401k Plan data: CYPRESS POINTE SURGICAL HOSPITAL 401(K) PLAN plan

CYPRESS POINTE SURGICAL HOSPITAL 401(K) PLAN 401k Plan overview

Plan Name	CYPRESS POINTE SURGICAL HOSPITAL 401(K) PLAN
Plan identification number	001

CYPRESS POINTE SURGICAL HOSPITAL 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
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

HAMMOND SURGICAL HOSPITAL, L.L.C. has sponsored the creation of one or more 401k plans.

Company Name: HAMMOND SURGICAL HOSPITAL, L.L.C.

Employer identification number (EIN): 272765802

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CYPRESS POINTE SURGICAL HOSPITAL 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 SHERI' LEBLANC 2023-10-03
001 2021-01-01 SHERI' LEBLANC 2022-09-15
001 2020-01-01
001 2019-01-01
001 2018-01-01
001 2017-01-01 SHERI' LEBLANC
001 2016-01-01 DARLENE YOUNG
001 2015-01-01 JAYE GUICE SCOT TREITLER 2016-08-16
001 2014-01-01 JAYE GUICE JAYE GUICE 2015-08-26
001 2013-01-01 JAYE GUICE
001 2012-01-01 CALVIN KAUL
001 2011-01-01 CALVIN KAUL 2012-08-06

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2022-01-01	SHERI' LEBLANC	2023-10-03
001	2021-01-01	SHERI' LEBLANC	2022-09-15
001	2020-01-01
001	2019-01-01
001	2018-01-01
001	2017-01-01	SHERI' LEBLANC
001	2016-01-01	DARLENE YOUNG
001	2015-01-01	JAYE GUICE		SCOT TREITLER	2016-08-16
001	2014-01-01	JAYE GUICE		JAYE GUICE	2015-08-26
001	2013-01-01	JAYE GUICE
001	2012-01-01	CALVIN KAUL
001	2011-01-01	CALVIN KAUL	2012-08-06

Plan Statistics for CYPRESS POINTE SURGICAL HOSPITAL 401(K) PLAN

401k plan membership statisitcs for CYPRESS POINTE SURGICAL HOSPITAL 401(K) PLAN

Measure Date Value
2022: CYPRESS POINTE SURGICAL HOSPITAL 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 166
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 126
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 42
Total of all active and inactive participants 2022-01-01 168
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 168
Number of participants with account balances 2022-01-01 131
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 10
2021: CYPRESS POINTE SURGICAL HOSPITAL 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 171
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 105
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 44
Total of all active and inactive participants 2021-01-01 149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 149
Number of participants with account balances 2021-01-01 124
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 20
2020: CYPRESS POINTE SURGICAL HOSPITAL 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 155
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 129
Number of retired or separated participants receiving benefits 2020-01-01 3
Number of other retired or separated participants entitled to future benefits 2020-01-01 28
Total of all active and inactive participants 2020-01-01 160
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 160
Number of participants with account balances 2020-01-01 121
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 18
2019: CYPRESS POINTE SURGICAL HOSPITAL 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 159
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 126
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 24
Total of all active and inactive participants 2019-01-01 150
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 150
Number of participants with account balances 2019-01-01 109
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 17
2018: CYPRESS POINTE SURGICAL HOSPITAL 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 174
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 127
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 28
Total of all active and inactive participants 2018-01-01 155
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 155
Number of participants with account balances 2018-01-01 111
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 11
2017: CYPRESS POINTE SURGICAL HOSPITAL 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 149
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 132
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 28
Total of all active and inactive participants 2017-01-01 160
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 160
Number of participants with account balances 2017-01-01 103
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 9
2016: CYPRESS POINTE SURGICAL HOSPITAL 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 177
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 170
Number of retired or separated participants receiving benefits 2016-01-01 1
Number of other retired or separated participants entitled to future benefits 2016-01-01 18
Total of all active and inactive participants 2016-01-01 189
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 189
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 8
2015: CYPRESS POINTE SURGICAL HOSPITAL 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 171
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 148
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 20
Total of all active and inactive participants 2015-01-01 168
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 168
Number of participants with account balances 2015-01-01 84
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 11
2014: CYPRESS POINTE SURGICAL HOSPITAL 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 177
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 142
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 20
Total of all active and inactive participants 2014-01-01 162
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 162
Number of participants with account balances 2014-01-01 79
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 18
2013: CYPRESS POINTE SURGICAL HOSPITAL 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 164
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 154
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 16
Total of all active and inactive participants 2013-01-01 170
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 170
Number of participants with account balances 2013-01-01 79
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 7
2012: CYPRESS POINTE SURGICAL HOSPITAL 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 132
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 146
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 14
Total of all active and inactive participants 2012-01-01 160
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 160
Number of participants with account balances 2012-01-01 66
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 9

