401k Plan data: PHS / MWA 401K PROFIT SHARING PLAN plan

PHS / MWA 401K PROFIT SHARING PLAN 401k Plan overview

Plan Name	PHS / MWA 401K PROFIT SHARING PLAN
Plan identification number	001

PHS / MWA 401K PROFIT SHARING 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.
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

PHS / MWA has sponsored the creation of one or more 401k plans.

Company Name: PHS / MWA

Employer identification number (EIN): 481289720

NAIC Classification: 336410

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PHS / MWA 401K PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2016-01-01 CINDY GRIGANAVICIUS
001 2016-01-01
001 2015-01-01 CINDY GRIGANAVICIUS
001 2014-01-01 MARY BALE
001 2013-01-01 MARY BETH BALE 2014-05-30 MARY BETH BALE 2014-05-30
001 2012-01-01 MARY BETH BALE 2013-05-31 MARY BETH BALE 2013-05-31
001 2010-01-01 MARY BETH BALE 2011-06-08 MARY BETH BALE 2011-06-08

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2016-01-01	CINDY GRIGANAVICIUS
001	2016-01-01
001	2015-01-01	CINDY GRIGANAVICIUS
001	2014-01-01	MARY BALE
001	2013-01-01	MARY BETH BALE	2014-05-30	MARY BETH BALE	2014-05-30
001	2012-01-01	MARY BETH BALE	2013-05-31	MARY BETH BALE	2013-05-31
001	2010-01-01	MARY BETH BALE	2011-06-08	MARY BETH BALE	2011-06-08

Plan Statistics for PHS / MWA 401K PROFIT SHARING PLAN

401k plan membership statisitcs for PHS / MWA 401K PROFIT SHARING PLAN

Measure Date Value
2016: PHS / MWA 401K PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 159
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 0
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 0
Number of participants with account balances 2016-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: PHS / MWA 401K PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 153
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 135
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 34
Total of all active and inactive participants 2015-01-01 169
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 169
Number of participants with account balances 2015-01-01 140
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 10
2014: PHS / MWA 401K PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 132
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 117
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 15
Total of all active and inactive participants 2014-01-01 132
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 132
Number of participants with account balances 2014-01-01 111
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 7

Measure	Date	Value
2016: PHS / MWA 401K PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	159
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	0
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	0
Number of participants with account balances	2016-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: PHS / MWA 401K PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	153
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	135
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	34
Total of all active and inactive participants	2015-01-01	169
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	169
Number of participants with account balances	2015-01-01	140
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	10
2014: PHS / MWA 401K PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	132
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	117
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	15
Total of all active and inactive participants	2014-01-01	132
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	132
Number of participants with account balances	2014-01-01	111
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	7

