401k Plan data: CANNON HEALTH LLC 401(K) PLAN plan

CANNON HEALTH LLC 401(K) PLAN 401k Plan overview

Plan Name	CANNON HEALTH LLC 401(K) PLAN
Plan identification number	001

CANNON HEALTH LLC 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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

401k Sponsoring company profile

CANNON HEALTH LLC has sponsored the creation of one or more 401k plans.

Company Name: CANNON HEALTH LLC

Employer identification number (EIN): 474197096

NAIC Classification: 621498
NAIC Description: All Other Outpatient Care Centers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CANNON HEALTH LLC 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01
001 2021-01-01
001 2020-01-01
001 2019-01-01
001 2018-01-01
001 2017-01-01 JESSICA JUNG
001 2016-01-01 JESSICA JUNG 2017-06-09
001 2015-01-01 JESSICA JUNG 2016-07-29

Plan Statistics for CANNON HEALTH LLC 401(K) PLAN

401k plan membership statisitcs for CANNON HEALTH LLC 401(K) PLAN

Measure Date Value
2022: CANNON HEALTH LLC 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 175
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 180
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 30
Total of all active and inactive participants 2022-01-01 210
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 210
Number of participants with account balances 2022-01-01 88
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: CANNON HEALTH LLC 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 180
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 162
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 21
Total of all active and inactive participants 2021-01-01 183
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 183
Number of participants with account balances 2021-01-01 85
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: CANNON HEALTH LLC 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 195
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 193
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 2020-01-01 213
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 213
Number of participants with account balances 2020-01-01 91
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: CANNON HEALTH LLC 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 211
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 251
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 18
Total of all active and inactive participants 2019-01-01 269
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 269
Number of participants with account balances 2019-01-01 93
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: CANNON HEALTH LLC 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 213
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 248
Number of other retired or separated participants entitled to future benefits 2018-01-01 16
Total of all active and inactive participants 2018-01-01 264
Total participants 2018-01-01 264
Number of participants with account balances 2018-01-01 102
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 6
2017: CANNON HEALTH LLC 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 154
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 194
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 19
Total of all active and inactive participants 2017-01-01 213
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 213
Number of participants with account balances 2017-01-01 101
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0

Measure	Date	Value
2022: CANNON HEALTH LLC 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	175
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	180
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	30
Total of all active and inactive participants	2022-01-01	210
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	210
Number of participants with account balances	2022-01-01	88
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: CANNON HEALTH LLC 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	180
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	162
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	21
Total of all active and inactive participants	2021-01-01	183
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	183
Number of participants with account balances	2021-01-01	85
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: CANNON HEALTH LLC 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	195
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	193
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	213
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	213
Number of participants with account balances	2020-01-01	91
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: CANNON HEALTH LLC 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	211
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	251
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	18
Total of all active and inactive participants	2019-01-01	269
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	269
Number of participants with account balances	2019-01-01	93
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: CANNON HEALTH LLC 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	213
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	248
Number of other retired or separated participants entitled to future benefits	2018-01-01	16
Total of all active and inactive participants	2018-01-01	264
Total participants	2018-01-01	264
Number of participants with account balances	2018-01-01	102
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	6
2017: CANNON HEALTH LLC 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	154
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	194
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	19
Total of all active and inactive participants	2017-01-01	213
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	213
Number of participants with account balances	2017-01-01	101
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0

