401k Plan data: BERGER AND BURROW ENTERPRISES, INC. D/B/A DYNAMIC MOBILE IMAGING 401(K) PLAN plan

BERGER AND BURROW ENTERPRISES, INC. D/B/A DYNAMIC MOBILE IMAGING 401(K) PLAN 401k Plan overview

Plan Name	BERGER AND BURROW ENTERPRISES, INC. D/B/A DYNAMIC MOBILE IMAGING 401(K) PLAN
Plan identification number	001

BERGER AND BURROW ENTERPRISES, INC. D/B/A DYNAMIC MOBILE IMAGING 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

BERGER AND BURROW ENTERPRISES, INC. has sponsored the creation of one or more 401k plans.

Company Name: BERGER AND BURROW ENTERPRISES, INC.

Employer identification number (EIN): 202342043

NAIC Classification: 621510
NAIC Description: Medical and Diagnostic Laboratories

Additional information about BERGER AND BURROW ENTERPRISES, INC.

Jurisdiction of Incorporation: Virginia Secretary of State

Incorporation Date: 2005-02-04

Company Identification Number: 0630976

Legal Registered Office Address: 1100 WELBORNE DRIVE
1802 BAYBERRY COURT, SUITE 200
RICHMOND
United States of America (USA)
23229

More information about BERGER AND BURROW ENTERPRISES, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BERGER AND BURROW ENTERPRISES, INC. D/B/A DYNAMIC MOBILE IMAGING 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01 DEBORAH BERGER 2023-01-24
001 2021-01-01 DEBORAH BERGER 2022-10-10
001 2020-01-01 DEBORAH BERGER 2021-10-05
001 2019-01-01 DEBORAH BERGER 2020-09-04 DEBORAH BERGER 2020-09-04
001 2018-01-01
001 2017-01-01 DEBORAH BERGER 2018-07-26 DEBORAH BERGER 2018-07-26

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2022-01-01	DEBORAH BERGER	2023-01-24
001	2021-01-01	DEBORAH BERGER	2022-10-10
001	2020-01-01	DEBORAH BERGER	2021-10-05
001	2019-01-01	DEBORAH BERGER	2020-09-04	DEBORAH BERGER	2020-09-04
001	2018-01-01
001	2017-01-01	DEBORAH BERGER	2018-07-26	DEBORAH BERGER	2018-07-26

Plan Statistics for BERGER AND BURROW ENTERPRISES, INC. D/B/A DYNAMIC MOBILE IMAGING 401(K) PLAN

401k plan membership statisitcs for BERGER AND BURROW ENTERPRISES, INC. D/B/A DYNAMIC MOBILE IMAGING 401(K) PLAN

Measure Date Value
2022: BERGER AND BURROW ENTERPRISES, INC. D/B/A DYNAMIC MOBILE IMAGING 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 150
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 0
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 0
Total of all active and inactive participants 2022-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 0
Number of participants with account balances 2022-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: BERGER AND BURROW ENTERPRISES, INC. D/B/A DYNAMIC MOBILE IMAGING 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 162
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 136
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 14
Total of all active and inactive participants 2021-01-01 150
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 150
Number of participants with account balances 2021-01-01 78
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: BERGER AND BURROW ENTERPRISES, INC. D/B/A DYNAMIC MOBILE IMAGING 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 146
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 139
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 7
Total of all active and inactive participants 2020-01-01 146
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 146
Number of participants with account balances 2020-01-01 63
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0

Measure	Date	Value
2022: BERGER AND BURROW ENTERPRISES, INC. D/B/A DYNAMIC MOBILE IMAGING 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	150
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	0
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	0
Total of all active and inactive participants	2022-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	0
Number of participants with account balances	2022-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: BERGER AND BURROW ENTERPRISES, INC. D/B/A DYNAMIC MOBILE IMAGING 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	162
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	136
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	14
Total of all active and inactive participants	2021-01-01	150
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	150
Number of participants with account balances	2021-01-01	78
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: BERGER AND BURROW ENTERPRISES, INC. D/B/A DYNAMIC MOBILE IMAGING 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	146
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	139
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	7
Total of all active and inactive participants	2020-01-01	146
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	146
Number of participants with account balances	2020-01-01	63
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0

