401k Plan data: FIVOS, INC. 401(K) PLAN plan

FIVOS, INC. 401(K) PLAN 401k Plan overview

Plan Name	FIVOS, INC. 401(K) PLAN
Plan identification number	001

FIVOS, INC. 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

FIVOS INC. has sponsored the creation of one or more 401k plans.

Company Name: FIVOS INC.

Employer identification number (EIN): 451573625

NAIC Classification: 621510
NAIC Description: Medical and Diagnostic Laboratories

Additional information about FIVOS INC.

Jurisdiction of Incorporation: Washington Secretary of State Corporations Division

Incorporation Date: 2007-01-04

Company Identification Number: 602682609

Legal Registered Office Address: 500 UNION ST STE 800

SEATTLE
United States of America (USA)
98101

More information about FIVOS INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FIVOS, INC. 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01
001 2021-01-01
001 2021-01-01
001 2020-01-01
001 2019-01-01
001 2018-01-01
001 2017-01-01 KATIE EMERSON KATIE EMERSON 2018-10-15

Plan Statistics for FIVOS, INC. 401(K) PLAN

401k plan membership statisitcs for FIVOS, INC. 401(K) PLAN

Measure Date Value
2022: FIVOS, INC. 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 126
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 85
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 41
Total of all active and inactive participants 2022-01-01 126
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 126
Number of participants with account balances 2022-01-01 101
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 7
2021: FIVOS, INC. 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 130
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 84
Number of retired or separated participants receiving benefits 2021-01-01 6
Number of other retired or separated participants entitled to future benefits 2021-01-01 36
Total of all active and inactive participants 2021-01-01 126
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 126
Number of participants with account balances 2021-01-01 105
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 5
2020: FIVOS, INC. 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 161
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 96
Number of retired or separated participants receiving benefits 2020-01-01 3
Number of other retired or separated participants entitled to future benefits 2020-01-01 31
Total of all active and inactive participants 2020-01-01 130
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 130
Number of participants with account balances 2020-01-01 99
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 9
2019: FIVOS, INC. 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 150
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 123
Number of retired or separated participants receiving benefits 2019-01-01 9
Number of other retired or separated participants entitled to future benefits 2019-01-01 30
Total of all active and inactive participants 2019-01-01 162
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 162
Number of participants with account balances 2019-01-01 109
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 3
2018: FIVOS, INC. 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 144
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 119
Number of retired or separated participants receiving benefits 2018-01-01 7
Number of other retired or separated participants entitled to future benefits 2018-01-01 23
Total of all active and inactive participants 2018-01-01 149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 149
Number of participants with account balances 2018-01-01 97
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 2
2017: FIVOS, INC. 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 143
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 124
Number of retired or separated participants receiving benefits 2017-01-01 2
Number of other retired or separated participants entitled to future benefits 2017-01-01 19
Total of all active and inactive participants 2017-01-01 145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 145
Number of participants with account balances 2017-01-01 84
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0

Measure	Date	Value
2022: FIVOS, INC. 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	126
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	85
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	41
Total of all active and inactive participants	2022-01-01	126
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	126
Number of participants with account balances	2022-01-01	101
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	7
2021: FIVOS, INC. 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	130
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	84
Number of retired or separated participants receiving benefits	2021-01-01	6
Number of other retired or separated participants entitled to future benefits	2021-01-01	36
Total of all active and inactive participants	2021-01-01	126
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	126
Number of participants with account balances	2021-01-01	105
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	5
2020: FIVOS, INC. 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	161
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	96
Number of retired or separated participants receiving benefits	2020-01-01	3
Number of other retired or separated participants entitled to future benefits	2020-01-01	31
Total of all active and inactive participants	2020-01-01	130
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	130
Number of participants with account balances	2020-01-01	99
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	9
2019: FIVOS, INC. 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	150
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	123
Number of retired or separated participants receiving benefits	2019-01-01	9
Number of other retired or separated participants entitled to future benefits	2019-01-01	30
Total of all active and inactive participants	2019-01-01	162
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	162
Number of participants with account balances	2019-01-01	109
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	3
2018: FIVOS, INC. 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	144
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	119
Number of retired or separated participants receiving benefits	2018-01-01	7
Number of other retired or separated participants entitled to future benefits	2018-01-01	23
Total of all active and inactive participants	2018-01-01	149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	149
Number of participants with account balances	2018-01-01	97
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	2
2017: FIVOS, INC. 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	143
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	124
Number of retired or separated participants receiving benefits	2017-01-01	2
Number of other retired or separated participants entitled to future benefits	2017-01-01	19
Total of all active and inactive participants	2017-01-01	145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	145
Number of participants with account balances	2017-01-01	84
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0

