401k Plan data: CHARLOTTE RADIOLOGY PA EMPLOYEE HEALTH & WELFARE PLAN plan

CHARLOTTE RADIOLOGY PA EMPLOYEE HEALTH & WELFARE PLAN 401k Plan overview

Plan Name	CHARLOTTE RADIOLOGY PA EMPLOYEE HEALTH & WELFARE PLAN
Plan identification number	502

CHARLOTTE RADIOLOGY PA EMPLOYEE HEALTH & WELFARE PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Long-term disability cover

401k Sponsoring company profile

CHARLOTTE RADIOLOGY, PA has sponsored the creation of one or more 401k plans.

Company Name: CHARLOTTE RADIOLOGY, PA

Employer identification number (EIN): 560954779

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CHARLOTTE RADIOLOGY PA EMPLOYEE HEALTH & WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
502 2021-01-01 WILL FOSTER 2022-10-05
502 2017-01-01 C PETER CHANG
502 2016-01-01 C PETER CHANG
502 2015-01-01 C PETER CHANG
502 2014-01-01 C PETER CHANG
502 2013-01-01 MICHAEL KELLEY MICHAEL KELLEY 2014-10-14
502 2012-01-01 ALLAN GOHEEN ALLAN GOHEEN 2013-10-15
502 2011-01-01 MICHAEL KELLEY
502 2009-01-01 MICHAEL KELLEY MICHAEL KELLEY 2010-10-15

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
502	2021-01-01	WILL FOSTER	2022-10-05
502	2017-01-01	C PETER CHANG
502	2016-01-01	C PETER CHANG
502	2015-01-01	C PETER CHANG
502	2014-01-01	C PETER CHANG
502	2013-01-01	MICHAEL KELLEY		MICHAEL KELLEY	2014-10-14
502	2012-01-01	ALLAN GOHEEN		ALLAN GOHEEN	2013-10-15
502	2011-01-01	MICHAEL KELLEY
502	2009-01-01	MICHAEL KELLEY		MICHAEL KELLEY	2010-10-15

Plan Statistics for CHARLOTTE RADIOLOGY PA EMPLOYEE HEALTH & WELFARE PLAN

401k plan membership statisitcs for CHARLOTTE RADIOLOGY PA EMPLOYEE HEALTH & WELFARE PLAN

Measure Date Value
2021: CHARLOTTE RADIOLOGY PA EMPLOYEE HEALTH & WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 100
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 100
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 0
Total of all active and inactive participants 2021-01-01 100
Number of employers contributing to the scheme 2021-01-01 0
2017: CHARLOTTE RADIOLOGY PA EMPLOYEE HEALTH & WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 448
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 442
Number of retired or separated participants receiving benefits 2017-01-01 9
Number of other retired or separated participants entitled to future benefits 2017-01-01 0
Total of all active and inactive participants 2017-01-01 451
2016: CHARLOTTE RADIOLOGY PA EMPLOYEE HEALTH & WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 434
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 430
Number of retired or separated participants receiving benefits 2016-01-01 18
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 448
2015: CHARLOTTE RADIOLOGY PA EMPLOYEE HEALTH & WELFARE PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 403
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 415
Number of retired or separated participants receiving benefits 2015-01-01 19
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 434
2014: CHARLOTTE RADIOLOGY PA EMPLOYEE HEALTH & WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 362
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 386
Number of retired or separated participants receiving benefits 2014-01-01 17
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 403
2013: CHARLOTTE RADIOLOGY PA EMPLOYEE HEALTH & WELFARE PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 358
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 352
Number of retired or separated participants receiving benefits 2013-01-01 10
Total of all active and inactive participants 2013-01-01 362
Total participants 2013-01-01 362
2012: CHARLOTTE RADIOLOGY PA EMPLOYEE HEALTH & WELFARE PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 350
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 346
Number of retired or separated participants receiving benefits 2012-01-01 12
Total of all active and inactive participants 2012-01-01 358
Total participants 2012-01-01 358
2011: CHARLOTTE RADIOLOGY PA EMPLOYEE HEALTH & WELFARE PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 0
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 346
Number of retired or separated participants receiving benefits 2011-01-01 4
Total of all active and inactive participants 2011-01-01 350
Total participants 2011-01-01 350
2009: CHARLOTTE RADIOLOGY PA EMPLOYEE HEALTH & WELFARE PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 315
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 0
Number of retired or separated participants receiving benefits 2009-01-01 0
Total of all active and inactive participants 2009-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 0
Number of participants with account balances 2009-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0
Number of employers contributing to the scheme 2009-01-01 0

