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ORTHOTENNESSEE GROUP MEDICAL AND DENTAL PLAN 401k Plan overview

Plan NameORTHOTENNESSEE GROUP MEDICAL AND DENTAL PLAN
Plan identification number 501

ORTHOTENNESSEE GROUP MEDICAL AND DENTAL PLAN Benefits

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

401k Sponsoring company profile

ORTHOTENNESSEE P.C. has sponsored the creation of one or more 401k plans.

Company Name:ORTHOTENNESSEE P.C.
Employer identification number (EIN):621700130
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ORTHOTENNESSEE GROUP MEDICAL AND DENTAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01
5012021-01-01
5012020-01-01
5012019-01-01
5012018-01-01
5012017-10-01CHERYL LAYSON
5012016-10-01CHERYL LAYSON
5012015-10-01CHERYL LAYSON
5012014-10-01CHERYL LAYSON
5012013-10-01CHERYL LAYSON
5012012-10-01CHERYL LAYSON
5012012-01-01ELLEN MASSEY
5012011-01-01CHERYL LAYSON PETERS
5012009-01-01CHERYL LAYSON PETERS

Plan Statistics for ORTHOTENNESSEE GROUP MEDICAL AND DENTAL PLAN

401k plan membership statisitcs for ORTHOTENNESSEE GROUP MEDICAL AND DENTAL PLAN

Measure Date Value
2022: ORTHOTENNESSEE GROUP MEDICAL AND DENTAL PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01613
Total number of active participants reported on line 7a of the Form 55002022-01-01645
Number of retired or separated participants receiving benefits2022-01-0112
Total of all active and inactive participants2022-01-01657
2021: ORTHOTENNESSEE GROUP MEDICAL AND DENTAL PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01603
Total number of active participants reported on line 7a of the Form 55002021-01-01613
Number of retired or separated participants receiving benefits2021-01-0113
Total of all active and inactive participants2021-01-01626
2020: ORTHOTENNESSEE GROUP MEDICAL AND DENTAL PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01585
Total number of active participants reported on line 7a of the Form 55002020-01-01603
Number of retired or separated participants receiving benefits2020-01-0114
Total of all active and inactive participants2020-01-01617
2019: ORTHOTENNESSEE GROUP MEDICAL AND DENTAL PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01564
Total number of active participants reported on line 7a of the Form 55002019-01-01585
Number of retired or separated participants receiving benefits2019-01-0113
Total of all active and inactive participants2019-01-01598
2018: ORTHOTENNESSEE GROUP MEDICAL AND DENTAL PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01567
Total number of active participants reported on line 7a of the Form 55002018-01-01564
Total of all active and inactive participants2018-01-01564
2017: ORTHOTENNESSEE GROUP MEDICAL AND DENTAL PLAN 2017 401k membership
Total participants, beginning-of-year2017-10-01561
Total number of active participants reported on line 7a of the Form 55002017-10-01567
Total of all active and inactive participants2017-10-01567
2016: ORTHOTENNESSEE GROUP MEDICAL AND DENTAL PLAN 2016 401k membership
Total participants, beginning-of-year2016-10-01536
Total number of active participants reported on line 7a of the Form 55002016-10-01557
Number of retired or separated participants receiving benefits2016-10-015
Total of all active and inactive participants2016-10-01562
2015: ORTHOTENNESSEE GROUP MEDICAL AND DENTAL PLAN 2015 401k membership
Total participants, beginning-of-year2015-10-01508
Total number of active participants reported on line 7a of the Form 55002015-10-01522
Number of retired or separated participants receiving benefits2015-10-0110
Total of all active and inactive participants2015-10-01532
2014: ORTHOTENNESSEE GROUP MEDICAL AND DENTAL PLAN 2014 401k membership
Total participants, beginning-of-year2014-10-01485
Total number of active participants reported on line 7a of the Form 55002014-10-01499
Number of retired or separated participants receiving benefits2014-10-019
Total of all active and inactive participants2014-10-01508
2013: ORTHOTENNESSEE GROUP MEDICAL AND DENTAL PLAN 2013 401k membership
Total participants, beginning-of-year2013-10-01482
Total number of active participants reported on line 7a of the Form 55002013-10-01476
Number of retired or separated participants receiving benefits2013-10-019
Total of all active and inactive participants2013-10-01485
2012: ORTHOTENNESSEE GROUP MEDICAL AND DENTAL PLAN 2012 401k membership
Total participants, beginning-of-year2012-10-01437
Total number of active participants reported on line 7a of the Form 55002012-10-01451
Number of retired or separated participants receiving benefits2012-10-019
Total of all active and inactive participants2012-10-01460
Total participants, beginning-of-year2012-01-01445
Total number of active participants reported on line 7a of the Form 55002012-01-01452
Number of retired or separated participants receiving benefits2012-01-018
Total of all active and inactive participants2012-01-01460
2011: ORTHOTENNESSEE GROUP MEDICAL AND DENTAL PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01428
Total number of active participants reported on line 7a of the Form 55002011-01-01435
Number of retired or separated participants receiving benefits2011-01-017
Total of all active and inactive participants2011-01-01442
2009: ORTHOTENNESSEE GROUP MEDICAL AND DENTAL PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01375
Total number of active participants reported on line 7a of the Form 55002009-01-01391
Number of retired or separated participants receiving benefits2009-01-013
Total of all active and inactive participants2009-01-01394

