401k Plan data: OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN plan

OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan Name	OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN
Plan identification number	004

OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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

401k Sponsoring company profile

OBSTETRICIANS & GYNECOLOGISTS, P.C. has sponsored the creation of one or more 401k plans.

Company Name: OBSTETRICIANS & GYNECOLOGISTS, P.C.

Employer identification number (EIN): 470603320

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
004 2022-01-01
004 2021-01-01
004 2020-01-01 TODD PANKRATZ 2021-10-03 TODD PANKRATZ 2021-10-03
004 2019-01-01 TODD PANKRATZ 2020-10-01 TODD PANKRATZ 2020-10-01
004 2018-01-01 TODD PANKRATZ 2019-09-09
004 2017-01-01
004 2016-01-01 MICHAEL KRINGS
004 2015-01-01 MICHAEL KRINGS
004 2014-01-01 MICHAEL KRINGS
004 2013-01-01 GEORGE ADAM
004 2012-01-01 GEORGE ADAM
004 2011-01-01 GEORGE ADAM
004 2010-01-01 GEORGE ADAM
004 2009-01-01 GEORGE ADAM

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
004	2022-01-01
004	2021-01-01
004	2020-01-01	TODD PANKRATZ	2021-10-03	TODD PANKRATZ	2021-10-03
004	2019-01-01	TODD PANKRATZ	2020-10-01	TODD PANKRATZ	2020-10-01
004	2018-01-01	TODD PANKRATZ	2019-09-09
004	2017-01-01
004	2016-01-01	MICHAEL KRINGS
004	2015-01-01	MICHAEL KRINGS
004	2014-01-01	MICHAEL KRINGS
004	2013-01-01	GEORGE ADAM
004	2012-01-01	GEORGE ADAM
004	2011-01-01	GEORGE ADAM
004	2010-01-01	GEORGE ADAM
004	2009-01-01	GEORGE ADAM

