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PROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan NamePROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN
Plan identification number 001

PROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Participant-directed brokerage accounts provided as an investment option under the plan.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

PROVIDENCE MEDICAL GROUP LLC has sponsored the creation of one or more 401k plans.

Company Name:PROVIDENCE MEDICAL GROUP LLC
Employer identification number (EIN):352095108
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01GEORGE B. BITTAR, M.D.2023-10-16
0012021-01-01
0012020-01-01
0012019-01-01
0012018-01-01
0012017-01-01GEORGE B. BITTAR, M.D.
0012016-01-01GEORGE B. BITTAR, M.D.
0012015-01-01GEORGE B. BITTAR, M.D.
0012014-01-01GEORGE B. BITTAR, M.D.
0012013-01-01GEORGE B. BITTAR, M.D.
0012012-01-01GEORGE B. BITTAR, M.D.
0012011-01-01GEORGE B. BITTAR, M.D.
0012010-01-01GEORGE B. BITTAR, M.D.
0012009-01-01GEORGE B. BITTAR, M.D. GEORGE B. BITTAR, M.D.2010-10-12
0012008-01-01GEORGE B. BITTAR, M.D.

Plan Statistics for PROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for PROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN

Measure Date Value
2022: PROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01178
Total number of active participants reported on line 7a of the Form 55002022-01-01118
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-0153
Total of all active and inactive participants2022-01-01171
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01171
Number of participants with account balances2022-01-01135
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010
2021: PROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01181
Total number of active participants reported on line 7a of the Form 55002021-01-01107
Number of retired or separated participants receiving benefits2021-01-0110
Number of other retired or separated participants entitled to future benefits2021-01-0161
Total of all active and inactive participants2021-01-01178
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01178
Number of participants with account balances2021-01-01152
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: PROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01172
Total number of active participants reported on line 7a of the Form 55002020-01-01123
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-0147
Total of all active and inactive participants2020-01-01170
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-011
Total participants2020-01-01171
Number of participants with account balances2020-01-01131
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: PROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01200
Total number of active participants reported on line 7a of the Form 55002019-01-01124
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-0146
Total of all active and inactive participants2019-01-01170
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01170
Number of participants with account balances2019-01-01136
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: PROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01196
Total number of active participants reported on line 7a of the Form 55002018-01-01168
Number of retired or separated participants receiving benefits2018-01-0111
Number of other retired or separated participants entitled to future benefits2018-01-0121
Total of all active and inactive participants2018-01-01200
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01200
Number of participants with account balances2018-01-01146
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: PROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01199
Total number of active participants reported on line 7a of the Form 55002017-01-01147
Number of retired or separated participants receiving benefits2017-01-0114
Number of other retired or separated participants entitled to future benefits2017-01-0124
Total of all active and inactive participants2017-01-01185
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-01185
Number of participants with account balances2017-01-01145
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: PROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01210
Total number of active participants reported on line 7a of the Form 55002016-01-01193
Number of retired or separated participants receiving benefits2016-01-014
Number of other retired or separated participants entitled to future benefits2016-01-0117
Total of all active and inactive participants2016-01-01214
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-01214
Number of participants with account balances2016-01-01137
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: PROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01229
Total number of active participants reported on line 7a of the Form 55002015-01-01183
Number of retired or separated participants receiving benefits2015-01-0127
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01210
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-01210
Number of participants with account balances2015-01-01142
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-012
2014: PROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01255
Total number of active participants reported on line 7a of the Form 55002014-01-01174
Number of retired or separated participants receiving benefits2014-01-0143
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01217
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-01217
Number of participants with account balances2014-01-01151
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: PROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01254
Total number of active participants reported on line 7a of the Form 55002013-01-01224
Number of retired or separated participants receiving benefits2013-01-0114
Number of other retired or separated participants entitled to future benefits2013-01-0117
Total of all active and inactive participants2013-01-01255
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-01255
Number of participants with account balances2013-01-01148
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: PROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01236
Total number of active participants reported on line 7a of the Form 55002012-01-01221
Number of retired or separated participants receiving benefits2012-01-0111
Number of other retired or separated participants entitled to future benefits2012-01-0118
Total of all active and inactive participants2012-01-01250
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-01250
Number of participants with account balances2012-01-01157
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-012
2011: PROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01256
Total number of active participants reported on line 7a of the Form 55002011-01-01203
Number of retired or separated participants receiving benefits2011-01-017
Number of other retired or separated participants entitled to future benefits2011-01-0126
Total of all active and inactive participants2011-01-01236
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-01236
Number of participants with account balances2011-01-01168
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2010: PROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01238
Total number of active participants reported on line 7a of the Form 55002010-01-01200
Number of retired or separated participants receiving benefits2010-01-0119
Number of other retired or separated participants entitled to future benefits2010-01-0133
Total of all active and inactive participants2010-01-01252
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-01252
Number of participants with account balances2010-01-01183
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-010
2009: PROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01249
Total number of active participants reported on line 7a of the Form 55002009-01-01218
Number of retired or separated participants receiving benefits2009-01-018
Number of other retired or separated participants entitled to future benefits2009-01-0122
Total of all active and inactive participants2009-01-01248
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-01248
Number of participants with account balances2009-01-01173
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010
2008: PROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2008 401k membership
Total participants, beginning-of-year2008-01-01251
Total number of active participants reported on line 7a of the Form 55002008-01-01212
Number of retired or separated participants receiving benefits2008-01-015
Number of other retired or separated participants entitled to future benefits2008-01-0121
Total of all active and inactive participants2008-01-01238
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2008-01-010
Total participants2008-01-01238
Number of participants with account balances2008-01-01172
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2008-01-01172

Financial Data on PROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN

Measure Date Value
2022 : PROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2022 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2022-12-31$-2,842,611
Total unrealized appreciation/depreciation of assets2022-12-31$-2,842,611
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$0
Total income from all sources (including contributions)2022-12-31$-2,530,999
Total loss/gain on sale of assets2022-12-31$141,777
Total of all expenses incurred2022-12-31$898,734
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$798,329
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$906,518
Value of total assets at end of year2022-12-31$18,370,202
Value of total assets at beginning of year2022-12-31$21,799,935
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$100,405
Total interest from all sources2022-12-31$6,986
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$503,077
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-12-31$503,077
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$1,000,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$605,328
Participant contributions at end of year2022-12-31$188,196
Participant contributions at beginning of year2022-12-31$175,783