Financial Data on FIVOS, INC. 401(K) PLAN

Measure	Date	Value
2022 : FIVOS, INC. 401(K) PLAN 2022 401k financial data
Unrealized appreciation/depreciation of real estate assets	2022-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2022-12-31	$0
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
Expenses. Interest paid	2022-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2022-12-31	$0
Total income from all sources (including contributions)	2022-12-31	$-580,491
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$1,780,951
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$1,771,947
Expenses. Certain deemed distributions of participant loans	2022-12-31	$5,762
Value of total corrective distributions	2022-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$1,099,268
Value of total assets at end of year	2022-12-31	$8,071,731
Value of total assets at beginning of year	2022-12-31	$10,433,173
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$3,242
Total income from rents	2022-12-31	$0
Total interest from all sources	2022-12-31	$8,854
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$163,462
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	$163,462
Assets. Real estate other than employer real property at end of year	2022-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2022-12-31	$0
Administrative expenses professional fees incurred	2022-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2022-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2022-12-31	$0
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	$730,123
Participant contributions at end of year	2022-12-31	$140,300
Participant contributions at beginning of year	2022-12-31	$165,027
Participant contributions at end of year	2022-12-31	$0
Participant contributions at beginning of year	2022-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2022-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2022-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$69,198
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2022-12-31	$0
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	$0
Assets. Loans (other than to participants) at end of year	2022-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2022-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2022-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2022-12-31	$0
Other income not declared elsewhere	2022-12-31	$3,838
Administrative expenses (other) incurred	2022-12-31	$0
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	$19,513
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
Income. Non cash contributions	2022-12-31	$0
Value of net income/loss	2022-12-31	$-2,361,442
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$8,071,731
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$10,433,173
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
Assets. partnership/joint venture interests at end of year	2022-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2022-12-31	$0
Investment advisory and management fees	2022-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$7,261,584
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$0
Value of interest in pooled separate accounts at end of year	2022-12-31	$660,125
Value of interest in pooled separate accounts at beginning of year	2022-12-31	$10,248,633
Interest on participant loans	2022-12-31	$8,849
Income. Interest from loans (other than to participants)	2022-12-31	$0
Interest earned on other investments	2022-12-31	$5
Income. Interest from US Government securities	2022-12-31	$0
Income. Interest from corporate debt instruments	2022-12-31	$0
Value of interest in master investment trust accounts at end of year	2022-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2022-12-31	$0
Value of interest in common/collective trusts at end of year	2022-12-31	$0
Value of interest in common/collective trusts at beginning of year	2022-12-31	$0
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	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2022-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2022-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2022-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2022-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$9,722
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2022-12-31	$0
Asset value of US Government securities at end of year	2022-12-31	$0
Asset value of US Government securities at beginning of year	2022-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-301,861
Net investment gain/loss from pooled separate accounts	2022-12-31	$-1,554,052
Net investment gain or loss from common/collective trusts	2022-12-31	$0
Net gain/loss from 103.12 investment entities	2022-12-31	$0
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	Yes
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Assets. Invements in employer securities at end of year	2022-12-31	$0
Assets. Invements in employer securities at beginning of year	2022-12-31	$0
Assets. Value of employer real property at end of year	2022-12-31	$0
Assets. Value of employer real property at beginning of year	2022-12-31	$0
Contributions received in cash from employer	2022-12-31	$299,947
Employer contributions (assets) at end of year	2022-12-31	$0
Employer contributions (assets) at beginning of year	2022-12-31	$0
Income. Dividends from preferred stock	2022-12-31	$0
Income. Dividends from common stock	2022-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$1,771,947
Asset. Corporate debt instrument preferred debt at end of year	2022-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2022-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2022-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2022-12-31	$0
Contract administrator fees	2022-12-31	$3,242
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
Assets. Corporate common stocks other than exployer securities at end of year	2022-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2022-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2022-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2022-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2022-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2022-12-31	$0
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
Aggregate proceeds on sale of assets	2022-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2022-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2022-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2022-12-31	$0
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	GALLAGHER, FLYNNE AND COMPANY, LLP
Accountancy firm EIN	2022-12-31	030225774
2021 : FIVOS, INC. 401(K) PLAN 2021 401k financial data
Expenses. Interest paid	2021-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$2,510,808
Total of all expenses incurred	2021-12-31	$1,405,059
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$1,394,880
Expenses. Certain deemed distributions of participant loans	2021-12-31	$7,471
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$1,315,178
Value of total assets at end of year	2021-12-31	$10,413,660
Value of total assets at beginning of year	2021-12-31	$9,307,911
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$2,708
Total interest from all sources	2021-12-31	$12,553
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$699,928
Participant contributions at end of year	2021-12-31	$165,027
Participant contributions at beginning of year	2021-12-31	$214,951
Participant contributions at beginning of year	2021-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$324,969
Other income not declared elsewhere	2021-12-31	$2,927
Administrative expenses (other) incurred	2021-12-31	$2,400
Total non interest bearing cash at end of year	2021-12-31	$0
Total non interest bearing cash at beginning of year	2021-12-31	$12,781
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
Income. Non cash contributions	2021-12-31	$0
Value of net income/loss	2021-12-31	$1,105,749
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$10,413,660
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$9,307,911
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest in pooled separate accounts at end of year	2021-12-31	$10,248,633
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$9,080,179
Interest on participant loans	2021-12-31	$12,553
Income. Interest from loans (other than to participants)	2021-12-31	$0
Net investment gain/loss from pooled separate accounts	2021-12-31	$1,180,150
Net investment gain or loss from common/collective trusts	2021-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$290,281
Employer contributions (assets) at beginning of year	2021-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$1,394,880
Contract administrator fees	2021-12-31	$308
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	GALLAGHER, FLYNN AND COMPANY, LLP
Accountancy firm EIN	2021-12-31	030225774
2020 : FIVOS, INC. 401(K) PLAN 2020 401k financial data
Total income from all sources (including contributions)	2020-12-31	$2,398,043