Measure	Date	Value
2021: CHARLOTTE RADIOLOGY PA EMPLOYEE HEALTH & WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	100
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	100
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	0
Total of all active and inactive participants	2021-01-01	100
Number of employers contributing to the scheme	2021-01-01	0
2017: CHARLOTTE RADIOLOGY PA EMPLOYEE HEALTH & WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	448
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	442
Number of retired or separated participants receiving benefits	2017-01-01	9
Number of other retired or separated participants entitled to future benefits	2017-01-01	0
Total of all active and inactive participants	2017-01-01	451
2016: CHARLOTTE RADIOLOGY PA EMPLOYEE HEALTH & WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	434
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	430
Number of retired or separated participants receiving benefits	2016-01-01	18
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	448
2015: CHARLOTTE RADIOLOGY PA EMPLOYEE HEALTH & WELFARE PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	403
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	415
Number of retired or separated participants receiving benefits	2015-01-01	19
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	434
2014: CHARLOTTE RADIOLOGY PA EMPLOYEE HEALTH & WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	362
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	386
Number of retired or separated participants receiving benefits	2014-01-01	17
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	403
2013: CHARLOTTE RADIOLOGY PA EMPLOYEE HEALTH & WELFARE PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	358
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	352
Number of retired or separated participants receiving benefits	2013-01-01	10
Total of all active and inactive participants	2013-01-01	362
Total participants	2013-01-01	362
2012: CHARLOTTE RADIOLOGY PA EMPLOYEE HEALTH & WELFARE PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	350
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	346
Number of retired or separated participants receiving benefits	2012-01-01	12
Total of all active and inactive participants	2012-01-01	358
Total participants	2012-01-01	358
2011: CHARLOTTE RADIOLOGY PA EMPLOYEE HEALTH & WELFARE PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	0
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	346
Number of retired or separated participants receiving benefits	2011-01-01	4
Total of all active and inactive participants	2011-01-01	350
Total participants	2011-01-01	350
2009: CHARLOTTE RADIOLOGY PA EMPLOYEE HEALTH & WELFARE PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	315
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	0
Number of retired or separated participants receiving benefits	2009-01-01	0
Total of all active and inactive participants	2009-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	0
Number of participants with account balances	2009-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0
Number of employers contributing to the scheme	2009-01-01	0

