401k Plan data: MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN plan

MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN 401k Plan overview

Plan Name	MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN
Plan identification number	004

MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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

401k Sponsoring company profile

MID-TENNESSEE BONE AND JOINT CLINIC, P.C. has sponsored the creation of one or more 401k plans.

Company Name: MID-TENNESSEE BONE AND JOINT CLINIC, P.C.

Employer identification number (EIN): 620960512

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
004 2021-01-01
004 2020-01-01
004 2019-01-01
004 2018-01-01 RANDALL DAVIDSON, M.D.
004 2017-01-01 RANDALL DAVIDSON, M.D.
004 2016-01-01 RANDALL DAVIDSON, M.D.
004 2015-01-01 RANDALL DAVIDSON, M.D.
004 2014-01-01 RANDALL DAVIDSON, M.D.
004 2013-01-01 RANDALL DAVIDSON, M.D.
004 2012-01-01 RANDALL DAVIDSON, M.D.
004 2011-01-01 RANDALL DAVIDSON, M.D.
004 2010-01-01 RANDALL DAVIDSON, M.D.
004 2009-01-01 RANDY WILMORE

Plan Statistics for MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN

401k plan membership statisitcs for MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN

Measure Date Value
2021: MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 104
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 0
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 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 0
Number of participants with account balances 2021-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 103
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 0
Number of retired or separated participants receiving benefits 2020-01-01 6
Number of other retired or separated participants entitled to future benefits 2020-01-01 98
Total of all active and inactive participants 2020-01-01 104
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 104
Number of participants with account balances 2020-01-01 104
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 3
2019: MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 115
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 82
Number of retired or separated participants receiving benefits 2019-01-01 3
Number of other retired or separated participants entitled to future benefits 2019-01-01 15
Total of all active and inactive participants 2019-01-01 100
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 100
Number of participants with account balances 2019-01-01 100
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 5
2018: MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 105
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 83
Number of retired or separated participants receiving benefits 2018-01-01 3
Number of other retired or separated participants entitled to future benefits 2018-01-01 22
Total of all active and inactive participants 2018-01-01 108
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 108
Number of participants with account balances 2018-01-01 108
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 5
2017: MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 98
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 71
Number of retired or separated participants receiving benefits 2017-01-01 4
Number of other retired or separated participants entitled to future benefits 2017-01-01 22
Total of all active and inactive participants 2017-01-01 97
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 97
Number of participants with account balances 2017-01-01 97
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 3
2016: MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 93
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 71
Number of retired or separated participants receiving benefits 2016-01-01 5
Number of other retired or separated participants entitled to future benefits 2016-01-01 19
Total of all active and inactive participants 2016-01-01 95
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 95
Number of participants with account balances 2016-01-01 95
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 5
2015: MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 91
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 74
Number of retired or separated participants receiving benefits 2015-01-01 4
Number of other retired or separated participants entitled to future benefits 2015-01-01 14
Total of all active and inactive participants 2015-01-01 92
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 92
Number of participants with account balances 2015-01-01 92
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 1
2014: MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 98
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 68
Number of retired or separated participants receiving benefits 2014-01-01 2
Number of other retired or separated participants entitled to future benefits 2014-01-01 13
Total of all active and inactive participants 2014-01-01 83
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 83
Number of participants with account balances 2014-01-01 83
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 1
2013: MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 90
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 60
Number of retired or separated participants receiving benefits 2013-01-01 8
Number of other retired or separated participants entitled to future benefits 2013-01-01 24
Total of all active and inactive participants 2013-01-01 92
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 92
Number of participants with account balances 2013-01-01 92
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 3
2012: MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 87
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 60
Number of retired or separated participants receiving benefits 2012-01-01 6
Number of other retired or separated participants entitled to future benefits 2012-01-01 22
Total of all active and inactive participants 2012-01-01 88
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 88
Number of participants with account balances 2012-01-01 88
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 3
2011: MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 86
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 53
Number of retired or separated participants receiving benefits 2011-01-01 5
Number of other retired or separated participants entitled to future benefits 2011-01-01 24
Total of all active and inactive participants 2011-01-01 82
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 82
Number of participants with account balances 2011-01-01 82
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 3
2010: MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 96
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 55
Number of retired or separated participants receiving benefits 2010-01-01 3
Number of other retired or separated participants entitled to future benefits 2010-01-01 25
Total of all active and inactive participants 2010-01-01 83
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 83
Number of participants with account balances 2010-01-01 83
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 5
2009: MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 89
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 55
Number of retired or separated participants receiving benefits 2009-01-01 8
Number of other retired or separated participants entitled to future benefits 2009-01-01 29
Total of all active and inactive participants 2009-01-01 92
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 92
Number of participants with account balances 2009-01-01 92
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 7