Total of all expenses incurred	2020-12-31	$1,292,128
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$1,287,011
Value of total corrective distributions	2020-12-31	$1,151
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$1,198,642
Value of total assets at end of year	2020-12-31	$9,307,911
Value of total assets at beginning of year	2020-12-31	$8,201,996
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$3,966
Total interest from all sources	2020-12-31	$13,799
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Administrative expenses professional fees incurred	2020-12-31	$3,600
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$617,351
Participant contributions at end of year	2020-12-31	$214,951
Participant contributions at beginning of year	2020-12-31	$202,946
Participant contributions at end of year	2020-12-31	$0
Participant contributions at beginning of year	2020-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$328,383
Other income not declared elsewhere	2020-12-31	$123
Total non interest bearing cash at end of year	2020-12-31	$12,781
Total non interest bearing cash at beginning of year	2020-12-31	$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	2020-12-31	No
Income. Non cash contributions	2020-12-31	$0
Value of net income/loss	2020-12-31	$1,105,915
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$9,307,911
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$8,201,996
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 pooled separate accounts at end of year	2020-12-31	$9,080,179
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$7,999,050
Interest on participant loans	2020-12-31	$13,799
Net investment gain/loss from pooled separate accounts	2020-12-31	$1,185,479
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$252,908
Employer contributions (assets) at end of year	2020-12-31	$0
Employer contributions (assets) at beginning of year	2020-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$1,287,011
Contract administrator fees	2020-12-31	$366
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Unqualified
Accountancy firm name	2020-12-31	CARON & BLETZER, PLLC
Accountancy firm EIN	2020-12-31	043499945
2019 : FIVOS, INC. 401(K) PLAN 2019 401k financial data
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$155
Expenses. Interest paid	2019-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$2,337,245
Total of all expenses incurred	2019-12-31	$264,073
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$252,188
Expenses. Certain deemed distributions of participant loans	2019-12-31	$0
Value of total corrective distributions	2019-12-31	$2,218
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$1,033,723
Value of total assets at end of year	2019-12-31	$8,201,996
Value of total assets at beginning of year	2019-12-31	$6,128,979
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$9,667
Total interest from all sources	2019-12-31	$12,134
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$250,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$621,971
Participant contributions at end of year	2019-12-31	$202,946
Participant contributions at beginning of year	2019-12-31	$191,666
Participant contributions at end of year	2019-12-31	$0
Participant contributions at beginning of year	2019-12-31	$574
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$145,827
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2019-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2019-12-31	$155
Administrative expenses (other) incurred	2019-12-31	$6,155
Total non interest bearing cash at end of year	2019-12-31	$0
Total non interest bearing cash at beginning of year	2019-12-31	$368
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	$2,073,172
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$8,201,996
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$6,128,824
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Investment advisory and management fees	2019-12-31	$312
Value of interest in pooled separate accounts at end of year	2019-12-31	$7,999,050
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$5,936,371
Interest on participant loans	2019-12-31	$12,134
Expenses. Payments to insurance carriers foe the provision of benefits	2019-12-31	$0
Net investment gain/loss from pooled separate accounts	2019-12-31	$1,291,388
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	Yes
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	$265,925
Employer contributions (assets) at end of year	2019-12-31	$0
Employer contributions (assets) at beginning of year	2019-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$252,188
Contract administrator fees	2019-12-31	$3,200
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	CARON & BLETZER, PLLC
Accountancy firm EIN	2019-12-31	043499945
2018 : FIVOS, INC. 401(K) PLAN 2018 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$155
Total income from all sources (including contributions)	2018-12-31	$490,041
Total of all expenses incurred	2018-12-31	$213,103
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$210,901
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$918,247
Value of total assets at end of year	2018-12-31	$6,128,979
Value of total assets at beginning of year	2018-12-31	$5,851,886
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$2,202
Total interest from all sources	2018-12-31	$7,483
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$250,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$580,681
Participant contributions at end of year	2018-12-31	$191,666
Participant contributions at beginning of year	2018-12-31	$82,875
Participant contributions at end of year	2018-12-31	$574
Participant contributions at beginning of year	2018-12-31	$944
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$118,633
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2018-12-31	$155
Total non interest bearing cash at end of year	2018-12-31	$368
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	$276,938
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$6,128,824
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$5,851,886
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
Investment advisory and management fees	2018-12-31	$252
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$0
Value of interest in pooled separate accounts at end of year	2018-12-31	$5,936,371
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$5,767,523
Interest on participant loans	2018-12-31	$7,483
Net investment gain/loss from pooled separate accounts	2018-12-31	$-435,689
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	$218,933
Employer contributions (assets) at end of year	2018-12-31	$0
Employer contributions (assets) at beginning of year	2018-12-31	$544
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$210,901
Contract administrator fees	2018-12-31	$1,950
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	CARON & BLETZER, PLLC
Accountancy firm EIN	2018-12-31	043499945
2017 : FIVOS, INC. 401(K) PLAN 2017 401k financial data
Total income from all sources (including contributions)	2017-12-31	$1,859,427
Total of all expenses incurred	2017-12-31	$500,858
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$499,160
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$1,005,133
Value of total assets at end of year	2017-12-31	$5,851,886
Value of total assets at beginning of year	2017-12-31	$4,493,317
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$1,698
Total interest from all sources	2017-12-31	$3,604
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$250,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$423,039
Participant contributions at end of year	2017-12-31	$82,875
Participant contributions at beginning of year	2017-12-31	$30,637
Participant contributions at end of year	2017-12-31	$944
Participant contributions at beginning of year	2017-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$403,871
Administrative expenses (other) incurred	2017-12-31	$1,500
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	$1,358,569
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$5,851,886
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$4,493,317
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	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$0
Value of interest in pooled separate accounts at end of year	2017-12-31	$5,767,523
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$4,462,336
Interest on participant loans	2017-12-31	$3,604
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$0
Net investment gain/loss from pooled separate accounts	2017-12-31	$850,690
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	$178,223
Employer contributions (assets) at end of year	2017-12-31	$544
Employer contributions (assets) at beginning of year	2017-12-31	$344
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$499,160
Contract administrator fees	2017-12-31	$198
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	CARON & BLETZER, PLLC
Accountancy firm EIN	2017-12-31	043499945

