401k Plan data: OPTIMUM HIT LLC 401K PROFIT SHARING PLAN & TRUST plan

OPTIMUM HIT LLC 401K PROFIT SHARING PLAN & TRUST 401k Plan overview

Plan Name	OPTIMUM HIT LLC 401K PROFIT SHARING PLAN & TRUST
Plan identification number	001

OPTIMUM HIT LLC 401K PROFIT SHARING PLAN & TRUST 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

OPTIMUM HEALTHCARE IT LLC has sponsored the creation of one or more 401k plans.

Company Name: OPTIMUM HEALTHCARE IT LLC

Employer identification number (EIN): 454481569

NAIC Classification: 541600

Form 5500 Filing Information

Submission information for form 5500 for 401k plan OPTIMUM HIT LLC 401K PROFIT SHARING PLAN & TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01 JENNIFER MAHONEY 2023-10-09
001 2021-01-01 SUSAN M. MORGAN 2022-10-24
001 2020-01-01 SUSAN M. MORGAN 2021-10-11
001 2019-01-01 SUSAN M. MORGAN 2020-09-22
001 2018-01-01 SUSAN M. MORGAN 2019-10-15
001 2018-01-01 SUSAN M. MORGAN 2019-10-31
001 2018-01-01 SUSAN M. MORGAN 2020-09-22
001 2017-01-01 SUSAN M. MORGAN SUSAN M. MORGAN 2018-10-15
001 2016-01-01 SUSAN M. MORGAN
001 2015-01-01 SUSAN M. MORGAN
001 2015-01-01 SUSAN M. MORGAN
001 2014-01-01 SUSIE MORGAN
001 2013-01-01 LYDIA VEAL 2014-06-02
001 2012-01-01 GENE SCHEURER 2013-07-31

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2022-01-01	JENNIFER MAHONEY	2023-10-09
001	2021-01-01	SUSAN M. MORGAN	2022-10-24
001	2020-01-01	SUSAN M. MORGAN	2021-10-11
001	2019-01-01	SUSAN M. MORGAN	2020-09-22
001	2018-01-01	SUSAN M. MORGAN	2019-10-15
001	2018-01-01	SUSAN M. MORGAN	2019-10-31
001	2018-01-01	SUSAN M. MORGAN	2020-09-22
001	2017-01-01	SUSAN M. MORGAN		SUSAN M. MORGAN	2018-10-15
001	2016-01-01	SUSAN M. MORGAN
001	2015-01-01	SUSAN M. MORGAN
001	2015-01-01	SUSAN M. MORGAN
001	2014-01-01	SUSIE MORGAN
001	2013-01-01	LYDIA VEAL	2014-06-02
001	2012-01-01	GENE SCHEURER	2013-07-31

Plan Statistics for OPTIMUM HIT LLC 401K PROFIT SHARING PLAN & TRUST

401k plan membership statisitcs for OPTIMUM HIT LLC 401K PROFIT SHARING PLAN & TRUST