Financial Data on ORTHOTENNESSEE GROUP MEDICAL AND DENTAL PLAN

Measure Date Value
2022 : ORTHOTENNESSEE GROUP MEDICAL AND DENTAL PLAN 2022 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$375,161
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$1,159,826
Total income from all sources (including contributions)2022-12-31$5,704,295
Total of all expenses incurred2022-12-31$5,704,295
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$5,175,739
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$5,704,295
Value of total assets at end of year2022-12-31$375,161
Value of total assets at beginning of year2022-12-31$1,159,826
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$528,556
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$1,000,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$1,775,920
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-12-31$300,000
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-12-31$890,000
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$0
Value of net assets at end of year (total assets less liabilities)2022-12-31$0
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$878,853
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$3,928,375
Employer contributions (assets) at end of year2022-12-31$375,161
Employer contributions (assets) at beginning of year2022-12-31$1,159,826
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$4,296,886
Contract administrator fees2022-12-31$528,556
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32022-12-31No
Liabilities. Value of benefit claims payable at end of year2022-12-31$75,161
Liabilities. Value of benefit claims payable at beginning of year2022-12-31$269,826
Did the plan have assets held for investment2022-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31COULTER & JUSTUS, P.C.
Accountancy firm EIN2022-12-31621532636
2021 : ORTHOTENNESSEE GROUP MEDICAL AND DENTAL PLAN 2021 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$1,159,826
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$364,653
Total income from all sources (including contributions)2021-12-31$7,607,193
Total of all expenses incurred2021-12-31$7,607,193
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$7,169,641
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$7,607,193
Value of total assets at end of year2021-12-31$1,159,826
Value of total assets at beginning of year2021-12-31$364,653
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$437,552
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$1,000,000
If this is an individual account plan, was there a blackout period2021-12-31No
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$1,629,735
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-12-31$890,000
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-12-31$310,000
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$0
Value of net assets at end of year (total assets less liabilities)2021-12-31$0
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$1,017,265
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$5,977,458
Employer contributions (assets) at end of year2021-12-31$1,159,826
Employer contributions (assets) at beginning of year2021-12-31$364,653
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$6,152,376
Contract administrator fees2021-12-31$437,552
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32021-12-31No
Liabilities. Value of benefit claims payable at end of year2021-12-31$269,826
Liabilities. Value of benefit claims payable at beginning of year2021-12-31$54,653
Did the plan have assets held for investment2021-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31COULTER & JUSTUS, P.C.
Accountancy firm EIN2021-12-31621532536
2020 : ORTHOTENNESSEE GROUP MEDICAL AND DENTAL PLAN 2020 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$364,653
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$737,864
Total income from all sources (including contributions)2020-12-31$6,211,633
Total of all expenses incurred2020-12-31$6,211,633
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$5,791,238
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$6,211,633
Value of total assets at end of year2020-12-31$364,653
Value of total assets at beginning of year2020-12-31$737,864
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$420,395
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$1,000,000
If this is an individual account plan, was there a blackout period2020-12-31No
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$1,544,830
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-12-31$310,000
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-12-31$560,000
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$0
Value of net assets at end of year (total assets less liabilities)2020-12-31$0
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$771,583
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$4,666,803
Employer contributions (assets) at end of year2020-12-31$364,653
Employer contributions (assets) at beginning of year2020-12-31$737,864
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$5,019,655
Contract administrator fees2020-12-31$420,395
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32020-12-31No
Liabilities. Value of benefit claims payable at end of year2020-12-31$54,653
Liabilities. Value of benefit claims payable at beginning of year2020-12-31$177,864
