401k Plan data: PSYCHOLOGICAL HEALTH CARE, PLLC RETIREMENT PLAN plan

PSYCHOLOGICAL HEALTH CARE, PLLC RETIREMENT PLAN 401k Plan overview

Plan Name	PSYCHOLOGICAL HEALTH CARE, PLLC RETIREMENT PLAN
Plan identification number	001

PSYCHOLOGICAL HEALTH CARE, PLLC RETIREMENT 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.
Plan covering Self-Employed individuals.
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

PSYCHOLOGICAL HEALTH CARE, PLLC has sponsored the creation of one or more 401k plans.

Company Name: PSYCHOLOGICAL HEALTH CARE, PLLC

Employer identification number (EIN): 161484552

NAIC Classification: 621112
NAIC Description: Offices of Physicians, Mental Health Specialists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PSYCHOLOGICAL HEALTH CARE, PLLC RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01
001 2021-01-01 JOEL RICHMAN 2022-08-11
001 2020-01-01
001 2019-01-01
001 2018-01-01
001 2017-01-01 JOEL RICHMAN
001 2016-01-01 JOEL RICHMAN
001 2015-01-01 JOEL RICHMAN
001 2014-01-01 JOEL RICHMAN JOEL RICHMAN 2015-10-14
001 2013-01-01 JOEL RICHMAN JOEL RICHMAN 2014-10-15
001 2012-01-01 JOEL RICHMAN JOEL RICHMAN 2013-10-14
001 2011-01-01 JOEL RICHMAN 2012-10-12 JOEL RICHMAN 2012-10-12
001 2010-01-01 JOEL RICHMAN 2011-10-04 JOEL RICHMAN 2011-10-04

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2022-01-01
001	2021-01-01	JOEL RICHMAN	2022-08-11
001	2020-01-01
001	2019-01-01
001	2018-01-01
001	2017-01-01	JOEL RICHMAN
001	2016-01-01	JOEL RICHMAN
001	2015-01-01	JOEL RICHMAN
001	2014-01-01	JOEL RICHMAN		JOEL RICHMAN	2015-10-14
001	2013-01-01	JOEL RICHMAN		JOEL RICHMAN	2014-10-15
001	2012-01-01	JOEL RICHMAN		JOEL RICHMAN	2013-10-14
001	2011-01-01	JOEL RICHMAN	2012-10-12	JOEL RICHMAN	2012-10-12
001	2010-01-01	JOEL RICHMAN	2011-10-04	JOEL RICHMAN	2011-10-04

Plan Statistics for PSYCHOLOGICAL HEALTH CARE, PLLC RETIREMENT PLAN

401k plan membership statisitcs for PSYCHOLOGICAL HEALTH CARE, PLLC RETIREMENT PLAN

Measure Date Value
2020: PSYCHOLOGICAL HEALTH CARE, PLLC RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 102
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 86
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 10
Total of all active and inactive participants 2020-01-01 96
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 96
Number of participants with account balances 2020-01-01 70
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 5
2019: PSYCHOLOGICAL HEALTH CARE, PLLC RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 115
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 88
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 12
Total of all active and inactive participants 2019-01-01 100
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 100
Number of participants with account balances 2019-01-01 70
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 2
2018: PSYCHOLOGICAL HEALTH CARE, PLLC RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 113
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 87
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 20
Total of all active and inactive participants 2018-01-01 107
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 107
Number of participants with account balances 2018-01-01 73
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 3
2017: PSYCHOLOGICAL HEALTH CARE, PLLC RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 103
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 94
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 15
Total of all active and inactive participants 2017-01-01 109
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 109
Number of participants with account balances 2017-01-01 78
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 4
2016: PSYCHOLOGICAL HEALTH CARE, PLLC RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 128
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 89
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 13
Total of all active and inactive participants 2016-01-01 102
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 102
Number of participants with account balances 2016-01-01 90
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 2
2015: PSYCHOLOGICAL HEALTH CARE, PLLC RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 129
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 114
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 10
Total of all active and inactive participants 2015-01-01 124
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 124
Number of participants with account balances 2015-01-01 86
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 2
2014: PSYCHOLOGICAL HEALTH CARE, PLLC RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 118
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 117
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 8
Total of all active and inactive participants 2014-01-01 125
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 125
Number of participants with account balances 2014-01-01 81
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 1
2013: PSYCHOLOGICAL HEALTH CARE, PLLC RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 122
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 110
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 7
Total of all active and inactive participants 2013-01-01 117
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 117
Number of participants with account balances 2013-01-01 76
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: PSYCHOLOGICAL HEALTH CARE, PLLC RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 128
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 113
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 6
Total of all active and inactive participants 2012-01-01 119
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 119
Number of participants with account balances 2012-01-01 79
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0

