401k Plan data: COFFEE MEDICAL GROUP, LLC DBA UNITED REGIONAL MEDICAL CENTER 401(K) PLAN plan

COFFEE MEDICAL GROUP, LLC DBA UNITED REGIONAL MEDICAL CENTER 401(K) PLAN 401k Plan overview

Plan Name	COFFEE MEDICAL GROUP, LLC DBA UNITED REGIONAL MEDICAL CENTER 401(K) PLAN
Plan identification number	101

COFFEE MEDICAL GROUP, LLC DBA UNITED REGIONAL MEDICAL CENTER 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.
Plan covering Self-Employed individuals.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

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

Company Name: COFFEE MEDICAL GROUP, LLC

Employer identification number (EIN): 460485169

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COFFEE MEDICAL GROUP, LLC DBA UNITED REGIONAL MEDICAL CENTER 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
101 2021-01-01
101 2020-01-01
101 2019-01-01
101 2018-01-01
101 2017-01-01 PHIL TISUE
101 2016-01-01 PHIL TISUE
101 2016-01-01
101 2015-01-01 PHIL TISUE
101 2014-01-01 PHIL TISUE
101 2013-01-01 PHIL TISUE 2014-06-26
101 2012-01-01 PHIL TISUE 2013-09-25

Plan Statistics for COFFEE MEDICAL GROUP, LLC DBA UNITED REGIONAL MEDICAL CENTER 401(K) PLAN

401k plan membership statisitcs for COFFEE MEDICAL GROUP, LLC DBA UNITED REGIONAL MEDICAL CENTER 401(K) PLAN

Measure Date Value
2021: COFFEE MEDICAL GROUP, LLC DBA UNITED REGIONAL MEDICAL CENTER 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 230
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 205
Number of retired or separated participants receiving benefits 2021-01-01 1
Number of other retired or separated participants entitled to future benefits 2021-01-01 19
Total of all active and inactive participants 2021-01-01 225
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 225
Number of participants with account balances 2021-01-01 91
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 1
2020: COFFEE MEDICAL GROUP, LLC DBA UNITED REGIONAL MEDICAL CENTER 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 226
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 195
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 20
Total of all active and inactive participants 2020-01-01 215
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 215
Number of participants with account balances 2020-01-01 59
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 1
2019: COFFEE MEDICAL GROUP, LLC DBA UNITED REGIONAL MEDICAL CENTER 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 233
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 187
Number of retired or separated participants receiving benefits 2019-01-01 1
Number of other retired or separated participants entitled to future benefits 2019-01-01 19
Total of all active and inactive participants 2019-01-01 207
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 207
Number of participants with account balances 2019-01-01 60
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: COFFEE MEDICAL GROUP, LLC DBA UNITED REGIONAL MEDICAL CENTER 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 229
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 193
Number of retired or separated participants receiving benefits 2018-01-01 2
Number of other retired or separated participants entitled to future benefits 2018-01-01 20
Total of all active and inactive participants 2018-01-01 215
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 215
Number of participants with account balances 2018-01-01 64
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 1
2017: COFFEE MEDICAL GROUP, LLC DBA UNITED REGIONAL MEDICAL CENTER 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 231
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 188
Number of retired or separated participants receiving benefits 2017-01-01 1
Number of other retired or separated participants entitled to future benefits 2017-01-01 26
Total of all active and inactive participants 2017-01-01 215
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 215
Number of participants with account balances 2017-01-01 71
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: COFFEE MEDICAL GROUP, LLC DBA UNITED REGIONAL MEDICAL CENTER 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 226
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 186
Number of retired or separated participants receiving benefits 2016-01-01 1
Number of other retired or separated participants entitled to future benefits 2016-01-01 27
Total of all active and inactive participants 2016-01-01 214
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 214
Number of participants with account balances 2016-01-01 72
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 2
2015: COFFEE MEDICAL GROUP, LLC DBA UNITED REGIONAL MEDICAL CENTER 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 144
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 206
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 25
Total of all active and inactive participants 2015-01-01 231
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 231
Number of participants with account balances 2015-01-01 74
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: COFFEE MEDICAL GROUP, LLC DBA UNITED REGIONAL MEDICAL CENTER 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 161
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 117
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 27
Total of all active and inactive participants 2014-01-01 144
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 144
Number of participants with account balances 2014-01-01 65
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 2