Measure Date Value
2022: OPTIMUM HIT LLC 401K PROFIT SHARING PLAN & TRUST 2022 401k membership
Total participants, beginning-of-year 2022-01-01 640
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 321
Number of retired or separated participants receiving benefits 2022-01-01 128
Number of other retired or separated participants entitled to future benefits 2022-01-01 0
Total of all active and inactive participants 2022-01-01 449
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 449
Number of participants with account balances 2022-01-01 321
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 23
2021: OPTIMUM HIT LLC 401K PROFIT SHARING PLAN & TRUST 2021 401k membership
Total participants, beginning-of-year 2021-01-01 291
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 170
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 85
Total of all active and inactive participants 2021-01-01 255
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 255
Number of participants with account balances 2021-01-01 255
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: OPTIMUM HIT LLC 401K PROFIT SHARING PLAN & TRUST 2020 401k membership
Total participants, beginning-of-year 2020-01-01 298
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 273
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 18
Total of all active and inactive participants 2020-01-01 291
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 291
Number of participants with account balances 2020-01-01 117
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: OPTIMUM HIT LLC 401K PROFIT SHARING PLAN & TRUST 2019 401k membership
Total participants, beginning-of-year 2019-01-01 640
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 349
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 93
Total of all active and inactive participants 2019-01-01 442
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 442
Number of participants with account balances 2019-01-01 209
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: OPTIMUM HIT LLC 401K PROFIT SHARING PLAN & TRUST 2018 401k membership
Total participants, beginning-of-year 2018-01-01 350
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 393
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 68
Total of all active and inactive participants 2018-01-01 461
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 461
Number of participants with account balances 2018-01-01 277
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: OPTIMUM HIT LLC 401K PROFIT SHARING PLAN & TRUST 2017 401k membership
Total participants, beginning-of-year 2017-01-01 578
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 255
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 95
Total of all active and inactive participants 2017-01-01 350
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 350
Number of participants with account balances 2017-01-01 238
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: OPTIMUM HIT LLC 401K PROFIT SHARING PLAN & TRUST 2016 401k membership
Total participants, beginning-of-year 2016-01-01 513
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 387
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 64
Total of all active and inactive participants 2016-01-01 451
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 451
Number of participants with account balances 2016-01-01 173
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: OPTIMUM HIT LLC 401K PROFIT SHARING PLAN & TRUST 2015 401k membership
Total participants, beginning-of-year 2015-01-01 325
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 409
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 33
Total of all active and inactive participants 2015-01-01 442
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 442
Number of participants with account balances 2015-01-01 119
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: OPTIMUM HIT LLC 401K PROFIT SHARING PLAN & TRUST 2014 401k membership
Total participants, beginning-of-year 2014-01-01 245
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 214
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 20
Total of all active and inactive participants 2014-01-01 234
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 234
Number of participants with account balances 2014-01-01 64
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0

Measure	Date	Value
2022: OPTIMUM HIT LLC 401K PROFIT SHARING PLAN & TRUST 2022 401k membership
Total participants, beginning-of-year	2022-01-01	640
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	321
Number of retired or separated participants receiving benefits	2022-01-01	128
Number of other retired or separated participants entitled to future benefits	2022-01-01	0
Total of all active and inactive participants	2022-01-01	449
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	449
Number of participants with account balances	2022-01-01	321
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	23
2021: OPTIMUM HIT LLC 401K PROFIT SHARING PLAN & TRUST 2021 401k membership
Total participants, beginning-of-year	2021-01-01	291
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	170
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	85
Total of all active and inactive participants	2021-01-01	255
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	255
Number of participants with account balances	2021-01-01	255
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: OPTIMUM HIT LLC 401K PROFIT SHARING PLAN & TRUST 2020 401k membership
Total participants, beginning-of-year	2020-01-01	298
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	273
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	18
Total of all active and inactive participants	2020-01-01	291
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	291
Number of participants with account balances	2020-01-01	117
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: OPTIMUM HIT LLC 401K PROFIT SHARING PLAN & TRUST 2019 401k membership
Total participants, beginning-of-year	2019-01-01	640
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	349
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	93
Total of all active and inactive participants	2019-01-01	442
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	442
Number of participants with account balances	2019-01-01	209
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: OPTIMUM HIT LLC 401K PROFIT SHARING PLAN & TRUST 2018 401k membership
Total participants, beginning-of-year	2018-01-01	350
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	393
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	68
Total of all active and inactive participants	2018-01-01	461
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	461
Number of participants with account balances	2018-01-01	277
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: OPTIMUM HIT LLC 401K PROFIT SHARING PLAN & TRUST 2017 401k membership
Total participants, beginning-of-year	2017-01-01	578
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	255
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	95
Total of all active and inactive participants	2017-01-01	350
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	350
Number of participants with account balances	2017-01-01	238
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: OPTIMUM HIT LLC 401K PROFIT SHARING PLAN & TRUST 2016 401k membership
Total participants, beginning-of-year	2016-01-01	513
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	387
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	64
Total of all active and inactive participants	2016-01-01	451
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	451
Number of participants with account balances	2016-01-01	173
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: OPTIMUM HIT LLC 401K PROFIT SHARING PLAN & TRUST 2015 401k membership
Total participants, beginning-of-year	2015-01-01	325
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	409
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	33
Total of all active and inactive participants	2015-01-01	442
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	442
Number of participants with account balances	2015-01-01	119
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: OPTIMUM HIT LLC 401K PROFIT SHARING PLAN & TRUST 2014 401k membership
Total participants, beginning-of-year	2014-01-01	245
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	214
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	20
Total of all active and inactive participants	2014-01-01	234
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	234
Number of participants with account balances	2014-01-01	64
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0