Did the plan have assets held for investment2020-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Unqualified
Accountancy firm name2020-12-31COULTER & JUSTUS, P.C
Accountancy firm EIN2020-12-31621532536
2019 : ORTHOTENNESSEE GROUP MEDICAL AND DENTAL PLAN 2019 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$737,864
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$737,864
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$725,142
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$725,142
Total income from all sources (including contributions)2019-12-31$7,247,658
Total income from all sources (including contributions)2019-12-31$7,247,658
Total of all expenses incurred2019-12-31$7,247,658
Total of all expenses incurred2019-12-31$7,247,658
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$6,897,261
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$6,897,261
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$7,247,658
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$7,247,658
Value of total assets at end of year2019-12-31$737,864
Value of total assets at end of year2019-12-31$737,864
Value of total assets at beginning of year2019-12-31$725,142
Value of total assets at beginning of year2019-12-31$725,142
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$350,397
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$350,397
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31Yes
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$1,000,000
Value of fidelity bond cover2019-12-31$1,000,000
If this is an individual account plan, was there a blackout period2019-12-31No
If this is an individual account plan, was there a blackout period2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$1,508,326
Contributions received from participants2019-12-31$1,508,326
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$123,849
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$123,849
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-12-31$560,000
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-12-31$560,000
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-12-31$490,000
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-12-31$490,000
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$0
Value of net income/loss2019-12-31$0
Value of net assets at end of year (total assets less liabilities)2019-12-31$0
Value of net assets at end of year (total assets less liabilities)2019-12-31$0
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$0
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$707,331
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$707,331
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$5,739,332
Contributions received in cash from employer2019-12-31$5,739,332
Employer contributions (assets) at end of year2019-12-31$737,864
Employer contributions (assets) at end of year2019-12-31$737,864
Employer contributions (assets) at beginning of year2019-12-31$601,293
Employer contributions (assets) at beginning of year2019-12-31$601,293
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$6,189,930
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$6,189,930
Contract administrator fees2019-12-31$350,397
Contract administrator fees2019-12-31$350,397
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32019-12-31No
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32019-12-31No
Liabilities. Value of benefit claims payable at end of year2019-12-31$177,864
Liabilities. Value of benefit claims payable at end of year2019-12-31$177,864
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$235,142
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$235,142
Did the plan have assets held for investment2019-12-31No
Did the plan have assets held for investment2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31No
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Opinion of an independent qualified public accountant for this plan2019-12-31Unqualified
Accountancy firm name2019-12-31COULTER & JUSTUS, P.C.
Accountancy firm name2019-12-31COULTER & JUSTUS, P.C.
Accountancy firm EIN2019-12-31621532536
Accountancy firm EIN2019-12-31621532536
2018 : ORTHOTENNESSEE GROUP MEDICAL AND DENTAL PLAN 2018 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$725,142
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$334,398
Total income from all sources (including contributions)2018-12-31$6,647,929
Total of all expenses incurred2018-12-31$6,647,929
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$6,315,729
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$6,647,929
Value of total assets at end of year2018-12-31$725,142
Value of total assets at beginning of year2018-12-31$334,398
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$332,200
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$1,000,000
If this is an individual account plan, was there a blackout period2018-12-31No
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$1,424,635
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-12-31$123,849
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2018-12-31$490,000
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-12-31$240,000
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$0
Value of net assets at end of year (total assets less liabilities)2018-12-31$0