Measure	Date	Value
2021: MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	104
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	0
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	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	0
Number of participants with account balances	2021-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	103
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	0
Number of retired or separated participants receiving benefits	2020-01-01	6
Number of other retired or separated participants entitled to future benefits	2020-01-01	98
Total of all active and inactive participants	2020-01-01	104
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	104
Number of participants with account balances	2020-01-01	104
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	3
2019: MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	115
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	82
Number of retired or separated participants receiving benefits	2019-01-01	3
Number of other retired or separated participants entitled to future benefits	2019-01-01	15
Total of all active and inactive participants	2019-01-01	100
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	100
Number of participants with account balances	2019-01-01	100
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	5
2018: MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	105
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	83
Number of retired or separated participants receiving benefits	2018-01-01	3
Number of other retired or separated participants entitled to future benefits	2018-01-01	22
Total of all active and inactive participants	2018-01-01	108
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	108
Number of participants with account balances	2018-01-01	108
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	5
2017: MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	98
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	71
Number of retired or separated participants receiving benefits	2017-01-01	4
Number of other retired or separated participants entitled to future benefits	2017-01-01	22
Total of all active and inactive participants	2017-01-01	97
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	97
Number of participants with account balances	2017-01-01	97
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	3
2016: MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	93
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	71
Number of retired or separated participants receiving benefits	2016-01-01	5
Number of other retired or separated participants entitled to future benefits	2016-01-01	19
Total of all active and inactive participants	2016-01-01	95
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	95
Number of participants with account balances	2016-01-01	95
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	5
2015: MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	91
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	74
Number of retired or separated participants receiving benefits	2015-01-01	4
Number of other retired or separated participants entitled to future benefits	2015-01-01	14
Total of all active and inactive participants	2015-01-01	92
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	92
Number of participants with account balances	2015-01-01	92
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	1
2014: MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	98
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	68
Number of retired or separated participants receiving benefits	2014-01-01	2
Number of other retired or separated participants entitled to future benefits	2014-01-01	13
Total of all active and inactive participants	2014-01-01	83
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	83
Number of participants with account balances	2014-01-01	83
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	1
2013: MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	90
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	60
Number of retired or separated participants receiving benefits	2013-01-01	8
Number of other retired or separated participants entitled to future benefits	2013-01-01	24
Total of all active and inactive participants	2013-01-01	92
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	92
Number of participants with account balances	2013-01-01	92
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	3
2012: MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	87
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	60
Number of retired or separated participants receiving benefits	2012-01-01	6
Number of other retired or separated participants entitled to future benefits	2012-01-01	22
Total of all active and inactive participants	2012-01-01	88
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	88
Number of participants with account balances	2012-01-01	88
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	3
2011: MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	86
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	53
Number of retired or separated participants receiving benefits	2011-01-01	5
Number of other retired or separated participants entitled to future benefits	2011-01-01	24
Total of all active and inactive participants	2011-01-01	82
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	82
Number of participants with account balances	2011-01-01	82
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	3
2010: MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	96
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	55
Number of retired or separated participants receiving benefits	2010-01-01	3
Number of other retired or separated participants entitled to future benefits	2010-01-01	25
Total of all active and inactive participants	2010-01-01	83
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	83
Number of participants with account balances	2010-01-01	83
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	5
2009: MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	89
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	55
Number of retired or separated participants receiving benefits	2009-01-01	8
Number of other retired or separated participants entitled to future benefits	2009-01-01	29
Total of all active and inactive participants	2009-01-01	92
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	92
Number of participants with account balances	2009-01-01	92
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	7