Financial Data on OPTIMUM HIT LLC 401K PROFIT SHARING PLAN & TRUST

Measure	Date	Value
2022 : OPTIMUM HIT LLC 401K PROFIT SHARING PLAN & TRUST 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	$1,874,408
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$1,219,775
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$1,145,362
Expenses. Certain deemed distributions of participant loans	2022-12-31	$9,061
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$3,612,147
Value of total assets at end of year	2022-12-31	$10,246,484
Value of total assets at beginning of year	2022-12-31	$9,591,851
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$65,352
Total interest from all sources	2022-12-31	$5,608
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$395,915
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	$395,915
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	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$2,272,336
Participant contributions at end of year	2022-12-31	$113,431
Participant contributions at beginning of year	2022-12-31	$111,199
Participant contributions at end of year	2022-12-31	$0
Participant contributions at beginning of year	2022-12-31	$1,495
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$931,459
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
Total non interest bearing cash at end of year	2022-12-31	$6,712
Total non interest bearing cash at beginning of year	2022-12-31	$4,873
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	$654,633
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$10,246,484
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$9,591,851
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
Investment advisory and management fees	2022-12-31	$65,352
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$9,708,503
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$9,245,428
Interest on participant loans	2022-12-31	$5,608
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 funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$246,232
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$228,856
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-2,139,262
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	$408,352
Employer contributions (assets) at end of year	2022-12-31	$171,606
Employer contributions (assets) at beginning of year	2022-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$1,145,362
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	FORVIS LLP
Accountancy firm EIN	2022-12-31	440160260
2021 : OPTIMUM HIT LLC 401K PROFIT SHARING PLAN & TRUST 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	$3,359,651
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$1,437,533
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$1,382,239
Expenses. Certain deemed distributions of participant loans	2021-12-31	$2,335
Value of total corrective distributions	2021-12-31	$18
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$2,043,726
Value of total assets at end of year	2021-12-31	$9,591,851
Value of total assets at beginning of year	2021-12-31	$7,669,733
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$52,941
Total interest from all sources	2021-12-31	$5,705
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$447,138
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	$447,138
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
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	$1,609,097
Participant contributions at end of year	2021-12-31	$111,199
Participant contributions at beginning of year	2021-12-31	$130,557
Participant contributions at end of year	2021-12-31	$1,495
Participant contributions at beginning of year	2021-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$434,629
Value of other receiveables (less allowance for doubtful accounts) at end of year	2021-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2021-12-31	$0
Total non interest bearing cash at end of year	2021-12-31	$4,873
Total non interest bearing cash at beginning of year	2021-12-31	$4,829
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	$1,922,118
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$9,591,851
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$7,669,733
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	$9,245,428
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$7,325,082
Interest on participant loans	2021-12-31	$5,705
Income. Interest from US Government securities	2021-12-31	$0
Income. Interest from corporate debt instruments	2021-12-31	$0
Value of interest in common/collective trusts at end of year	2021-12-31	$0
Value of interest in common/collective trusts at beginning of year	2021-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$228,856
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$209,265
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$863,082
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	$0
Employer contributions (assets) at end of year	2021-12-31	$0
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	$1,382,239
Contract administrator fees	2021-12-31	$52,941
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	FORVIS, LLP
Accountancy firm EIN	2021-12-31	440160260
2020 : OPTIMUM HIT LLC 401K PROFIT SHARING PLAN & TRUST 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	$2,939,817
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$2,324,371
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$2,021,081
Value of total corrective distributions	2020-12-31	$261,855
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$1,727,208
Value of total assets at end of year	2020-12-31	$7,669,733
Value of total assets at beginning of year	2020-12-31	$7,054,287
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$41,435
Total interest from all sources	2020-12-31	$6,594
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$254,521
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	$254,521
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
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	$1,359,475
Participant contributions at end of year	2020-12-31	$130,557
Participant contributions at beginning of year	2020-12-31	$130,959
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	$367,733
Value of other receiveables (less allowance for doubtful accounts) at end of year	2020-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2020-12-31	$0
Total non interest bearing cash at end of year	2020-12-31	$4,829
Total non interest bearing cash at beginning of year	2020-12-31	$4,780
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	$615,446
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$7,669,733
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$7,054,287
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	$7,325,082
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$6,763,111
Interest on participant loans	2020-12-31	$6,594
Income. Interest from US Government securities	2020-12-31	$0
Income. Interest from corporate debt instruments	2020-12-31	$0
Value of interest in common/collective trusts at end of year	2020-12-31	$0
Value of interest in common/collective trusts at beginning of year	2020-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$209,265
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$155,437
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$951,494
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	$0
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	$2,021,081
Contract administrator fees	2020-12-31	$41,435
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	DIXON HUGHES GOODMAN LLP
Accountancy firm EIN	2020-12-31	560747981
2019 : OPTIMUM HIT LLC 401K PROFIT SHARING PLAN & TRUST 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	$3,042,782
Total income from all sources (including contributions)	2019-12-31	$3,042,782
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	$2,086,564
Total of all expenses incurred	2019-12-31	$2,086,564
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$2,036,117