Plan Statistics for OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN

Measure Date Value
2020: OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 55
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 43
Number of retired or separated participants receiving benefits 2020-01-01 5
Number of other retired or separated participants entitled to future benefits 2020-01-01 9
Total of all active and inactive participants 2020-01-01 57
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 57
Number of participants with account balances 2020-01-01 57
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 1
2019: OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 52
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 38
Number of retired or separated participants receiving benefits 2019-01-01 8
Number of other retired or separated participants entitled to future benefits 2019-01-01 9
Total of all active and inactive participants 2019-01-01 55
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 55
Number of participants with account balances 2019-01-01 55
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 5
2018: OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 49
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 36
Number of retired or separated participants receiving benefits 2018-01-01 5
Number of other retired or separated participants entitled to future benefits 2018-01-01 8
Total of all active and inactive participants 2018-01-01 49
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 49
Number of participants with account balances 2018-01-01 49
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 5
2017: OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 45
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 40
Number of retired or separated participants receiving benefits 2017-01-01 3
Number of other retired or separated participants entitled to future benefits 2017-01-01 6
Total of all active and inactive participants 2017-01-01 49
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 49
Number of participants with account balances 2017-01-01 49
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 3
2016: OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 44
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 34
Number of retired or separated participants receiving benefits 2016-01-01 2
Number of other retired or separated participants entitled to future benefits 2016-01-01 6
Total of all active and inactive participants 2016-01-01 42
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 42
Number of participants with account balances 2016-01-01 42
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 4
2015: OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 36
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 29
Number of retired or separated participants receiving benefits 2015-01-01 3
Number of other retired or separated participants entitled to future benefits 2015-01-01 9
Total of all active and inactive participants 2015-01-01 41
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 41
Number of participants with account balances 2015-01-01 41
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 1
2014: OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 31
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 26
Number of retired or separated participants receiving benefits 2014-01-01 1
Number of other retired or separated participants entitled to future benefits 2014-01-01 5
Total of all active and inactive participants 2014-01-01 32
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 32
Number of participants with account balances 2014-01-01 32
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 2
2013: OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 27
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 26
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 4
Total of all active and inactive participants 2013-01-01 30
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 30
Number of participants with account balances 2013-01-01 30
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 1
2012: OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 23
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 25
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 1
Total of all active and inactive participants 2012-01-01 26
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 26
Number of participants with account balances 2012-01-01 26
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 20
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 21
Number of retired or separated participants receiving benefits 2011-01-01 1
Number of other retired or separated participants entitled to future benefits 2011-01-01 1
Total of all active and inactive participants 2011-01-01 23
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 23
Number of participants with account balances 2011-01-01 23
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 22
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 19
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 0
Total of all active and inactive participants 2010-01-01 19
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 19
Number of participants with account balances 2010-01-01 18
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 20
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 17
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 3
Total of all active and inactive participants 2009-01-01 20
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 20
Number of participants with account balances 2009-01-01 20
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2020: OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	55
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	43
Number of retired or separated participants receiving benefits	2020-01-01	5
Number of other retired or separated participants entitled to future benefits	2020-01-01	9
Total of all active and inactive participants	2020-01-01	57
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	57
Number of participants with account balances	2020-01-01	57
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	1
2019: OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	52
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	38
Number of retired or separated participants receiving benefits	2019-01-01	8
Number of other retired or separated participants entitled to future benefits	2019-01-01	9
Total of all active and inactive participants	2019-01-01	55
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	55
Number of participants with account balances	2019-01-01	55
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	5
2018: OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	49
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	36
Number of retired or separated participants receiving benefits	2018-01-01	5
Number of other retired or separated participants entitled to future benefits	2018-01-01	8
Total of all active and inactive participants	2018-01-01	49
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	49
Number of participants with account balances	2018-01-01	49
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	5
2017: OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	45
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	40
Number of retired or separated participants receiving benefits	2017-01-01	3
Number of other retired or separated participants entitled to future benefits	2017-01-01	6
Total of all active and inactive participants	2017-01-01	49
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	49
Number of participants with account balances	2017-01-01	49
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	3
2016: OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	44
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	34
Number of retired or separated participants receiving benefits	2016-01-01	2
Number of other retired or separated participants entitled to future benefits	2016-01-01	6
Total of all active and inactive participants	2016-01-01	42
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	42
Number of participants with account balances	2016-01-01	42
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	4
2015: OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	36
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	29
Number of retired or separated participants receiving benefits	2015-01-01	3
Number of other retired or separated participants entitled to future benefits	2015-01-01	9
Total of all active and inactive participants	2015-01-01	41
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	41
Number of participants with account balances	2015-01-01	41
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	1
2014: OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	31
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	26
Number of retired or separated participants receiving benefits	2014-01-01	1
Number of other retired or separated participants entitled to future benefits	2014-01-01	5
Total of all active and inactive participants	2014-01-01	32
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	32
Number of participants with account balances	2014-01-01	32
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	2
2013: OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	27
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	26
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	4
Total of all active and inactive participants	2013-01-01	30
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	30
Number of participants with account balances	2013-01-01	30
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	1
2012: OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	23
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	25
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	1
Total of all active and inactive participants	2012-01-01	26
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	26
Number of participants with account balances	2012-01-01	26
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	20
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	21
Number of retired or separated participants receiving benefits	2011-01-01	1
Number of other retired or separated participants entitled to future benefits	2011-01-01	1
Total of all active and inactive participants	2011-01-01	23
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	23
Number of participants with account balances	2011-01-01	23
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	22
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	19
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	0
Total of all active and inactive participants	2010-01-01	19
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	19
Number of participants with account balances	2010-01-01	18
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	20
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	17
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	3
Total of all active and inactive participants	2009-01-01	20
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	20
Number of participants with account balances	2009-01-01	20
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN

Measure	Date	Value
2020 : OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN 2020 401k financial data
Total income from all sources	2020-12-31	$2,197,273
Expenses. Total of all expenses incurred	2020-12-31	$133,286
Benefits paid (including direct rollovers)	2020-12-31	$133,286
Total plan assets at end of year	2020-12-31	$9,261,747
Total plan assets at beginning of year	2020-12-31	$7,197,760
Value of fidelity bond covering the plan	2020-12-31	$500,000
Total contributions received or receivable from participants	2020-12-31	$171,941
Contributions received from other sources (not participants or employers)	2020-12-31	$133,584
Other income received	2020-12-31	$1,715,027
Net income (gross income less expenses)	2020-12-31	$2,063,987
Net plan assets at end of year (total assets less liabilities)	2020-12-31	$9,261,747
Net plan assets at beginning of year (total assets less liabilities)	2020-12-31	$7,197,760
Assets. Value of assets in partnership/joint-venture interests	2020-12-31	$0
Total contributions received or receivable from employer(s)	2020-12-31	$176,721
2019 : OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN 2019 401k financial data
Total income from all sources	2019-12-31	$2,545,937
Expenses. Total of all expenses incurred	2019-12-31	$4,827,079
Benefits paid (including direct rollovers)	2019-12-31	$4,827,079
Total plan assets at end of year	2019-12-31	$7,197,760
Total plan assets at beginning of year	2019-12-31	$9,478,902
Value of fidelity bond covering the plan	2019-12-31	$500,000
Total contributions received or receivable from participants	2019-12-31	$155,003
Contributions received from other sources (not participants or employers)	2019-12-31	$34,415
Other income received	2019-12-31	$2,149,738
Net income (gross income less expenses)	2019-12-31	$-2,281,142
Net plan assets at end of year (total assets less liabilities)	2019-12-31	$7,197,760
Net plan assets at beginning of year (total assets less liabilities)	2019-12-31	$9,478,902
Assets. Value of assets in partnership/joint-venture interests	2019-12-31	$52,213
Total contributions received or receivable from employer(s)	2019-12-31	$206,781
2018 : OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN 2018 401k financial data
Total income from all sources	2018-12-31	$112,726
Expenses. Total of all expenses incurred	2018-12-31	$194,472
Benefits paid (including direct rollovers)	2018-12-31	$194,472
Total plan assets at end of year	2018-12-31	$9,478,902
Total plan assets at beginning of year	2018-12-31	$9,560,648
Value of fidelity bond covering the plan	2018-12-31	$500,000
Total contributions received or receivable from participants	2018-12-31	$141,514
Contributions received from other sources (not participants or employers)	2018-12-31	$242,408
Other income received	2018-12-31	$-470,877
Net income (gross income less expenses)	2018-12-31	$-81,746
Net plan assets at end of year (total assets less liabilities)	2018-12-31	$9,478,902
Net plan assets at beginning of year (total assets less liabilities)	2018-12-31	$9,560,648
Assets. Value of assets in partnership/joint-venture interests	2018-12-31	$0
Total contributions received or receivable from employer(s)	2018-12-31	$199,681
2017 : OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN 2017 401k financial data
Total income from all sources	2017-12-31	$2,031,089
Expenses. Total of all expenses incurred	2017-12-31	$1,934,401
Benefits paid (including direct rollovers)	2017-12-31	$1,934,401
Total plan assets at end of year	2017-12-31	$9,560,648
Total plan assets at beginning of year	2017-12-31	$9,463,960
Value of fidelity bond covering the plan	2017-12-31	$500,000
Total contributions received or receivable from participants	2017-12-31	$118,955
Contributions received from other sources (not participants or employers)	2017-12-31	$217,758
Other income received	2017-12-31	$1,543,828
Net income (gross income less expenses)	2017-12-31	$96,688
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$9,560,648
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$9,463,960
Assets. Value of assets in partnership/joint-venture interests	2017-12-31	$746
Total contributions received or receivable from employer(s)	2017-12-31	$150,548
2016 : OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN 2016 401k financial data
Total income from all sources	2016-12-31	$800,687
Expenses. Total of all expenses incurred	2016-12-31	$680,971
Benefits paid (including direct rollovers)	2016-12-31	$680,971
Total plan assets at end of year	2016-12-31	$9,463,960
Total plan assets at beginning of year	2016-12-31	$9,344,244
Value of fidelity bond covering the plan	2016-12-31	$500,000
Total contributions received or receivable from participants	2016-12-31	$112,780
Contributions received from other sources (not participants or employers)	2016-12-31	$39,089
Other income received	2016-12-31	$474,331
Net income (gross income less expenses)	2016-12-31	$119,716
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$9,463,960
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$9,344,244
Assets. Value of assets in partnership/joint-venture interests	2016-12-31	$4,487
Total contributions received or receivable from employer(s)	2016-12-31	$174,487
2015 : OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN 2015 401k financial data
Total income from all sources	2015-12-31	$348,801
Expenses. Total of all expenses incurred	2015-12-31	$14,424
Benefits paid (including direct rollovers)	2015-12-31	$14,424
Total plan assets at end of year	2015-12-31	$9,344,244
Total plan assets at beginning of year	2015-12-31	$9,009,867
Value of fidelity bond covering the plan	2015-12-31	$525,000
Total contributions received or receivable from participants	2015-12-31	$105,946
Contributions received from other sources (not participants or employers)	2015-12-31	$2,386
