401k Plan data: BEVERLY PATHOLOGY, INC. 401(K) PROFIT SHARING PLAN plan

BEVERLY PATHOLOGY, INC. 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan Name	BEVERLY PATHOLOGY, INC. 401(K) PROFIT SHARING PLAN
Plan identification number	004

BEVERLY PATHOLOGY, INC. 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.
Participant-directed brokerage accounts provided as an investment option under the plan.
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

BEVERLY PATHOLOGY, INC. has sponsored the creation of one or more 401k plans.

Company Name: BEVERLY PATHOLOGY, INC.

Employer identification number (EIN): 471564915

NAIC Classification: 812990
NAIC Description: All Other Personal Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BEVERLY PATHOLOGY, INC. 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
004 2023-01-01 BRADLEY ROSBOROUGH 2024-08-27
004 2022-01-01 BRADLEY ROSBOROUGH 2023-10-12
004 2021-01-01 BRADLEY ROSBOROUGH 2022-06-22 BRADLEY ROSBOROUGH 2022-06-22
004 2020-01-01 BRADLEY ROSBOROUGH 2021-09-07
004 2019-01-01 DANIEL LUTHRINGER 2020-10-12 DANIEL LUTHRINGER 2020-10-12
004 2018-01-01 DANIEL LUTHRINGER 2019-10-02
004 2017-01-01
004 2016-01-01
004 2015-01-01

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
004	2023-01-01	BRADLEY ROSBOROUGH	2024-08-27
004	2022-01-01	BRADLEY ROSBOROUGH	2023-10-12
004	2021-01-01	BRADLEY ROSBOROUGH	2022-06-22	BRADLEY ROSBOROUGH	2022-06-22
004	2020-01-01	BRADLEY ROSBOROUGH	2021-09-07
004	2019-01-01	DANIEL LUTHRINGER	2020-10-12	DANIEL LUTHRINGER	2020-10-12
004	2018-01-01	DANIEL LUTHRINGER	2019-10-02
004	2017-01-01
004	2016-01-01
004	2015-01-01