Financial Data on CHARLOTTE RADIOLOGY PA EMPLOYEE HEALTH & WELFARE PLAN

Measure	Date	Value
2017 : CHARLOTTE RADIOLOGY PA EMPLOYEE HEALTH & WELFARE PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$171,889
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$177,169
Total income from all sources (including contributions)	2017-12-31	$4,908,162
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$6,149,688
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$5,814,117
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$4,891,237
Value of total assets at end of year	2017-12-31	$425,619
Value of total assets at beginning of year	2017-12-31	$1,672,425
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$335,571
Total interest from all sources	2017-12-31	$388
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$500,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$2,126,867
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2017-12-31	$1,313,658
Value of other receiveables (less allowance for doubtful accounts) at end of year	2017-12-31	$39,558
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2017-12-31	$121,050
Other income not declared elsewhere	2017-12-31	$16,537
Total non interest bearing cash at end of year	2017-12-31	$386,061
Total non interest bearing cash at beginning of year	2017-12-31	$1,551,375
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$-1,241,526
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$253,730
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$1,495,256
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
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2017-12-31	$388
Expenses. Payments to insurance carriers foe the provision of benefits	2017-12-31	$1,651,900
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	$2,764,370
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$2,848,559
Contract administrator fees	2017-12-31	$335,571
Liabilities. Value of benefit claims payable at end of year	2017-12-31	$171,889
Liabilities. Value of benefit claims payable at beginning of year	2017-12-31	$177,169
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	No
Opinion of an independent qualified public accountant for this plan	2017-12-31	Unqualified
Accountancy firm name	2017-12-31	CLIFTONLARSONALLEN LLP
Accountancy firm EIN	2017-12-31	410746749
2016 : CHARLOTTE RADIOLOGY PA EMPLOYEE HEALTH & WELFARE PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$177,169
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$122,585
Total income from all sources (including contributions)	2016-12-31	$4,530,943
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$5,658,982
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$5,305,827
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$4,845,837
Value of total assets at end of year	2016-12-31	$1,672,425
Value of total assets at beginning of year	2016-12-31	$2,745,880
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$353,155
Total interest from all sources	2016-12-31	$1,535
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$500,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$2,045,904
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2016-12-31	$1,203,438
Value of other receiveables (less allowance for doubtful accounts) at end of year	2016-12-31	$121,050
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2016-12-31	$300,671
Other income not declared elsewhere	2016-12-31	$-316,429
Administrative expenses (other) incurred	2016-12-31	$18,779
Total non interest bearing cash at end of year	2016-12-31	$1,551,375
Total non interest bearing cash at beginning of year	2016-12-31	$1,849,919
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$-1,128,039
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$1,495,256
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$2,623,295
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2016-12-31	$1,535
Expenses. Payments to insurance carriers foe the provision of benefits	2016-12-31	$1,571,869
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$2,799,933
Employer contributions (assets) at end of year	2016-12-31	$0
Employer contributions (assets) at beginning of year	2016-12-31	$595,290
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$2,530,520
Contract administrator fees	2016-12-31	$334,376
Liabilities. Value of benefit claims payable at end of year	2016-12-31	$177,169
Liabilities. Value of benefit claims payable at beginning of year	2016-12-31	$122,585
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	No
Opinion of an independent qualified public accountant for this plan	2016-12-31	Unqualified
Accountancy firm name	2016-12-31	CLIFTONLARSONALLEN LLP
Accountancy firm EIN	2016-12-31	410746749
2015 : CHARLOTTE RADIOLOGY PA EMPLOYEE HEALTH & WELFARE 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	$122,585
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$219,916
Total income from all sources (including contributions)	2015-12-31	$5,881,720
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$5,046,431
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$4,727,821
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$5,301,341
Value of total assets at end of year	2015-12-31	$2,745,880
Value of total assets at beginning of year	2015-12-31	$2,007,922
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$318,610
Total interest from all sources	2015-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$500,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$1,679,433
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2015-12-31	$1,133,094
Value of other receiveables (less allowance for doubtful accounts) at end of year	2015-12-31	$300,671
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2015-12-31	$79,443
Other income not declared elsewhere	2015-12-31	$580,379
Administrative expenses (other) incurred	2015-12-31	$27,027
Total non interest bearing cash at end of year	2015-12-31	$1,849,919
Total non interest bearing cash at beginning of year	2015-12-31	$1,928,479
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$835,289
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$2,623,295
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$1,788,006
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
Expenses. Payments to insurance carriers foe the provision of benefits	2015-12-31	$1,369,917
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	No
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	$3,621,908
Employer contributions (assets) at end of year	2015-12-31	$595,290
Employer contributions (assets) at beginning of year	2015-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$2,224,810
Contract administrator fees	2015-12-31	$291,583
Liabilities. Value of benefit claims payable at end of year	2015-12-31	$122,585
Liabilities. Value of benefit claims payable at beginning of year	2015-12-31	$219,916
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	No
Opinion of an independent qualified public accountant for this plan	2015-12-31	Unqualified
Accountancy firm name	2015-12-31	CLIFTON LARSON ALLEN LLP
Accountancy firm EIN	2015-12-31	410746749
2014 : CHARLOTTE RADIOLOGY PA EMPLOYEE HEALTH & WELFARE 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	$219,916
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$197,872
Total income from all sources (including contributions)	2014-12-31	$5,278,213
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$4,886,002
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$4,578,738
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$5,028,858
Value of total assets at end of year	2014-12-31	$2,007,922
Value of total assets at beginning of year	2014-12-31	$1,593,667
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$307,264
Total interest from all sources	2014-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$500,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$1,786,558
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2014-12-31	$1,199,401
Value of other receiveables (less allowance for doubtful accounts) at end of year	2014-12-31	$79,443
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2014-12-31	$63,889
Other income not declared elsewhere	2014-12-31	$249,355
Administrative expenses (other) incurred	2014-12-31	$40,093
Total non interest bearing cash at end of year	2014-12-31	$1,928,479
Total non interest bearing cash at beginning of year	2014-12-31	$1,529,778
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	$392,211
