401k Plan data: NOVA MEDICAL GROUP 401K PLAN plan

NOVA MEDICAL GROUP 401K PLAN 401k Plan overview

Plan Name	NOVA MEDICAL GROUP 401K PLAN
Plan identification number	001

NOVA MEDICAL GROUP 401K 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

NOVA MEDICAL AND URGENT CARE CENTER has sponsored the creation of one or more 401k plans.

Company Name: NOVA MEDICAL AND URGENT CARE CENTER

Employer identification number (EIN): 202657730

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NOVA MEDICAL GROUP 401K PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2016-01-01
001 2015-01-01
001 2014-01-01 GRACE L. KEENAN
001 2013-01-01 GRACE L. KEENAN
001 2012-01-01 GRACE L. KEENAN
001 2011-01-01 GRACE L. KEENAN

Plan Statistics for NOVA MEDICAL GROUP 401K PLAN

401k plan membership statisitcs for NOVA MEDICAL GROUP 401K PLAN

Measure Date Value
2016: NOVA MEDICAL GROUP 401K PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 211
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 0
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 0
Total of all active and inactive participants 2016-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 0
Number of participants with account balances 2016-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: NOVA MEDICAL GROUP 401K PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 232
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 181
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 24
Total of all active and inactive participants 2015-01-01 205
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 205
Number of participants with account balances 2015-01-01 71
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 5
2014: NOVA MEDICAL GROUP 401K PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 232
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 207
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 21
Total of all active and inactive participants 2014-01-01 228
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 228
Number of participants with account balances 2014-01-01 84
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 2
2013: NOVA MEDICAL GROUP 401K PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 176
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 196
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 23
Total of all active and inactive participants 2013-01-01 219
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 219
Number of participants with account balances 2013-01-01 73
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 5
2012: NOVA MEDICAL GROUP 401K PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 159
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 152
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 16
Total of all active and inactive participants 2012-01-01 168
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 168
Number of participants with account balances 2012-01-01 63
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: NOVA MEDICAL GROUP 401K PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 140
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 146
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 11
Total of all active and inactive participants 2011-01-01 157
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 157
Number of participants with account balances 2011-01-01 55
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 4

Measure	Date	Value
2016: NOVA MEDICAL GROUP 401K PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	211
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	0
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	0
Total of all active and inactive participants	2016-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	0
Number of participants with account balances	2016-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: NOVA MEDICAL GROUP 401K PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	232
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	181
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	24
Total of all active and inactive participants	2015-01-01	205
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	205
Number of participants with account balances	2015-01-01	71
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	5
2014: NOVA MEDICAL GROUP 401K PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	232
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	207
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	21
Total of all active and inactive participants	2014-01-01	228
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	228
Number of participants with account balances	2014-01-01	84
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	2
2013: NOVA MEDICAL GROUP 401K PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	176
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	196
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	23
Total of all active and inactive participants	2013-01-01	219
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	219
Number of participants with account balances	2013-01-01	73
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	5
2012: NOVA MEDICAL GROUP 401K PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	159
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	152
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	16
Total of all active and inactive participants	2012-01-01	168
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	168
Number of participants with account balances	2012-01-01	63
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: NOVA MEDICAL GROUP 401K PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	140
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	146
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	11
Total of all active and inactive participants	2011-01-01	157
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	157
Number of participants with account balances	2011-01-01	55
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	4