Financial Data on BEVERLY PATHOLOGY, INC. 401(K) PROFIT SHARING PLAN

Measure	Date	Value
2023 : BEVERLY PATHOLOGY, INC. 401(K) PROFIT SHARING PLAN 2023 401k financial data
Transfers to/from the plan	2023-12-31	$0
Total plan liabilities at end of year	2023-12-31	$0
Total plan liabilities at beginning of year	2023-12-31	$0
Total income from all sources	2023-12-31	$5,245,191
Expenses. Total of all expenses incurred	2023-12-31	$633,335
Benefits paid (including direct rollovers)	2023-12-31	$622,043
Total plan assets at end of year	2023-12-31	$23,370,386
Total plan assets at beginning of year	2023-12-31	$18,758,530
Value of fidelity bond covering the plan	2023-12-31	$1,000,000
Total contributions received or receivable from participants	2023-12-31	$771,312
Expenses. Other expenses not covered elsewhere	2023-12-31	$0
Contributions received from other sources (not participants or employers)	2023-12-31	$7,310
Other income received	2023-12-31	$3,166,122
Noncash contributions received	2023-12-31	$0
Net income (gross income less expenses)	2023-12-31	$4,611,856
Net plan assets at end of year (total assets less liabilities)	2023-12-31	$23,370,386
Net plan assets at beginning of year (total assets less liabilities)	2023-12-31	$18,758,530
Assets. Value of participant loans	2023-12-31	$64,874
Total contributions received or receivable from employer(s)	2023-12-31	$1,300,447
Value of certain deemed distributions of participant loans	2023-12-31	$0
Value of corrective distributions	2023-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2023-12-31	$11,292
2022 : BEVERLY PATHOLOGY, INC. 401(K) PROFIT SHARING PLAN 2022 401k financial data
Transfers to/from the plan	2022-12-31	$0
Total plan liabilities at end of year	2022-12-31	$0
Total plan liabilities at beginning of year	2022-12-31	$0
Total income from all sources	2022-12-31	$-3,133,012
Expenses. Total of all expenses incurred	2022-12-31	$5,901,116
Benefits paid (including direct rollovers)	2022-12-31	$5,891,187
Total plan assets at end of year	2022-12-31	$18,758,530
Total plan assets at beginning of year	2022-12-31	$27,792,658
Value of fidelity bond covering the plan	2022-12-31	$1,000,000
Total contributions received or receivable from participants	2022-12-31	$612,209
Expenses. Other expenses not covered elsewhere	2022-12-31	$0
Contributions received from other sources (not participants or employers)	2022-12-31	$0
Other income received	2022-12-31	$-4,907,404
Noncash contributions received	2022-12-31	$0
Net income (gross income less expenses)	2022-12-31	$-9,034,128
Net plan assets at end of year (total assets less liabilities)	2022-12-31	$18,758,530
Net plan assets at beginning of year (total assets less liabilities)	2022-12-31	$27,792,658
Assets. Value of participant loans	2022-12-31	$179,246
Total contributions received or receivable from employer(s)	2022-12-31	$1,162,183
Value of certain deemed distributions of participant loans	2022-12-31	$0
Value of corrective distributions	2022-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2022-12-31	$9,929
2021 : BEVERLY PATHOLOGY, INC. 401(K) PROFIT SHARING PLAN 2021 401k financial data
Transfers to/from the plan	2021-12-31	$0
Total plan liabilities at end of year	2021-12-31	$0
Total plan liabilities at beginning of year	2021-12-31	$0
Total income from all sources	2021-12-31	$4,423,765
Expenses. Total of all expenses incurred	2021-12-31	$1,043,544
Benefits paid (including direct rollovers)	2021-12-31	$1,034,997
Total plan assets at end of year	2021-12-31	$27,792,658
Total plan assets at beginning of year	2021-12-31	$24,412,437
Value of fidelity bond covering the plan	2021-12-31	$1,000,000
Total contributions received or receivable from participants	2021-12-31	$679,025
Expenses. Other expenses not covered elsewhere	2021-12-31	$0
Contributions received from other sources (not participants or employers)	2021-12-31	$0
Other income received	2021-12-31	$2,608,866
Noncash contributions received	2021-12-31	$0
Net income (gross income less expenses)	2021-12-31	$3,380,221
Net plan assets at end of year (total assets less liabilities)	2021-12-31	$27,792,658
Net plan assets at beginning of year (total assets less liabilities)	2021-12-31	$24,412,437
Assets. Value of participant loans	2021-12-31	$198,607
Total contributions received or receivable from employer(s)	2021-12-31	$1,135,874
Value of certain deemed distributions of participant loans	2021-12-31	$0
Value of corrective distributions	2021-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2021-12-31	$8,547
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
2020 : BEVERLY PATHOLOGY, INC. 401(K) PROFIT SHARING PLAN 2020 401k financial data
Total plan liabilities at end of year	2020-12-31	$0
Total plan liabilities at beginning of year	2020-12-31	$0
Total income from all sources	2020-12-31	$4,243,854
Expenses. Total of all expenses incurred	2020-12-31	$1,898,926
Benefits paid (including direct rollovers)	2020-12-31	$1,884,742
Total plan assets at end of year	2020-12-31	$24,412,437
Total plan assets at beginning of year	2020-12-31	$22,067,509
Value of fidelity bond covering the plan	2020-12-31	$500,000
Total contributions received or receivable from participants	2020-12-31	$706,150
Contributions received from other sources (not participants or employers)	2020-12-31	$0
Other income received	2020-12-31	$2,386,998
Noncash contributions received	2020-12-31	$0
Net income (gross income less expenses)	2020-12-31	$2,344,928
Net plan assets at end of year (total assets less liabilities)	2020-12-31	$24,412,437
Net plan assets at beginning of year (total assets less liabilities)	2020-12-31	$22,067,509
Assets. Value of participant loans	2020-12-31	$217,530
Total contributions received or receivable from employer(s)	2020-12-31	$1,150,706
Value of certain deemed distributions of participant loans	2020-12-31	$0
Value of corrective distributions	2020-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2020-12-31	$14,184