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$585,257
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$5,223,294
Employer contributions (assets) at end of year2018-12-31$601,293
Employer contributions (assets) at beginning of year2018-12-31$334,398
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$5,730,472
Contract administrator fees2018-12-31$332,200
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32018-12-31No
Liabilities. Value of benefit claims payable at end of year2018-12-31$235,142
Liabilities. Value of benefit claims payable at beginning of year2018-12-31$94,398
Did the plan have assets held for investment2018-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31No
Opinion of an independent qualified public accountant for this plan2018-12-31Unqualified
Accountancy firm name2018-12-31COULTER & JUSTUS, P.C.
Accountancy firm EIN2018-12-31621532536
2017 : ORTHOTENNESSEE GROUP MEDICAL AND DENTAL PLAN 2017 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$334,398
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$446,418
Total income from all sources (including contributions)2017-12-31$1,344,344
Total of all expenses incurred2017-12-31$1,344,344
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$1,272,454
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$1,344,344
Value of total assets at end of year2017-12-31$334,398
Value of total assets at beginning of year2017-12-31$446,418
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$71,890
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$1,000,000
If this is an individual account plan, was there a blackout period2017-12-31No
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$336,542
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-12-31$46,621
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2017-12-31$240,000
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-12-31$220,000
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$0
Value of net assets at end of year (total assets less liabilities)2017-12-31$0
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$150,919
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$1,007,802
Employer contributions (assets) at end of year2017-12-31$334,398
Employer contributions (assets) at beginning of year2017-12-31$399,797
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$1,121,535
Contract administrator fees2017-12-31$71,890
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-12-31No
Liabilities. Value of benefit claims payable at end of year2017-12-31$94,398
Liabilities. Value of benefit claims payable at beginning of year2017-12-31$226,418
Did the plan have assets held for investment2017-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-09-30$446,418
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-09-30$380,712
Total income from all sources (including contributions)2017-09-30$5,721,016
Total of all expenses incurred2017-09-30$5,721,016
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-09-30$5,478,364
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-09-30$5,721,016
Value of total assets at end of year2017-09-30$446,418
Value of total assets at beginning of year2017-09-30$380,712
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-09-30$242,652
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-09-30No
Was this plan covered by a fidelity bond2017-09-30Yes
Value of fidelity bond cover2017-09-30$1,000,000
If this is an individual account plan, was there a blackout period2017-09-30No
Were there any nonexempt tranactions with any party-in-interest2017-09-30No
Contributions received from participants2017-09-30$1,353,681
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-09-30$46,621
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2017-09-30$220,000
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-09-30$210,000
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-09-30No
Value of net income/loss2017-09-30$0
Value of net assets at end of year (total assets less liabilities)2017-09-30$0
Value of net assets at beginning of year (total assets less liabilities)2017-09-30$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2017-09-30No
Were any leases to which the plan was party in default or uncollectible2017-09-30No
Expenses. Payments to insurance carriers foe the provision of benefits2017-09-30$463,972
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-09-30No
Was there a failure to transmit to the plan any participant contributions2017-09-30No
Has the plan failed to provide any benefit when due under the plan2017-09-30No
Contributions received in cash from employer2017-09-30$4,367,335
Employer contributions (assets) at end of year2017-09-30$399,797
Employer contributions (assets) at beginning of year2017-09-30$380,712
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-09-30$5,014,392
Contract administrator fees2017-09-30$242,652
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-09-30No
Liabilities. Value of benefit claims payable at end of year2017-09-30$226,418
Liabilities. Value of benefit claims payable at beginning of year2017-09-30$170,712
Did the plan have assets held for investment2017-09-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-09-30No
Opinion of an independent qualified public accountant for this plan2017-09-30Unqualified
Accountancy firm name2017-09-30COULTER & JUSTUS, P.C.