Measure	Date	Value
2022: CYPRESS POINTE SURGICAL HOSPITAL 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	166
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	126
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	42
Total of all active and inactive participants	2022-01-01	168
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	168
Number of participants with account balances	2022-01-01	131
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	10
2021: CYPRESS POINTE SURGICAL HOSPITAL 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	171
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	105
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	44
Total of all active and inactive participants	2021-01-01	149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	149
Number of participants with account balances	2021-01-01	124
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	20
2020: CYPRESS POINTE SURGICAL HOSPITAL 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	155
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	129
Number of retired or separated participants receiving benefits	2020-01-01	3
Number of other retired or separated participants entitled to future benefits	2020-01-01	28
Total of all active and inactive participants	2020-01-01	160
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	160
Number of participants with account balances	2020-01-01	121
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	18
2019: CYPRESS POINTE SURGICAL HOSPITAL 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	159
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	126
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	24
Total of all active and inactive participants	2019-01-01	150
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	150
Number of participants with account balances	2019-01-01	109
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	17
2018: CYPRESS POINTE SURGICAL HOSPITAL 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	174
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	127
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	28
Total of all active and inactive participants	2018-01-01	155
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	155
Number of participants with account balances	2018-01-01	111
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	11
2017: CYPRESS POINTE SURGICAL HOSPITAL 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	149
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	132
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	28
Total of all active and inactive participants	2017-01-01	160
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	160
Number of participants with account balances	2017-01-01	103
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	9
2016: CYPRESS POINTE SURGICAL HOSPITAL 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	177
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	170
Number of retired or separated participants receiving benefits	2016-01-01	1
Number of other retired or separated participants entitled to future benefits	2016-01-01	18
Total of all active and inactive participants	2016-01-01	189
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	189
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	8
2015: CYPRESS POINTE SURGICAL HOSPITAL 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	171
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	148
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	20
Total of all active and inactive participants	2015-01-01	168
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	168
Number of participants with account balances	2015-01-01	84
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	11
2014: CYPRESS POINTE SURGICAL HOSPITAL 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	177
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	142
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	20
Total of all active and inactive participants	2014-01-01	162
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	162
Number of participants with account balances	2014-01-01	79
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	18
2013: CYPRESS POINTE SURGICAL HOSPITAL 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	164
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	154
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	16
Total of all active and inactive participants	2013-01-01	170
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	170
Number of participants with account balances	2013-01-01	79
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	7
2012: CYPRESS POINTE SURGICAL HOSPITAL 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	132
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	146
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	14
Total of all active and inactive participants	2012-01-01	160
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	160
Number of participants with account balances	2012-01-01	66
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	9