Financial Data on NOVA MEDICAL GROUP 401K PLAN

Measure	Date	Value
2016 : NOVA MEDICAL GROUP 401K PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
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	$189,478
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$3,020,315
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$2,985,953
Value of total corrective distributions	2016-12-31	$30,888
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$129,478
Value of total assets at end of year	2016-12-31	$0
Value of total assets at beginning of year	2016-12-31	$2,830,837
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$3,474
Total interest from all sources	2016-12-31	$4,122
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2016-12-31	$0
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$300,000
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	$118,589
Participant contributions at end of year	2016-12-31	$0
Participant contributions at beginning of year	2016-12-31	$20,411
Participant contributions at end of year	2016-12-31	$0
Participant contributions at beginning of year	2016-12-31	$23,663
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$507
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
Value of net income/loss	2016-12-31	$-2,830,837
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$2,830,837
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 pooled separate accounts at end of year	2016-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$2,577,354
Interest on participant loans	2016-12-31	$298
Interest earned on other investments	2016-12-31	$3,824
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$151,909
Net investment gain/loss from pooled separate accounts	2016-12-31	$55,878
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	$10,382
Employer contributions (assets) at end of year	2016-12-31	$0
Employer contributions (assets) at beginning of year	2016-12-31	$57,500
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$2,985,953
Contract administrator fees	2016-12-31	$3,474
Did the plan have assets held for investment	2016-12-31	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	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	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	YOUNT, HYDE & BARBOUR, P.C.
Accountancy firm EIN	2016-12-31	541149263
2015 : NOVA MEDICAL GROUP 401K PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	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
Total income from all sources (including contributions)	2015-12-31	$526,977
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$251,136
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$227,937
Value of total corrective distributions	2015-12-31	$22,014
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$543,094
Value of total assets at end of year	2015-12-31	$2,830,837
Value of total assets at beginning of year	2015-12-31	$2,554,996
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$1,185
Total interest from all sources	2015-12-31	$5,384
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$300,000
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	$363,878
Participant contributions at end of year	2015-12-31	$20,411
Participant contributions at beginning of year	2015-12-31	$8,311
Participant contributions at end of year	2015-12-31	$23,663
Participant contributions at beginning of year	2015-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$131,215
Administrative expenses (other) incurred	2015-12-31	$50
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
Value of net income/loss	2015-12-31	$275,841
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$2,830,837
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$2,554,996
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
Value of interest in pooled separate accounts at end of year	2015-12-31	$2,577,354
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$2,316,226
Interest on participant loans	2015-12-31	$272
Interest earned on other investments	2015-12-31	$5,112
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$151,909
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$179,693
Net investment gain/loss from pooled separate accounts	2015-12-31	$-21,501
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	$48,001
Employer contributions (assets) at end of year	2015-12-31	$57,500
Employer contributions (assets) at beginning of year	2015-12-31	$50,766
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$227,937
Contract administrator fees	2015-12-31	$1,135
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
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	YOUNT, HYDE & BARBOUR, P.C.
Accountancy firm EIN	2015-12-31	541149263
2014 : NOVA MEDICAL GROUP 401K 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	$0
Total income from all sources (including contributions)	2014-12-31	$563,002
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$290,033
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$289,073
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$408,562
Value of total assets at end of year	2014-12-31	$2,554,996
Value of total assets at beginning of year	2014-12-31	$2,282,027
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$960
Total interest from all sources	2014-12-31	$5,939
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	$300,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$322,723
Participant contributions at end of year	2014-12-31	$8,311
Participant contributions at beginning of year	2014-12-31	$15,426
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$37,901
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	$272,969
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$2,554,996
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$2,282,027
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 pooled separate accounts at end of year	2014-12-31	$2,316,226
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$2,012,301
Interest on participant loans	2014-12-31	$489
Interest earned on other investments	2014-12-31	$5,450
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$179,693
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$200,833
Net investment gain/loss from pooled separate accounts	2014-12-31	$148,501
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	$47,938
Employer contributions (assets) at end of year	2014-12-31	$50,766
Employer contributions (assets) at beginning of year	2014-12-31	$53,467
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$289,073
Contract administrator fees	2014-12-31	$960
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	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	YOUNT, HYDE & BARBOUR, P.C.
Accountancy firm EIN	2014-12-31	541149263
2013 : NOVA MEDICAL GROUP 401K PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$738,148
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$220,378
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$216,799
Expenses. Certain deemed distributions of participant loans	2013-12-31	$2,924
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$380,701
Value of total assets at end of year	2013-12-31	$2,282,027
Value of total assets at beginning of year	2013-12-31	$1,764,257
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$655
Total interest from all sources	2013-12-31	$5,747
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$200,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$290,072
Participant contributions at end of year	2013-12-31	$15,426
Participant contributions at beginning of year	2013-12-31	$12,693
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$40,518
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
Value of net income/loss	2013-12-31	$517,770
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$2,282,027
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$1,764,257
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
Value of interest in pooled separate accounts at end of year	2013-12-31	$2,012,301
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$1,588,546
Interest on participant loans	2013-12-31	$690
Interest earned on other investments	2013-12-31	$5,057
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$200,833
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$128,515
Net investment gain/loss from pooled separate accounts	2013-12-31	$351,700
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	$50,111
Employer contributions (assets) at end of year	2013-12-31	$53,467
Employer contributions (assets) at beginning of year	2013-12-31	$34,503
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$216,799
Contract administrator fees	2013-12-31	$655
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
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	YOUNT, HYDE & BARBOUR, P.C.
Accountancy firm EIN	2013-12-31	541149263
2012 : NOVA MEDICAL GROUP 401K PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	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
Total income from all sources (including contributions)	2012-12-31	$431,873
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$18,993
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$10,222
Value of total corrective distributions	2012-12-31	$8,361
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$276,857
Value of total assets at end of year	2012-12-31	$1,764,257
Value of total assets at beginning of year	2012-12-31	$1,351,377
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$410
Total interest from all sources	2012-12-31	$8,929
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
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$200,000
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	$238,423
Participant contributions at end of year	2012-12-31	$12,693
Participant contributions at beginning of year	2012-12-31	$14,138
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$4,127
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
Value of net income/loss	2012-12-31	$412,880
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$1,764,257
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$1,351,377
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
Value of interest in pooled separate accounts at end of year	2012-12-31	$1,588,546
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$1,230,090
Interest on participant loans	2012-12-31	$517
Interest earned on other investments	2012-12-31	$8,412
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$128,515
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$107,149
Net investment gain/loss from pooled separate accounts	2012-12-31	$146,087
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	$34,307
Employer contributions (assets) at end of year	2012-12-31	$34,503
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$10,222
Contract administrator fees	2012-12-31	$410
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
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	YOUNT, HYDE & BARBOUR, P.C.
Accountancy firm EIN	2012-12-31	541149263
2011 : NOVA MEDICAL GROUP 401K PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$164,341
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$87,101
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$86,761
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$195,964
Value of total assets at end of year	2011-12-31	$1,351,377
Value of total assets at beginning of year	2011-12-31	$1,274,137
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$340
Total interest from all sources	2011-12-31	$3,525
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$200,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$192,651
Participant contributions at end of year	2011-12-31	$14,138
Participant contributions at beginning of year	2011-12-31	$8,244
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Income. Non cash contributions	2011-12-31	$3,313
Value of net income/loss	2011-12-31	$77,240
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$1,351,377
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$1,274,137
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in pooled separate accounts at end of year	2011-12-31	$1,230,090
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$1,160,299
Interest on participant loans	2011-12-31	$372
Interest earned on other investments	2011-12-31	$3,153
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$107,149
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$105,594
Net investment gain/loss from pooled separate accounts	2011-12-31	$-35,148
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$86,761
Contract administrator fees	2011-12-31	$340
Did the plan have assets held for investment	2011-12-31	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	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	YOUNT, HYDE & BARBOUR, P.C.
Accountancy firm EIN	2011-12-31	541149263
2010 : NOVA MEDICAL GROUP 401K PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total income from all sources (including contributions)	2010-12-31	$344,586
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$222,658
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$189,631
Value of total corrective distributions	2010-12-31	$32,031
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$195,099
Value of total assets at end of year	2010-12-31	$1,274,137
Value of total assets at beginning of year	2010-12-31	$1,152,209
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$996
Total interest from all sources	2010-12-31	$2,919
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$200,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$194,895
Participant contributions at end of year	2010-12-31	$8,244
Participant contributions at beginning of year	2010-12-31	$8,788
Participant contributions at beginning of year	2010-12-31	$27
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$204
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$121,928
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$1,274,137
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$1,152,209
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in pooled separate accounts at end of year	2010-12-31	$1,160,299
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$1,075,362
Interest on participant loans	2010-12-31	$407
Interest earned on other investments	2010-12-31	$2,512
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$105,594
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$68,032
Net investment gain/loss from pooled separate accounts	2010-12-31	$146,568
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$189,631
Contract administrator fees	2010-12-31	$996
Did the plan have assets held for investment	2010-12-31	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	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	YOUNT, HYDE & BARBOUR, P.C.
Accountancy firm EIN	2010-12-31	541149263