Financial Data on MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN

Measure	Date	Value
2021 : MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN 2021 401k financial data
Total income from all sources	2021-11-15	$1,842,476
Expenses. Total of all expenses incurred	2021-11-15	$19,208,536
Benefits paid (including direct rollovers)	2021-11-15	$19,134,699
Total plan assets at end of year	2021-11-15	$0
Total plan assets at beginning of year	2021-11-15	$17,366,060
Value of fidelity bond covering the plan	2021-11-15	$1,000,000
Other income received	2021-11-15	$1,842,476
Net income (gross income less expenses)	2021-11-15	$-17,366,060
Net plan assets at end of year (total assets less liabilities)	2021-11-15	$0
Net plan assets at beginning of year (total assets less liabilities)	2021-11-15	$17,366,060
Assets. Value of participant loans	2021-11-15	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2021-11-15	$73,837
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-11-15	$50,000
2020 : MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN 2020 401k financial data
Transfers to/from the plan	2020-12-31	$0
Total income from all sources	2020-12-31	$2,910,080
Expenses. Total of all expenses incurred	2020-12-31	$4,238,307
Benefits paid (including direct rollovers)	2020-12-31	$4,155,339
Total plan assets at end of year	2020-12-31	$17,366,060
Total plan assets at beginning of year	2020-12-31	$18,694,287
Value of fidelity bond covering the plan	2020-12-31	$1,000,000
Total contributions received or receivable from participants	2020-12-31	$353,392
Expenses. Other expenses not covered elsewhere	2020-12-31	$0
Contributions received from other sources (not participants or employers)	2020-12-31	$45,277
Other income received	2020-12-31	$1,871,141
Noncash contributions received	2020-12-31	$0
Net income (gross income less expenses)	2020-12-31	$-1,328,227
Net plan assets at end of year (total assets less liabilities)	2020-12-31	$17,366,060
Net plan assets at beginning of year (total assets less liabilities)	2020-12-31	$18,694,287
Assets. Value of participant loans	2020-12-31	$92,942
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2020-12-31	$13,208
Total contributions received or receivable from employer(s)	2020-12-31	$640,270
Value of certain deemed distributions of participant loans	2020-12-31	$0
Value of corrective distributions	2020-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2020-12-31	$82,968
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
2019 : MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN 2019 401k financial data
Total income from all sources	2019-12-31	$3,993,481
Expenses. Total of all expenses incurred	2019-12-31	$1,332,958
Benefits paid (including direct rollovers)	2019-12-31	$1,230,767
Total plan assets at end of year	2019-12-31	$18,694,287
Total plan assets at beginning of year	2019-12-31	$16,033,764
Value of fidelity bond covering the plan	2019-12-31	$1,000,000
Total contributions received or receivable from participants	2019-12-31	$354,881
Contributions received from other sources (not participants or employers)	2019-12-31	$2,734
Other income received	2019-12-31	$3,057,247
Net income (gross income less expenses)	2019-12-31	$2,660,523
Net plan assets at end of year (total assets less liabilities)	2019-12-31	$18,694,287
Net plan assets at beginning of year (total assets less liabilities)	2019-12-31	$16,033,764
Assets. Value of participant loans	2019-12-31	$214,431
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2019-12-31	$13,208
Total contributions received or receivable from employer(s)	2019-12-31	$578,619
Expenses. Administrative service providers (salaries,fees and commissions)	2019-12-31	$102,191
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
2018 : MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN 2018 401k financial data
Total income from all sources	2018-12-31	$-51,241
Expenses. Total of all expenses incurred	2018-12-31	$114,093
Benefits paid (including direct rollovers)	2018-12-31	$13,910
Total plan assets at end of year	2018-12-31	$16,033,764
Total plan assets at beginning of year	2018-12-31	$16,199,098
Value of fidelity bond covering the plan	2018-12-31	$1,000,000
Total contributions received or receivable from participants	2018-12-31	$323,887
Expenses. Other expenses not covered elsewhere	2018-12-31	$0
Contributions received from other sources (not participants or employers)	2018-12-31	$0
Other income received	2018-12-31	$-912,997
Noncash contributions received	2018-12-31	$0
Net income (gross income less expenses)	2018-12-31	$-165,334
Net plan assets at end of year (total assets less liabilities)	2018-12-31	$16,033,764
Net plan assets at beginning of year (total assets less liabilities)	2018-12-31	$16,199,098
Assets. Value of participant loans	2018-12-31	$137,661
Total contributions received or receivable from employer(s)	2018-12-31	$537,869
Value of certain deemed distributions of participant loans	2018-12-31	$0
Value of corrective distributions	2018-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2018-12-31	$100,183