Financial Data on CYPRESS POINTE SURGICAL HOSPITAL 401(K) PLAN

Measure	Date	Value
2022 : CYPRESS POINTE SURGICAL HOSPITAL 401(K) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total income from all sources (including contributions)	2022-12-31	$81,730
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$358,593
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$351,183
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$488,059
Value of total assets at end of year	2022-12-31	$2,328,407
Value of total assets at beginning of year	2022-12-31	$2,605,270
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$7,410
Total interest from all sources	2022-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Administrative expenses professional fees incurred	2022-12-31	$7,410
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$260,527
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$362,471
Participant contributions at end of year	2022-12-31	$0
Participant contributions at beginning of year	2022-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2022-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2022-12-31	$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	2022-12-31	No
Value of net income/loss	2022-12-31	$-276,863
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$2,328,407
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$2,605,270
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$0
Value of interest in pooled separate accounts at end of year	2022-12-31	$2,313,303
Value of interest in pooled separate accounts at beginning of year	2022-12-31	$2,537,093
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$15,104
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$64,077
Net investment gain/loss from pooled separate accounts	2022-12-31	$-406,329
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$125,588
Employer contributions (assets) at end of year	2022-12-31	$0
Employer contributions (assets) at beginning of year	2022-12-31	$4,100
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$351,183
Did the plan have assets held for investment	2022-12-31	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	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	BOURGEOIS BENNETT LLC
Accountancy firm EIN	2022-12-31	720136870
2021 : CYPRESS POINTE SURGICAL HOSPITAL 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	$0
Total income from all sources (including contributions)	2021-12-31	$848,698
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$477,551
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$468,939
Value of total corrective distributions	2021-12-31	$269
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$482,272
Value of total assets at end of year	2021-12-31	$2,605,270
Value of total assets at beginning of year	2021-12-31	$2,234,123
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$8,343
Total interest from all sources	2021-12-31	$0
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	No
Administrative expenses professional fees incurred	2021-12-31	$8,343
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$223,413
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	$318,905
Participant contributions at end of year	2021-12-31	$0
Participant contributions at beginning of year	2021-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$57,353
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2021-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2021-12-31	$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	2021-12-31	No
Value of net income/loss	2021-12-31	$371,147
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$2,605,270
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$2,234,123
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 registered invesment companies (eg mutual funds) at end of year	2021-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$2,175,743
Value of interest in pooled separate accounts at end of year	2021-12-31	$2,537,093
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$64,077
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$53,503
Net investment gain/loss from pooled separate accounts	2021-12-31	$366,426
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	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$106,014
Employer contributions (assets) at end of year	2021-12-31	$4,100
Employer contributions (assets) at beginning of year	2021-12-31	$4,877
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$468,939
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
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	STEPHEN C. HIMEL, CPA, LLC
Accountancy firm EIN	2021-12-31	208410792
2020 : CYPRESS POINTE SURGICAL HOSPITAL 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	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$18,276
Total income from all sources (including contributions)	2020-12-31	$589,489
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$217,511
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$213,467
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$341,218
Value of total assets at end of year	2020-12-31	$2,234,123
Value of total assets at beginning of year	2020-12-31	$1,880,421
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$4,044
Total interest from all sources	2020-12-31	$0
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	$222,924
If this is an individual account plan, was there a blackout period	2020-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$251,165
Participant contributions at beginning of year	2020-12-31	$10,079
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$16,255
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2020-12-31	$18,276
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	$371,978
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$2,234,123
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$1,862,145
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	$4,044
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$2,175,743
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$1,810,790
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$53,503
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$55,425
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$248,271
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	$73,798
Employer contributions (assets) at end of year	2020-12-31	$4,877
Employer contributions (assets) at beginning of year	2020-12-31	$4,127
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$213,467
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	Unqualified
Accountancy firm name	2020-12-31	STEPHEN C. HIMEL, CPA LLC
Accountancy firm EIN	2020-12-31	208410792
2019 : CYPRESS POINTE SURGICAL HOSPITAL 401(K) PLAN 2019 401k financial data
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	$18,276
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$2,735
Total income from all sources (including contributions)	2019-12-31	$671,194
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$395,402
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$368,161
Value of total corrective distributions	2019-12-31	$16,505
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$337,393
Value of total assets at end of year	2019-12-31	$1,880,421
Value of total assets at beginning of year	2019-12-31	$1,589,088
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$10,736
Total interest from all sources	2019-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$187,834
If this is an individual account plan, was there a blackout period	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	$277,737
Participant contributions at end of year	2019-12-31	$10,079
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$4,451
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2019-12-31	$18,276
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2019-12-31	$2,735
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	$275,792
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$1,862,145
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$1,586,353
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 leases to which the plan was party in default or uncollectible	2019-12-31	No
