venture interests	2011-12-31	$273,956
Total contributions received or receivable from employer(s)	2011-12-31	$402,407
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
2010 : EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$1,180,524
Expenses. Total of all expenses incurred	2010-12-31	$169,263
Benefits paid (including direct rollovers)	2010-12-31	$169,263
Total plan assets at end of year	2010-12-31	$6,272,671
Total plan assets at beginning of year	2010-12-31	$5,261,410
Value of fidelity bond covering the plan	2010-12-31	$500,000
Total contributions received or receivable from participants	2010-12-31	$187,648
Other income received	2010-12-31	$597,279
Net income (gross income less expenses)	2010-12-31	$1,011,261
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$6,272,671
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$5,261,410
Assets. Value of participant loans	2010-12-31	$97,275
Assets. Value of assets in partnership/joint-venture interests	2010-12-31	$278,522
Total contributions received or receivable from employer(s)	2010-12-31	$395,597
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
2009 : EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS 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 EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS PLAN

2021: EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS PLAN 2021 form 5500 responses
2021-10-01	Type of plan entity	Single employer plan
2021-10-01	Submission has been amended	No
2021-10-01	This submission is the final filing	No
2021-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-10-01	Plan is a collectively bargained plan	No
2021-10-01	Plan funding arrangement – Trust	Yes
2021-10-01	Plan benefit arrangement - Trust	Yes
2020: EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS PLAN 2020 form 5500 responses
2020-10-01	Type of plan entity	Single employer plan
2020-10-01	Submission has been amended	No
2020-10-01	This submission is the final filing	No
2020-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-10-01	Plan is a collectively bargained plan	No
2020-10-01	Plan funding arrangement – Trust	Yes
2020-10-01	Plan benefit arrangement - Trust	Yes
2019: EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS PLAN 2019 form 5500 responses
2019-10-01	Type of plan entity	Single employer plan
2019-10-01	Submission has been amended	No
2019-10-01	This submission is the final filing	No
2019-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-10-01	Plan is a collectively bargained plan	No
2019-10-01	Plan funding arrangement – Trust	Yes
2019-10-01	Plan benefit arrangement - Trust	Yes
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)	Yes
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS 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 – Trust	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS 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: EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS 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: EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS 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 – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS 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: EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS 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: EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS 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: EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: EAST LAKELAND OB-GYN ASSOCIATES, PA 401(K) SALARY SAVINGS PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

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

Policy contract number

375891-01

Policy instance

Insurance contract or identification number	375891-01
Number of Individuals Covered	33
Insurance policy start date	2021-10-01
Insurance policy end date	2022-09-30
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

375891-01

Policy instance

Insurance contract or identification number	375891-01
Number of Individuals Covered	32
Insurance policy start date	2020-10-01
Insurance policy end date	2021-09-30
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

375891-01

Policy instance

Insurance contract or identification number	375891-01
Number of Individuals Covered	43
Insurance policy start date	2019-01-01
Insurance policy end date	2019-09-30
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

375891-01

Policy instance

Insurance contract or identification number	375891-01
Number of Individuals Covered	39
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $9,030
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $9,030
Insurance broker organization code?	3

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

Policy contract number

375891-01

Policy instance

Insurance contract or identification number	375891-01
Number of Individuals Covered	42
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $9,591
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $9,591
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

37589-01

Policy instance

Insurance contract or identification number	37589-01
Number of Individuals Covered	46
Insurance policy start date	2016-01-01
Insurance policy end date	2016-12-31
Total amount of commissions paid to insurance broker	USD $5,785
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
Commission paid to Insurance Broker	USD $3,858
Insurance broker organization code?	3
Insurance broker name	CHARLES MARION

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Company Name:	EAST LAKELAND OB-GYN ASSOCIATES, PA
Employer identification number (EIN):	640821400
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)