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
2017 : MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN 2017 401k financial data
Total income from all sources	2017-12-31	$3,056,495
Expenses. Total of all expenses incurred	2017-12-31	$149,303
Benefits paid (including direct rollovers)	2017-12-31	$62,533
Total plan assets at end of year	2017-12-31	$16,199,098
Total plan assets at beginning of year	2017-12-31	$13,291,906
Value of fidelity bond covering the plan	2017-12-31	$1,000,000
Total contributions received or receivable from participants	2017-12-31	$295,838
Contributions received from other sources (not participants or employers)	2017-12-31	$0
Other income received	2017-12-31	$2,282,123
Noncash contributions received	2017-12-31	$0
Net income (gross income less expenses)	2017-12-31	$2,907,192
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$16,199,098
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$13,291,906
Assets. Value of participant loans	2017-12-31	$50,993
Total contributions received or receivable from employer(s)	2017-12-31	$478,534
Value of certain deemed distributions of participant loans	2017-12-31	$0
Value of corrective distributions	2017-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2017-12-31	$86,770
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
2016 : MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN 2016 401k financial data
Total income from all sources	2016-12-31	$1,742,094
Expenses. Total of all expenses incurred	2016-12-31	$153,307
Benefits paid (including direct rollovers)	2016-12-31	$77,743
Total plan assets at end of year	2016-12-31	$13,291,906
Total plan assets at beginning of year	2016-12-31	$11,703,119
Value of fidelity bond covering the plan	2016-12-31	$1,000,000
Total contributions received or receivable from participants	2016-12-31	$273,985
Expenses. Other expenses not covered elsewhere	2016-12-31	$0
Contributions received from other sources (not participants or employers)	2016-12-31	$0
Other income received	2016-12-31	$1,008,009
Noncash contributions received	2016-12-31	$0
Net income (gross income less expenses)	2016-12-31	$1,588,787
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$13,291,906
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$11,703,119
Assets. Value of participant loans	2016-12-31	$58,315
Total contributions received or receivable from employer(s)	2016-12-31	$460,100
Value of certain deemed distributions of participant loans	2016-12-31	$0
Value of corrective distributions	2016-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2016-12-31	$75,564
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
2015 : MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN 2015 401k financial data
Total income from all sources	2015-12-31	$529,701
Expenses. Total of all expenses incurred	2015-12-31	$103,048
Benefits paid (including direct rollovers)	2015-12-31	$16,872
Total plan assets at end of year	2015-12-31	$11,703,119
Total plan assets at beginning of year	2015-12-31	$11,276,466
Value of fidelity bond covering the plan	2015-12-31	$1,000,000
Total contributions received or receivable from participants	2015-12-31	$274,988
Expenses. Other expenses not covered elsewhere	2015-12-31	$0
Contributions received from other sources (not participants or employers)	2015-12-31	$0
Other income received	2015-12-31	$-220,308
Noncash contributions received	2015-12-31	$0
Net income (gross income less expenses)	2015-12-31	$426,653
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$11,703,119
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$11,276,466
Assets. Value of participant loans	2015-12-31	$59,269
Total contributions received or receivable from employer(s)	2015-12-31	$475,021
Value of certain deemed distributions of participant loans	2015-12-31	$0
Value of corrective distributions	2015-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2015-12-31	$86,176
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
2014 : MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN 2014 401k financial data
Total income from all sources	2014-12-31	$1,112,108
Expenses. Total of all expenses incurred	2014-12-31	$84,432
Benefits paid (including direct rollovers)	2014-12-31	$3,673
Total plan assets at end of year	2014-12-31	$11,276,466
Total plan assets at beginning of year	2014-12-31	$10,248,790
Value of fidelity bond covering the plan	2014-12-31	$1,000,000
Total contributions received or receivable from participants	2014-12-31	$217,979
Expenses. Other expenses not covered elsewhere	2014-12-31	$0
Contributions received from other sources (not participants or employers)	2014-12-31	$12,809
Other income received	2014-12-31	$506,331
Noncash contributions received	2014-12-31	$0
Net income (gross income less expenses)	2014-12-31	$1,027,676
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$11,276,466
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$10,248,790
Assets. Value of participant loans	2014-12-31	$42,440
Total contributions received or receivable from employer(s)	2014-12-31	$374,989
Value of certain deemed distributions of participant loans	2014-12-31	$0