Participant contributions at end of year2022-12-31$10,794
Participant contributions at beginning of year2022-12-31$17,779
Assets. Other investments not covered elsewhere at end of year2022-12-31$11,814,201
Assets. Other investments not covered elsewhere at beginning of year2022-12-31$13,880,669
Other income not declared elsewhere2022-12-31$7,816
Administrative expenses (other) incurred2022-12-31$100,405
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-3,429,733
Value of net assets at end of year (total assets less liabilities)2022-12-31$18,370,202
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$21,799,935
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest in pooled separate accounts at end of year2022-12-31$5,893,350
Value of interest in pooled separate accounts at beginning of year2022-12-31$7,342,298
Interest on participant loans2022-12-31$6,986
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$359,481
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$200,584
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$0
Net investment gain/loss from pooled separate accounts2022-12-31$-1,254,562
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31Yes
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$301,190
Employer contributions (assets) at end of year2022-12-31$104,180
Employer contributions (assets) at beginning of year2022-12-31$182,822
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$798,329
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Aggregate proceeds on sale of assets2022-12-31$1,184,835
Aggregate carrying amount (costs) on sale of assets2022-12-31$1,043,058
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31PILE CPAS
Accountancy firm EIN2022-12-31350865680
2021 : PROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2021 401k financial data
Unrealized appreciation/depreciation of real estate assets2021-12-31$1,285,265
Total unrealized appreciation/depreciation of assets2021-12-31$1,285,265
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$4,187,569
Total loss/gain on sale of assets2021-12-31$597,209
Total of all expenses incurred2021-12-31$1,397,874
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$1,262,862
Value of total corrective distributions2021-12-31$3,072
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$941,684
Value of total assets at end of year2021-12-31$21,799,935
Value of total assets at beginning of year2021-12-31$19,010,240
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$131,940
Total interest from all sources2021-12-31$8,469
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$586,505
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2021-12-31$586,505
Assets. Real estate other than employer real property at end of year2021-12-31$0
Assets. Real estate other than employer real property at beginning of year2021-12-31$0
Administrative expenses professional fees incurred2021-12-31$131,940
Assets. Corporate prefeered stocks other than exployer securities at end of year2021-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2021-12-31$0
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$1,000,000
If this is an individual account plan, was there a blackout period2021-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$614,681
Participant contributions at end of year2021-12-31$175,783
Participant contributions at beginning of year2021-12-31$202,847
Participant contributions at end of year2021-12-31$17,779
Participant contributions at beginning of year2021-12-31$10,120
Assets. Other investments not covered elsewhere at end of year2021-12-31$13,880,669
Assets. Other investments not covered elsewhere at beginning of year2021-12-31$10,596,272
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$7,503
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-12-31$0
Assets. Loans (other than to participants) at end of year2021-12-31$0
Assets. Loans (other than to participants) at beginning of year2021-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-12-31$0
Other income not declared elsewhere2021-12-31$20,956
Liabilities. Value of operating payables at end of year2021-12-31$0
Liabilities. Value of operating payables at beginning of year2021-12-31$0
Total non interest bearing cash at end of year2021-12-31$0
Total non interest bearing cash at beginning of year2021-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$2,789,695
Value of net assets at end of year (total assets less liabilities)2021-12-31$21,799,935
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$19,010,240
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Assets. partnership/joint venture interests at end of year2021-12-31$0
Assets. partnership/joint venture interests at beginning of year2021-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$0
Value of interest in pooled separate accounts at end of year2021-12-31$7,342,298
Value of interest in pooled separate accounts at beginning of year2021-12-31$7,874,633
Interest earned on other investments2021-12-31$8,469
Value of interest in master investment trust accounts at end of year2021-12-31$0
Value of interest in master investment trust accounts at beginning of year2021-12-31$0
Value of interest in common/collective trusts at end of year2021-12-31$0
Value of interest in common/collective trusts at beginning of year2021-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-12-31$0
Assets. Value of investments in 103.12 investment entities at end of year2021-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2021-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$200,584
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$200,639
Asset value of US Government securities at end of year2021-12-31$0
Asset value of US Government securities at beginning of year2021-12-31$0
Net investment gain/loss from pooled separate accounts2021-12-31$747,481
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31Yes
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Assets. Invements in employer securities at end of year2021-12-31$0
Assets. Invements in employer securities at beginning of year2021-12-31$0
Assets. Value of employer real property at end of year2021-12-31$0
Assets. Value of employer real property at beginning of year2021-12-31$0
Contributions received in cash from employer2021-12-31$319,500
Employer contributions (assets) at end of year2021-12-31$182,822
Employer contributions (assets) at beginning of year2021-12-31$125,729
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$1,262,862
Asset. Corporate debt instrument preferred debt at end of year2021-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2021-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2021-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2021-12-31$0
Assets. Corporate common stocks other than exployer securities at end of year2021-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2021-12-31$0
Liabilities. Value of benefit claims payable at end of year2021-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2021-12-31$0
Assets. Value of buildings and other operty used in plan operation at end of year2021-12-31$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2021-12-31$0
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Aggregate proceeds on sale of assets2021-12-31$2,021,471
Aggregate carrying amount (costs) on sale of assets2021-12-31$1,424,262
Liabilities. Value of acquisition indebtedness at end of year2021-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2021-12-31$0
Opinion of an independent qualified public accountant for this plan2021-12-31Disclaimer
Accountancy firm name2021-12-31PILE CPAS
Accountancy firm EIN2021-12-31350865680
2020 : PROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total income from all sources (including contributions)2020-12-31$3,735,940
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$854,905
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$743,403
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$910,346
Value of total assets at end of year2020-12-31$19,010,240
Value of total assets at beginning of year2020-12-31$16,129,205
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$111,502
Total interest from all sources2020-12-31$9,433
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$451,624
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2020-12-31$451,624
Assets. Real estate other than employer real property at end of year2020-12-31$0
Assets. Real estate other than employer real property at beginning of year2020-12-31$0
Administrative expenses professional fees incurred2020-12-31$111,502
Assets. Corporate prefeered stocks other than exployer securities at end of year2020-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2020-12-31$0
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$1,000,000
If this is an individual account plan, was there a blackout period2020-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$597,703
Participant contributions at end of year2020-12-31$202,847
Participant contributions at beginning of year2020-12-31$232,100
Participant contributions at end of year2020-12-31$10,120
Participant contributions at beginning of year2020-12-31$8,581
Assets. Other investments not covered elsewhere at end of year2020-12-31$10,596,272
Assets. Other investments not covered elsewhere at beginning of year2020-12-31$7,815,372
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-12-31$0
Assets. Loans (other than to participants) at end of year2020-12-31$0
Assets. Loans (other than to participants) at beginning of year2020-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-12-31$0
Other income not declared elsewhere2020-12-31$25,368
Liabilities. Value of operating payables at end of year2020-12-31$0
Liabilities. Value of operating payables at beginning of year2020-12-31$0
Total non interest bearing cash at end of year2020-12-31$0
Total non interest bearing cash at beginning of year2020-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$2,881,035
Value of net assets at end of year (total assets less liabilities)2020-12-31$19,010,240
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$16,129,205
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Assets. partnership/joint venture interests at end of year2020-12-31$0
Assets. partnership/joint venture interests at beginning of year2020-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$0