Investment advisory and management fees	2019-12-31	$10,736
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$1,810,790
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$1,516,686
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$55,425
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$72,402
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$333,801
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
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	$55,205
Employer contributions (assets) at end of year	2019-12-31	$4,127
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$368,161
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
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
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	STEPHEN C. HIMEL, CPA, LLC
Accountancy firm EIN	2019-12-31	208410792
2018 : CYPRESS POINTE SURGICAL HOSPITAL 401(K) 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	$2,735
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$6,575
Total income from all sources (including contributions)	2018-12-31	$252,884
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$223,344
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$219,142
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$367,679
Value of total assets at end of year	2018-12-31	$1,589,088
Value of total assets at beginning of year	2018-12-31	$1,563,388
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$4,202
Total interest from all sources	2018-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$156,339
If this is an individual account plan, was there a blackout period	2018-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$261,459
Participant contributions at beginning of year	2018-12-31	$7,081
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2018-12-31	$2,735
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2018-12-31	$6,575
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$29,540
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$1,586,353
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$1,556,813
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	$1,516,686
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$1,520,095
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$72,402
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$33,096
Net investment gain/loss from pooled separate accounts	2018-12-31	$-114,795
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	$106,220
Employer contributions (assets) at beginning of year	2018-12-31	$3,116
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$219,142
Contract administrator fees	2018-12-31	$4,202
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	STEPHEN C. HIMEL, CPA LLC
Accountancy firm EIN	2018-12-31	208410792
2017 : CYPRESS POINTE SURGICAL HOSPITAL 401(K) 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	$6,575
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	$572,132
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$99,932
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$78,255
Value of total corrective distributions	2017-12-31	$6,575
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$358,607
Value of total assets at end of year	2017-12-31	$1,563,388
Value of total assets at beginning of year	2017-12-31	$1,084,613
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$15,102
Total interest from all sources	2017-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$2,785
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$2,785
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$156,339
If this is an individual account plan, was there a blackout period	2017-12-31	Yes
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$249,899
Participant contributions at end of year	2017-12-31	$7,081
Participant contributions at beginning of year	2017-12-31	$518
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$10,337
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2017-12-31	$6,575
Total non interest bearing cash at beginning of year	2017-12-31	$13,266
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
Value of net income/loss	2017-12-31	$472,200
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$1,556,813
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$1,084,613
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	$1,520,095
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$1,000,163
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2017-12-31	$70,472
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2017-12-31	$70,472
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$33,096
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$118,119
Net investment gain/loss from pooled separate accounts	2017-12-31	$92,621
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	$98,371
Employer contributions (assets) at end of year	2017-12-31	$3,116
Employer contributions (assets) at beginning of year	2017-12-31	$194
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$78,255
Contract administrator fees	2017-12-31	$15,102
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2017-12-31	Yes
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	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	STEPHEN C. HIMEL, CPA LLC
Accountancy firm EIN	2017-12-31	208410792
2016 : CYPRESS POINTE SURGICAL HOSPITAL 401(K) 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	$721
Total income from all sources (including contributions)	2016-12-31	$362,646
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$174,498
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$169,110
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$287,992
Value of total assets at end of year	2016-12-31	$1,084,613
Value of total assets at beginning of year	2016-12-31	$897,186
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$5,388
Total interest from all sources	2016-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$36,952
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$36,952
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$150,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$199,723
Participant contributions at end of year	2016-12-31	$518
Participant contributions at beginning of year	2016-12-31	$6,239
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$5,158
Liabilities. Value of operating payables at beginning of year	2016-12-31	$721
Total non interest bearing cash at end of year	2016-12-31	$13,266
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	$188,148
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$1,084,613
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$896,465
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	$1,000,163
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$860,177
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2016-12-31	$70,472
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2016-12-31	$27,808
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2016-12-31	$27,808
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$37,702
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	No
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	$83,111
Employer contributions (assets) at end of year	2016-12-31	$194
Employer contributions (assets) at beginning of year	2016-12-31	$2,962
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$169,110
Contract administrator fees	2016-12-31	$5,388
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	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	STEPHEN C. HIMEL, CPA LLC
Accountancy firm EIN	2016-12-31	208410792
2015 : CYPRESS POINTE SURGICAL HOSPITAL 401(K) 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	$721
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$10,662
Total income from all sources (including contributions)	2015-12-31	$225,616
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$92,368
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$85,162
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$241,519
Value of total assets at end of year	2015-12-31	$897,186
Value of total assets at beginning of year	2015-12-31	$773,879
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$7,206
Total interest from all sources	2015-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$47,556