Value of corrective distributions	2014-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2014-12-31	$80,759
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
2013 : MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN 2013 401k financial data
Total income from all sources	2013-12-31	$2,051,414
Expenses. Total of all expenses incurred	2013-12-31	$221,876
Benefits paid (including direct rollovers)	2013-12-31	$158,735
Total plan assets at end of year	2013-12-31	$10,248,790
Total plan assets at beginning of year	2013-12-31	$8,419,252
Value of fidelity bond covering the plan	2013-12-31	$1,000,000
Total contributions received or receivable from participants	2013-12-31	$231,408
Contributions received from other sources (not participants or employers)	2013-12-31	$63,708
Other income received	2013-12-31	$1,388,412
Net income (gross income less expenses)	2013-12-31	$1,829,538
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$10,248,790
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$8,419,252
Assets. Value of participant loans	2013-12-31	$32,071
Total contributions received or receivable from employer(s)	2013-12-31	$367,886
Expenses. Administrative service providers (salaries,fees and commissions)	2013-12-31	$63,141
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
2012 : MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$1,437,255
Expenses. Total of all expenses incurred	2012-12-31	$111,880
Benefits paid (including direct rollovers)	2012-12-31	$62,721
Total plan assets at end of year	2012-12-31	$8,419,252
Total plan assets at beginning of year	2012-12-31	$7,093,877
Value of fidelity bond covering the plan	2012-12-31	$1,000,000
Total contributions received or receivable from participants	2012-12-31	$223,585
Expenses. Other expenses not covered elsewhere	2012-12-31	$0
Contributions received from other sources (not participants or employers)	2012-12-31	$664
Other income received	2012-12-31	$846,369
Noncash contributions received	2012-12-31	$0
Net income (gross income less expenses)	2012-12-31	$1,325,375
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$8,419,252
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$7,093,877
Assets. Value of participant loans	2012-12-31	$49,049
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2012-12-31	$2,083
Total contributions received or receivable from employer(s)	2012-12-31	$366,637
Value of certain deemed distributions of participant loans	2012-12-31	$0
Value of corrective distributions	2012-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2012-12-31	$49,159
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
2011 : MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$564,148
Expenses. Total of all expenses incurred	2011-12-31	$194,120
Benefits paid (including direct rollovers)	2011-12-31	$144,603
Total plan assets at end of year	2011-12-31	$7,093,877
Total plan assets at beginning of year	2011-12-31	$6,723,849
Value of fidelity bond covering the plan	2011-12-31	$1,000,000
Total contributions received or receivable from participants	2011-12-31	$202,378
Expenses. Other expenses not covered elsewhere	2011-12-31	$0
Contributions received from other sources (not participants or employers)	2011-12-31	$300,465
Other income received	2011-12-31	$-249,436
Noncash contributions received	2011-12-31	$0
Net income (gross income less expenses)	2011-12-31	$370,028
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$7,093,877
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$6,723,849
Assets. Value of participant loans	2011-12-31	$72,665
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2011-12-31	$2,083
Total contributions received or receivable from employer(s)	2011-12-31	$310,741
Value of certain deemed distributions of participant loans	2011-12-31	$0
Value of corrective distributions	2011-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$49,517
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
2010 : MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$1,387,471
Expenses. Total of all expenses incurred	2010-12-31	$192,276
Benefits paid (including direct rollovers)	2010-12-31	$146,026
Total plan assets at end of year	2010-12-31	$6,723,849
Total plan assets at beginning of year	2010-12-31	$5,528,654
Value of fidelity bond covering the plan	2010-12-31	$1,000,000
Total contributions received or receivable from participants	2010-12-31	$215,770
Contributions received from other sources (not participants or employers)	2010-12-31	$106,901
Other income received	2010-12-31	$683,256
Net income (gross income less expenses)	2010-12-31	$1,195,195
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$6,723,849
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$5,528,654
Assets. Value of participant loans	2010-12-31	$124,978
Total contributions received or receivable from employer(s)	2010-12-31	$381,544
Value of certain deemed distributions of participant loans	2010-12-31	$2,857
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$43,393
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0