Value of interest in pooled separate accounts at end of year2020-12-31$7,874,633
Value of interest in pooled separate accounts at beginning of year2020-12-31$7,858,090
Interest on participant loans2020-12-31$9,433
Value of interest in master investment trust accounts at end of year2020-12-31$0
Value of interest in master investment trust accounts at beginning of year2020-12-31$0
Value of interest in common/collective trusts at end of year2020-12-31$0
Value of interest in common/collective trusts at beginning of year2020-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-12-31$0
Assets. Value of investments in 103.12 investment entities at end of year2020-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2020-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$200,639
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$120,327
Asset value of US Government securities at end of year2020-12-31$0
Asset value of US Government securities at beginning of year2020-12-31$0
Net investment gain/loss from pooled separate accounts2020-12-31$2,339,169
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31Yes
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Assets. Invements in employer securities at end of year2020-12-31$0
Assets. Invements in employer securities at beginning of year2020-12-31$0
Assets. Value of employer real property at end of year2020-12-31$0
Assets. Value of employer real property at beginning of year2020-12-31$0
Contributions received in cash from employer2020-12-31$312,643
Employer contributions (assets) at end of year2020-12-31$125,729
Employer contributions (assets) at beginning of year2020-12-31$94,735
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$743,403
Asset. Corporate debt instrument preferred debt at end of year2020-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2020-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2020-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2020-12-31$0
Assets. Corporate common stocks other than exployer securities at end of year2020-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2020-12-31$0
Liabilities. Value of benefit claims payable at end of year2020-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2020-12-31$0
Assets. Value of buildings and other operty used in plan operation at end of year2020-12-31$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2020-12-31$0
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Liabilities. Value of acquisition indebtedness at end of year2020-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2020-12-31$0
Opinion of an independent qualified public accountant for this plan2020-12-31Disclaimer
Accountancy firm name2020-12-31PILE CPAS
Accountancy firm EIN2020-12-31350865680
2019 : PROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total income from all sources (including contributions)2019-12-31$4,038,558
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$1,200,442
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$1,150,778
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$899,795
Value of total assets at end of year2019-12-31$16,129,205
Value of total assets at beginning of year2019-12-31$13,291,089
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$49,664
Total interest from all sources2019-12-31$8,700
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$446,167
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$446,167
Assets. Real estate other than employer real property at end of year2019-12-31$0
Assets. Real estate other than employer real property at beginning of year2019-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2019-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2019-12-31$0
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$1,000,000
If this is an individual account plan, was there a blackout period2019-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$589,864
Participant contributions at end of year2019-12-31$232,100
Participant contributions at beginning of year2019-12-31$189,200
Participant contributions at end of year2019-12-31$8,581
Participant contributions at beginning of year2019-12-31$20,422
Assets. Other investments not covered elsewhere at end of year2019-12-31$7,815,372
Assets. Other investments not covered elsewhere at beginning of year2019-12-31$5,868,596
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$0
Assets. Loans (other than to participants) at end of year2019-12-31$0
Assets. Loans (other than to participants) at beginning of year2019-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-12-31$0
Liabilities. Value of operating payables at end of year2019-12-31$0
Liabilities. Value of operating payables at beginning of year2019-12-31$0
Total non interest bearing cash at end of year2019-12-31$0
Total non interest bearing cash at beginning of year2019-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$2,838,116
Value of net assets at end of year (total assets less liabilities)2019-12-31$16,129,205
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$13,291,089
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Assets. partnership/joint venture interests at end of year2019-12-31$0
Assets. partnership/joint venture interests at beginning of year2019-12-31$0
Investment advisory and management fees2019-12-31$49,664
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$0
Value of interest in pooled separate accounts at end of year2019-12-31$7,858,090
Value of interest in pooled separate accounts at beginning of year2019-12-31$6,961,290
Income. Interest from loans (other than to participants)2019-12-31$8,700
Value of interest in master investment trust accounts at end of year2019-12-31$0
Value of interest in master investment trust accounts at beginning of year2019-12-31$0
Value of interest in common/collective trusts at end of year2019-12-31$0
Value of interest in common/collective trusts at beginning of year2019-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$0
Assets. Value of investments in 103.12 investment entities at end of year2019-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2019-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$120,327
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$163,152
Asset value of US Government securities at end of year2019-12-31$0
Asset value of US Government securities at beginning of year2019-12-31$0
Net investment gain/loss from pooled separate accounts2019-12-31$2,683,896
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Assets. Invements in employer securities at end of year2019-12-31$0
Assets. Invements in employer securities at beginning of year2019-12-31$0
Assets. Value of employer real property at end of year2019-12-31$0
Assets. Value of employer real property at beginning of year2019-12-31$0
Contributions received in cash from employer2019-12-31$309,931
Employer contributions (assets) at end of year2019-12-31$94,735
Employer contributions (assets) at beginning of year2019-12-31$88,429
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$1,150,778
Asset. Corporate debt instrument preferred debt at end of year2019-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2019-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2019-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2019-12-31$0
Assets. Corporate common stocks other than exployer securities at end of year2019-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2019-12-31$0
Liabilities. Value of benefit claims payable at end of year2019-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$0
Assets. Value of buildings and other operty used in plan operation at end of year2019-12-31$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2019-12-31$0
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Liabilities. Value of acquisition indebtedness at end of year2019-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2019-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31PILE CPAS
Accountancy firm EIN2019-12-31350865680
2018 : PROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2018 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2018-12-31$0
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$2,562
Total income from all sources (including contributions)2018-12-31$94,159
Total loss/gain on sale of assets2018-12-31$562,141
Total of all expenses incurred2018-12-31$1,234,009
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$1,187,402
Expenses. Certain deemed distributions of participant loans2018-12-31$4,794
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$917,651
Value of total assets at end of year2018-12-31$13,291,089
Value of total assets at beginning of year2018-12-31$14,433,501
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$41,813
Total interest from all sources2018-12-31$7,618
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$536,903
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2018-12-31$402,743
Assets. Real estate other than employer real property at end of year2018-12-31$0
Assets. Real estate other than employer real property at beginning of year2018-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2018-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2018-12-31$0
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$1,000,000
If this is an individual account plan, was there a blackout period2018-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$607,256
Participant contributions at end of year2018-12-31$189,200
Participant contributions at beginning of year2018-12-31$154,822
Participant contributions at end of year2018-12-31$20,422
Participant contributions at beginning of year2018-12-31$5,803
Assets. Other investments not covered elsewhere at end of year2018-12-31$5,868,596
Assets. Other investments not covered elsewhere at beginning of year2018-12-31$6,598,539
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-12-31$0
Assets. Loans (other than to participants) at end of year2018-12-31$0
Assets. Loans (other than to participants) at beginning of year2018-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2018-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-12-31$2,562
Other income not declared elsewhere2018-12-31$-1,032,511
Liabilities. Value of operating payables at end of year2018-12-31$0
Liabilities. Value of operating payables at beginning of year2018-12-31$0
