401k Plan data: PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN plan

PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 401k Plan overview

Plan Name	PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN
Plan identification number	001

PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
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.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

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

Company Name: PROVIDENCE MEDICAL GROUP, INC.

Employer identification number (EIN): 421534506

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

Additional information about PROVIDENCE MEDICAL GROUP, INC.

Jurisdiction of Incorporation: Ohio Secretary of State Business Services Division

Incorporation Date: 2002-04-17

Company Identification Number: 1313008

Legal Registered Office Address: 33 WEST FIRST STREET
SUITE 600
DAYTON
United States of America (USA)
45402

More information about PROVIDENCE MEDICAL GROUP, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01 SUSAN BECKER 2023-10-16
001 2021-01-01 SUSAN J BECKER 2022-10-07
001 2020-01-01 SUSAN J BECKER 2021-10-07
001 2019-01-01 SUSAN J BECKER 2020-10-13
001 2018-01-01 SUSAN BECKER 2019-10-15
001 2017-01-01
001 2016-01-01
001 2015-01-01
001 2014-01-01 SUSAN BECKER
001 2013-01-01 SUSAN BECKER
001 2012-01-01 SUSAN BECKER
001 2011-01-01 SUSAN BECKER
001 2009-01-01 JENNIFER HAYNES

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2022-01-01	SUSAN BECKER	2023-10-16
001	2021-01-01	SUSAN J BECKER	2022-10-07
001	2020-01-01	SUSAN J BECKER	2021-10-07
001	2019-01-01	SUSAN J BECKER	2020-10-13
001	2018-01-01	SUSAN BECKER	2019-10-15
001	2017-01-01
001	2016-01-01
001	2015-01-01
001	2014-01-01	SUSAN BECKER
001	2013-01-01	SUSAN BECKER
001	2012-01-01	SUSAN BECKER
001	2011-01-01	SUSAN BECKER
001	2009-01-01	JENNIFER HAYNES

Plan Statistics for PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN

401k plan membership statisitcs for PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN

Measure Date Value
2022: PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 248
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 123
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 95
Total of all active and inactive participants 2022-01-01 218
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 218
Number of participants with account balances 2022-01-01 209
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 5
2021: PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 237
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 146
Number of retired or separated participants receiving benefits 2021-01-01 27
Number of other retired or separated participants entitled to future benefits 2021-01-01 75
Total of all active and inactive participants 2021-01-01 248
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 248
Number of participants with account balances 2021-01-01 247
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 2
2020: PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 269
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 147
Number of retired or separated participants receiving benefits 2020-01-01 18
Number of other retired or separated participants entitled to future benefits 2020-01-01 72
Total of all active and inactive participants 2020-01-01 237
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 237
Number of participants with account balances 2020-01-01 237
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 3
2019: PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 279
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 145
Number of retired or separated participants receiving benefits 2019-01-01 32
Number of other retired or separated participants entitled to future benefits 2019-01-01 90
Total of all active and inactive participants 2019-01-01 267
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 1
Total participants 2019-01-01 268
Number of participants with account balances 2019-01-01 268
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 4
2018: PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 318
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 151
Number of retired or separated participants receiving benefits 2018-01-01 24
Number of other retired or separated participants entitled to future benefits 2018-01-01 101
Total of all active and inactive participants 2018-01-01 276
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 276
Number of participants with account balances 2018-01-01 276
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 5
2017: PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 381
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 155
Number of retired or separated participants receiving benefits 2017-01-01 42
Number of other retired or separated participants entitled to future benefits 2017-01-01 111
Total of all active and inactive participants 2017-01-01 308
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 308
Number of participants with account balances 2017-01-01 308
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 12
2016: PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 383
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 208
Number of retired or separated participants receiving benefits 2016-01-01 33
Number of other retired or separated participants entitled to future benefits 2016-01-01 131
Total of all active and inactive participants 2016-01-01 372
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 372
Number of participants with account balances 2016-01-01 372
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 8
2015: PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 378
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 242
Number of retired or separated participants receiving benefits 2015-01-01 19
Number of other retired or separated participants entitled to future benefits 2015-01-01 118
Total of all active and inactive participants 2015-01-01 379
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 379
Number of participants with account balances 2015-01-01 379
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 11
2014: PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 390
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 245
Number of retired or separated participants receiving benefits 2014-01-01 21
Number of other retired or separated participants entitled to future benefits 2014-01-01 91
Total of all active and inactive participants 2014-01-01 357
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 357
Number of participants with account balances 2014-01-01 357
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 3
2013: PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 397
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 248
Number of retired or separated participants receiving benefits 2013-01-01 17
Number of other retired or separated participants entitled to future benefits 2013-01-01 120
Total of all active and inactive participants 2013-01-01 385
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 385
Number of participants with account balances 2013-01-01 385
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 5
2012: PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 299
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 251
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 137
Total of all active and inactive participants 2012-01-01 388
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 388
Number of participants with account balances 2012-01-01 388
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 5
2011: PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 439
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 273
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 26
Total of all active and inactive participants 2011-01-01 299
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 299
Number of participants with account balances 2011-01-01 216
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 13
2009: PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 328
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 234
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 118
Total of all active and inactive participants 2009-01-01 352
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 352
Number of participants with account balances 2009-01-01 328
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 6