Financial Data on CANNON HEALTH LLC 401(K) PLAN

Measure	Date	Value
2022 : CANNON HEALTH LLC 401(K) PLAN 2022 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$1,212
Total income from all sources (including contributions)	2022-12-31	$-485,456
Total of all expenses incurred	2022-12-31	$100,935
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$54,251
Expenses. Certain deemed distributions of participant loans	2022-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$624,644
Value of total assets at end of year	2022-12-31	$4,970,356
Value of total assets at beginning of year	2022-12-31	$5,557,959
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$46,684
Total interest from all sources	2022-12-31	$5,482
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-12-31	$0
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$500,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$441,366
Participant contributions at end of year	2022-12-31	$60,591
Participant contributions at beginning of year	2022-12-31	$115,381
Participant contributions at end of year	2022-12-31	$0
Participant contributions at beginning of year	2022-12-31	$1,852
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2022-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2022-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2022-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2022-12-31	$1,212
Total non interest bearing cash at end of year	2022-12-31	$2,988
Total non interest bearing cash at beginning of year	2022-12-31	$6,159
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$-586,391
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$4,970,356
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$5,556,747
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Investment advisory and management fees	2022-12-31	$46,684
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$4,906,777
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$5,431,957
Value of interest in pooled separate accounts at end of year	2022-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2022-12-31	$0
Interest on participant loans	2022-12-31	$5,482
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2022-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2022-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-1,115,582
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$183,278
Employer contributions (assets) at end of year	2022-12-31	$0
Employer contributions (assets) at beginning of year	2022-12-31	$2,610
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$54,251
Did the plan have assets held for investment	2022-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	AC CPA, PLLC
Accountancy firm EIN	2022-12-31	873863558
2021 : CANNON HEALTH LLC 401(K) PLAN 2021 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$1,212
Total income from all sources (including contributions)	2021-12-31	$1,446,650
Total of all expenses incurred	2021-12-31	$1,203,093
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$1,142,364
Expenses. Certain deemed distributions of participant loans	2021-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$575,349
Value of total assets at end of year	2021-12-31	$5,557,959
Value of total assets at beginning of year	2021-12-31	$5,313,190
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$60,729
Total interest from all sources	2021-12-31	$7,066
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
Total dividends received from registered investment company shares (eg mutual funds)	2021-12-31	$0
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$531,319
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	$397,985
Participant contributions at end of year	2021-12-31	$115,381
Participant contributions at beginning of year	2021-12-31	$112,487
Participant contributions at end of year	2021-12-31	$1,852
Participant contributions at beginning of year	2021-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2021-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2021-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2021-12-31	$1,212
Total non interest bearing cash at end of year	2021-12-31	$6,159
Total non interest bearing cash at beginning of year	2021-12-31	$6,257
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	$243,557
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$5,556,747
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$5,313,190
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$5,431,957
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$5,194,446
Interest on participant loans	2021-12-31	$7,066
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2021-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2021-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$864,235
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	$177,364
Employer contributions (assets) at end of year	2021-12-31	$2,610
Employer contributions (assets) at beginning of year	2021-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$1,142,364
Contract administrator fees	2021-12-31	$60,729
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	AC CPA, PLLC
Accountancy firm EIN	2021-12-31	873863558
2020 : CANNON HEALTH LLC 401(K) PLAN 2020 401k financial data
Total income from all sources (including contributions)	2020-12-31	$1,327,021
Total of all expenses incurred	2020-12-31	$462,456
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$412,445
Expenses. Certain deemed distributions of participant loans	2020-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$552,020
Value of total assets at end of year	2020-12-31	$5,313,190
Value of total assets at beginning of year	2020-12-31	$4,448,625
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$50,011
Total interest from all sources	2020-12-31	$7,590
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
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-31	$0
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$444,863
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	$364,131
Participant contributions at end of year	2020-12-31	$112,487
Participant contributions at beginning of year	2020-12-31	$124,102
Participant contributions at end of year	2020-12-31	$0
Participant contributions at beginning of year	2020-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2020-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2020-12-31	$0
Total non interest bearing cash at end of year	2020-12-31	$6,257
Total non interest bearing cash at beginning of year	2020-12-31	$7,631
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	$864,565
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$5,313,190
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$4,448,625
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$5,194,446
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$4,316,892
Interest on participant loans	2020-12-31	$7,590
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2020-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2020-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$767,411
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$187,889
Employer contributions (assets) at end of year	2020-12-31	$0
Employer contributions (assets) at beginning of year	2020-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$412,445
Contract administrator fees	2020-12-31	$50,011
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	POTTER & COMPANY, PA
Accountancy firm EIN	2020-12-31	561220683
2019 : CANNON HEALTH LLC 401(K) PLAN 2019 401k financial data
Total income from all sources (including contributions)	2019-12-31	$1,942,834
Total of all expenses incurred	2019-12-31	$470,286
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$428,036
Expenses. Certain deemed distributions of participant loans	2019-12-31	$0
Value of total corrective distributions	2019-12-31	$202
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$1,185,003
Value of total assets at end of year	2019-12-31	$4,448,625
Value of total assets at beginning of year	2019-12-31	$2,976,077
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$42,048
Total interest from all sources	2019-12-31	$5,130
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
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$0
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$444,863
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	$434,146
Participant contributions at end of year	2019-12-31	$124,102
Participant contributions at beginning of year	2019-12-31	$25,921
Participant contributions at end of year	2019-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$537,153
Value of other receiveables (less allowance for doubtful accounts) at end of year	2019-12-31	$0
Total non interest bearing cash at end of year	2019-12-31	$7,631
Total non interest bearing cash at beginning of year	2019-12-31	$8,923
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	$1,472,548
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$4,448,625
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$2,976,077
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Investment advisory and management fees	2019-12-31	$42,048
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$4,316,892
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$2,941,233
Interest on participant loans	2019-12-31	$5,130
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2019-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$752,701
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$213,704
Employer contributions (assets) at end of year	2019-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$428,036
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	POTTER & COMPANY, PA
Accountancy firm EIN	2019-12-31	561220683
2018 : CANNON HEALTH LLC 401(K) PLAN 2018 401k financial data
Total income from all sources (including contributions)	2018-12-31	$372,609
Total of all expenses incurred	2018-12-31	$190,565
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$155,693
Expenses. Certain deemed distributions of participant loans	2018-12-31	$430
Value of total corrective distributions	2018-12-31	$1,050
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$633,575
Value of total assets at end of year	2018-12-31	$2,976,077
Value of total assets at beginning of year	2018-12-31	$2,794,033
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$33,392
Total interest from all sources	2018-12-31	$2,235
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	$300,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$431,122
Participant contributions at end of year	2018-12-31	$25,921
Participant contributions at beginning of year	2018-12-31	$49,897
Participant contributions at beginning of year	2018-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$25,717
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2018-12-31	$0
Total non interest bearing cash at end of year	2018-12-31	$8,923
Total non interest bearing cash at beginning of year	2018-12-31	$9,321
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	$182,044
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$2,976,077
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$2,794,033
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Investment advisory and management fees	2018-12-31	$33,392
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$2,941,233
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$2,734,815
Interest on participant loans	2018-12-31	$2,235
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-263,201
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	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$176,736
Employer contributions (assets) at beginning of year	2018-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$155,693
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	POTTER & COMPANY, PA
Accountancy firm EIN	2018-12-31	561220683
2017 : CANNON HEALTH LLC 401(K) PLAN 2017 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2017-12-31	$0
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$966,994
Total of all expenses incurred	2017-12-31	$69,704
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$41,406
Expenses. Certain deemed distributions of participant loans	2017-12-31	$2,253
Value of total corrective distributions	2017-12-31	$600
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$562,325
Value of total assets at end of year	2017-12-31	$2,794,033
Value of total assets at beginning of year	2017-12-31	$1,896,743
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$25,445
Total interest from all sources	2017-12-31	$2,474
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
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$0
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$250,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
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	$386,787
Participant contributions at end of year	2017-12-31	$49,897
Participant contributions at beginning of year	2017-12-31	$49,917
Participant contributions at end of year	2017-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2017-12-31	$0
Administrative expenses (other) incurred	2017-12-31	$0
Total non interest bearing cash at end of year	2017-12-31	$9,321
Total non interest bearing cash at beginning of year	2017-12-31	$8,400
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
Income. Non cash contributions	2017-12-31	$0
Value of net income/loss	2017-12-31	$897,290
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$2,794,033
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$1,896,743
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$2,734,815
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$1,838,426
Interest on participant loans	2017-12-31	$0
Interest earned on other investments	2017-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2017-12-31	$2,474
Expenses. Payments to insurance carriers foe the provision of benefits	2017-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$402,195
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$175,538
Employer contributions (assets) at end of year	2017-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$41,406
Contract administrator fees	2017-12-31	$25,445
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	POTTER & COMPANY, PA
Accountancy firm EIN	2017-12-31	561220683