Financial Data on BERGER AND BURROW ENTERPRISES, INC. D/B/A DYNAMIC MOBILE IMAGING 401(K) PLAN

Measure	Date	Value
2022 : BERGER AND BURROW ENTERPRISES, INC. D/B/A DYNAMIC MOBILE IMAGING 401(K) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-03-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-03-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-03-31	$0
Total income from all sources (including contributions)	2022-03-31	$-159,697
Total loss/gain on sale of assets	2022-03-31	$0
Total of all expenses incurred	2022-03-31	$1,927,058
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-03-31	$1,917,804
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-03-31	$0
Value of total assets at end of year	2022-03-31	$0
Value of total assets at beginning of year	2022-03-31	$2,086,755
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-03-31	$9,254
Total interest from all sources	2022-03-31	$61
Total dividends received (eg from common stock, registered investment company shares)	2022-03-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-03-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2022-03-31	$0
Was this plan covered by a fidelity bond	2022-03-31	Yes
Value of fidelity bond cover	2022-03-31	$150,000
If this is an individual account plan, was there a blackout period	2022-03-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-03-31	No
Participant contributions at end of year	2022-03-31	$0
Participant contributions at beginning of year	2022-03-31	$464
Assets. Loans (other than to participants) at end of year	2022-03-31	$0
Assets. Loans (other than to participants) at beginning of year	2022-03-31	$12,872
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-03-31	No
Value of net income/loss	2022-03-31	$-2,086,755
Value of net assets at end of year (total assets less liabilities)	2022-03-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2022-03-31	$2,086,755
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-03-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-03-31	No
Were any leases to which the plan was party in default or uncollectible	2022-03-31	No
Value of interest in pooled separate accounts at end of year	2022-03-31	$0
Value of interest in pooled separate accounts at beginning of year	2022-03-31	$2,073,419
Interest on participant loans	2022-03-31	$61
Net investment gain/loss from pooled separate accounts	2022-03-31	$-159,758
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-03-31	No
Was there a failure to transmit to the plan any participant contributions	2022-03-31	Yes
Has the plan failed to provide any benefit when due under the plan	2022-03-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-03-31	$1,917,804
Contract administrator fees	2022-03-31	$9,254
Did the plan have assets held for investment	2022-03-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-03-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-03-31	Yes
Liabilities. Value of acquisition indebtedness at end of year	2022-03-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2022-03-31	$0
Opinion of an independent qualified public accountant for this plan	2022-03-31	Unqualified
Accountancy firm name	2022-03-31	WINDHAM BRANNON, LLC
Accountancy firm EIN	2022-03-31	581763439
2021 : BERGER AND BURROW ENTERPRISES, INC. D/B/A DYNAMIC MOBILE IMAGING 401(K) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$36,189
Total income from all sources (including contributions)	2021-12-31	$594,970
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$71,100
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$52,220
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$319,083
Value of total assets at end of year	2021-12-31	$2,086,755
Value of total assets at beginning of year	2021-12-31	$1,599,074
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$18,880
Total interest from all sources	2021-12-31	$711
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2021-12-31	$0
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$150,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$306,356
Participant contributions at end of year	2021-12-31	$464
Participant contributions at beginning of year	2021-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$12,727
Assets. Loans (other than to participants) at end of year	2021-12-31	$12,872
Assets. Loans (other than to participants) at beginning of year	2021-12-31	$13,205
Administrative expenses (other) incurred	2021-12-31	$575
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$523,870
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$2,086,755
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$1,562,885
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest in pooled separate accounts at end of year	2021-12-31	$2,073,419
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$1,585,869
Interest on participant loans	2021-12-31	$711
Net investment gain/loss from pooled separate accounts	2021-12-31	$275,176
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$52,220
Contract administrator fees	2021-12-31	$18,305
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Liabilities. Value of acquisition indebtedness at end of year	2021-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2021-12-31	$36,189
2020 : BERGER AND BURROW ENTERPRISES, INC. D/B/A DYNAMIC MOBILE IMAGING 401(K) 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	$36,189
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	$496,605
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$406,257
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$385,371
Value of total corrective distributions	2020-12-31	$6,443
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$274,198
Value of total assets at end of year	2020-12-31	$1,599,074
Value of total assets at beginning of year	2020-12-31	$1,472,537
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$14,443
Total interest from all sources	2020-12-31	$643
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$250,000
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	$266,073
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	$8,125
Assets. Loans (other than to participants) at end of year	2020-12-31	$13,205
Assets. Loans (other than to participants) at beginning of year	2020-12-31	$6,923
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$90,348
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$1,562,885
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$1,472,537
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
Investment advisory and management fees	2020-12-31	$975
Value of interest in pooled separate accounts at end of year	2020-12-31	$1,585,869
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$1,465,614
Income. Interest from loans (other than to participants)	2020-12-31	$643
Net investment gain/loss from pooled separate accounts	2020-12-31	$221,764
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	Yes
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$385,371
Contract administrator fees	2020-12-31	$13,468
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
Liabilities. Value of acquisition indebtedness at end of year	2020-12-31	$36,189
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	MEADOW URQUHART ACREE & COOK, LLP
Accountancy firm EIN	2020-12-31	201485301