Measure	Date	Value
2022: PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	248
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	123
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	95
Total of all active and inactive participants	2022-01-01	218
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	218
Number of participants with account balances	2022-01-01	209
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	5
2021: PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	237
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	146
Number of retired or separated participants receiving benefits	2021-01-01	27
Number of other retired or separated participants entitled to future benefits	2021-01-01	75
Total of all active and inactive participants	2021-01-01	248
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	248
Number of participants with account balances	2021-01-01	247
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	2
2020: PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	269
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	147
Number of retired or separated participants receiving benefits	2020-01-01	18
Number of other retired or separated participants entitled to future benefits	2020-01-01	72
Total of all active and inactive participants	2020-01-01	237
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	237
Number of participants with account balances	2020-01-01	237
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	3
2019: PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	279
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	145
Number of retired or separated participants receiving benefits	2019-01-01	32
Number of other retired or separated participants entitled to future benefits	2019-01-01	90
Total of all active and inactive participants	2019-01-01	267
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	1
Total participants	2019-01-01	268
Number of participants with account balances	2019-01-01	268
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	4
2018: PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	318
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	151
Number of retired or separated participants receiving benefits	2018-01-01	24
Number of other retired or separated participants entitled to future benefits	2018-01-01	101
Total of all active and inactive participants	2018-01-01	276
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	276
Number of participants with account balances	2018-01-01	276
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	5
2017: PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	381
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	155
Number of retired or separated participants receiving benefits	2017-01-01	42
Number of other retired or separated participants entitled to future benefits	2017-01-01	111
Total of all active and inactive participants	2017-01-01	308
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	308
Number of participants with account balances	2017-01-01	308
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	12
2016: PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	383
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	208
Number of retired or separated participants receiving benefits	2016-01-01	33
Number of other retired or separated participants entitled to future benefits	2016-01-01	131
Total of all active and inactive participants	2016-01-01	372
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	372
Number of participants with account balances	2016-01-01	372
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	8
2015: PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	378
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	242
Number of retired or separated participants receiving benefits	2015-01-01	19
Number of other retired or separated participants entitled to future benefits	2015-01-01	118
Total of all active and inactive participants	2015-01-01	379
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	379
Number of participants with account balances	2015-01-01	379
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	11
2014: PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	390
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	245
Number of retired or separated participants receiving benefits	2014-01-01	21
Number of other retired or separated participants entitled to future benefits	2014-01-01	91
Total of all active and inactive participants	2014-01-01	357
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	357
Number of participants with account balances	2014-01-01	357
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	3
2013: PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	397
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	248
Number of retired or separated participants receiving benefits	2013-01-01	17
Number of other retired or separated participants entitled to future benefits	2013-01-01	120
Total of all active and inactive participants	2013-01-01	385
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	385
Number of participants with account balances	2013-01-01	385
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	5
2012: PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	299
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	251
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	137
Total of all active and inactive participants	2012-01-01	388
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	388
Number of participants with account balances	2012-01-01	388
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	5
2011: PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	439
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	273
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	26
Total of all active and inactive participants	2011-01-01	299
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	299
Number of participants with account balances	2011-01-01	216
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	13
2009: PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	328
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	234
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	118
Total of all active and inactive participants	2009-01-01	352
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	352
Number of participants with account balances	2009-01-01	328
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	6