Accountancy firm EIN2017-09-30621532536
2016 : ORTHOTENNESSEE GROUP MEDICAL AND DENTAL PLAN 2016 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-09-30$380,712
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-09-30$306,668
Total income from all sources (including contributions)2016-09-30$5,639,481
Total of all expenses incurred2016-09-30$5,639,481
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-09-30$5,426,635
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-09-30$5,639,481
Value of total assets at end of year2016-09-30$380,712
Value of total assets at beginning of year2016-09-30$306,668
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-09-30$212,846
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-09-30No
Was this plan covered by a fidelity bond2016-09-30Yes
Value of fidelity bond cover2016-09-30$1,000,000
If this is an individual account plan, was there a blackout period2016-09-30No
Were there any nonexempt tranactions with any party-in-interest2016-09-30No
Contributions received from participants2016-09-30$1,319,634
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2016-09-30$210,000
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-09-30$230,000
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-09-30No
Value of net income/loss2016-09-30$0
Value of net assets at end of year (total assets less liabilities)2016-09-30$0
Value of net assets at beginning of year (total assets less liabilities)2016-09-30$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2016-09-30No
Were any leases to which the plan was party in default or uncollectible2016-09-30No
Expenses. Payments to insurance carriers foe the provision of benefits2016-09-30$538,164
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-09-30No
Was there a failure to transmit to the plan any participant contributions2016-09-30No
Has the plan failed to provide any benefit when due under the plan2016-09-30No
Contributions received in cash from employer2016-09-30$4,319,847
Employer contributions (assets) at end of year2016-09-30$380,712
Employer contributions (assets) at beginning of year2016-09-30$306,668
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-09-30$4,888,471
Contract administrator fees2016-09-30$212,846
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-09-30No
Liabilities. Value of benefit claims payable at end of year2016-09-30$170,712
Liabilities. Value of benefit claims payable at beginning of year2016-09-30$76,668
Did the plan have assets held for investment2016-09-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-09-30No
Opinion of an independent qualified public accountant for this plan2016-09-30Unqualified
Accountancy firm name2016-09-30COULTER & JUSTUS, P.C.
Accountancy firm EIN2016-09-30621532536
2015 : ORTHOTENNESSEE GROUP MEDICAL AND DENTAL PLAN 2015 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-09-30$306,668
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-09-30$355,607
Total income from all sources (including contributions)2015-09-30$5,475,438
Total of all expenses incurred2015-09-30$5,475,438
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-09-30$5,293,473
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-09-30$5,475,438
Value of total assets at end of year2015-09-30$306,668
Value of total assets at beginning of year2015-09-30$355,607
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-09-30$181,965
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-09-30No
Was this plan covered by a fidelity bond2015-09-30Yes
Value of fidelity bond cover2015-09-30$1,000,000
If this is an individual account plan, was there a blackout period2015-09-30No
Were there any nonexempt tranactions with any party-in-interest2015-09-30No
Contributions received from participants2015-09-30$1,151,758
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2015-09-30$230,000
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2015-09-30$300,000
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-09-30No
Value of net income/loss2015-09-30$0
Value of net assets at end of year (total assets less liabilities)2015-09-30$0
Value of net assets at beginning of year (total assets less liabilities)2015-09-30$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2015-09-30No
Were any leases to which the plan was party in default or uncollectible2015-09-30No
Expenses. Payments to insurance carriers foe the provision of benefits2015-09-30$510,089
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-09-30No
Was there a failure to transmit to the plan any participant contributions2015-09-30No
Has the plan failed to provide any benefit when due under the plan2015-09-30No
Contributions received in cash from employer2015-09-30$4,323,680
Employer contributions (assets) at end of year2015-09-30$306,668
Employer contributions (assets) at beginning of year2015-09-30$355,607
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-09-30$4,783,384
Contract administrator fees2015-09-30$181,965
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32015-09-30No
Liabilities. Value of benefit claims payable at end of year2015-09-30$76,668
Liabilities. Value of benefit claims payable at beginning of year2015-09-30$55,607
Did the plan have assets held for investment2015-09-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-09-30No
Opinion of an independent qualified public accountant for this plan2015-09-30Unqualified