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	$47,556
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$150,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$162,468
Participant contributions at end of year	2015-12-31	$6,239
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$2,495
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2015-12-31	$8,514
Liabilities. Value of operating payables at end of year	2015-12-31	$721
Total non interest bearing cash at beginning of year	2015-12-31	$8,514
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	$133,248
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$896,465
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$763,217
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 registered invesment companies (eg mutual funds) at end of year	2015-12-31	$860,177
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$742,817
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2015-12-31	$27,808
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2015-12-31	$22,508
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2015-12-31	$22,508
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-63,459
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	$76,556
Employer contributions (assets) at end of year	2015-12-31	$2,962
Employer contributions (assets) at beginning of year	2015-12-31	$40
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$85,162
Contract administrator fees	2015-12-31	$7,206
Liabilities. Value of benefit claims payable at beginning of year	2015-12-31	$2,148
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	STEPHEN C. HIMEL, CPA LLC
Accountancy firm EIN	2015-12-31	208410792
2014 : CYPRESS POINTE SURGICAL HOSPITAL 401(K) 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	$10,662
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$11,095
Total income from all sources (including contributions)	2014-12-31	$267,768
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$108,219
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$100,991
Value of total corrective distributions	2014-12-31	$2,148
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$229,561
Value of total assets at end of year	2014-12-31	$773,879
Value of total assets at beginning of year	2014-12-31	$614,763
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$5,080
Total interest from all sources	2014-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$44,444
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$44,444
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$150,000
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	$156,038
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2014-12-31	$8,514
Total non interest bearing cash at end of year	2014-12-31	$8,514
Total non interest bearing cash at beginning of year	2014-12-31	$9,084
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	$159,549
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$763,217
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$603,668
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	$742,817
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$588,346
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2014-12-31	$22,508
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2014-12-31	$17,333
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2014-12-31	$17,333
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$-6,237
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	$73,523
Employer contributions (assets) at end of year	2014-12-31	$40
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$100,991
Contract administrator fees	2014-12-31	$5,080
Liabilities. Value of benefit claims payable at end of year	2014-12-31	$2,148
Liabilities. Value of benefit claims payable at beginning of year	2014-12-31	$11,095
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	STEPHEN C. HIMEL, CPA LLC
Accountancy firm EIN	2014-12-31	208410792
2013 : CYPRESS POINTE SURGICAL HOSPITAL 401(K) 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	$11,095
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	$343,146
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$34,953
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$20,613
Value of total corrective distributions	2013-12-31	$11,095
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$252,611
Value of total assets at end of year	2013-12-31	$614,763
Value of total assets at beginning of year	2013-12-31	$295,475
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$3,245
Total interest from all sources	2013-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$31,861
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	$31,861
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$150,000
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	$156,955
Participant contributions at beginning of year	2013-12-31	$4,488
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$20,461
Total non interest bearing cash at end of year	2013-12-31	$9,084
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	$308,193
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$603,668
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$295,475
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 registered invesment companies (eg mutual funds) at end of year	2013-12-31	$588,346
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$278,843
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2013-12-31	$17,333
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2013-12-31	$9,965
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2013-12-31	$9,965
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$58,674
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	$75,195
Employer contributions (assets) at beginning of year	2013-12-31	$2,179
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$20,613
Contract administrator fees	2013-12-31	$3,245
Liabilities. Value of benefit claims payable at end of year	2013-12-31	$11,095
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	STEPHEN C HIMEL, CPA LLC
Accountancy firm EIN	2013-12-31	208410792
2012 : CYPRESS POINTE SURGICAL HOSPITAL 401(K) 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	$206,339
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$3,076
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$2,720
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$184,071
Value of total assets at end of year	2012-12-31	$295,475
Value of total assets at beginning of year	2012-12-31	$92,212
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$356
Total interest from all sources	2012-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$6,409
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	$6,409
Administrative expenses professional fees incurred	2012-12-31	$356
Was this plan covered by a fidelity bond	2012-12-31	No
If this is an individual account plan, was there a blackout period	2012-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$126,944
Participant contributions at end of year	2012-12-31	$4,488
Participant contributions at beginning of year	2012-12-31	$4,248
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$439
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	$203,263
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$295,475
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$92,212
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 registered invesment companies (eg mutual funds) at end of year	2012-12-31	$278,843
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$83,285
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-12-31	$9,965
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-12-31	$2,919
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-12-31	$2,919
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$15,859
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	$56,688
Employer contributions (assets) at end of year	2012-12-31	$2,179
Employer contributions (assets) at beginning of year	2012-12-31	$1,760
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$2,720
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	STEPHEN C HIMEL, CPA LLC
Accountancy firm EIN	2012-12-31	208410792