Financial Data on PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN

Measure	Date	Value
2022 : PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total income from all sources (including contributions)	2022-12-31	$-1,354,480
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$2,533,550
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$2,460,974
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$854,178
Value of total assets at end of year	2022-12-31	$16,012,663
Value of total assets at beginning of year	2022-12-31	$19,900,693
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$72,576
Total interest from all sources	2022-12-31	$3,633
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$638,694
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-12-31	$638,694
Administrative expenses professional fees incurred	2022-12-31	$72,576
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$500,000
If this is an individual account plan, was there a blackout period	2022-12-31	Yes
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$508,170
Participant contributions at end of year	2022-12-31	$120,979
Participant contributions at beginning of year	2022-12-31	$95,969
Participant contributions at end of year	2022-12-31	$39,838
Participant contributions at beginning of year	2022-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$82,115
Value of other receiveables (less allowance for doubtful accounts) at end of year	2022-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2022-12-31	$3,966
Total non interest bearing cash at end of year	2022-12-31	$0
Total non interest bearing cash at beginning of year	2022-12-31	$6,159
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$-3,888,030
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$16,012,663
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$19,900,693
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$13,691,008
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$17,210,377
Interest on participant loans	2022-12-31	$3,633
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2022-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2022-12-31	$2,014,310
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2022-12-31	$2,014,310
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$1,896,945
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-2,850,985
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$263,893
Employer contributions (assets) at end of year	2022-12-31	$263,893
Employer contributions (assets) at beginning of year	2022-12-31	$569,912
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$2,460,974
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2022-12-31	Yes
Did the plan have assets held for investment	2022-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	FLAGEL HUBER FLAGEL
Accountancy firm EIN	2022-12-31	310796034
2021 : PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$3,672,672
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$2,885,710
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$2,807,251
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$1,132,516
Value of total assets at end of year	2021-12-31	$19,900,693
Value of total assets at beginning of year	2021-12-31	$19,113,731
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$78,459
Total interest from all sources	2021-12-31	$4,939
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$942,560
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2021-12-31	$942,560
Administrative expenses professional fees incurred	2021-12-31	$78,459
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$1,911,143
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$528,915
Participant contributions at end of year	2021-12-31	$95,969
Participant contributions at beginning of year	2021-12-31	$118,622
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$33,689
Value of other receiveables (less allowance for doubtful accounts) at end of year	2021-12-31	$3,966
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2021-12-31	$3,401
Total non interest bearing cash at end of year	2021-12-31	$6,159
Total non interest bearing cash at beginning of year	2021-12-31	$29,623
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$786,962
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$19,900,693
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$19,113,731
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$17,210,377
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$16,477,703
Income. Interest from loans (other than to participants)	2021-12-31	$4,939
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2021-12-31	$2,014,310
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2021-12-31	$1,850,198
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2021-12-31	$1,850,198
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$1,592,657
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$569,912
Employer contributions (assets) at end of year	2021-12-31	$569,912
Employer contributions (assets) at beginning of year	2021-12-31	$634,184
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$2,807,251
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	FLAGEL HUBER FLAGEL
Accountancy firm EIN	2021-12-31	310796034
2020 : PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$3,699,712
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$3,806,933
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$3,730,521
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$1,292,103
Value of total assets at end of year	2020-12-31	$19,113,731
Value of total assets at beginning of year	2020-12-31	$19,220,952
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$76,412
Total interest from all sources	2020-12-31	$4,152
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$627,509
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-31	$627,509
Administrative expenses professional fees incurred	2020-12-31	$76,412
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$1,921,679
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$577,702
Participant contributions at end of year	2020-12-31	$118,622
Participant contributions at beginning of year	2020-12-31	$46,194
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$64,102
Value of other receiveables (less allowance for doubtful accounts) at end of year	2020-12-31	$3,401
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2020-12-31	$36,781
Total non interest bearing cash at end of year	2020-12-31	$29,623
Total non interest bearing cash at beginning of year	2020-12-31	$12,817
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$-107,221
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$19,113,731
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$19,220,952
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$16,477,703
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$18,017,530
Interest on participant loans	2020-12-31	$4,152
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2020-12-31	$1,850,198
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2020-12-31	$586,385
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2020-12-31	$586,385