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$2,036,117
Value of total corrective distributions	2019-12-31	$12,104
Value of total corrective distributions	2019-12-31	$12,104
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$1,622,577
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$1,622,577
Value of total assets at end of year	2019-12-31	$7,054,287
Value of total assets at end of year	2019-12-31	$7,054,287
Value of total assets at beginning of year	2019-12-31	$6,098,069
Value of total assets at beginning of year	2019-12-31	$6,098,069
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$38,343
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$38,343
Total interest from all sources	2019-12-31	$7,714
Total interest from all sources	2019-12-31	$7,714
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$242,628
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$242,628
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	$242,628
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$242,628
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	$500,000
Value of fidelity bond cover	2019-12-31	$500,000
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	$1,315,513
Participant contributions at end of year	2019-12-31	$130,959
Participant contributions at end of year	2019-12-31	$130,959
Participant contributions at beginning of year	2019-12-31	$125,488
Participant contributions at beginning of year	2019-12-31	$125,488
Participant contributions at end of year	2019-12-31	$0
Participant contributions at end of year	2019-12-31	$0
Participant contributions at beginning of year	2019-12-31	$0
Participant contributions at beginning of year	2019-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$307,064
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$307,064
Value of other receiveables (less allowance for doubtful accounts) at end of year	2019-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2019-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2019-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2019-12-31	$0
Total non interest bearing cash at end of year	2019-12-31	$4,780
Total non interest bearing cash at beginning of year	2019-12-31	$0
Total non interest bearing cash at beginning of year	2019-12-31	$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	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
Income. Non cash contributions	2019-12-31	$0
Income. Non cash contributions	2019-12-31	$0
Value of net income/loss	2019-12-31	$956,218
Value of net income/loss	2019-12-31	$956,218
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$7,054,287
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$7,054,287
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$6,098,069
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$6,098,069
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	$6,763,111
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$6,763,111
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$5,889,395
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$5,889,395
Interest on participant loans	2019-12-31	$7,714
Interest on participant loans	2019-12-31	$7,714
Income. Interest from US Government securities	2019-12-31	$0
Income. Interest from US Government securities	2019-12-31	$0
Income. Interest from corporate debt instruments	2019-12-31	$0
Value of interest in common/collective trusts at end of year	2019-12-31	$0
Value of interest in common/collective trusts at end of year	2019-12-31	$0
Value of interest in common/collective trusts at beginning of year	2019-12-31	$0
Value of interest in common/collective trusts at beginning of year	2019-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$155,437
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$155,437
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$83,186
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$83,186
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$1,169,863
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$1,169,863
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	$0
Contributions received in cash from employer	2019-12-31	$0
Employer contributions (assets) at end of year	2019-12-31	$0
Employer contributions (assets) at end of year	2019-12-31	$0
Employer contributions (assets) at beginning 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	$2,036,117
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$2,036,117
Contract administrator fees	2019-12-31	$38,343
Contract administrator fees	2019-12-31	$38,343
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	DIXON HUGHES GOODMAN LLP
Accountancy firm name	2019-12-31	DIXON HUGHES GOODMAN LLP
Accountancy firm EIN	2019-12-31	560747981
Accountancy firm EIN	2019-12-31	560747981
2018 : OPTIMUM HIT LLC 401K PROFIT SHARING PLAN & TRUST 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	$1,468,063
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$1,778,979
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$1,631,592
Expenses. Certain deemed distributions of participant loans	2018-12-31	$638
Value of total corrective distributions	2018-12-31	$104,688
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$1,978,198
Value of total assets at end of year	2018-12-31	$6,102,788
Value of total assets at beginning of year	2018-12-31	$6,413,704
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$42,061
Total interest from all sources	2018-12-31	$8,000
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$318,244
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	$318,244
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	Yes
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	$1,978,198
Participant contributions at end of year	2018-12-31	$125,488
Participant contributions at beginning of year	2018-12-31	$108,860
Participant contributions at end of year	2018-12-31	$0
Participant contributions at beginning of year	2018-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2018-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2018-12-31	$0
Other income not declared elsewhere	2018-12-31	$3,801
Total non interest bearing cash at end of year	2018-12-31	$4,719
Total non interest bearing cash at beginning of year	2018-12-31	$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	2018-12-31	No
Value of net income/loss	2018-12-31	$-310,916
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$6,102,788
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$6,413,704
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	$5,889,395
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$6,221,007
Interest on participant loans	2018-12-31	$8,000
Value of interest in common/collective trusts at end of year	2018-12-31	$0
Value of interest in common/collective trusts at beginning of year	2018-12-31	$83,837
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$83,186
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-840,180
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
Employer contributions (assets) at end of year	2018-12-31	$0
Employer contributions (assets) at beginning of year	2018-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$1,631,592
Contract administrator fees	2018-12-31	$42,061
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	2018-12-31	Yes
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	DIXON HUGHES GOODMAN LLP
Accountancy firm EIN	2018-12-31	560747981
2017 : OPTIMUM HIT LLC 401K PROFIT SHARING PLAN & TRUST 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total transfer of assets to this plan	2017-12-31	$0
Total transfer of assets from this plan	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	$3,069,922
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$683,616
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$680,510
Expenses. Certain deemed distributions of participant loans	2017-12-31	$181
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$2,171,578
Value of total assets at end of year	2017-12-31	$6,413,704