Measure	Date	Value
2020: PSYCHOLOGICAL HEALTH CARE, PLLC RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	102
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	86
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	10
Total of all active and inactive participants	2020-01-01	96
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	96
Number of participants with account balances	2020-01-01	70
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	5
2019: PSYCHOLOGICAL HEALTH CARE, PLLC RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	115
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	88
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	12
Total of all active and inactive participants	2019-01-01	100
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	100
Number of participants with account balances	2019-01-01	70
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	2
2018: PSYCHOLOGICAL HEALTH CARE, PLLC RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	113
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	87
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	20
Total of all active and inactive participants	2018-01-01	107
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	107
Number of participants with account balances	2018-01-01	73
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	3
2017: PSYCHOLOGICAL HEALTH CARE, PLLC RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	103
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	94
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	15
Total of all active and inactive participants	2017-01-01	109
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	109
Number of participants with account balances	2017-01-01	78
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	4
2016: PSYCHOLOGICAL HEALTH CARE, PLLC RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	128
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	89
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	13
Total of all active and inactive participants	2016-01-01	102
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	102
Number of participants with account balances	2016-01-01	90
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	2
2015: PSYCHOLOGICAL HEALTH CARE, PLLC RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	129
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	114
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	10
Total of all active and inactive participants	2015-01-01	124
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	124
Number of participants with account balances	2015-01-01	86
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	2
2014: PSYCHOLOGICAL HEALTH CARE, PLLC RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	118
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	117
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	8
Total of all active and inactive participants	2014-01-01	125
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	125
Number of participants with account balances	2014-01-01	81
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	1
2013: PSYCHOLOGICAL HEALTH CARE, PLLC RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	122
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	110
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	7
Total of all active and inactive participants	2013-01-01	117
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	117
Number of participants with account balances	2013-01-01	76
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: PSYCHOLOGICAL HEALTH CARE, PLLC RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	128
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	113
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	6
Total of all active and inactive participants	2012-01-01	119
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	119
Number of participants with account balances	2012-01-01	79
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0