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$1,775,948
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$650,299
Employer contributions (assets) at end of year	2020-12-31	$634,184
Employer contributions (assets) at beginning of year	2020-12-31	$521,245
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$3,730,521
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	FLAGEL HUBER FLAGEL
Accountancy firm EIN	2020-12-31	310796034
2019 : PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$4,559,359
Total income from all sources (including contributions)	2019-12-31	$4,559,359
Total loss/gain on sale of assets	2019-12-31	$0
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$2,654,675
Total of all expenses incurred	2019-12-31	$2,654,675
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$2,572,832
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$2,572,832
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$925,886
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$925,886
Value of total assets at end of year	2019-12-31	$19,220,952
Value of total assets at end of year	2019-12-31	$19,220,952
Value of total assets at beginning of year	2019-12-31	$17,316,268
Value of total assets at beginning of year	2019-12-31	$17,316,268
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$81,843
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$81,843
Total interest from all sources	2019-12-31	$6,611
Total interest from all sources	2019-12-31	$6,611
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$864,938
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$864,938
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$864,938
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$864,938
Administrative expenses professional fees incurred	2019-12-31	$81,843
Administrative expenses professional fees incurred	2019-12-31	$81,843
Was this plan covered by a fidelity bond	2019-12-31	Yes
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$1,731,627
Value of fidelity bond cover	2019-12-31	$1,731,627
If this is an individual account plan, was there a blackout period	2019-12-31	No
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$388,323
Contributions received from participants	2019-12-31	$388,323
Participant contributions at end of year	2019-12-31	$46,194
Participant contributions at end of year	2019-12-31	$46,194
Participant contributions at beginning of year	2019-12-31	$147,493
Participant contributions at beginning of year	2019-12-31	$147,493
Participant contributions at beginning of year	2019-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$16,318
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$16,318
Value of other receiveables (less allowance for doubtful accounts) at end of year	2019-12-31	$36,781
Value of other receiveables (less allowance for doubtful accounts) at end of year	2019-12-31	$36,781
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2019-12-31	$25,152
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2019-12-31	$25,152
Total non interest bearing cash at end of year	2019-12-31	$12,817
Total non interest bearing cash at end of year	2019-12-31	$12,817
Total non interest bearing cash at beginning of year	2019-12-31	$13,251
Total non interest bearing cash at beginning of year	2019-12-31	$13,251
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$1,904,684
Value of net income/loss	2019-12-31	$1,904,684
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$19,220,952
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$19,220,952
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$17,316,268
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$17,316,268
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$18,017,530
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$18,017,530
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$15,818,851
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$15,818,851
Interest on participant loans	2019-12-31	$6,611
Interest on participant loans	2019-12-31	$6,611
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2019-12-31	$586,385
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2019-12-31	$586,385
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2019-12-31	$763,772
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2019-12-31	$763,772
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2019-12-31	$763,772
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2019-12-31	$763,772
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$2,761,924
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$2,761,924
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$521,245
Contributions received in cash from employer	2019-12-31	$521,245
Employer contributions (assets) at end of year	2019-12-31	$521,245
Employer contributions (assets) at end of year	2019-12-31	$521,245
Employer contributions (assets) at beginning of year	2019-12-31	$547,749
Employer contributions (assets) at beginning of year	2019-12-31	$547,749
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$2,572,832
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$2,572,832
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	FLAGEL HUBER FLAGEL
Accountancy firm name	2019-12-31	FLAGEL HUBER FLAGEL
Accountancy firm EIN	2019-12-31	310796034
Accountancy firm EIN	2019-12-31	310796034
2018 : PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$334,204
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$3,349,762
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$3,265,625
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$1,068,982
Value of total assets at end of year	2018-12-31	$17,316,268
Value of total assets at beginning of year	2018-12-31	$20,331,826
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$84,137
Total interest from all sources	2018-12-31	$6,392
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$1,117,282
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2018-12-31	$1,117,282
Administrative expenses professional fees incurred	2018-12-31	$84,137
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$500,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$404,200
Participant contributions at end of year	2018-12-31	$147,493
Participant contributions at beginning of year	2018-12-31	$148,879
Participant contributions at end of year	2018-12-31	$0
Participant contributions at beginning of year	2018-12-31	$26,495
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$117,033
Value of other receiveables (less allowance for doubtful accounts) at end of year	2018-12-31	$25,152
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2018-12-31	$23,346
Total non interest bearing cash at end of year	2018-12-31	$13,251
Total non interest bearing cash at beginning of year	2018-12-31	$17,926
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$-3,015,558
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$17,316,268
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$20,331,826
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$15,818,851
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$18,494,856