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$1,788,006
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$1,395,795
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
Expenses. Payments to insurance carriers foe the provision of benefits	2014-12-31	$1,344,629
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	No
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	$3,242,300
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$2,034,708
Contract administrator fees	2014-12-31	$267,171
Liabilities. Value of benefit claims payable at end of year	2014-12-31	$219,916
Liabilities. Value of benefit claims payable at beginning of year	2014-12-31	$197,872
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	No
Opinion of an independent qualified public accountant for this plan	2014-12-31	Unqualified
Accountancy firm name	2014-12-31	CLIFTON LARSON ALLEN LLP
Accountancy firm EIN	2014-12-31	410746749
2013 : CHARLOTTE RADIOLOGY PA EMPLOYEE HEALTH & WELFARE PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$197,872
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$259,718
Total income from all sources (including contributions)	2013-12-31	$3,698,110
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$2,907,627
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$1,969,140
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$3,698,110
Value of total assets at end of year	2013-12-31	$1,593,667
Value of total assets at beginning of year	2013-12-31	$865,030
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$938,487
Total interest from all sources	2013-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$500,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$311,291
Value of other receiveables (less allowance for doubtful accounts) at end of year	2013-12-31	$63,889
Administrative expenses (other) incurred	2013-12-31	$732,348
Total non interest bearing cash at end of year	2013-12-31	$1,529,778
Total non interest bearing cash at beginning of year	2013-12-31	$259,708
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$790,483
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$1,395,795
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$605,312
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$3,386,819
Employer contributions (assets) at beginning of year	2013-12-31	$605,322
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$1,969,140
Contract administrator fees	2013-12-31	$206,139
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	2013-12-31	No
Liabilities. Value of benefit claims payable at end of year	2013-12-31	$197,872
Liabilities. Value of benefit claims payable at beginning of year	2013-12-31	$259,718
Did the plan have assets held for investment	2013-12-31	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	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	No
Opinion of an independent qualified public accountant for this plan	2013-12-31	Unqualified
Accountancy firm name	2013-12-31	JACK L. ANTHONY, CPA, PA
Accountancy firm EIN	2013-12-31	562209352
2012 : CHARLOTTE RADIOLOGY PA EMPLOYEE HEALTH & WELFARE PLAN 2012 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$259,718
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$334,265
Total income from all sources (including contributions)	2012-12-31	$3,332,367
Total of all expenses incurred	2012-12-31	$3,476,212
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$2,702,477
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$3,332,367
Value of total assets at end of year	2012-12-31	$865,030
Value of total assets at beginning of year	2012-12-31	$1,083,422
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$773,735
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$500,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$232,711
Administrative expenses (other) incurred	2012-12-31	$580,471
Total non interest bearing cash at end of year	2012-12-31	$259,708
Total non interest bearing cash at beginning of year	2012-12-31	$1,083,422
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$-143,845
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$605,312
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$749,157
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$3,099,656
Employer contributions (assets) at end of year	2012-12-31	$605,322
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$2,702,477
Contract administrator fees	2012-12-31	$193,264
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	2012-12-31	No
Liabilities. Value of benefit claims payable at end of year	2012-12-31	$259,718
Liabilities. Value of benefit claims payable at beginning of year	2012-12-31	$334,265
Did the plan have assets held for investment	2012-12-31	No
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	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	No
Opinion of an independent qualified public accountant for this plan	2012-12-31	Unqualified
Accountancy firm name	2012-12-31	JACK L ANTHONY CPA PA
Accountancy firm EIN	2012-12-31	562209352
2011 : CHARLOTTE RADIOLOGY PA EMPLOYEE HEALTH & WELFARE PLAN 2011 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$334,265
Total income from all sources (including contributions)	2011-12-31	$3,013,840
Total of all expenses incurred	2011-12-31	$3,053,426
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$2,430,702
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$3,013,840
Value of total assets at end of year	2011-12-31	$1,083,422
Value of total assets at beginning of year	2011-12-31	$788,746
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$622,724
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$50,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$179,476
Administrative expenses (other) incurred	2011-12-31	$402,925
Total non interest bearing cash at end of year	2011-12-31	$1,083,422
Total non interest bearing cash at beginning of year	2011-12-31	$788,746
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$-39,586
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$749,157
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$788,746
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$2,834,364
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$2,430,702
Contract administrator fees	2011-12-31	$219,799
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	2011-12-31	No
Liabilities. Value of benefit claims payable at end of year	2011-12-31	$334,265
Did the plan have assets held for investment	2011-12-31	No
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	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	No
Opinion of an independent qualified public accountant for this plan	2011-12-31	Unqualified
Accountancy firm name	2011-12-31	ANTHONY & FLETCHER, CPAS PA
Accountancy firm EIN	2011-12-31	562209352
2010 : CHARLOTTE RADIOLOGY PA EMPLOYEE HEALTH & WELFARE PLAN 2010 401k financial data
Total income from all sources (including contributions)	2010-12-31	$250,000
Total of all expenses incurred	2010-12-31	$52,763
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$10,924
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$250,000
Value of total assets at end of year	2010-12-31	$788,743
Value of total assets at beginning of year	2010-12-31	$591,506
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$41,839
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Was this plan covered by a fidelity bond	2010-12-31	No
If this is an individual account plan, was there a blackout period	2010-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2010-12-31	$250,000
Total non interest bearing cash at end of year	2010-12-31	$788,743
Total non interest bearing cash at beginning of year	2010-12-31	$341,506
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$197,237
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$788,743
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$591,506
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$250,000
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$10,924
Contract administrator fees	2010-12-31	$41,839
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	2010-12-31	No
Did the plan have assets held for investment	2010-12-31	No
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	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	No
Opinion of an independent qualified public accountant for this plan	2010-12-31	Unqualified
Accountancy firm name	2010-12-31	ANTHONY & ROBINSON, CPA PA
Accountancy firm EIN	2010-12-31	562209352