Total non interest bearing cash at end of year2018-12-31$0
Total non interest bearing cash at beginning of year2018-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Income. Non cash contributions2018-12-31$0
Value of net income/loss2018-12-31$-1,139,850
Value of net assets at end of year (total assets less liabilities)2018-12-31$13,291,089
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$14,430,939
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Assets. partnership/joint venture interests at end of year2018-12-31$0
Assets. partnership/joint venture interests at beginning of year2018-12-31$0
Investment advisory and management fees2018-12-31$35,353
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$0
Value of interest in pooled separate accounts at end of year2018-12-31$6,961,290
Value of interest in pooled separate accounts at beginning of year2018-12-31$7,457,443
Interest on participant loans2018-12-31$7,618
Value of interest in master investment trust accounts at end of year2018-12-31$0
Value of interest in master investment trust accounts at beginning of year2018-12-31$0
Value of interest in common/collective trusts at end of year2018-12-31$0
Value of interest in common/collective trusts at beginning of year2018-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-12-31$0
Assets. Value of investments in 103.12 investment entities at end of year2018-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2018-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$163,152
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$138,017
Asset value of US Government securities at end of year2018-12-31$0
Asset value of US Government securities at beginning of year2018-12-31$0
Net investment gain/loss from pooled separate accounts2018-12-31$-897,643
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Assets. Invements in employer securities at end of year2018-12-31$0
Assets. Invements in employer securities at beginning of year2018-12-31$0
Assets. Value of employer real property at end of year2018-12-31$0
Assets. Value of employer real property at beginning of year2018-12-31$0
Contributions received in cash from employer2018-12-31$310,395
Employer contributions (assets) at end of year2018-12-31$88,429
Employer contributions (assets) at beginning of year2018-12-31$78,877
Income. Dividends from common stock2018-12-31$134,160
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$1,187,402
Asset. Corporate debt instrument preferred debt at end of year2018-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2018-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2018-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2018-12-31$0
Contract administrator fees2018-12-31$6,460
Assets. Corporate common stocks other than exployer securities at end of year2018-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2018-12-31$0
Liabilities. Value of benefit claims payable at end of year2018-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2018-12-31$0
Assets. Value of buildings and other operty used in plan operation at end of year2018-12-31$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2018-12-31$0
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Aggregate proceeds on sale of assets2018-12-31$2,106,670
Aggregate carrying amount (costs) on sale of assets2018-12-31$1,544,529
Liabilities. Value of acquisition indebtedness at end of year2018-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2018-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31PILE CPAS
Accountancy firm EIN2018-12-31350865680
2017 : PROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2017 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2017-12-31$0
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$2,562
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$3,070,719
Total loss/gain on sale of assets2017-12-31$115,734
Total of all expenses incurred2017-12-31$715,562
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$684,907
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$952,265
Value of total assets at end of year2017-12-31$14,433,501
Value of total assets at beginning of year2017-12-31$12,075,782
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$30,655
Total interest from all sources2017-12-31$6,666
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$496,310
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2017-12-31$380,245
Assets. Real estate other than employer real property at end of year2017-12-31$0
Assets. Real estate other than employer real property at beginning of year2017-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2017-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2017-12-31$0
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$1,000,000
If this is an individual account plan, was there a blackout period2017-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$609,775
Participant contributions at end of year2017-12-31$154,822
Participant contributions at beginning of year2017-12-31$187,278
Participant contributions at end of year2017-12-31$5,803
Participant contributions at beginning of year2017-12-31$4,575
Assets. Other investments not covered elsewhere at end of year2017-12-31$6,598,539
Assets. Other investments not covered elsewhere at beginning of year2017-12-31$5,455,602
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$28,490
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-12-31$0
Assets. Loans (other than to participants) at end of year2017-12-31$0
Assets. Loans (other than to participants) at beginning of year2017-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2017-12-31$2,562
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-12-31$0
Other income not declared elsewhere2017-12-31$887,314
Liabilities. Value of operating payables at end of year2017-12-31$0
Liabilities. Value of operating payables at beginning of year2017-12-31$0
Total non interest bearing cash at end of year2017-12-31$0
Total non interest bearing cash at beginning of year2017-12-31$19,135
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Income. Non cash contributions2017-12-31$0
Value of net income/loss2017-12-31$2,355,157
Value of net assets at end of year (total assets less liabilities)2017-12-31$14,430,939
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$12,075,782
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Assets. partnership/joint venture interests at end of year2017-12-31$0
Assets. partnership/joint venture interests at beginning of year2017-12-31$0
Investment advisory and management fees2017-12-31$28,088
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$0
Value of interest in pooled separate accounts at end of year2017-12-31$7,457,443
Value of interest in pooled separate accounts at beginning of year2017-12-31$6,140,761
Interest on participant loans2017-12-31$6,473
Interest earned on other investments2017-12-31$193
Value of interest in master investment trust accounts at end of year2017-12-31$0
Value of interest in master investment trust accounts at beginning of year2017-12-31$0
Value of interest in common/collective trusts at end of year2017-12-31$0
Value of interest in common/collective trusts at beginning of year2017-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-12-31$0
Assets. Value of investments in 103.12 investment entities at end of year2017-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2017-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-12-31$138,017
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-12-31$201,222
Asset value of US Government securities at end of year2017-12-31$0
Asset value of US Government securities at beginning of year2017-12-31$0
Net investment gain/loss from pooled separate accounts2017-12-31$612,430
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Assets. Invements in employer securities at end of year2017-12-31$0
Assets. Invements in employer securities at beginning of year2017-12-31$0
Assets. Value of employer real property at end of year2017-12-31$0
Assets. Value of employer real property at beginning of year2017-12-31$0
Contributions received in cash from employer2017-12-31$314,000
Employer contributions (assets) at end of year2017-12-31$78,877
Employer contributions (assets) at beginning of year2017-12-31$67,209
Income. Dividends from common stock2017-12-31$116,065
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$684,907
Asset. Corporate debt instrument preferred debt at end of year2017-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2017-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2017-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2017-12-31$0
Contract administrator fees2017-12-31$2,567
Assets. Corporate common stocks other than exployer securities at end of year2017-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2017-12-31$0
Liabilities. Value of benefit claims payable at end of year2017-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2017-12-31$0
Assets. Value of buildings and other operty used in plan operation at end of year2017-12-31$0
Assets. Value of buildings and other operty used in plan operation at beginning of year2017-12-31$0
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Aggregate proceeds on sale of assets2017-12-31$1,243,163
Aggregate carrying amount (costs) on sale of assets2017-12-31$1,127,429
Liabilities. Value of acquisition indebtedness at end of year2017-12-31$0
Liabilities. Value of acquisition indebtedness at beginning of year2017-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31PILE CPAS
Accountancy firm EIN2017-12-31350865680
2016 : PROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$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$1,894,352
Total loss/gain on sale of assets2016-12-31$7,369
Total of all expenses incurred2016-12-31$1,001,995
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$987,100
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$928,365
Value of total assets at end of year2016-12-31$12,075,782
Value of total assets at beginning of year2016-12-31$11,183,425
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$14,895
Total interest from all sources2016-12-31$6,317
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$282,706
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2016-12-31$208,991
Assets. Real estate other than employer real property at end of year2016-12-31$0