Form 5500 Responses for CYPRESS POINTE SURGICAL HOSPITAL 401(K) PLAN

2022: CYPRESS POINTE SURGICAL HOSPITAL 401(K) PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: CYPRESS POINTE SURGICAL HOSPITAL 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: CYPRESS POINTE SURGICAL HOSPITAL 401(K) PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: CYPRESS POINTE SURGICAL HOSPITAL 401(K) PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: CYPRESS POINTE SURGICAL HOSPITAL 401(K) PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: CYPRESS POINTE SURGICAL HOSPITAL 401(K) PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: CYPRESS POINTE SURGICAL HOSPITAL 401(K) PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: CYPRESS POINTE SURGICAL HOSPITAL 401(K) PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: CYPRESS POINTE SURGICAL HOSPITAL 401(K) PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: CYPRESS POINTE SURGICAL HOSPITAL 401(K) PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: CYPRESS POINTE SURGICAL HOSPITAL 401(K) PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

808539

Policy instance

Insurance contract or identification number	808539
Number of Individuals Covered	168
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $6,023
Total amount of fees paid to insurance company	USD $1,191
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 $6,023
Insurance broker organization code?	3
Amount paid for insurance broker fees	907
Additional information about fees paid to insurance broker	ADMIN FEES

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

808539

Policy instance

Insurance contract or identification number	808539
Number of Individuals Covered	149
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $6,155
Total amount of fees paid to insurance company	USD $1,241
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 $6,155
Insurance broker organization code?	3
Amount paid for insurance broker fees	917
Additional information about fees paid to insurance broker	TPA PARTNERSHIP PROGRAM TPA ALLIANCE PROGRAM

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

808539-000

Policy instance

Insurance contract or identification number	808539-000
Number of Individuals Covered	137
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $4,659
Total amount of fees paid to insurance company	USD $938
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?	Yes
Commission paid to Insurance Broker	USD $4,659
Insurance broker organization code?	3
Amount paid for insurance broker fees	938
Additional information about fees paid to insurance broker	TPA PARTNERSHIP PROGRAM TPA ALLIANCE PROGRAM

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

86231

Policy instance

Insurance contract or identification number	86231
Number of Individuals Covered	111
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $4,233
Total amount of fees paid to insurance company	USD $850
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?	Yes
Commission paid to Insurance Broker	USD $4,233
Insurance broker organization code?	3
Amount paid for insurance broker fees	850
Additional information about fees paid to insurance broker	TPA PARTNERSHIP PROGRAM TPA ALLIANCE PROGRAM

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

86231

Policy instance

Insurance contract or identification number	86231
Number of Individuals Covered	111
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $2,667
Total amount of fees paid to insurance company	USD $1,506
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?	Yes
Commission paid to Insurance Broker	USD $2,019
Insurance broker organization code?	3
Amount paid for insurance broker fees	1506
Additional information about fees paid to insurance broker	TPA PARTNERSHIP PROGRAM TPA ALLIANCE PROGRAM

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

86231

Policy instance

Insurance contract or identification number	86231
Number of Individuals Covered	103
Insurance policy start date	2017-05-18
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $7,540
Total amount of fees paid to insurance company	USD $5,546
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 $7,385
Insurance broker organization code?	3
Amount paid for insurance broker fees	5546
Additional information about fees paid to insurance broker	TPA PARTNERSHIP PROGRAM TPA ALLIANCE PROGRAM
Insurance broker name	RETIREMENT STRATEGIES GROUP

Potentially related plans

CYPRESS POINTE HOSPITAL EAST 401(K) PROFIT PLAN AND TRUST [EIN = 522363244]

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Company Name:	HAMMOND SURGICAL HOSPITAL, L.L.C.
Employer identification number (EIN):	272765802
NAIC Classification:	622000
NAIC Description:	Hospitals