Form 5500 Responses for CANNON HEALTH LLC 401(K) PLAN

2022: CANNON HEALTH LLC 401(K) PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
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: CANNON HEALTH LLC 401(K) PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
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: CANNON HEALTH LLC 401(K) PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
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: CANNON HEALTH LLC 401(K) PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
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: CANNON HEALTH LLC 401(K) PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
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: CANNON HEALTH LLC 401(K) PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

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

Policy contract number

123834

Policy instance

Insurance contract or identification number	123834
Number of Individuals Covered	93
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $23,648
Total amount of fees paid to insurance company	USD $6,792
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $23,648
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	BROKER COMMISSIONS
Insurance broker organization code?	3

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

Policy contract number

123834

Policy instance

Insurance contract or identification number	123834
Number of Individuals Covered	88
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $28,787
Total amount of fees paid to insurance company	USD $7,133
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $28,787
Additional information about fees paid to insurance broker	BROKER COMMISSIONS
Insurance broker organization code?	3
Amount paid for insurance broker fees	7133

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

Policy contract number

123834

Policy instance

Insurance contract or identification number	123834
Number of Individuals Covered	93
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $21,918
Total amount of fees paid to insurance company	USD $4,886
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $21,918
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	BROKER COMMISSIONS
Insurance broker organization code?	3

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

Policy contract number

123834

Policy instance

Insurance contract or identification number	123834
Number of Individuals Covered	95
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $17,965
Total amount of fees paid to insurance company	USD $4,620
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $17,965
Insurance broker organization code?	3
Amount paid for insurance broker fees	4620
Additional information about fees paid to insurance broker	TPA FEES

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

Policy contract number

123834

Policy instance

Insurance contract or identification number	123834
Number of Individuals Covered	106
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $14,840
Total amount of fees paid to insurance company	USD $3,540
Commission paid to Insurance Broker	USD $14,840
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	BROKERS COMMISSION
Insurance broker organization code?	3

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

Policy contract number

123834

Policy instance

Insurance contract or identification number	123834
Number of Individuals Covered	102
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $11,158
Total amount of fees paid to insurance company	USD $5,637
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $11,158
Additional information about fees paid to insurance broker	BROKERS COMMISION
Insurance broker organization code?	3
Amount paid for insurance broker fees	4324
Insurance broker name	NOVA 401K ASSOCIATES

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Company Name:	CANNON HEALTH LLC
Employer identification number (EIN):	474197096
NAIC Classification:	621498
NAIC Description:	All Other Outpatient Care Centers