Assets. Real estate other than employer real property at beginning of year2016-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2016-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2016-12-31$0
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$1,000,000
If this is an individual account plan, was there a blackout period2016-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$608,591
Participant contributions at end of year2016-12-31$187,278
Participant contributions at beginning of year2016-12-31$179,680
Participant contributions at end of year2016-12-31$4,575
Participant contributions at beginning of year2016-12-31$8,478
Assets. Other investments not covered elsewhere at end of year2016-12-31$5,455,602
Assets. Other investments not covered elsewhere at beginning of year2016-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-12-31$0
Assets. Loans (other than to participants) at end of year2016-12-31$0
Assets. Loans (other than to participants) at beginning of year2016-12-31$0
Administrative expenses (other) incurred2016-12-31$300
Total non interest bearing cash at end of year2016-12-31$19,135
Total non interest bearing cash at beginning of year2016-12-31$6,779
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$892,357
Value of net assets at end of year (total assets less liabilities)2016-12-31$12,075,782
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$11,183,425
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Assets. partnership/joint venture interests at end of year2016-12-31$0
Assets. partnership/joint venture interests at beginning of year2016-12-31$0
Investment advisory and management fees2016-12-31$12,302
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$1,044,381
Value of interest in pooled separate accounts at end of year2016-12-31$6,140,761
Value of interest in pooled separate accounts at beginning of year2016-12-31$7,349,648
Interest on participant loans2016-12-31$6,317
Value of interest in master investment trust accounts at end of year2016-12-31$0
Value of interest in master investment trust accounts at beginning of year2016-12-31$0
Value of interest in common/collective trusts at end of year2016-12-31$0
Value of interest in common/collective trusts at beginning of year2016-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$390,426
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$390,426
Assets. Value of investments in 103.12 investment entities at end of year2016-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2016-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-12-31$201,222
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-12-31$275,026
Asset value of US Government securities at end of year2016-12-31$0
Asset value of US Government securities at beginning of year2016-12-31$0
Net investment gain/loss from pooled separate accounts2016-12-31$669,595
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$319,774
Employer contributions (assets) at end of year2016-12-31$67,209
Employer contributions (assets) at beginning of year2016-12-31$75,140
Income. Dividends from common stock2016-12-31$73,715
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$987,100
Asset. Corporate debt instrument preferred debt at end of year2016-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2016-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2016-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2016-12-31$63,848
Contract administrator fees2016-12-31$2,293
Assets. Corporate common stocks other than exployer securities at end of year2016-12-31$0
Assets. Corporate common stocks other than exployer securities at beginning of year2016-12-31$1,790,019
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Aggregate proceeds on sale of assets2016-12-31$712,383
Aggregate carrying amount (costs) on sale of assets2016-12-31$705,014
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31PILE CPAS
Accountancy firm EIN2016-12-31350865680
2015 : PROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$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$863,472
Total loss/gain on sale of assets2015-12-31$92,587
Total of all expenses incurred2015-12-31$1,114,714
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$1,099,532
Expenses. Certain deemed distributions of participant loans2015-12-31$904
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$971,049
Value of total assets at end of year2015-12-31$11,183,425
Value of total assets at beginning of year2015-12-31$11,434,667
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$14,278
Total interest from all sources2015-12-31$8,478
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$474,727
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2015-12-31$361,045
Assets. Real estate other than employer real property at end of year2015-12-31$0
Assets. Real estate other than employer real property at beginning of year2015-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2015-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2015-12-31$0
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$1,000,000
If this is an individual account plan, was there a blackout period2015-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$644,895
Participant contributions at end of year2015-12-31$179,680
Participant contributions at beginning of year2015-12-31$235,773
Participant contributions at end of year2015-12-31$8,478
Participant contributions at beginning of year2015-12-31$3,342
Assets. Other investments not covered elsewhere at end of year2015-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2015-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-12-31$0
Assets. Loans (other than to participants) at end of year2015-12-31$0
Assets. Loans (other than to participants) at beginning of year2015-12-31$0
Other income not declared elsewhere2015-12-31$1,590
Total non interest bearing cash at end of year2015-12-31$6,779
Total non interest bearing cash at beginning of year2015-12-31$22,039
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$-251,242
Value of net assets at end of year (total assets less liabilities)2015-12-31$11,183,425
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$11,434,667
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Assets. partnership/joint venture interests at end of year2015-12-31$0
Assets. partnership/joint venture interests at beginning of year2015-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$1,044,381
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$1,131,443
Value of interest in pooled separate accounts at end of year2015-12-31$7,349,648
Value of interest in pooled separate accounts at beginning of year2015-12-31$7,966,296
Interest on participant loans2015-12-31$8,478
Value of interest in master investment trust accounts at end of year2015-12-31$0
Value of interest in master investment trust accounts at beginning of year2015-12-31$0
Value of interest in common/collective trusts at end of year2015-12-31$0
Value of interest in common/collective trusts at beginning of year2015-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-12-31$390,426
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-12-31$302,792
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-12-31$302,792
Assets. Value of investments in 103.12 investment entities at end of year2015-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2015-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2015-12-31$275,026
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2015-12-31$142,851
Asset value of US Government securities at end of year2015-12-31$0
Asset value of US Government securities at beginning of year2015-12-31$0
Net investment gain/loss from pooled separate accounts2015-12-31$-684,959
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$326,154
Employer contributions (assets) at end of year2015-12-31$75,140
Employer contributions (assets) at beginning of year2015-12-31$60,073
Income. Dividends from common stock2015-12-31$113,682
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$1,099,532
Asset. Corporate debt instrument preferred debt at end of year2015-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2015-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2015-12-31$63,848
Asset. Corporate debt instrument debt (other) at beginning of year2015-12-31$62,568
Contract administrator fees2015-12-31$14,278
Assets. Corporate common stocks other than exployer securities at end of year2015-12-31$1,790,019
Assets. Corporate common stocks other than exployer securities at beginning of year2015-12-31$1,507,490
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Aggregate proceeds on sale of assets2015-12-31$530,145
Aggregate carrying amount (costs) on sale of assets2015-12-31$437,558
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31PILE CPAS
Accountancy firm EIN2015-12-31350865680
2014 : PROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-12-31$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$1,551,307
Total loss/gain on sale of assets2014-12-31$125,637
Total of all expenses incurred2014-12-31$771,264
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$751,522
Expenses. Certain deemed distributions of participant loans2014-12-31$3,456
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$851,912
Value of total assets at end of year2014-12-31$11,434,667
Value of total assets at beginning of year2014-12-31$10,654,624
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$16,286
Total interest from all sources2014-12-31$6,464
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$613,287
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2014-12-31$481,152
Assets. Real estate other than employer real property at end of year2014-12-31$0
Assets. Real estate other than employer real property at beginning of year2014-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2014-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2014-12-31$0
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$1,000,000
If this is an individual account plan, was there a blackout period2014-12-31No
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$566,122
Participant contributions at end of year2014-12-31$235,773
Participant contributions at beginning of year2014-12-31$218,246
Participant contributions at end of year2014-12-31$3,342