Interest on participant loans	2018-12-31	$6,392
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2018-12-31	$763,772
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2018-12-31	$989,763
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2018-12-31	$989,763
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-1,858,452
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$547,749
Employer contributions (assets) at end of year	2018-12-31	$547,749
Employer contributions (assets) at beginning of year	2018-12-31	$630,561
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$3,265,625
Did the plan have assets held for investment	2018-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	FLAGEL HUBER & FLAGEL
Accountancy firm EIN	2018-12-31	310796034
2017 : PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$4,474,993
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$6,436,413
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$6,343,201
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$1,073,674
Value of total assets at end of year	2017-12-31	$20,331,826
Value of total assets at beginning of year	2017-12-31	$22,293,246
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$93,212
Total interest from all sources	2017-12-31	$5,622
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$1,098,694
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$1,098,694
Administrative expenses professional fees incurred	2017-12-31	$93,212
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$500,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$440,113
Participant contributions at end of year	2017-12-31	$148,879
Participant contributions at beginning of year	2017-12-31	$144,445
Participant contributions at end of year	2017-12-31	$26,495
Participant contributions at beginning of year	2017-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$3,000
Value of other receiveables (less allowance for doubtful accounts) at end of year	2017-12-31	$23,346
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2017-12-31	$28,934
Total non interest bearing cash at end of year	2017-12-31	$17,926
Total non interest bearing cash at beginning of year	2017-12-31	$29,065
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$-1,961,420
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$20,331,826
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$22,293,246
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$18,494,856
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$20,049,618
Interest on participant loans	2017-12-31	$5,622
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2017-12-31	$989,763
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2017-12-31	$1,198,058
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2017-12-31	$1,198,058
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$2,297,003
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$630,561
Employer contributions (assets) at end of year	2017-12-31	$630,561
Employer contributions (assets) at beginning of year	2017-12-31	$843,126
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$6,343,201
Did the plan have assets held for investment	2017-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	FLAGEL HUBER & FLAGEL
Accountancy firm EIN	2017-12-31	310796034
2016 : PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$3,377,744
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$3,300,900
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$3,213,040
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$1,604,728
Value of total assets at end of year	2016-12-31	$22,277,545
Value of total assets at beginning of year	2016-12-31	$22,200,701
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$87,860
Total interest from all sources	2016-12-31	$6,232
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$1,766,784
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$1,766,784
Administrative expenses professional fees incurred	2016-12-31	$87,860
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$500,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$679,643
Participant contributions at end of year	2016-12-31	$144,445
Participant contributions at beginning of year	2016-12-31	$230,398
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$81,959
Value of other receiveables (less allowance for doubtful accounts) at end of year	2016-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2016-12-31	$10,993
Total non interest bearing cash at end of year	2016-12-31	$21,289,974
Total non interest bearing cash at beginning of year	2016-12-31	$44,363
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$76,844
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$22,277,545
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$22,200,701
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$20,007,496
Interest on participant loans	2016-12-31	$6,232
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2016-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2016-12-31	$928,794
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2016-12-31	$928,794
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$843,126
Employer contributions (assets) at end of year	2016-12-31	$843,126
Employer contributions (assets) at beginning of year	2016-12-31	$978,657
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$3,213,040
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	FLAGEL HUBER & FLAGEL
Accountancy firm EIN	2016-12-31	310796034
2015 : PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$1,847,162
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$3,097,183
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$2,997,919
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$1,888,120
Value of total assets at end of year	2015-12-31	$22,200,701
Value of total assets at beginning of year	2015-12-31	$23,450,722
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$99,264
Total interest from all sources	2015-12-31	$7,331
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$1,080,790
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$1,080,790
Administrative expenses professional fees incurred	2015-12-31	$8,546
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$500,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$774,906
Participant contributions at end of year	2015-12-31	$230,398
Participant contributions at beginning of year	2015-12-31	$174,337
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$134,557
Value of other receiveables (less allowance for doubtful accounts) at end of year	2015-12-31	$10,993
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2015-12-31	$16,630
Total non interest bearing cash at end of year	2015-12-31	$44,363
Total non interest bearing cash at beginning of year	2015-12-31	$77,319
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$-1,250,021
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$22,200,701
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$23,450,722
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Investment advisory and management fees	2015-12-31	$62,737
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$20,007,496