Form 5500 Responses for MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN

2021: MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	Yes
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: MID-TENNESSEE BONE AND JOINT CLINIC 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: MID-TENNESSEE BONE AND JOINT CLINIC 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
2013: MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING 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 – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	Yes
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: MID-TENNESSEE BONE AND JOINT CLINIC PROFIT SHARING PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

GA-824130

Policy instance

Insurance contract or identification number	GA-824130
Number of Individuals Covered	0
Insurance policy start date	2021-01-01
Insurance policy end date	2021-06-30
Total amount of commissions paid to insurance broker	USD $6,194
Total amount of fees paid to insurance company	USD $1,621
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,194
Insurance broker organization code?	3
Amount paid for insurance broker fees	1621
Additional information about fees paid to insurance broker	ADMINISTRATIVE ALLOWANCE

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

GA-824130

Policy instance

Insurance contract or identification number	GA-824130
Number of Individuals Covered	93
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $10,218
Total amount of fees paid to insurance company	USD $2,670
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?	Yes
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Other information about contract	GROUP ANNUITY
Commission paid to Insurance Broker	USD $9,974
Insurance broker organization code?	3
Amount paid for insurance broker fees	2670
Additional information about fees paid to insurance broker	ADMINISTRATIVE ALLOWANCE

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

824130

Policy instance

Insurance contract or identification number	824130
Number of Individuals Covered	91
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $7,326
Total amount of fees paid to insurance company	USD $2,522
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $7,326
Insurance broker organization code?	3
Amount paid for insurance broker fees	2522
Additional information about fees paid to insurance broker	ADMINISTRATIVE ALLOWANCE

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

824130

Policy instance

Insurance contract or identification number	824130
Number of Individuals Covered	99
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $9,537
Total amount of fees paid to insurance company	USD $1,889
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $9,537
Insurance broker organization code?	3
Amount paid for insurance broker fees	1889
Additional information about fees paid to insurance broker	ADMINISTRATIVE ALLOWANCE

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

824130

Policy instance

Insurance contract or identification number	824130
Number of Individuals Covered	86
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $10,245
Total amount of fees paid to insurance company	USD $2,682
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $10,245
Insurance broker organization code?	3
Amount paid for insurance broker fees	2682
Additional information about fees paid to insurance broker	ADMINISTRATIVE ALLOWANCE
Insurance broker name	ACUFF & ASSOCIATES

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

824130

Policy instance

Insurance contract or identification number	824130
Number of Individuals Covered	80
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $6,305
Total amount of fees paid to insurance company	USD $1,576
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,305
Insurance broker organization code?	3
Amount paid for insurance broker fees	1576
Additional information about fees paid to insurance broker	ADMINISTRATIVE ALLOWANCE
Insurance broker name	ACUFF & ASSOCIATES

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

824130

Policy instance

Insurance contract or identification number	824130
Number of Individuals Covered	73
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $5,455
Total amount of fees paid to insurance company	USD $1,364
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,455
Insurance broker organization code?	3
Amount paid for insurance broker fees	1364
Additional information about fees paid to insurance broker	ADMINISTRATIVE ALLOWANCE
Insurance broker name	ACUFF & ASSOCIATES

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

824130

Policy instance

Insurance contract or identification number	824130
Number of Individuals Covered	92
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $4,453
Total amount of fees paid to insurance company	USD $1,113
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,453
Insurance broker organization code?	3
Amount paid for insurance broker fees	1113
Additional information about fees paid to insurance broker	ADMINISTRATIVE ALLOWANCE
Insurance broker name	ACUFF & ASSOCIATES

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

824130

Policy instance

Insurance contract or identification number	824130
Number of Individuals Covered	88
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $3,920
Total amount of fees paid to insurance company	USD $1,071
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,920
Insurance broker organization code?	3
Amount paid for insurance broker fees	980
Additional information about fees paid to insurance broker	ADMINISTRATIVE ALLOWANCE
Insurance broker name	MORGANSTANLEY SMITHBARNEY LLC

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

824130

Policy instance

Insurance contract or identification number	824130
Number of Individuals Covered	76
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $6,105
Total amount of fees paid to insurance company	USD $101
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

48786

Policy instance

Insurance contract or identification number	48786
Number of Individuals Covered	0
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $5,599
Total amount of fees paid to insurance company	USD $1,475
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,738
Insurance broker organization code?	4
Amount paid for insurance broker fees	1475
Additional information about fees paid to insurance broker	TPA FEES
Insurance broker name	ACUFF & ASSOCIATES

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

824130

Policy instance

Insurance contract or identification number	824130
Number of Individuals Covered	70
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $38,333
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $33,333
Insurance broker organization code?	4
Insurance broker name	ACUFF & ASSOCIATES

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Company Name:	MID-TENNESSEE BONE AND JOINT CLINIC, P.C.
Employer identification number (EIN):	620960512
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)