Participant contributions at beginning of year2014-12-31$3,086
Assets. Other investments not covered elsewhere at end of year2014-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2014-12-31$3,425
Income. Received or receivable in cash from other sources (including rollovers)2014-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-12-31$0
Assets. Loans (other than to participants) at end of year2014-12-31$0
Assets. Loans (other than to participants) at beginning of year2014-12-31$0
Total non interest bearing cash at end of year2014-12-31$22,039
Total non interest bearing cash at beginning of year2014-12-31$81
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$780,043
Value of net assets at end of year (total assets less liabilities)2014-12-31$11,434,667
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$10,654,624
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Assets. partnership/joint venture interests at end of year2014-12-31$0
Assets. partnership/joint venture interests at beginning of year2014-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$1,131,443
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$1,080,081
Value of interest in pooled separate accounts at end of year2014-12-31$7,966,296
Value of interest in pooled separate accounts at beginning of year2014-12-31$7,600,830
Interest on participant loans2014-12-31$6,464
Value of interest in master investment trust accounts at end of year2014-12-31$0
Value of interest in master investment trust accounts at beginning of year2014-12-31$0
Value of interest in common/collective trusts at end of year2014-12-31$0
Value of interest in common/collective trusts at beginning of year2014-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-12-31$302,792
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-12-31$270,193
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-12-31$270,193
Assets. Value of investments in 103.12 investment entities at end of year2014-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2014-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2014-12-31$142,851
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2014-12-31$131,607
Asset value of US Government securities at end of year2014-12-31$0
Asset value of US Government securities at beginning of year2014-12-31$0
Net investment gain/loss from pooled separate accounts2014-12-31$-45,993
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$285,790
Employer contributions (assets) at end of year2014-12-31$60,073
Employer contributions (assets) at beginning of year2014-12-31$66,100
Income. Dividends from common stock2014-12-31$132,135
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$751,522
Asset. Corporate debt instrument preferred debt at end of year2014-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2014-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2014-12-31$62,568
Asset. Corporate debt instrument debt (other) at beginning of year2014-12-31$29,162
Contract administrator fees2014-12-31$16,286
Assets. Corporate common stocks other than exployer securities at end of year2014-12-31$1,507,490
Assets. Corporate common stocks other than exployer securities at beginning of year2014-12-31$1,251,813
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Aggregate proceeds on sale of assets2014-12-31$456,544
Aggregate carrying amount (costs) on sale of assets2014-12-31$330,907
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31PILE CPAS
Accountancy firm EIN2014-12-31350865680
2013 : PROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-12-31$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$2,548,469
Total loss/gain on sale of assets2013-12-31$55,682
Total of all expenses incurred2013-12-31$470,316
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$456,615
Expenses. Certain deemed distributions of participant loans2013-12-31$1,914
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$935,325
Value of total assets at end of year2013-12-31$10,654,624
Value of total assets at beginning of year2013-12-31$8,576,471
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$11,787
Total interest from all sources2013-12-31$6,493
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$350,605
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2013-12-31$282,383
Assets. Real estate other than employer real property at end of year2013-12-31$0
Assets. Real estate other than employer real property at beginning of year2013-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2013-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2013-12-31$0
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$1,000,000
If this is an individual account plan, was there a blackout period2013-12-31No
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$561,735
Participant contributions at end of year2013-12-31$218,246
Participant contributions at beginning of year2013-12-31$195,918
Participant contributions at end of year2013-12-31$3,086
Participant contributions at beginning of year2013-12-31$0
Assets. Other investments not covered elsewhere at end of year2013-12-31$3,425
Assets. Other investments not covered elsewhere at beginning of year2013-12-31$4,780
Income. Received or receivable in cash from other sources (including rollovers)2013-12-31$79,374
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-12-31$0
Assets. Loans (other than to participants) at end of year2013-12-31$0
Assets. Loans (other than to participants) at beginning of year2013-12-31$0
Total non interest bearing cash at end of year2013-12-31$81
Total non interest bearing cash at beginning of year2013-12-31$391
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Income. Non cash contributions2013-12-31$0
Value of net income/loss2013-12-31$2,078,153
Value of net assets at end of year (total assets less liabilities)2013-12-31$10,654,624
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$8,576,471
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Assets. partnership/joint venture interests at end of year2013-12-31$0
Assets. partnership/joint venture interests at beginning of year2013-12-31$0
Investment advisory and management fees2013-12-31$11,787
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-12-31$1,080,081
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$873,500
Value of interest in pooled separate accounts at end of year2013-12-31$7,600,830
Value of interest in pooled separate accounts at beginning of year2013-12-31$6,296,816
Interest on participant loans2013-12-31$6,493
Value of interest in master investment trust accounts at end of year2013-12-31$0
Value of interest in master investment trust accounts at beginning of year2013-12-31$0
Value of interest in common/collective trusts at end of year2013-12-31$0
Value of interest in common/collective trusts at beginning of year2013-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-12-31$270,193
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-12-31$301,782
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-12-31$301,782
Assets. Value of investments in 103.12 investment entities at end of year2013-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2013-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2013-12-31$131,607
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2013-12-31$0
Asset value of US Government securities at end of year2013-12-31$0
Asset value of US Government securities at beginning of year2013-12-31$0
Net investment gain/loss from pooled separate accounts2013-12-31$1,200,364
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31Yes
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$294,216
Employer contributions (assets) at end of year2013-12-31$66,100
Employer contributions (assets) at beginning of year2013-12-31$74,258
Income. Dividends from common stock2013-12-31$68,222
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$456,615
Asset. Corporate debt instrument preferred debt at end of year2013-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2013-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2013-12-31$29,162
Asset. Corporate debt instrument debt (other) at beginning of year2013-12-31$0
Assets. Corporate common stocks other than exployer securities at end of year2013-12-31$1,251,813
Assets. Corporate common stocks other than exployer securities at beginning of year2013-12-31$829,026
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Aggregate proceeds on sale of assets2013-12-31$264,455
Aggregate carrying amount (costs) on sale of assets2013-12-31$208,773
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31Yes
Opinion of an independent qualified public accountant for this plan2013-12-31Disclaimer
Accountancy firm name2013-12-31PILE CPAS
Accountancy firm EIN2013-12-31350865680
2012 : PROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2012 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2012-12-31$678,237
Total unrealized appreciation/depreciation of assets2012-12-31$678,237
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$1,891,534
Total loss/gain on sale of assets2012-12-31$72,223
Total of all expenses incurred2012-12-31$713,337
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$701,381
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$949,592
Value of total assets at end of year2012-12-31$8,576,471
Value of total assets at beginning of year2012-12-31$7,398,274
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$11,956
Total interest from all sources2012-12-31$50,216
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$141,266
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2012-12-31$141,266
Assets. Real estate other than employer real property at end of year2012-12-31$0
Assets. Real estate other than employer real property at beginning of year2012-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2012-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2012-12-31$0
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$500,000
If this is an individual account plan, was there a blackout period2012-12-31No
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$610,763
Participant contributions at end of year2012-12-31$195,918
Participant contributions at beginning of year2012-12-31$78,987
Participant contributions at end of year2012-12-31$0
Participant contributions at beginning of year2012-12-31$0
Assets. Other investments not covered elsewhere at end of year2012-12-31$4,780