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$22,347,622
Interest on participant loans	2015-12-31	$7,331
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2015-12-31	$928,794
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2015-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2015-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-1,129,079
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$978,657
Employer contributions (assets) at end of year	2015-12-31	$978,657
Employer contributions (assets) at beginning of year	2015-12-31	$834,814
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$2,997,919
Contract administrator fees	2015-12-31	$27,981
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	FLAGEL HUBER & FLAGEL
Accountancy firm EIN	2015-12-31	310796034
2014 : PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$2,851,830
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$1,370,632
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$1,260,080
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$1,545,631
Value of total assets at end of year	2014-12-31	$23,450,722
Value of total assets at beginning of year	2014-12-31	$21,969,524
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$110,552
Total interest from all sources	2014-12-31	$5,838
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$1,296,866
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$1,296,866
Administrative expenses professional fees incurred	2014-12-31	$13,893
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$500,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$698,835
Participant contributions at end of year	2014-12-31	$174,337
Participant contributions at beginning of year	2014-12-31	$138,910
Participant contributions at end of year	2014-12-31	$0
Participant contributions at beginning of year	2014-12-31	$22,500
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$11,983
Value of other receiveables (less allowance for doubtful accounts) at end of year	2014-12-31	$16,630
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2014-12-31	$8,371
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2014-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2014-12-31	$0
Total non interest bearing cash at end of year	2014-12-31	$77,319
Total non interest bearing cash at beginning of year	2014-12-31	$763
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$1,481,198
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$23,450,722
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$21,969,524
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Investment advisory and management fees	2014-12-31	$62,476
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$22,347,622
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$20,997,795
Interest on participant loans	2014-12-31	$5,838
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$3,495
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$834,813
Employer contributions (assets) at end of year	2014-12-31	$834,814
Employer contributions (assets) at beginning of year	2014-12-31	$801,185
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$1,260,080
Contract administrator fees	2014-12-31	$34,183
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	FLAGEL HUBER & FLAGEL
Accountancy firm EIN	2014-12-31	310796034
2013 : PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$4,925,494
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$1,900,344
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$1,811,599
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$1,447,149
Value of total assets at end of year	2013-12-31	$21,969,524
Value of total assets at beginning of year	2013-12-31	$18,944,374
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$88,745
Total interest from all sources	2013-12-31	$6,705
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$852,617
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-12-31	$852,617
Administrative expenses professional fees incurred	2013-12-31	$60,575
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$500,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$645,964
Participant contributions at end of year	2013-12-31	$138,910
Participant contributions at beginning of year	2013-12-31	$168,480
Participant contributions at end of year	2013-12-31	$22,500
Participant contributions at beginning of year	2013-12-31	$17,500
Value of other receiveables (less allowance for doubtful accounts) at end of year	2013-12-31	$8,371
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2013-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2013-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2013-12-31	$0
Total non interest bearing cash at end of year	2013-12-31	$763
Total non interest bearing cash at beginning of year	2013-12-31	$28,506
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$3,025,150
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$21,969,524
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$18,944,374
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Investment advisory and management fees	2013-12-31	$28,170
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$20,997,795
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$17,905,679
Interest on participant loans	2013-12-31	$6,705
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$2,619,023
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$801,185
Employer contributions (assets) at end of year	2013-12-31	$801,185
Employer contributions (assets) at beginning of year	2013-12-31	$824,209
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$1,811,599
Did the plan have assets held for investment	2013-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	FLAGEL HUBER & FLAGEL
Accountancy firm EIN	2013-12-31	310796034
2012 : PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$3,441,742
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$524,517
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$458,939
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$1,504,190
Value of total assets at end of year	2012-12-31	$18,944,374
Value of total assets at beginning of year	2012-12-31	$16,027,149
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$65,578
Total interest from all sources	2012-12-31	$7,856
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$476,456
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-12-31	$476,456
Administrative expenses professional fees incurred	2012-12-31	$12,397
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$500,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$659,394
Participant contributions at end of year	2012-12-31	$168,480
Participant contributions at beginning of year	2012-12-31	$218,238
Participant contributions at end of year	2012-12-31	$17,500
Participant contributions at beginning of year	2012-12-31	$8,003
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$20,587
Value of other receiveables (less allowance for doubtful accounts) at end of year	2012-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2012-12-31	$2,319