Financial Data on PSYCHOLOGICAL HEALTH CARE, PLLC RETIREMENT PLAN

Measure	Date	Value
2020 : PSYCHOLOGICAL HEALTH CARE, PLLC RETIREMENT PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$1,319,066
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$587,061
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$550,356
Expenses. Certain deemed distributions of participant loans	2020-12-31	$14,647
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$454,772
Value of total assets at end of year	2020-12-31	$5,987,038
Value of total assets at beginning of year	2020-12-31	$5,255,033
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$22,058
Total interest from all sources	2020-12-31	$9,341
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$68,946
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-31	$68,946
Administrative expenses professional fees incurred	2020-12-31	$22,058
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$373,786
Participant contributions at end of year	2020-12-31	$101,906
Participant contributions at beginning of year	2020-12-31	$92,443
Participant contributions at end of year	2020-12-31	$0
Participant contributions at beginning of year	2020-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Income. Non cash contributions	2020-12-31	$0
Value of net income/loss	2020-12-31	$732,005
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$5,987,038
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$5,255,033
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$5,535,729
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$5,017,410
Interest on participant loans	2020-12-31	$7,115
Interest earned on other investments	2020-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2020-12-31	$2,226
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$332,169
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$123,667
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$786,007
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$80,986
Employer contributions (assets) at end of year	2020-12-31	$17,234
Employer contributions (assets) at beginning of year	2020-12-31	$21,513
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$550,356
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	GROSSMAN ST AMOUR
Accountancy firm EIN	2020-12-31	460475780
2019 : PSYCHOLOGICAL HEALTH CARE, PLLC RETIREMENT PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$1,364,744
Total income from all sources (including contributions)	2019-12-31	$1,364,744
Total loss/gain on sale of assets	2019-12-31	$0
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$332,885
Total of all expenses incurred	2019-12-31	$332,885
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$285,672
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$285,672
Value of total corrective distributions	2019-12-31	$16,606
Value of total corrective distributions	2019-12-31	$16,606
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$499,857
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$499,857
Value of total assets at end of year	2019-12-31	$5,255,033
Value of total assets at end of year	2019-12-31	$5,255,033
Value of total assets at beginning of year	2019-12-31	$4,223,174
Value of total assets at beginning of year	2019-12-31	$4,223,174
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$30,607
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$30,607
Total interest from all sources	2019-12-31	$5,109
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$80,567
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$80,567
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$80,567
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$80,567
Administrative expenses professional fees incurred	2019-12-31	$8,300
Administrative expenses professional fees incurred	2019-12-31	$8,300
Was this plan covered by a fidelity bond	2019-12-31	Yes
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
Value of fidelity bond cover	2019-12-31	$500,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$327,763
Contributions received from participants	2019-12-31	$327,763
Participant contributions at end of year	2019-12-31	$92,443
Participant contributions at end of year	2019-12-31	$92,443
Participant contributions at beginning of year	2019-12-31	$47,613
Participant contributions at beginning of year	2019-12-31	$47,613
Participant contributions at end of year	2019-12-31	$0
Participant contributions at end of year	2019-12-31	$0
Participant contributions at beginning of year	2019-12-31	$12,690
Participant contributions at beginning of year	2019-12-31	$12,690
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$109,448
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$109,448
Administrative expenses (other) incurred	2019-12-31	$20,153
Administrative expenses (other) incurred	2019-12-31	$20,153
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$1,031,859
Value of net income/loss	2019-12-31	$1,031,859
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$5,255,033
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$5,255,033
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$4,223,174
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$4,223,174
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$5,017,410
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$5,017,410
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$4,066,612
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$4,066,612
Interest on participant loans	2019-12-31	$3,770
Interest on participant loans	2019-12-31	$3,770
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-31	$1,339
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-31	$1,339
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$123,667
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$123,667
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$86,610
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$86,610
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$779,211
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$779,211
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$62,646
Contributions received in cash from employer	2019-12-31	$62,646
Employer contributions (assets) at end of year	2019-12-31	$21,513
Employer contributions (assets) at end of year	2019-12-31	$21,513
Employer contributions (assets) at beginning of year	2019-12-31	$9,649
Employer contributions (assets) at beginning of year	2019-12-31	$9,649
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$285,672
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$285,672
Contract administrator fees	2019-12-31	$2,154
Contract administrator fees	2019-12-31	$2,154
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	GROSSMAN ST AMOUR
Accountancy firm name	2019-12-31	GROSSMAN ST AMOUR