Assets. Other investments not covered elsewhere at beginning of year2012-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-12-31$0
Assets. Loans (other than to participants) at end of year2012-12-31$0
Assets. Loans (other than to participants) at beginning of year2012-12-31$0
Total non interest bearing cash at end of year2012-12-31$391
Total non interest bearing cash at beginning of year2012-12-31$67
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$1,178,197
Value of net assets at end of year (total assets less liabilities)2012-12-31$8,576,471
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$7,398,274
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Assets. partnership/joint venture interests at end of year2012-12-31$0
Assets. partnership/joint venture interests at beginning of year2012-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-12-31$873,500
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-12-31$819,600
Value of interest in pooled separate accounts at end of year2012-12-31$6,296,816
Value of interest in pooled separate accounts at beginning of year2012-12-31$5,613,194
Interest on participant loans2012-12-31$5,411
Interest earned on other investments2012-12-31$0
Income. Interest from corporate debt instruments2012-12-31$44,805
Value of interest in master investment trust accounts at end of year2012-12-31$0
Value of interest in master investment trust accounts at beginning of year2012-12-31$0
Value of interest in common/collective trusts at end of year2012-12-31$0
Value of interest in common/collective trusts at beginning of year2012-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-12-31$301,782
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-12-31$242,607
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-12-31$242,607
Assets. Value of investments in 103.12 investment entities at end of year2012-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2012-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2012-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2012-12-31$0
Asset value of US Government securities at end of year2012-12-31$0
Asset value of US Government securities at beginning of year2012-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31Yes
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$338,829
Employer contributions (assets) at end of year2012-12-31$74,258
Employer contributions (assets) at beginning of year2012-12-31$67,301
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$701,381
Asset. Corporate debt instrument preferred debt at end of year2012-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2012-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2012-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2012-12-31$0
Contract administrator fees2012-12-31$11,956
Assets. Corporate common stocks other than exployer securities at end of year2012-12-31$829,026
Assets. Corporate common stocks other than exployer securities at beginning of year2012-12-31$576,518
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Aggregate proceeds on sale of assets2012-12-31$538,802
Aggregate carrying amount (costs) on sale of assets2012-12-31$466,579
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31Yes
Opinion of an independent qualified public accountant for this plan2012-12-31Disclaimer
Accountancy firm name2012-12-31R.J. PILE, LLC
Accountancy firm EIN2012-12-31350865680
2011 : PROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2011 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2011-12-31$67,892
Total unrealized appreciation/depreciation of assets2011-12-31$67,892
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$803,345
Total loss/gain on sale of assets2011-12-31$14,846
Total of all expenses incurred2011-12-31$723,523
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$717,332
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$958,452
Value of total assets at end of year2011-12-31$7,398,274
Value of total assets at beginning of year2011-12-31$7,318,452
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$6,191
Total interest from all sources2011-12-31$3,142
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$126,901
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2011-12-31$126,901
Assets. Real estate other than employer real property at end of year2011-12-31$0
Assets. Real estate other than employer real property at beginning of year2011-12-31$0
Administrative expenses professional fees incurred2011-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2011-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2011-12-31$0
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$750,000
If this is an individual account plan, was there a blackout period2011-12-31No
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$600,950
Participant contributions at end of year2011-12-31$78,987
Participant contributions at beginning of year2011-12-31$71,747
Participant contributions at end of year2011-12-31$0
Participant contributions at beginning of year2011-12-31$2,062
Assets. Other investments not covered elsewhere at end of year2011-12-31$0
Assets. Other investments not covered elsewhere at beginning of year2011-12-31$13,872
Income. Received or receivable in cash from other sources (including rollovers)2011-12-31$28,969
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-12-31$0
Assets. Loans (other than to participants) at end of year2011-12-31$0
Assets. Loans (other than to participants) at beginning of year2011-12-31$0
Total non interest bearing cash at end of year2011-12-31$67
Total non interest bearing cash at beginning of year2011-12-31$1,560
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$79,822
Value of net assets at end of year (total assets less liabilities)2011-12-31$7,398,274
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$7,318,452
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Assets. partnership/joint venture interests at end of year2011-12-31$0
Assets. partnership/joint venture interests at beginning of year2011-12-31$0
Investment advisory and management fees2011-12-31$3,112
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-12-31$819,600
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-12-31$739,068
Value of interest in pooled separate accounts at end of year2011-12-31$5,613,194
Value of interest in pooled separate accounts at beginning of year2011-12-31$5,729,668
Interest on participant loans2011-12-31$3,094
Income. Interest from loans (other than to participants)2011-12-31$0
Interest earned on other investments2011-12-31$0
Income. Interest from US Government securities2011-12-31$0
Income. Interest from corporate debt instruments2011-12-31$0
Value of interest in master investment trust accounts at end of year2011-12-31$0
Value of interest in master investment trust accounts at beginning of year2011-12-31$0
Value of interest in common/collective trusts at end of year2011-12-31$0
Value of interest in common/collective trusts at beginning of year2011-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-12-31$242,607
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-12-31$207,167
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-12-31$207,167
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$48
Assets. Value of investments in 103.12 investment entities at end of year2011-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2011-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-12-31$0
Asset value of US Government securities at end of year2011-12-31$0
Asset value of US Government securities at beginning of year2011-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-12-31$-367,888
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$328,533
Employer contributions (assets) at end of year2011-12-31$67,301
Employer contributions (assets) at beginning of year2011-12-31$76,895
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$717,332
Asset. Corporate debt instrument preferred debt at end of year2011-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2011-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2011-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2011-12-31$0
Contract administrator fees2011-12-31$3,079
Assets. Corporate common stocks other than exployer securities at end of year2011-12-31$576,518
Assets. Corporate common stocks other than exployer securities at beginning of year2011-12-31$476,413
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Aggregate proceeds on sale of assets2011-12-31$263,509
Aggregate carrying amount (costs) on sale of assets2011-12-31$248,663
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31R.J. PILE, LLC
Accountancy firm EIN2011-12-31350865680
2010 : PROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2010 401k financial data
Unrealized appreciation/depreciation of real estate assets2010-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2010-12-31$91,888
Total unrealized appreciation/depreciation of assets2010-12-31$91,888
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$1,746,771
Total loss/gain on sale of assets2010-12-31$-17,243
Total of all expenses incurred2010-12-31$251,219
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$242,007
Expenses. Certain deemed distributions of participant loans2010-12-31$1,709
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$959,556
Value of total assets at end of year2010-12-31$7,318,452
Value of total assets at beginning of year2010-12-31$5,822,900
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$7,503
Total income from rents2010-12-31$0
Total interest from all sources2010-12-31$4,307
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$99,071
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2010-12-31$94,766
Assets. Real estate other than employer real property at end of year2010-12-31$0
Assets. Real estate other than employer real property at beginning of year2010-12-31$0
Administrative expenses professional fees incurred2010-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at end of year2010-12-31$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year2010-12-31$0
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$750,000
If this is an individual account plan, was there a blackout period2010-12-31No
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$347,904
Participant contributions at end of year2010-12-31$71,747