Measure	Date	Value
2021: COFFEE MEDICAL GROUP, LLC DBA UNITED REGIONAL MEDICAL CENTER 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	230
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	205
Number of retired or separated participants receiving benefits	2021-01-01	1
Number of other retired or separated participants entitled to future benefits	2021-01-01	19
Total of all active and inactive participants	2021-01-01	225
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	225
Number of participants with account balances	2021-01-01	91
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	1
2020: COFFEE MEDICAL GROUP, LLC DBA UNITED REGIONAL MEDICAL CENTER 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	226
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	195
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	20
Total of all active and inactive participants	2020-01-01	215
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	215
Number of participants with account balances	2020-01-01	59
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	1
2019: COFFEE MEDICAL GROUP, LLC DBA UNITED REGIONAL MEDICAL CENTER 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	233
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	187
Number of retired or separated participants receiving benefits	2019-01-01	1
Number of other retired or separated participants entitled to future benefits	2019-01-01	19
Total of all active and inactive participants	2019-01-01	207
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	207
Number of participants with account balances	2019-01-01	60
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: COFFEE MEDICAL GROUP, LLC DBA UNITED REGIONAL MEDICAL CENTER 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	229
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	193
Number of retired or separated participants receiving benefits	2018-01-01	2
Number of other retired or separated participants entitled to future benefits	2018-01-01	20
Total of all active and inactive participants	2018-01-01	215
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	215
Number of participants with account balances	2018-01-01	64
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	1
2017: COFFEE MEDICAL GROUP, LLC DBA UNITED REGIONAL MEDICAL CENTER 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	231
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	188
Number of retired or separated participants receiving benefits	2017-01-01	1
Number of other retired or separated participants entitled to future benefits	2017-01-01	26
Total of all active and inactive participants	2017-01-01	215
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	215
Number of participants with account balances	2017-01-01	71
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: COFFEE MEDICAL GROUP, LLC DBA UNITED REGIONAL MEDICAL CENTER 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	226
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	186
Number of retired or separated participants receiving benefits	2016-01-01	1
Number of other retired or separated participants entitled to future benefits	2016-01-01	27
Total of all active and inactive participants	2016-01-01	214
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	214
Number of participants with account balances	2016-01-01	72
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	2
2015: COFFEE MEDICAL GROUP, LLC DBA UNITED REGIONAL MEDICAL CENTER 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	144
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	206
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	25
Total of all active and inactive participants	2015-01-01	231
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	231
Number of participants with account balances	2015-01-01	74
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: COFFEE MEDICAL GROUP, LLC DBA UNITED REGIONAL MEDICAL CENTER 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	161
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	117
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	27
Total of all active and inactive participants	2014-01-01	144
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	144
Number of participants with account balances	2014-01-01	65
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	2