Other income received	2015-12-31	$57,675
Net income (gross income less expenses)	2015-12-31	$334,377
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$9,344,244
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$9,009,867
Assets. Value of assets in partnership/joint-venture interests	2015-12-31	$4,544
Total contributions received or receivable from employer(s)	2015-12-31	$182,794
2014 : OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN 2014 401k financial data
Total income from all sources	2014-12-31	$897,302
Expenses. Total of all expenses incurred	2014-12-31	$1,977,847
Benefits paid (including direct rollovers)	2014-12-31	$1,977,847
Total plan assets at end of year	2014-12-31	$9,009,867
Total plan assets at beginning of year	2014-12-31	$10,090,412
Value of fidelity bond covering the plan	2014-12-31	$500,000
Total contributions received or receivable from participants	2014-12-31	$116,887
Contributions received from other sources (not participants or employers)	2014-12-31	$33,445
Other income received	2014-12-31	$544,493
Net income (gross income less expenses)	2014-12-31	$-1,080,545
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$9,009,867
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$10,090,412
Assets. Value of assets in partnership/joint-venture interests	2014-12-31	$7,911
Total contributions received or receivable from employer(s)	2014-12-31	$202,477
2013 : OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN 2013 401k financial data
Total income from all sources	2013-12-31	$1,817,053
Expenses. Total of all expenses incurred	2013-12-31	$36,660
Benefits paid (including direct rollovers)	2013-12-31	$36,660
Total plan assets at end of year	2013-12-31	$10,090,412
Total plan assets at beginning of year	2013-12-31	$8,310,019
Value of fidelity bond covering the plan	2013-12-31	$500,000
Total contributions received or receivable from participants	2013-12-31	$126,082
Contributions received from other sources (not participants or employers)	2013-12-31	$28,996
Other income received	2013-12-31	$1,455,976
Net income (gross income less expenses)	2013-12-31	$1,780,393
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$10,090,412
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$8,310,019
Assets. Value of assets in partnership/joint-venture interests	2013-12-31	$10,571
Total contributions received or receivable from employer(s)	2013-12-31	$205,999
2012 : OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$1,218,949
Expenses. Total of all expenses incurred	2012-12-31	$191,621
Benefits paid (including direct rollovers)	2012-12-31	$191,471
Total plan assets at end of year	2012-12-31	$8,310,019
Total plan assets at beginning of year	2012-12-31	$7,282,691
Value of fidelity bond covering the plan	2012-12-31	$500,000
Total contributions received or receivable from participants	2012-12-31	$117,465
Contributions received from other sources (not participants or employers)	2012-12-31	$44,957
Other income received	2012-12-31	$876,492
Net income (gross income less expenses)	2012-12-31	$1,027,328
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$8,310,019
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$7,282,691
Assets. Value of assets in partnership/joint-venture interests	2012-12-31	$13,101
Total contributions received or receivable from employer(s)	2012-12-31	$180,035
Expenses. Administrative service providers (salaries,fees and commissions)	2012-12-31	$150
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
2011 : OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$1,667,564
Expenses. Total of all expenses incurred	2011-12-31	$158,999
Benefits paid (including direct rollovers)	2011-12-31	$158,999
Total plan assets at end of year	2011-12-31	$7,282,691
Total plan assets at beginning of year	2011-12-31	$5,774,126
Value of fidelity bond covering the plan	2011-12-31	$500,000
Total contributions received or receivable from participants	2011-12-31	$106,985
Contributions received from other sources (not participants or employers)	2011-12-31	$1,447,327
Other income received	2011-12-31	$-43,188
Net income (gross income less expenses)	2011-12-31	$1,508,565
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$7,282,691
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$5,774,126
Assets. Value of assets in partnership/joint-venture interests	2011-12-31	$15,448
Total contributions received or receivable from employer(s)	2011-12-31	$156,440
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
2010 : OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN 2010 401k financial data
Total plan liabilities at end of year	2010-12-31	$0
Total plan liabilities at beginning of year	2010-12-31	$0
Total income from all sources	2010-12-31	$886,784
Expenses. Total of all expenses incurred	2010-12-31	$1,448,847
Benefits paid (including direct rollovers)	2010-12-31	$1,448,847
Total plan assets at end of year	2010-12-31	$5,774,126
Total plan assets at beginning of year	2010-12-31	$6,336,189
Value of fidelity bond covering the plan	2010-12-31	$500,000
Total contributions received or receivable from participants	2010-12-31	$97,469
Contributions received from other sources (not participants or employers)	2010-12-31	$237
Other income received	2010-12-31	$622,674
Net income (gross income less expenses)	2010-12-31	$-562,063
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$5,774,126
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$6,336,189
Assets. Value of assets in partnership/joint-venture interests	2010-12-31	$8,188
Total contributions received or receivable from employer(s)	2010-12-31	$166,404
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
2009 : OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN

2020: OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING 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 - Trust	Yes
2019: OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING 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 - Trust	Yes
2018: OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING 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 - Trust	Yes
2017: OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING 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 - Trust	Yes
2016: OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING 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 - Trust	Yes
2014: OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING 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 - Trust	Yes
2013: OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	Yes
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: OBSTETRICIANS & GYNECOLOGISTS, P.C. 401(K) PROFIT SHARING PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

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

Policy contract number

332267-01

Policy instance

Insurance contract or identification number	332267-01
Number of Individuals Covered	6
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $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
Insurance broker organization code?	3

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

Policy contract number

332267-01

Policy instance

Insurance contract or identification number	332267-01
Number of Individuals Covered	5
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $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
Insurance broker organization code?	3

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

Policy contract number

332267-01

Policy instance

Insurance contract or identification number	332267-01
Number of Individuals Covered	8
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $0
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
Insurance broker organization code?	3

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

Policy contract number

332267-01

Policy instance

Insurance contract or identification number	332267-01
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $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
Insurance broker organization code?	3
Insurance broker name

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

Policy contract number

332267-01

Policy instance

Insurance contract or identification number	332267-01
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $0
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
Insurance broker organization code?	3
Insurance broker name

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

Policy contract number

332267-01

Policy instance

Insurance contract or identification number	332267-01
Number of Individuals Covered	7
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $0
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
Insurance broker organization code?	3
Insurance broker name

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

Policy contract number

332267-01

Policy instance

Insurance contract or identification number	332267-01
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $243
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
Insurance broker organization code?	3
Commission paid to Insurance Broker	USD $243
Insurance broker name

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

Policy contract number

332267-01

Policy instance

Insurance contract or identification number	332267-01
Number of Individuals Covered	7
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $2,816
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
Commission paid to Insurance Broker	USD $2,816
Insurance broker organization code?	3
Insurance broker name	DOUGLAS OAKESON

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

Policy contract number

332267-01

Policy instance

Insurance contract or identification number	332267-01
Number of Individuals Covered	4
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $2,296
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

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Company Name:	OBSTETRICIANS & GYNECOLOGISTS, P.C.
Employer identification number (EIN):	470603320
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)