Form 5500 Responses for NOVA MEDICAL GROUP 401K PLAN

2016: NOVA MEDICAL GROUP 401K 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	Yes
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: NOVA MEDICAL GROUP 401K 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: NOVA MEDICAL GROUP 401K 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: NOVA MEDICAL GROUP 401K PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: NOVA MEDICAL GROUP 401K 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 – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: NOVA MEDICAL GROUP 401K PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

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

Policy contract number

RM84833-1

Policy instance

Insurance contract or identification number	RM84833-1
Number of Individuals Covered	71
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $6,751
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 $3,295
Insurance broker organization code?	1
Insurance broker name	NFP INSURANCE SERVICES INC.

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

Policy contract number

RM84833-1

Policy instance

Insurance contract or identification number	RM84833-1
Number of Individuals Covered	84
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $5,956
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 $3,860
Insurance broker organization code?	1
Insurance broker name	LYNNE L. HARTZLER

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

Policy contract number

RM84833-1

Policy instance

Insurance contract or identification number	RM84833-1
Number of Individuals Covered	73
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $5,259
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 $3,315
Insurance broker organization code?	1
Insurance broker name	LYNNE L. HARTZLER

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

Policy contract number

RM84833-1

Policy instance

Insurance contract or identification number	RM84833-1
Number of Individuals Covered	63
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $4,574
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 $2,756
Insurance broker organization code?	3
Insurance broker name	LPL FINANCIAL CORPORATION

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

Policy contract number

RM84833-1

Policy instance

Insurance contract or identification number	RM84833-1
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $3,549
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

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

Policy contract number

RM84833-1

Policy instance

Insurance contract or identification number	RM84833-1
Number of Individuals Covered	58
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $3,676
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

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Company Name:	NOVA MEDICAL AND URGENT CARE CENTER
Employer identification number (EIN):	202657730
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)