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
2019 : BEVERLY PATHOLOGY, INC. 401(K) PROFIT SHARING PLAN 2019 401k financial data
Total plan liabilities at beginning of year	2019-12-31	$0
Total income from all sources	2019-12-31	$4,925,645
Expenses. Total of all expenses incurred	2019-12-31	$1,259,311
Benefits paid (including direct rollovers)	2019-12-31	$1,249,514
Total plan assets at end of year	2019-12-31	$22,067,509
Total plan assets at beginning of year	2019-12-31	$18,401,175
Value of fidelity bond covering the plan	2019-12-31	$500,000
Total contributions received or receivable from participants	2019-12-31	$615,194
Expenses. Other expenses not covered elsewhere	2019-12-31	$0
Contributions received from other sources (not participants or employers)	2019-12-31	$9,636
Other income received	2019-12-31	$3,306,710
Noncash contributions received	2019-12-31	$0
Net income (gross income less expenses)	2019-12-31	$3,666,334
Net plan assets at end of year (total assets less liabilities)	2019-12-31	$22,067,509
Net plan assets at beginning of year (total assets less liabilities)	2019-12-31	$18,401,175
Assets. Value of participant loans	2019-12-31	$25,349
Total contributions received or receivable from employer(s)	2019-12-31	$994,105
Value of certain deemed distributions of participant loans	2019-12-31	$0
Value of corrective distributions	2019-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2019-12-31	$9,797
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
2018 : BEVERLY PATHOLOGY, INC. 401(K) PROFIT SHARING PLAN 2018 401k financial data
Transfers to/from the plan	2018-12-31	$42,511
Total income from all sources	2018-12-31	$402,966
Expenses. Total of all expenses incurred	2018-12-31	$1,772,218
Benefits paid (including direct rollovers)	2018-12-31	$1,763,049
Total plan assets at end of year	2018-12-31	$18,401,175
Total plan assets at beginning of year	2018-12-31	$19,727,916
Value of fidelity bond covering the plan	2018-12-31	$500,000
Total contributions received or receivable from participants	2018-12-31	$566,983
Contributions received from other sources (not participants or employers)	2018-12-31	$129,356
Other income received	2018-12-31	$-1,049,648
Net income (gross income less expenses)	2018-12-31	$-1,369,252
Net plan assets at end of year (total assets less liabilities)	2018-12-31	$18,401,175
Net plan assets at beginning of year (total assets less liabilities)	2018-12-31	$19,727,916
Total contributions received or receivable from employer(s)	2018-12-31	$756,275
Expenses. Administrative service providers (salaries,fees and commissions)	2018-12-31	$9,169
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
2017 : BEVERLY PATHOLOGY, INC. 401(K) PROFIT SHARING PLAN 2017 401k financial data
Total income from all sources	2017-12-31	$6,024,953
Expenses. Total of all expenses incurred	2017-12-31	$1,486,968
Benefits paid (including direct rollovers)	2017-12-31	$1,456,459
Total plan assets at end of year	2017-12-31	$19,727,916
Total plan assets at beginning of year	2017-12-31	$15,189,931
Value of fidelity bond covering the plan	2017-12-31	$500,000
Total contributions received or receivable from participants	2017-12-31	$858,052
Contributions received from other sources (not participants or employers)	2017-12-31	$2,072,143
Other income received	2017-12-31	$2,458,764
Net income (gross income less expenses)	2017-12-31	$4,537,985
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$19,727,916
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$15,189,931
Total contributions received or receivable from employer(s)	2017-12-31	$635,994
Expenses. Administrative service providers (salaries,fees and commissions)	2017-12-31	$30,509
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
2016 : BEVERLY PATHOLOGY, INC. 401(K) PROFIT SHARING PLAN 2016 401k financial data
Total income from all sources	2016-12-31	$2,844,588
Expenses. Total of all expenses incurred	2016-12-31	$1,525,969
Benefits paid (including direct rollovers)	2016-12-31	$1,481,220
Total plan assets at end of year	2016-12-31	$15,189,931
Total plan assets at beginning of year	2016-12-31	$13,871,312
Value of fidelity bond covering the plan	2016-12-31	$1,000,000
Total contributions received or receivable from participants	2016-12-31	$487,750
Contributions received from other sources (not participants or employers)	2016-12-31	$299,646
Other income received	2016-12-31	$1,160,701
Noncash contributions received	2016-12-31	$0
Net income (gross income less expenses)	2016-12-31	$1,318,619
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$15,189,931
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$13,871,312
Total contributions received or receivable from employer(s)	2016-12-31	$896,491
Expenses. Administrative service providers (salaries,fees and commissions)	2016-12-31	$44,749
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
2015 : BEVERLY PATHOLOGY, INC. 401(K) PROFIT SHARING PLAN 2015 401k financial data
Total income from all sources	2015-12-31	$1,216,601
Expenses. Total of all expenses incurred	2015-12-31	$2,185,608
Benefits paid (including direct rollovers)	2015-12-31	$2,141,873
Total plan assets at end of year	2015-12-31	$13,871,312
Total plan assets at beginning of year	2015-12-31	$14,840,319
Value of fidelity bond covering the plan	2015-12-31	$1,000,000
Total contributions received or receivable from participants	2015-12-31	$636,201
Other income received	2015-12-31	$-291,536
Net income (gross income less expenses)	2015-12-31	$-969,007
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$13,871,312
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$14,840,319
Assets. Value of participant loans	2015-12-31	$0
Assets. Value of assets in partnership/joint-venture interests	2015-12-31	$30,696
Total contributions received or receivable from employer(s)	2015-12-31	$871,936
Expenses. Administrative service providers (salaries,fees and commissions)	2015-12-31	$43,735
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0