Accountancy firm EIN	2019-12-31	460475780
Accountancy firm EIN	2019-12-31	460475780
2018 : PSYCHOLOGICAL HEALTH CARE, PLLC RETIREMENT PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$174,658
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$839,515
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$807,759
Expenses. Certain deemed distributions of participant loans	2018-12-31	$5,790
Value of total corrective distributions	2018-12-31	$7,211
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$359,618
Value of total assets at end of year	2018-12-31	$4,223,174
Value of total assets at beginning of year	2018-12-31	$4,888,031
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$18,755
Total interest from all sources	2018-12-31	$4,963
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$83,587
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2018-12-31	$83,587
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$500,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$303,467
Participant contributions at end of year	2018-12-31	$47,613
Participant contributions at beginning of year	2018-12-31	$114,802
Participant contributions at end of year	2018-12-31	$12,690
Participant contributions at beginning of year	2018-12-31	$13,668
Administrative expenses (other) incurred	2018-12-31	$18,755
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$-664,857
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$4,223,174
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$4,888,031
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$4,066,612
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$4,751,129
Interest on participant loans	2018-12-31	$4,146
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2018-12-31	$817
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$86,610
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-273,510
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$56,151
Employer contributions (assets) at end of year	2018-12-31	$9,649
Employer contributions (assets) at beginning of year	2018-12-31	$8,432
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$807,759
Did the plan have assets held for investment	2018-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	GROSSMAN ST AMOUR
Accountancy firm EIN	2018-12-31	460475780
2017 : PSYCHOLOGICAL HEALTH CARE, PLLC RETIREMENT PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$1,170,902
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$849,558
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$847,388
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$482,264
Value of total assets at end of year	2017-12-31	$4,888,031
Value of total assets at beginning of year	2017-12-31	$4,566,687
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$2,170
Total interest from all sources	2017-12-31	$3,675
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$500,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$316,569
Participant contributions at end of year	2017-12-31	$114,802
Participant contributions at beginning of year	2017-12-31	$21,712
Participant contributions at end of year	2017-12-31	$13,668
Participant contributions at beginning of year	2017-12-31	$12,464
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$106,162
Administrative expenses (other) incurred	2017-12-31	$2,170
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Income. Non cash contributions	2017-12-31	$0
Value of net income/loss	2017-12-31	$321,344
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$4,888,031
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$4,566,687
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$4,751,129
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$4,527,394
Interest on participant loans	2017-12-31	$3,675
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$684,963
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$59,533
Employer contributions (assets) at end of year	2017-12-31	$8,432
Employer contributions (assets) at beginning of year	2017-12-31	$5,117
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$847,388
Did the plan have assets held for investment	2017-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	No
Opinion of an independent qualified public accountant for this plan	2017-12-31	Unqualified
Accountancy firm name	2017-12-31	GROSSMAN ST AMOUR
Accountancy firm EIN	2017-12-31	460475780
2016 : PSYCHOLOGICAL HEALTH CARE, PLLC RETIREMENT PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total transfer of assets from this plan	2016-12-31	$521,157
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$704,429
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$266,418
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$264,559
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$438,812
Value of total assets at end of year	2016-12-31	$4,566,687
Value of total assets at beginning of year	2016-12-31	$4,649,833
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$1,859
Total interest from all sources	2016-12-31	$1,689
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$97,841
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$500,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$364,470
Participant contributions at end of year	2016-12-31	$21,712
Participant contributions at beginning of year	2016-12-31	$45,481
Participant contributions at end of year	2016-12-31	$12,464
Participant contributions at beginning of year	2016-12-31	$11,560
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$1,570
Administrative expenses (other) incurred	2016-12-31	$1,859
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Income. Non cash contributions	2016-12-31	$0
Value of net income/loss	2016-12-31	$438,011
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$4,566,687
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$4,649,833
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$4,527,394
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$4,588,405
Interest on participant loans	2016-12-31	$1,689
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$166,087
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$72,772
Employer contributions (assets) at end of year	2016-12-31	$5,117
Employer contributions (assets) at beginning of year	2016-12-31	$4,387
Income. Dividends from preferred stock	2016-12-31	$97,841
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$264,559
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	No
Opinion of an independent qualified public accountant for this plan	2016-12-31	Unqualified
Accountancy firm name	2016-12-31	GROSSMAN ST AMOUR
Accountancy firm EIN	2016-12-31	460475780
2015 : PSYCHOLOGICAL HEALTH CARE, PLLC RETIREMENT PLAN 2015 401k financial data