Financial Data on PHS / MWA 401K PROFIT SHARING PLAN

Measure	Date	Value
2016 : PHS / MWA 401K PROFIT SHARING PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-03-31	$0
Total transfer of assets to this plan	2016-03-31	$0
Total transfer of assets from this plan	2016-03-31	$1,377,526
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-03-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-03-31	$0
Total income from all sources (including contributions)	2016-03-31	$57,379
Total loss/gain on sale of assets	2016-03-31	$0
Total of all expenses incurred	2016-03-31	$37,466
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-03-31	$21,633
Value of total corrective distributions	2016-03-31	$12,861
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-03-31	$32,951
Value of total assets at end of year	2016-03-31	$0
Value of total assets at beginning of year	2016-03-31	$1,357,613
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-03-31	$2,972
Total interest from all sources	2016-03-31	$456
Total dividends received (eg from common stock, registered investment company shares)	2016-03-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-03-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2016-03-31	$0
Administrative expenses professional fees incurred	2016-03-31	$430
Was this plan covered by a fidelity bond	2016-03-31	Yes
Value of fidelity bond cover	2016-03-31	$120,000
If this is an individual account plan, was there a blackout period	2016-03-31	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-03-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-03-31	No
Contributions received from participants	2016-03-31	$32,951
Participant contributions at end of year	2016-03-31	$0
Participant contributions at beginning of year	2016-03-31	$41,978
Participant contributions at end of year	2016-03-31	$0
Participant contributions at beginning of year	2016-03-31	$5,208
Value of other receiveables (less allowance for doubtful accounts) at end of year	2016-03-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2016-03-31	$150,000
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-03-31	No
Value of net income/loss	2016-03-31	$19,913
Value of net assets at end of year (total assets less liabilities)	2016-03-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2016-03-31	$1,357,613
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-03-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-03-31	No
Were any leases to which the plan was party in default or uncollectible	2016-03-31	No
Investment advisory and management fees	2016-03-31	$2,488
Value of interest in pooled separate accounts at end of year	2016-03-31	$0
Value of interest in pooled separate accounts at beginning of year	2016-03-31	$1,160,427
Interest on participant loans	2016-03-31	$456
Value of interest in common/collective trusts at end of year	2016-03-31	$0
Value of interest in common/collective trusts at beginning of year	2016-03-31	$0
Net investment gain/loss from pooled separate accounts	2016-03-31	$23,972
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-03-31	No
Was there a failure to transmit to the plan any participant contributions	2016-03-31	No
Has the plan failed to provide any benefit when due under the plan	2016-03-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-03-31	$21,633
Contract administrator fees	2016-03-31	$54
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2016-03-31	Yes
Liabilities. Value of benefit claims payable at end of year	2016-03-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2016-03-31	$0
Did the plan have assets held for investment	2016-03-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-03-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-03-31	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-03-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-03-31	Disclaimer
Accountancy firm name	2016-03-31	CONSIDINE & CONSIDINE
Accountancy firm EIN	2016-03-31	952694444
2015 : PHS / MWA 401K PROFIT SHARING PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$306,670
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$572,809
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$540,858
Value of total corrective distributions	2015-12-31	$24,530
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$349,969
Value of total assets at end of year	2015-12-31	$1,357,613
Value of total assets at beginning of year	2015-12-31	$1,623,752
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$7,421
Total interest from all sources	2015-12-31	$1,573
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$0
Administrative expenses professional fees incurred	2015-12-31	$1,575
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$500,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$162,317
Participant contributions at end of year	2015-12-31	$41,978
Participant contributions at beginning of year	2015-12-31	$39,658
Participant contributions at end of year	2015-12-31	$5,208
Participant contributions at beginning of year	2015-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$37,652
Value of other receiveables (less allowance for doubtful accounts) at end of year	2015-12-31	$150,000
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2015-12-31	$120,000
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Income. Non cash contributions	2015-12-31	$0
Value of net income/loss	2015-12-31	$-266,139
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$1,357,613
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$1,623,752
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Investment advisory and management fees	2015-12-31	$5,580
Value of interest in pooled separate accounts at end of year	2015-12-31	$1,160,427
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$1,464,094
Interest on participant loans	2015-12-31	$1,416
Interest earned on other investments	2015-12-31	$157
Value of interest in common/collective trusts at end of year	2015-12-31	$0
Value of interest in common/collective trusts at beginning of year	2015-12-31	$0
Net investment gain/loss from pooled separate accounts	2015-12-31	$-44,872
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$150,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$540,858
Contract administrator fees	2015-12-31	$266
Liabilities. Value of benefit claims payable at end of year	2015-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2015-12-31	$0
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	CONSIDINE & CONSIDINE
Accountancy firm EIN	2015-12-31	952694444
2014 : PHS / MWA 401K PROFIT SHARING PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Expenses. Interest paid	2014-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$346,619
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$64,544
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$45,233
Expenses. Certain deemed distributions of participant loans	2014-12-31	$0
Value of total corrective distributions	2014-12-31	$13,059
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$299,172
Value of total assets at end of year	2014-12-31	$1,623,752
Value of total assets at beginning of year	2014-12-31	$1,341,677
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$6,252
Total interest from all sources	2014-12-31	$1,796
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$0
Administrative expenses professional fees incurred	2014-12-31	$440
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$500,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$179,172
Participant contributions at end of year	2014-12-31	$39,658
Participant contributions at beginning of year	2014-12-31	$53,486
Participant contributions at end of year	2014-12-31	$0
Participant contributions at beginning of year	2014-12-31	$6,357
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2014-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2014-12-31	$120,000
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2014-12-31	$100,002
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$282,075
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$1,623,752
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$1,341,677
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Investment advisory and management fees	2014-12-31	$2,343
Value of interest in pooled separate accounts at end of year	2014-12-31	$1,464,094
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$862,276
Interest on participant loans	2014-12-31	$1,796
Value of interest in common/collective trusts at end of year	2014-12-31	$0
Value of interest in common/collective trusts at beginning of year	2014-12-31	$319,556
Expenses. Payments to insurance carriers foe the provision of benefits	2014-12-31	$0
Net investment gain/loss from pooled separate accounts	2014-12-31	$44,194
Net investment gain or loss from common/collective trusts	2014-12-31	$1,457
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$120,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$45,233
Contract administrator fees	2014-12-31	$3,469
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	CONSIDINE & CONSIDINE
Accountancy firm EIN	2014-12-31	952694444

Form 5500 Responses for PHS / MWA 401K PROFIT SHARING PLAN

2016: PHS / MWA 401K PROFIT SHARING PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	Yes
2016-01-01	This submission is the final filing	Yes
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: PHS / MWA 401K 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 – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: PHS / MWA 401K 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 – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 78778 )

Policy contract number

300418

Policy instance

Insurance contract or identification number	300418
Number of Individuals Covered	0
Insurance policy start date	2016-01-01
Insurance policy end date	2016-03-31
Total amount of commissions paid to insurance broker	USD $1,217
Total amount of fees paid to insurance company	USD $74
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,217
Insurance broker organization code?	3
Amount paid for insurance broker fees	74
Additional information about fees paid to insurance broker	ADVISORY SERVICES
Insurance broker name	SWBC INVESTMENT ADVIS. SERVICES LLC

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 78778 )

Policy contract number

300418

Policy instance

Insurance contract or identification number	300418
Number of Individuals Covered	140
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $4,763
Total amount of fees paid to insurance company	USD $461
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,763
Insurance broker organization code?	3
Amount paid for insurance broker fees	280
Additional information about fees paid to insurance broker	ADVISORY SERVICES
Insurance broker name	TROMBINO PENSION ADMINISTRATORS, IN

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 78778 )

Policy contract number

300418

Policy instance

Insurance contract or identification number	300418
Number of Individuals Covered	93
Insurance policy start date	2014-04-22
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $17,387
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $17,387
Insurance broker organization code?	3
Insurance broker name	JASON GIORGIO, PARK AVE SECURITIES

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

Policy contract number

800557

Policy instance

Insurance contract or identification number	800557
Number of Individuals Covered	0
Insurance policy start date	2014-01-01
Insurance policy end date	2014-04-21
Total amount of commissions paid to insurance broker	USD $1,204
Total amount of fees paid to insurance company	USD $595
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?	Yes
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,204
Insurance broker organization code?	3
Amount paid for insurance broker fees	595
Additional information about fees paid to insurance broker	ADMIN FEE
Insurance broker name	LANG, LANG & CO., CPAS

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Company Name:	PHS / MWA
Employer identification number (EIN):	481289720
NAIC Classification:	336410