Value of total assets at beginning of year	2017-12-31	$4,027,398
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$2,925
Total interest from all sources	2017-12-31	$5,091
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$235,873
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	$235,873
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$403,000
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	$2,118,863
Participant contributions at end of year	2017-12-31	$108,860
Participant contributions at beginning of year	2017-12-31	$80,944
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$52,715
Administrative expenses (other) incurred	2017-12-31	$2,925
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	$2,386,306
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$6,413,704
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$4,027,398
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	$6,221,007
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$3,692,219
Interest on participant loans	2017-12-31	$5,091
Value of interest in common/collective trusts at end of year	2017-12-31	$83,837
Value of interest in common/collective trusts at beginning of year	2017-12-31	$254,235
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$645,403
Net investment gain or loss from common/collective trusts	2017-12-31	$11,977
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$680,510
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	DIXON HUGHES GOODMAN LLP
Accountancy firm EIN	2017-12-31	560747981
2016 : OPTIMUM HIT LLC 401K PROFIT SHARING PLAN & TRUST 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total transfer of assets to this plan	2016-12-31	$0
Total transfer of assets from this plan	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	$2,389,269
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$494,799
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$489,363
Expenses. Certain deemed distributions of participant loans	2016-12-31	$3,461
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$2,112,828
Value of total assets at end of year	2016-12-31	$4,027,398
Value of total assets at beginning of year	2016-12-31	$2,132,928
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$1,975
Total interest from all sources	2016-12-31	$3,385
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$123,309
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	$123,309
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$214,000
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	$1,476,819
Participant contributions at end of year	2016-12-31	$80,944
Participant contributions at beginning of year	2016-12-31	$69,705
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$636,009
Other income not declared elsewhere	2016-12-31	$1,453
Administrative expenses (other) incurred	2016-12-31	$1,975
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	$1,894,470
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$4,027,398
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$2,132,928
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	$3,692,219
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$1,945,855
Interest on participant loans	2016-12-31	$3,385
Value of interest in common/collective trusts at end of year	2016-12-31	$254,235
Value of interest in common/collective trusts at beginning of year	2016-12-31	$117,368
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$105,176
Net investment gain or loss from common/collective trusts	2016-12-31	$43,118
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$489,363
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	DIXON HUGHES GOODMAN LLP
Accountancy firm EIN	2016-12-31	560747981
2015 : OPTIMUM HIT LLC 401K PROFIT SHARING PLAN & TRUST 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total transfer of assets to this plan	2015-12-31	$0
Total transfer of assets from this plan	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	$1,051,458
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$213,770
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$207,877
Expenses. Certain deemed distributions of participant loans	2015-12-31	$5
Value of total corrective distributions	2015-12-31	$3,613
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$1,088,685
Value of total assets at end of year	2015-12-31	$2,132,928
Value of total assets at beginning of year	2015-12-31	$1,295,240
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$2,275
Total interest from all sources	2015-12-31	$3,484
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$92,308
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	$92,308
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$130,000
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	$1,037,824
Participant contributions at end of year	2015-12-31	$69,705
Participant contributions at beginning of year	2015-12-31	$78,279
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$50,861
Administrative expenses (other) incurred	2015-12-31	$2,275
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	$837,688
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$2,132,928
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$1,295,240
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$1,945,855
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$1,178,107
Interest on participant loans	2015-12-31	$3,484
Value of interest in common/collective trusts at end of year	2015-12-31	$117,368
Value of interest in common/collective trusts at beginning of year	2015-12-31	$38,854
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-128,031
Net investment gain or loss from common/collective trusts	2015-12-31	$-4,988
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$207,877
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	DIXON HUGHES GOODMAN LLP
Accountancy firm EIN	2015-12-31	560747981
2014 : OPTIMUM HIT LLC 401K PROFIT SHARING PLAN & TRUST 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total transfer of assets to this plan	2014-12-31	$0
Total transfer of assets from this plan	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	$890,985
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$244,764
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$233,818
Expenses. Certain deemed distributions of participant loans	2014-12-31	$7,231
Value of total corrective distributions	2014-12-31	$1,140
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$839,543
Value of total assets at end of year	2014-12-31	$1,295,240
Value of total assets at beginning of year	2014-12-31	$649,019
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$2,575
Total interest from all sources	2014-12-31	$1,133
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$43,469
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	$43,469
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$65,000
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	$633,233
Participant contributions at end of year	2014-12-31	$78,279
Participant contributions at beginning of year	2014-12-31	$18,623
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$206,310
Administrative expenses (other) incurred	2014-12-31	$2,575
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$646,221
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$1,295,240
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$649,019
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$1,178,107
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$623,842
Interest on participant loans	2014-12-31	$1,133
Value of interest in common/collective trusts at end of year	2014-12-31	$38,854
Value of interest in common/collective trusts at beginning of year	2014-12-31	$6,554
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$5,636
Net investment gain or loss from common/collective trusts	2014-12-31	$1,204
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$233,818
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	DIXON HUGHES GOODMAN LLP
Accountancy firm EIN	2014-12-31	560747981