Unrealized appreciation/depreciation of real estate assets	2015-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2015-12-31	$0
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total transfer of assets to this plan	2015-12-31	$0
Total transfer of assets from this plan	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Expenses. Interest paid	2015-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$269,635
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$516,398
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$509,374
Expenses. Certain deemed distributions of participant loans	2015-12-31	$4,600
Value of total corrective distributions	2015-12-31	$587
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$485,581
Value of total assets at end of year	2015-12-31	$4,649,833
Value of total assets at beginning of year	2015-12-31	$4,896,596
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$1,837
Total income from rents	2015-12-31	$0
Total interest from all sources	2015-12-31	$1,407
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$359,417
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$359,417
Administrative expenses professional fees incurred	2015-12-31	$0
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$500,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$396,099
Participant contributions at end of year	2015-12-31	$45,481
Participant contributions at beginning of year	2015-12-31	$75,154
Participant contributions at end of year	2015-12-31	$11,560
Participant contributions at beginning of year	2015-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$9,233
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2015-12-31	$0
Administrative expenses (other) incurred	2015-12-31	$1,837
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Income. Non cash contributions	2015-12-31	$0
Value of net income/loss	2015-12-31	$-246,763
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$4,649,833
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$4,896,596
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Investment advisory and management fees	2015-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$4,588,405
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$4,817,824
Interest on participant loans	2015-12-31	$1,407
Income. Interest from loans (other than to participants)	2015-12-31	$0
Income. Interest from US Government securities	2015-12-31	$0
Income. Interest from corporate debt instruments	2015-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2015-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2015-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-576,770
Net investment gain/loss from pooled separate accounts	2015-12-31	$0
Net investment gain or loss from common/collective trusts	2015-12-31	$0
Net gain/loss from 103.12 investment entities	2015-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$80,249
Employer contributions (assets) at end of year	2015-12-31	$4,387
Employer contributions (assets) at beginning of year	2015-12-31	$3,618
Income. Dividends from preferred stock	2015-12-31	$0
Income. Dividends from common stock	2015-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$509,374
Contract administrator fees	2015-12-31	$0
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Aggregate proceeds on sale of assets	2015-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2015-12-31	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	No
Opinion of an independent qualified public accountant for this plan	2015-12-31	Unqualified
Accountancy firm name	2015-12-31	GROSSMAN ST AMOUR
Accountancy firm EIN	2015-12-31	460475780
2014 : PSYCHOLOGICAL HEALTH CARE, PLLC RETIREMENT PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$175
Total income from all sources (including contributions)	2014-12-31	$636,845
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$21,085
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$9,702
Value of total corrective distributions	2014-12-31	$9,469
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$428,367
Value of total assets at end of year	2014-12-31	$4,896,596
Value of total assets at beginning of year	2014-12-31	$4,281,011
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$1,914
Total interest from all sources	2014-12-31	$3,297
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$500,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$341,812
Participant contributions at end of year	2014-12-31	$75,154
Participant contributions at beginning of year	2014-12-31	$90,967
Participant contributions at beginning of year	2014-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$5,762
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2014-12-31	$175
Administrative expenses (other) incurred	2014-12-31	$1,914
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$615,760
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$4,896,596
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$4,280,836
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$4,817,824
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$4,187,355
Interest on participant loans	2014-12-31	$3,297
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$205,181
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$80,793
Employer contributions (assets) at end of year	2014-12-31	$3,618
Employer contributions (assets) at beginning of year	2014-12-31	$2,689
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$9,702
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	No
Opinion of an independent qualified public accountant for this plan	2014-12-31	Unqualified
Accountancy firm name	2014-12-31	GROSSMAN ST AMOUR
Accountancy firm EIN	2014-12-31	460475780
2013 : PSYCHOLOGICAL HEALTH CARE, PLLC RETIREMENT PLAN 2013 401k financial data
Unrealized appreciation/depreciation of real estate assets	2013-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2013-12-31	$0
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total transfer of assets to this plan	2013-12-31	$0
Total transfer of assets from this plan	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$175
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Expenses. Interest paid	2013-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$997,818
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$437,735
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$431,030
Expenses. Certain deemed distributions of participant loans	2013-12-31	$613
Value of total corrective distributions	2013-12-31	$2,101
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$445,021
Value of total assets at end of year	2013-12-31	$4,281,011
Value of total assets at beginning of year	2013-12-31	$3,720,753
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$3,991
Total interest from all sources	2013-12-31	$3,438