Form 5500 Responses for BEVERLY PATHOLOGY, INC. 401(K) PROFIT SHARING PLAN

2023: BEVERLY PATHOLOGY, INC. 401(K) PROFIT SHARING PLAN 2023 form 5500 responses
2023-01-01	Type of plan entity	Single employer plan
2023-01-01	Submission has been amended	No
2023-01-01	This submission is the final filing	No
2023-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2023-01-01	Plan is a collectively bargained plan	No
2023-01-01	Plan funding arrangement – Insurance	Yes
2023-01-01	Plan funding arrangement – Trust	Yes
2023-01-01	Plan benefit arrangement – Insurance	Yes
2023-01-01	Plan benefit arrangement - Trust	Yes
2022: BEVERLY PATHOLOGY, INC. 401(K) PROFIT SHARING PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: BEVERLY PATHOLOGY, INC. 401(K) PROFIT SHARING 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 - Trust	Yes
2020: BEVERLY PATHOLOGY, INC. 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: BEVERLY PATHOLOGY, INC. 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: BEVERLY PATHOLOGY, INC. 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: BEVERLY PATHOLOGY, INC. 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: BEVERLY PATHOLOGY, INC. 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: BEVERLY PATHOLOGY, INC. 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

Insurance Providers Used on plan

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

PHU987

Policy instance

Insurance contract or identification number	PHU987
Number of Individuals Covered	2
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

516226-01

Policy instance

Insurance contract or identification number	516226-01
Number of Individuals Covered	27
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

PHU987

Policy instance

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

Policy contract number

516226-01

Policy instance

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

PHU987

Policy instance

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

PHU987

Policy instance

VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 )

Policy contract number

PHU987

Policy instance

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Company Name:	BEVERLY PATHOLOGY, INC.
Employer identification number (EIN):	471564915
NAIC Classification:	812990
NAIC Description:	All Other Personal Services