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2012-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2012-12-31	$0
Total non interest bearing cash at end of year	2012-12-31	$28,506
Total non interest bearing cash at beginning of year	2012-12-31	$694
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$2,917,225
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$18,944,374
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$16,027,149
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Investment advisory and management fees	2012-12-31	$53,181
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$17,905,679
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$14,954,434
Interest on participant loans	2012-12-31	$7,856
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$1,453,240
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$824,209
Employer contributions (assets) at end of year	2012-12-31	$824,209
Employer contributions (assets) at beginning of year	2012-12-31	$843,461
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$458,939
Did the plan have assets held for investment	2012-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	FLAGEL HUBER & FLAGEL
Accountancy firm EIN	2012-12-31	310796034
2011 : PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$0
Total income from all sources (including contributions)	2011-12-31	$1,367,332
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$691,939
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$624,470
Expenses. Certain deemed distributions of participant loans	2011-12-31	$3,442
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$1,570,246
Value of total assets at end of year	2011-12-31	$16,027,149
Value of total assets at beginning of year	2011-12-31	$15,351,756
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$64,027
Total interest from all sources	2011-12-31	$10,338
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$332,176
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2011-12-31	$332,176
Administrative expenses professional fees incurred	2011-12-31	$64,027
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$500,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$702,160
Participant contributions at end of year	2011-12-31	$218,238
Participant contributions at beginning of year	2011-12-31	$235,985
Participant contributions at end of year	2011-12-31	$8,003
Participant contributions at beginning of year	2011-12-31	$17,000
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$24,625
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-12-31	$2,319
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-12-31	$4,685
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2011-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2011-12-31	$0
Total non interest bearing cash at end of year	2011-12-31	$694
Total non interest bearing cash at beginning of year	2011-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$675,393
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$16,027,149
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$15,351,756
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$14,954,434
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$14,346,023
Interest on participant loans	2011-12-31	$10,338
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-545,428
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$843,461
Employer contributions (assets) at end of year	2011-12-31	$843,461
Employer contributions (assets) at beginning of year	2011-12-31	$748,063
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$624,470
Did the plan have assets held for investment	2011-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	FLAGEL HUBER & FLAGEL
Accountancy firm EIN	2011-12-31	310796034
2010 : PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$637
Total income from all sources (including contributions)	2010-12-31	$2,991,188
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$524,610
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$462,940
Expenses. Certain deemed distributions of participant loans	2010-12-31	$7,912
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$1,413,303
Value of total assets at end of year	2010-12-31	$15,351,756
Value of total assets at beginning of year	2010-12-31	$12,885,815
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$53,758
Total interest from all sources	2010-12-31	$14,203
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$207,372
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2010-12-31	$207,372
Administrative expenses professional fees incurred	2010-12-31	$53,758
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$500,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$640,524
Participant contributions at end of year	2010-12-31	$235,985
Participant contributions at beginning of year	2010-12-31	$256,834
Participant contributions at end of year	2010-12-31	$17,000
Participant contributions at beginning of year	2010-12-31	$23,560
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$24,717
Value of other receiveables (less allowance for doubtful accounts) at end of year	2010-12-31	$4,685
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2010-12-31	$2,454
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2010-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2010-12-31	$637
Total non interest bearing cash at end of year	2010-12-31	$0
Total non interest bearing cash at beginning of year	2010-12-31	$1,142
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$2,466,578
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$15,351,756
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$12,885,178
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$14,346,023
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$11,812,679
Interest on participant loans	2010-12-31	$14,203
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$1,356,310
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$748,062
Employer contributions (assets) at end of year	2010-12-31	$748,063
Employer contributions (assets) at beginning of year	2010-12-31	$789,146
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$462,940
Did the plan have assets held for investment	2010-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	DOHNER LOUIS & STEPHENS, INC
Accountancy firm EIN	2010-12-31	310796135
2009 : PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN

2022: PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: PROVIDENCE MEDICAL GROUP INC. RETIREMENT PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

518045-01

Policy instance

Insurance contract or identification number	518045-01
Number of Individuals Covered	36
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	Yes
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	PROVIDENCE MEDICAL GROUP, INC.
Employer identification number (EIN):	421534506
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)

Jurisdiction of Incorporation:	Ohio Secretary of State Business Services Division
Incorporation Date:	2002-04-17
Company Identification Number:	1313008
Legal Registered Office Address:	33 WEST FIRST STREET SUITE 600 DAYTON United States of America (USA) 45402