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$136,905
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-12-31	$136,905
Administrative expenses professional fees incurred	2013-12-31	$0
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$400,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$338,242
Participant contributions at end of year	2013-12-31	$90,967
Participant contributions at beginning of year	2013-12-31	$75,111
Participant contributions at end of year	2013-12-31	$0
Participant contributions at beginning of year	2013-12-31	$13,089
Assets. Other investments not covered elsewhere at beginning of year	2013-12-31	$625,303
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$23,078
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2013-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2013-12-31	$175
Administrative expenses (other) incurred	2013-12-31	$440
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Income. Non cash contributions	2013-12-31	$0
Value of net income/loss	2013-12-31	$560,083
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$4,280,836
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$3,720,753
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Investment advisory and management fees	2013-12-31	$2,159
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$4,187,355
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$2,999,861
Interest on participant loans	2013-12-31	$3,438
Income. Interest from loans (other than to participants)	2013-12-31	$0
Interest earned on other investments	2013-12-31	$0
Income. Interest from US Government securities	2013-12-31	$0
Income. Interest from corporate debt instruments	2013-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2013-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2013-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$412,454
Net investment gain/loss from pooled separate accounts	2013-12-31	$0
Net investment gain or loss from common/collective trusts	2013-12-31	$0
Net gain/loss from 103.12 investment entities	2013-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$83,701
Employer contributions (assets) at end of year	2013-12-31	$2,689
Employer contributions (assets) at beginning of year	2013-12-31	$7,389
Income. Dividends from preferred stock	2013-12-31	$0
Income. Dividends from common stock	2013-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$431,030
Contract administrator fees	2013-12-31	$1,392
Did the plan have assets held for investment	2013-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Aggregate proceeds on sale of assets	2013-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2013-12-31	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	No
Opinion of an independent qualified public accountant for this plan	2013-12-31	Unqualified
Accountancy firm name	2013-12-31	GROSSMAN ST AMOUR
Accountancy firm EIN	2013-12-31	460475780
2012 : PSYCHOLOGICAL HEALTH CARE, PLLC RETIREMENT PLAN 2012 401k financial data
Unrealized appreciation/depreciation of real estate assets	2012-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2012-12-31	$107,822
Total unrealized appreciation/depreciation of assets	2012-12-31	$107,822
Total transfer of assets to this plan	2012-12-31	$0
Total transfer of assets from this plan	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Expenses. Interest paid	2012-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$779,987
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$537,130
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$534,407
Expenses. Certain deemed distributions of participant loans	2012-12-31	$0
Value of total corrective distributions	2012-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$462,022
Value of total assets at end of year	2012-12-31	$3,720,753
Value of total assets at beginning of year	2012-12-31	$3,477,896
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$2,723
Total income from rents	2012-12-31	$0
Total interest from all sources	2012-12-31	$3,095
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-12-31	$0
Administrative expenses professional fees incurred	2012-12-31	$0
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$400,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$344,885
Participant contributions at end of year	2012-12-31	$75,111
Participant contributions at beginning of year	2012-12-31	$86,802
Participant contributions at end of year	2012-12-31	$13,089
Participant contributions at beginning of year	2012-12-31	$14,252
Assets. Other investments not covered elsewhere at end of year	2012-12-31	$625,303
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$35,595
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2012-12-31	$0
Other income not declared elsewhere	2012-12-31	$0
Administrative expenses (other) incurred	2012-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Income. Non cash contributions	2012-12-31	$0
Value of net income/loss	2012-12-31	$242,857
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$3,720,753
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$3,477,896
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Investment advisory and management fees	2012-12-31	$2,723
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$2,999,861
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$3,371,058
Interest on participant loans	2012-12-31	$3,095
Income. Interest from loans (other than to participants)	2012-12-31	$0
Interest earned on other investments	2012-12-31	$0
Income. Interest from US Government securities	2012-12-31	$0
Income. Interest from corporate debt instruments	2012-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2012-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$207,048
Net investment gain/loss from pooled separate accounts	2012-12-31	$0
Net investment gain or loss from common/collective trusts	2012-12-31	$0
Net gain/loss from 103.12 investment entities	2012-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$81,542
Employer contributions (assets) at end of year	2012-12-31	$7,389
Employer contributions (assets) at beginning of year	2012-12-31	$5,784
Income. Dividends from preferred stock	2012-12-31	$0
Income. Dividends from common stock	2012-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$534,407
Contract administrator fees	2012-12-31	$0
Did the plan have assets held for investment	2012-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Aggregate proceeds on sale of assets	2012-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2012-12-31	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	No
Opinion of an independent qualified public accountant for this plan	2012-12-31	Unqualified
Accountancy firm name	2012-12-31	GROSSMAN ST AMOUR
Accountancy firm EIN	2012-12-31	460475780