Form 5500 Responses for OPTIMUM HIT LLC 401K PROFIT SHARING PLAN & TRUST

2022: OPTIMUM HIT LLC 401K PROFIT SHARING PLAN & TRUST 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: OPTIMUM HIT LLC 401K PROFIT SHARING PLAN & TRUST 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: OPTIMUM HIT LLC 401K PROFIT SHARING PLAN & TRUST 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: OPTIMUM HIT LLC 401K PROFIT SHARING PLAN & TRUST 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: OPTIMUM HIT LLC 401K PROFIT SHARING PLAN & TRUST 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: OPTIMUM HIT LLC 401K PROFIT SHARING PLAN & TRUST 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: OPTIMUM HIT LLC 401K PROFIT SHARING PLAN & TRUST 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: OPTIMUM HIT LLC 401K PROFIT SHARING PLAN & TRUST 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	Yes
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: OPTIMUM HIT LLC 401K PROFIT SHARING PLAN & TRUST 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

Insurance Providers Used on plan

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

Policy contract number

504934-01

Policy instance

Insurance contract or identification number	504934-01
Number of Individuals Covered	52
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $702
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $351
Insurance broker organization code?	3

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

Policy contract number

504934-01

Policy instance

Insurance contract or identification number	504934-01
Number of Individuals Covered	39
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $642
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $321
Insurance broker organization code?	3

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

Policy contract number

504934-01

Policy instance

Insurance contract or identification number	504934-01
Number of Individuals Covered	34
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $582
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $291
Insurance broker organization code?	3

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

Policy contract number

504934-01

Policy instance

Insurance contract or identification number	504934-01
Number of Individuals Covered	32
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $436
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $218
Insurance broker organization code?	3

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

Policy contract number

504934-01

Policy instance

Insurance contract or identification number	504934-01
Number of Individuals Covered	461
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
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?	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:	OPTIMUM HEALTHCARE IT LLC
Employer identification number (EIN):	454481569
NAIC Classification:	541600