Financial Data on COFFEE MEDICAL GROUP, LLC DBA UNITED REGIONAL MEDICAL CENTER 401(K) PLAN

Measure	Date	Value
2021 : COFFEE MEDICAL GROUP, LLC DBA UNITED REGIONAL MEDICAL CENTER 401(K) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$23,557
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$10,502
Total income from all sources (including contributions)	2021-12-31	$675,777
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$52,146
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$36,561
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$455,071
Value of total assets at end of year	2021-12-31	$2,323,258
Value of total assets at beginning of year	2021-12-31	$1,686,572
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$15,585
Total interest from all sources	2021-12-31	$3,854
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
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	$270,518
Participant contributions at end of year	2021-12-31	$15,299
Participant contributions at beginning of year	2021-12-31	$26,560
Participant contributions at end of year	2021-12-31	$0
Participant contributions at beginning of year	2021-12-31	$5,206
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$36,621
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2021-12-31	$23,557
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2021-12-31	$10,502
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$623,631
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$2,299,701
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$1,676,070
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	$2,096,474
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$1,487,462
Interest on participant loans	2021-12-31	$1,240
Interest earned on other investments	2021-12-31	$2,614
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$197,306
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$167,344
Net investment gain/loss from pooled separate accounts	2021-12-31	$216,852
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	$147,932
Employer contributions (assets) at end of year	2021-12-31	$14,179
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	$36,561
Contract administrator fees	2021-12-31	$15,585
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	COULTER & JUSTUS
Accountancy firm EIN	2021-12-31	621532536
2020 : COFFEE MEDICAL GROUP, LLC DBA UNITED REGIONAL MEDICAL CENTER 401(K) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$10,502
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	$429,936
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$208,123
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$201,909
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$177,117
Value of total assets at end of year	2020-12-31	$1,686,572
Value of total assets at beginning of year	2020-12-31	$1,454,257
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$6,214
Total interest from all sources	2020-12-31	$4,495
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$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	$177,117
Participant contributions at end of year	2020-12-31	$26,560
Participant contributions at beginning of year	2020-12-31	$40,850
Participant contributions at end of year	2020-12-31	$5,206
Participant contributions at beginning of year	2020-12-31	$13,526
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2020-12-31	$10,502
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) 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
Value of net income/loss	2020-12-31	$221,813
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$1,676,070
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$1,454,257
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	$1,487,462
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$1,254,570
Interest on participant loans	2020-12-31	$1,948
Interest earned on other investments	2020-12-31	$2,547
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$167,344
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$145,311
Net investment gain/loss from pooled separate accounts	2020-12-31	$248,324
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$201,909
Contract administrator fees	2020-12-31	$6,214
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	COULTER & JUSTUS
Accountancy firm EIN	2020-12-31	621532536
2019 : COFFEE MEDICAL GROUP, LLC DBA UNITED REGIONAL MEDICAL CENTER 401(K) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$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	$401,194
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$34,945
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$20,429
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$186,149
Value of total assets at end of year	2019-12-31	$1,454,257
Value of total assets at beginning of year	2019-12-31	$1,088,008
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$14,516
Total interest from all sources	2019-12-31	$4,464
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
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
Contributions received from participants	2019-12-31	$186,149
Participant contributions at end of year	2019-12-31	$40,850
Participant contributions at beginning of year	2019-12-31	$40,762
Participant contributions at end of year	2019-12-31	$13,526
Participant contributions at beginning of year	2019-12-31	$8,689
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2019-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) 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
Value of net income/loss	2019-12-31	$366,249
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$1,454,257
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$1,088,008
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
Value of interest in pooled separate accounts at end of year	2019-12-31	$1,254,570
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$908,028
Interest on participant loans	2019-12-31	$2,265
Interest earned on other investments	2019-12-31	$2,199
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$145,311
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$130,529
Net investment gain/loss from pooled separate accounts	2019-12-31	$210,581
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$20,429
Contract administrator fees	2019-12-31	$14,516
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	COULTER & JUSTUS
Accountancy firm EIN	2019-12-31	621532536
2018 : COFFEE MEDICAL GROUP, LLC DBA UNITED REGIONAL MEDICAL CENTER 401(K) PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$3,088
Total income from all sources (including contributions)	2018-12-31	$77,620
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$127,200
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$112,998
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$150,261
Value of total assets at end of year	2018-12-31	$1,088,008
Value of total assets at beginning of year	2018-12-31	$1,140,676
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$14,202
Total interest from all sources	2018-12-31	$3,421
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$500,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$150,261
Participant contributions at end of year	2018-12-31	$40,762
Participant contributions at beginning of year	2018-12-31	$19,090
Participant contributions at end of year	2018-12-31	$8,689
Participant contributions at beginning of year	2018-12-31	$8,842
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2018-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2018-12-31	$3,088
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	$-49,580
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$1,088,008
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$1,137,588
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 pooled separate accounts at end of year	2018-12-31	$908,028
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$1,097,308
Interest on participant loans	2018-12-31	$2,179
Interest earned on other investments	2018-12-31	$1,242
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$130,529
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$15,436
Net investment gain/loss from pooled separate accounts	2018-12-31	$-76,062
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$112,998
Contract administrator fees	2018-12-31	$14,202
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	No