Form 5500 Responses for FIVOS, INC. 401(K) PLAN

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

Insurance Providers Used on plan

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

Policy contract number

1261284-01

Policy instance

Insurance contract or identification number	1261284-01
Number of Individuals Covered	3
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?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

Policy instance

Number of Individuals Covered	107
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $37,176
Amount paid for insurance broker fees	23878
Additional information about fees paid to insurance broker	BROKER COMMISSION
Insurance broker organization code?	7

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

Policy contract number

Policy instance

Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $32,576
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	20169
Additional information about fees paid to insurance broker	BROKER COMMISSION
Insurance broker organization code?	7

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

Policy contract number

Policy instance

Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $26,247
Amount paid for insurance broker fees	17926
Additional information about fees paid to insurance broker	BROKER COMMISSION
Insurance broker organization code?	7

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

Policy contract number

Policy instance

Number of Individuals Covered	94
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $17,646
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	13454
Additional information about fees paid to insurance broker	BROKER COMMISSION
Insurance broker organization code?	7
Insurance broker name	THE PENSION SERVICE

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Company Name:	FIVOS INC.
Employer identification number (EIN):	451573625
NAIC Classification:	621510
NAIC Description:	Medical and Diagnostic Laboratories

Jurisdiction of Incorporation:	Washington Secretary of State Corporations Division
Incorporation Date:	2007-01-04
Company Identification Number:	602682609
Legal Registered Office Address:	500 UNION ST STE 800 SEATTLE United States of America (USA) 98101