Form 5500 Responses for CHARLOTTE RADIOLOGY PA EMPLOYEE HEALTH & WELFARE PLAN

2021: CHARLOTTE RADIOLOGY PA EMPLOYEE HEALTH & WELFARE PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2021-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2017: CHARLOTTE RADIOLOGY PA EMPLOYEE HEALTH & WELFARE 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 funding arrangement – General assets of the sponsor	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2017-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2016: CHARLOTTE RADIOLOGY PA EMPLOYEE HEALTH & WELFARE 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 funding arrangement – General assets of the sponsor	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2016-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2015: CHARLOTTE RADIOLOGY PA EMPLOYEE HEALTH & WELFARE 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 funding arrangement – General assets of the sponsor	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2015-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: CHARLOTTE RADIOLOGY PA EMPLOYEE HEALTH & WELFARE 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 funding arrangement – General assets of the sponsor	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2014-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: CHARLOTTE RADIOLOGY PA EMPLOYEE HEALTH & WELFARE PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: CHARLOTTE RADIOLOGY PA EMPLOYEE HEALTH & WELFARE PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: CHARLOTTE RADIOLOGY PA EMPLOYEE HEALTH & WELFARE PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: CHARLOTTE RADIOLOGY PA EMPLOYEE HEALTH & WELFARE PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	First time form 5500 has been submitted	Yes
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

COMMUNITY EYE CARE (National Association of Insurance Commissioners NAIC id number: 52429 )

Policy contract number

TP035012

Policy instance

Insurance contract or identification number	TP035012
Number of Individuals Covered	511
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $2,665
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	Yes
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
Welfare Benefit Premiums Paid to Carrier	USD $26,650
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,665
Insurance broker organization code?	3
Insurance broker name	WELLS FARGO INSURANCE SERVICES USA