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	COULTER & JUSTUS
Accountancy firm EIN	2018-12-31	621532536
2017 : COFFEE MEDICAL GROUP, LLC DBA UNITED REGIONAL MEDICAL CENTER 401(K) PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$3,088
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	$302,313
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$91,324
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$80,362
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$138,905
Value of total assets at end of year	2017-12-31	$1,140,676
Value of total assets at beginning of year	2017-12-31	$926,599
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$10,962
Total interest from all sources	2017-12-31	$417
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
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	$500,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$138,905
Participant contributions at end of year	2017-12-31	$19,090
Participant contributions at beginning of year	2017-12-31	$0
Participant contributions at end of year	2017-12-31	$8,842
Participant contributions at beginning of year	2017-12-31	$7,940
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2017-12-31	$3,088
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2017-12-31	$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	2017-12-31	No
Value of net income/loss	2017-12-31	$210,989
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$1,137,588
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$926,599
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 pooled separate accounts at end of year	2017-12-31	$1,097,308
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$905,998
Interest on participant loans	2017-12-31	$236
Interest earned on other investments	2017-12-31	$181
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$15,436
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$12,661
Net investment gain/loss from pooled separate accounts	2017-12-31	$162,991
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
Employer contributions (assets) at end of year	2017-12-31	$0
Employer contributions (assets) at beginning of year	2017-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$80,362
Contract administrator fees	2017-12-31	$10,962
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2017-12-31	No
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	COULTER & JUSTUS
Accountancy firm EIN	2017-12-31	621532536
2016 : COFFEE MEDICAL GROUP, LLC DBA UNITED REGIONAL MEDICAL CENTER 401(K) PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$235,971
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$100,187
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$87,307
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$173,883
Value of total assets at end of year	2016-12-31	$926,599
Value of total assets at beginning of year	2016-12-31	$790,815
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$12,880
Total interest from all sources	2016-12-31	$118
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Administrative expenses professional fees incurred	2016-12-31	$1,157
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$500,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$107,850
Participant contributions at end of year	2016-12-31	$7,940
Participant contributions at beginning of year	2016-12-31	$3,446
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$66,033
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	$135,784
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$926,599
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$790,815
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 pooled separate accounts at end of year	2016-12-31	$905,998
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$782,499
Interest earned on other investments	2016-12-31	$118
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$12,661
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$4,870
Net investment gain/loss from pooled separate accounts	2016-12-31	$61,970
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	Yes
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Employer contributions (assets) at end of year	2016-12-31	$0
Employer contributions (assets) at beginning of year	2016-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$87,307
Contract administrator fees	2016-12-31	$11,723
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	2016-12-31	No
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	COULTER & JUSTUS
Accountancy firm EIN	2016-12-31	621532536
2015 : COFFEE MEDICAL GROUP, LLC DBA UNITED REGIONAL MEDICAL CENTER 401(K) PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$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	$45,374
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$15,484
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$2,954
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$57,074
Value of total assets at end of year	2015-12-31	$790,815
Value of total assets at beginning of year	2015-12-31	$760,925
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$12,530
Total interest from all sources	2015-12-31	$84
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$500,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$57,074
Participant contributions at end of year	2015-12-31	$3,446
Participant contributions at beginning of year	2015-12-31	$1,466
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	$29,890
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$790,815
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$760,925
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 pooled separate accounts at end of year	2015-12-31	$782,499
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$750,900
Interest earned on other investments	2015-12-31	$84
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$4,870
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$8,559
Net investment gain/loss from pooled separate accounts	2015-12-31	$-11,784
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	Yes
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Employer contributions (assets) at end of year	2015-12-31	$0
Employer contributions (assets) at beginning of year	2015-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$2,954
Contract administrator fees	2015-12-31	$12,530
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	2015-12-31	No
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	COULTER & JUSTUS
Accountancy firm EIN	2015-12-31	621532536
2014 : COFFEE MEDICAL GROUP, LLC DBA UNITED REGIONAL MEDICAL CENTER 401(K) PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$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	$85,125
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$187,734
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$179,724
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$45,992
Value of total assets at end of year	2014-12-31	$760,925
Value of total assets at beginning of year	2014-12-31	$863,534
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$8,010
Total interest from all sources	2014-12-31	$133
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$500,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$45,992
Participant contributions at end of year	2014-12-31	$1,466
Participant contributions at beginning of year	2014-12-31	$1,695
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	$-102,609
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$760,925
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$863,534
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 pooled separate accounts at end of year	2014-12-31	$750,900
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$855,342
Interest earned on other investments	2014-12-31	$133
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$8,559
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$6,497
Net investment gain/loss from pooled separate accounts	2014-12-31	$39,000
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	Yes
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Employer contributions (assets) at end of year	2014-12-31	$0
Employer contributions (assets) at beginning of year	2014-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$179,724
Contract administrator fees	2014-12-31	$8,010
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	COULTER & JUSTUS
Accountancy firm EIN	2014-12-31	621532536