Form 5500 Responses for BERGER AND BURROW ENTERPRISES, INC. D/B/A DYNAMIC MOBILE IMAGING 401(K) PLAN

2022: BERGER AND BURROW ENTERPRISES, INC. D/B/A DYNAMIC MOBILE IMAGING 401(K) PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	Yes
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: BERGER AND BURROW ENTERPRISES, INC. D/B/A DYNAMIC MOBILE IMAGING 401(K) PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: BERGER AND BURROW ENTERPRISES, INC. D/B/A DYNAMIC MOBILE IMAGING 401(K) PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

129010

Policy instance

Insurance contract or identification number	129010
Number of Individuals Covered	0
Insurance policy start date	2022-01-01
Insurance policy end date	2022-03-28
Total amount of commissions paid to insurance broker	USD $1,395
Total amount of fees paid to insurance company	USD $6,891
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Commission paid to Insurance Broker	USD $1,395
Insurance broker organization code?	7
Amount paid for insurance broker fees	6750
Additional information about fees paid to insurance broker	TPA FEES

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

129010

Policy instance

Insurance contract or identification number	129010
Number of Individuals Covered	85
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $9,072
Total amount of fees paid to insurance company	USD $1,491
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Commission paid to Insurance Broker	USD $9,072
Insurance broker organization code?	7
Amount paid for insurance broker fees	916
Additional information about fees paid to insurance broker	TPA COMPENSATION/ALLOWANCES

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

129010

Policy instance

Insurance contract or identification number	129010
Number of Individuals Covered	77
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $6,745
Total amount of fees paid to insurance company	USD $681
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Commission paid to Insurance Broker	USD $6,745
Insurance broker organization code?	7
Amount paid for insurance broker fees	681
Additional information about fees paid to insurance broker	TPA COMPENSATION/ALLOWANCES

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Company Name:	BERGER AND BURROW ENTERPRISES, INC.
Employer identification number (EIN):	202342043
NAIC Classification:	621510
NAIC Description:	Medical and Diagnostic Laboratories

Jurisdiction of Incorporation:	Virginia Secretary of State
Incorporation Date:	2005-02-04
Company Identification Number:	0630976
Legal Registered Office Address:	1100 WELBORNE DRIVE 1802 BAYBERRY COURT, SUITE 200 RICHMOND United States of America (USA) 23229