Participant contributions at beginning of year2010-12-31$62,491
Participant contributions at end of year2010-12-31$2,062
Participant contributions at beginning of year2010-12-31$0
Assets. Other investments not covered elsewhere at end of year2010-12-31$13,872
Assets. Other investments not covered elsewhere at beginning of year2010-12-31$27,885
Income. Received or receivable in cash from other sources (including rollovers)2010-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at end of year2010-12-31$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2010-12-31$16
Assets. Loans (other than to participants) at end of year2010-12-31$0
Assets. Loans (other than to participants) at beginning of year2010-12-31$0
Total non interest bearing cash at end of year2010-12-31$1,560
Total non interest bearing cash at beginning of year2010-12-31$15
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$1,495,552
Value of net assets at end of year (total assets less liabilities)2010-12-31$7,318,452
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$5,822,900
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Assets. partnership/joint venture interests at end of year2010-12-31$0
Assets. partnership/joint venture interests at beginning of year2010-12-31$0
Investment advisory and management fees2010-12-31$5,884
Value of interest in registered invesment companies (eg mutual funds) at end of year2010-12-31$739,068
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$529,491
Value of interest in pooled separate accounts at end of year2010-12-31$5,729,668
Value of interest in pooled separate accounts at beginning of year2010-12-31$4,583,020
Interest on participant loans2010-12-31$4,216
Income. Interest from loans (other than to participants)2010-12-31$0
Interest earned on other investments2010-12-31$0
Income. Interest from US Government securities2010-12-31$0
Income. Interest from corporate debt instruments2010-12-31$0
Value of interest in master investment trust accounts at end of year2010-12-31$0
Value of interest in master investment trust accounts at beginning of year2010-12-31$0
Value of interest in common/collective trusts at end of year2010-12-31$0
Value of interest in common/collective trusts at beginning of year2010-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2010-12-31$207,167
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2010-12-31$115,036
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2010-12-31$115,036
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$91
Assets. Value of investments in 103.12 investment entities at end of year2010-12-31$0
Assets. Value of investments in 103.12 investment entities at beginning of year2010-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2010-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2010-12-31$0
Asset value of US Government securities at end of year2010-12-31$0
Asset value of US Government securities at beginning of year2010-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2010-12-31$46,133
Net investment gain/loss from pooled separate accounts2010-12-31$563,059
Net investment gain or loss from common/collective trusts2010-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$611,652
Employer contributions (assets) at end of year2010-12-31$76,895
Employer contributions (assets) at beginning of year2010-12-31$92,321
Income. Dividends from preferred stock2010-12-31$0
Income. Dividends from common stock2010-12-31$4,305
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$242,007
Asset. Corporate debt instrument preferred debt at end of year2010-12-31$0
Asset. Corporate debt instrument preferred debt at beginning of year2010-12-31$0
Asset. Corporate debt instrument debt (other) at end of year2010-12-31$0
Asset. Corporate debt instrument debt (other) at beginning of year2010-12-31$4,993
Contract administrator fees2010-12-31$1,619
Assets. Corporate common stocks other than exployer securities at end of year2010-12-31$476,413
Assets. Corporate common stocks other than exployer securities at beginning of year2010-12-31$407,632
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Aggregate proceeds on sale of assets2010-12-31$154,994
Aggregate carrying amount (costs) on sale of assets2010-12-31$172,237
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31R.J. PILE, LLC
Accountancy firm EIN2010-12-31350865680

Form 5500 Responses for PROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN

2022: PROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: PROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: PROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: PROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: PROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: PROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: PROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: PROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: PROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement - TrustYes
2013: PROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement - TrustYes
2012: PROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement - TrustYes
2011: PROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement - TrustYes
2010: PROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement - TrustYes
2009: PROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement - TrustYes
2008: PROVIDENCE MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2008 form 5500 responses
2008-01-01Type of plan entitySingle employer plan
2008-01-01Submission has been amendedYes
2008-01-01This submission is the final filingNo
2008-01-01This return/report is a short plan year return/report (less than 12 months)No
2008-01-01Plan is a collectively bargained planNo
2008-01-01Plan funding arrangement – InsuranceYes
2008-01-01Plan funding arrangement – TrustYes
2008-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract number754086-01
Policy instance 1
Insurance contract or identification number754086-01
Number of Individuals Covered122
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-829477
Policy instance 1
Insurance contract or identification numberGA-829477
Number of Individuals Covered131
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 BrokerUSD $0
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerTPA
Insurance broker organization code?5
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-829477
Policy instance 1
Insurance contract or identification numberGA-829477
Number of Individuals Covered131
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $3,714
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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
Amount paid for insurance broker fees3714
Additional information about fees paid to insurance brokerTPA
Insurance broker organization code?3
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-829477
Policy instance 1
Insurance contract or identification numberGA-829477
Number of Individuals Covered136
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $15,058
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 BrokerUSD $15,058
Insurance broker organization code?3
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-829477
Policy instance 1
Insurance contract or identification numberGA-829477
Number of Individuals Covered136
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $20,528
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 BrokerUSD $20,528
Insurance broker organization code?3
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-829477
Policy instance 1
Insurance contract or identification numberGA-829477
Number of Individuals Covered136
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $23,328
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 BrokerUSD $23,328
Insurance broker organization code?3
Insurance broker nameMERRILL LYNCH LIFE AGENCY INC.
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-829477
Policy instance 1
Insurance contract or identification numberGA-829477
Number of Individuals Covered133
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $21,641
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 BrokerUSD $21,641
Insurance broker organization code?3
Insurance broker nameMERRILL LYNCH LIFE AGENCY
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-829477
Policy instance 1
Insurance contract or identification numberGA-829477
Number of Individuals Covered142
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $21,055
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 BrokerUSD $21,055
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerFEE
Insurance broker organization code?3
Insurance broker nameMERRILL LYNCH LIFE AGENCY
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-711658
Policy instance 1
Insurance contract or identification numberGA-711658
Number of Individuals Covered135
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $10,085
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
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?Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 BrokerUSD $10,085
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerFEE
Insurance broker organization code?3
Insurance broker nameMERRILL LYNCH LIFE AGENCY
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-711658
Policy instance 1
Insurance contract or identification numberGA-711658
Number of Individuals Covered147
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $17,800
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 BrokerUSD $17,800
Insurance broker organization code?4
Insurance broker nameMERRILL LYNCH LIFE AGENCY
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-711658
Policy instance 1
Insurance contract or identification numberGA-711658
Number of Individuals Covered162
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $17,593
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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
HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )
Policy contract numberGA-711658
Policy instance 1
Insurance contract or identification numberGA-711658
Number of Individuals Covered172
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $14,216
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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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