Form 5500 Responses for COFFEE MEDICAL GROUP, LLC DBA UNITED REGIONAL MEDICAL CENTER 401(K) PLAN

2021: COFFEE MEDICAL GROUP, LLC DBA UNITED REGIONAL MEDICAL CENTER 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: COFFEE MEDICAL GROUP, LLC DBA UNITED REGIONAL MEDICAL CENTER 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: COFFEE MEDICAL GROUP, LLC DBA UNITED REGIONAL MEDICAL CENTER 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: COFFEE MEDICAL GROUP, LLC DBA UNITED REGIONAL MEDICAL CENTER 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: COFFEE MEDICAL GROUP, LLC DBA UNITED REGIONAL MEDICAL CENTER 401(K) PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: COFFEE MEDICAL GROUP, LLC DBA UNITED REGIONAL MEDICAL CENTER 401(K) PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	Yes
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 – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: COFFEE MEDICAL GROUP, LLC DBA UNITED REGIONAL MEDICAL CENTER 401(K) PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: COFFEE MEDICAL GROUP, LLC DBA UNITED REGIONAL MEDICAL CENTER 401(K) PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

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

Policy contract number

931061-00052

Policy instance

Insurance contract or identification number	931061-00052
Number of Individuals Covered	240
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $8,735
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 $8,735
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3

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

Policy contract number

931061-00052

Policy instance

Insurance contract or identification number	931061-00052
Number of Individuals Covered	225
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $7,949
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 $7,949
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3

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

Policy contract number

931061-00052

Policy instance

Insurance contract or identification number	931061-00052
Number of Individuals Covered	215
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $5,456
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 $5,456
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3

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

Policy contract number

931061-00052

Policy instance

Insurance contract or identification number	931061-00052
Number of Individuals Covered	207
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $4,890
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 $4,890
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3

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

Policy contract number

931061-052

Policy instance

Insurance contract or identification number	931061-052
Number of Individuals Covered	215
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $4,066
Total amount of fees paid to insurance company	USD $421
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 $4,066
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3
Insurance broker name	TAG RESOURCES, LLC

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

Policy contract number

931061-052

Policy instance

Insurance contract or identification number	931061-052
Number of Individuals Covered	231
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $3,110
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $1,555
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	0.00
Insurance broker organization code?	3
Insurance broker name	FSC AGENCY INC

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

Policy contract number

931061-052

Policy instance

Insurance contract or identification number	931061-052
Number of Individuals Covered	144
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $3,144
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating 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 $1,572
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	0.00
Insurance broker organization code?	3
Insurance broker name	FSC AGENCY INC

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Company Name:	COFFEE MEDICAL GROUP, LLC
Employer identification number (EIN):	460485169
NAIC Classification:	622000
NAIC Description:	Hospitals