Form 5500 Responses for PSYCHOLOGICAL HEALTH CARE, PLLC RETIREMENT PLAN

2020: PSYCHOLOGICAL HEALTH CARE, PLLC RETIREMENT 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: PSYCHOLOGICAL HEALTH CARE, PLLC RETIREMENT 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: PSYCHOLOGICAL HEALTH CARE, PLLC RETIREMENT 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: PSYCHOLOGICAL HEALTH CARE, PLLC RETIREMENT 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: PSYCHOLOGICAL HEALTH CARE, PLLC RETIREMENT 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: PSYCHOLOGICAL HEALTH CARE, PLLC RETIREMENT 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: PSYCHOLOGICAL HEALTH CARE, PLLC RETIREMENT PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: PSYCHOLOGICAL HEALTH CARE, PLLC RETIREMENT 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: PSYCHOLOGICAL HEALTH CARE, PLLC RETIREMENT 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

Insurance Providers Used on plan

FIRST GREAT WEST LIFE INSURANCE & ANNUITY CO (National Association of Insurance Commissioners NAIC id number: 60214 )

Policy contract number

386510-01

Policy instance

Insurance contract or identification number	386510-01
Number of Individuals Covered	90
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

FIRST GREAT WEST LIFE INSURANCE & ANNUITY CO (National Association of Insurance Commissioners NAIC id number: 60214 )

Policy contract number

386510-01

Policy instance

Insurance contract or identification number	386510-01
Number of Individuals Covered	14
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

FIRST GREAT WEST LIFE INSURANCE & ANNUITY CO (National Association of Insurance Commissioners NAIC id number: 60214 )

Policy contract number

386510-01

Policy instance

Insurance contract or identification number	386510-01
Number of Individuals Covered	16
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
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

FIRST GREAT WEST LIFE INSURANCE & ANNUITY CO (National Association of Insurance Commissioners NAIC id number: 60214 )

Policy contract number

386510-01

Policy instance

Insurance contract or identification number	386510-01
Number of Individuals Covered	78
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $121
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 $41
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	COMMISSIONS
Insurance broker organization code?	3
Insurance broker name	MICHAEL TISDELL

FIRST GREAT WEST LIFE INSURANCE & ANNUITY CO (National Association of Insurance Commissioners NAIC id number: 60214 )

Policy contract number

386510-01

Policy instance

Insurance contract or identification number	386510-01
Number of Individuals Covered	7
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $523
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 $523
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	COMMISSIONS
Insurance broker organization code?	3
Insurance broker name	MICHAEL TISDELL

FIRST GREAT WEST LIFE INSURANCE & ANNUITY CO (National Association of Insurance Commissioners NAIC id number: 60214 )

Policy contract number

386510-01

Policy instance

Insurance contract or identification number	386510-01
Number of Individuals Covered	5
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $395
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 $223
Insurance broker organization code?	3
Insurance broker name	MICHAEL TISDELL

FIRST GREAT WEST LIFE INSURANCE & ANNUITY CO (National Association of Insurance Commissioners NAIC id number: 60214 )

Policy contract number

386510-01

Policy instance

Insurance contract or identification number	386510-01
Number of Individuals Covered	5
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $46
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 $26
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	MICHAEL TISDELL

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Company Name:	PSYCHOLOGICAL HEALTH CARE, PLLC
Employer identification number (EIN):	161484552
NAIC Classification:	621112
NAIC Description:	Offices of Physicians, Mental Health Specialists