HUMANA (National Association of Insurance Commissioners NAIC id number: 70580 )

Policy contract number

739320

Policy instance

Insurance contract or identification number	739320
Number of Individuals Covered	314
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $48,323
Total amount of fees paid to insurance company	USD $6,410
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	Yes
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
Welfare Benefit Premiums Paid to Carrier	USD $323,990
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $32,215
Amount paid for insurance broker fees	6410
Additional information about fees paid to insurance broker	BONUSES
Insurance broker organization code?	3
Insurance broker name	IBSI HOLDINGS INC

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

038067G

Policy instance

Insurance contract or identification number	038067G
Number of Individuals Covered	442
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $41,653
Total amount of fees paid to insurance company	USD $4,212
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $383,846
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $41,653
Insurance broker organization code?	3
Amount paid for insurance broker fees	4212
Additional information about fees paid to insurance broker	BONUSES
Insurance broker name	USI INSURANCE SERVICES NATIONAL INC

HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )

Policy contract number

HCL32857

Policy instance

Insurance contract or identification number	HCL32857
Number of Individuals Covered	398
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
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?	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
Welfare Benefit Premiums Paid to Carrier	USD $893,834
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )

Policy contract number

073560

Policy instance

Insurance contract or identification number	073560
Number of Individuals Covered	389
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
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?	No
Health Insurance Welfare Benefit	Yes
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

HUMANA (National Association of Insurance Commissioners NAIC id number: 70580 )

Policy contract number

739320

Policy instance

Insurance contract or identification number	739320
Number of Individuals Covered	271
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $38,394
Total amount of fees paid to insurance company	USD $1,983
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	Yes
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
Welfare Benefit Premiums Paid to Carrier	USD $256,575
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $25,596
Amount paid for insurance broker fees	1983
Additional information about fees paid to insurance broker	BONUSES
Insurance broker organization code?	3
Insurance broker name	IBSI HOLDINGS INC

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

038067G

Policy instance

Insurance contract or identification number	038067G
Number of Individuals Covered	415
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $38,817
Total amount of fees paid to insurance company	USD $3,233
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	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $373,740
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $38,817
Insurance broker organization code?	3
Amount paid for insurance broker fees	3233
Additional information about fees paid to insurance broker	BONUSES
Insurance broker name	WELLS FARGO INS SERVICES USA INC

BERKLEY LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64890 )

Policy contract number

ERLL15100488005

Policy instance

Insurance contract or identification number	ERLL15100488005
Number of Individuals Covered	366
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
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
Welfare Benefit Premiums Paid to Carrier	USD $742,499
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )

Policy contract number

073560

Policy instance

Insurance contract or identification number	073560
Number of Individuals Covered	359
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
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	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	Yes
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

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

038067G

Policy instance

Insurance contract or identification number	038067G
Number of Individuals Covered	386
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $41,070
Total amount of fees paid to insurance company	USD $3,805
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	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $323,257
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $24,254
Insurance broker organization code?	3
Amount paid for insurance broker fees	3805
Additional information about fees paid to insurance broker	BONUSES
Insurance broker name	WELLS FARGO INS SERVICES USA INC

AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 )

Policy contract number

219R50

Policy instance

Insurance contract or identification number	219R50
Number of Individuals Covered	261
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $38,976
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	Yes
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
Welfare Benefit Premiums Paid to Carrier	USD $258,430
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $25,843
Insurance broker organization code?	3
Insurance broker name	IBSI HOLDINGS INC

BERKLEY LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64890 )

Policy contract number

ERLL14100488004

Policy instance

Insurance contract or identification number	ERLL14100488004
Number of Individuals Covered	337
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
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
Welfare Benefit Premiums Paid to Carrier	USD $738,904
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )

Policy contract number

073560

Policy instance

Insurance contract or identification number	073560
Number of Individuals Covered	337
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $63,438
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	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	Yes
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 $63,438
Insurance broker organization code?	3
Insurance broker name	LARRY HIGHTOWER

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Company Name:	CHARLOTTE RADIOLOGY, PA
Employer identification number (EIN):	560954779
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)