Accountancy firm name2015-09-30COULTER & JUSTUS, P.C.
Accountancy firm EIN2015-09-30621532536
2014 : ORTHOTENNESSEE GROUP MEDICAL AND DENTAL PLAN 2014 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-09-30$355,607
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-09-30$365,300
Total income from all sources (including contributions)2014-09-30$4,761,793
Total of all expenses incurred2014-09-30$4,761,793
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-09-30$4,554,570
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-09-30$4,761,793
Value of total assets at end of year2014-09-30$355,607
Value of total assets at beginning of year2014-09-30$365,300
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-09-30$207,223
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-09-30No
Was this plan covered by a fidelity bond2014-09-30Yes
Value of fidelity bond cover2014-09-30$1,000,000
If this is an individual account plan, was there a blackout period2014-09-30No
Were there any nonexempt tranactions with any party-in-interest2014-09-30No
Contributions received from participants2014-09-30$837,862
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2014-09-30$300,000
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2014-09-30$310,000
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-09-30No
Value of net income/loss2014-09-30$0
Value of net assets at end of year (total assets less liabilities)2014-09-30$0
Value of net assets at beginning of year (total assets less liabilities)2014-09-30$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2014-09-30No
Were any leases to which the plan was party in default or uncollectible2014-09-30No
Expenses. Payments to insurance carriers foe the provision of benefits2014-09-30$466,978
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-09-30No
Was there a failure to transmit to the plan any participant contributions2014-09-30No
Has the plan failed to provide any benefit when due under the plan2014-09-30No
Contributions received in cash from employer2014-09-30$3,923,931
Employer contributions (assets) at end of year2014-09-30$355,607
Employer contributions (assets) at beginning of year2014-09-30$365,300
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-09-30$4,087,592
Contract administrator fees2014-09-30$207,223
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32014-09-30No
Liabilities. Value of benefit claims payable at end of year2014-09-30$55,607
Liabilities. Value of benefit claims payable at beginning of year2014-09-30$55,300
Did the plan have assets held for investment2014-09-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-09-30No
Opinion of an independent qualified public accountant for this plan2014-09-30Unqualified
Accountancy firm name2014-09-30COULTER & JUSTUS, P.C.
Accountancy firm EIN2014-09-30621532536
2013 : ORTHOTENNESSEE GROUP MEDICAL AND DENTAL PLAN 2013 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-09-30$365,300
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-09-30$432,140
Total income from all sources (including contributions)2013-09-30$4,343,818
Total of all expenses incurred2013-09-30$4,343,818
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-09-30$4,115,232
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-09-30$4,343,818
Value of total assets at end of year2013-09-30$365,300
Value of total assets at beginning of year2013-09-30$432,140
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-09-30$228,586
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-09-30No
Was this plan covered by a fidelity bond2013-09-30Yes
Value of fidelity bond cover2013-09-30$1,000,000
If this is an individual account plan, was there a blackout period2013-09-30No
Were there any nonexempt tranactions with any party-in-interest2013-09-30No
Contributions received from participants2013-09-30$809,710
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2013-09-30$310,000
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2013-09-30$320,000
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-09-30No
Value of net income/loss2013-09-30$0
Value of net assets at end of year (total assets less liabilities)2013-09-30$0
Value of net assets at beginning of year (total assets less liabilities)2013-09-30$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2013-09-30No
Were any leases to which the plan was party in default or uncollectible2013-09-30No
Expenses. Payments to insurance carriers foe the provision of benefits2013-09-30$417,989
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-09-30No
Was there a failure to transmit to the plan any participant contributions2013-09-30No
Has the plan failed to provide any benefit when due under the plan2013-09-30No
Contributions received in cash from employer2013-09-30$3,534,108
Employer contributions (assets) at end of year2013-09-30$365,300
Employer contributions (assets) at beginning of year2013-09-30$432,140
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-09-30$3,697,243
Contract administrator fees2013-09-30$228,586
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32013-09-30No
Liabilities. Value of benefit claims payable at end of year2013-09-30$55,300
Liabilities. Value of benefit claims payable at beginning of year2013-09-30$112,140
Did the plan have assets held for investment2013-09-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-09-30No
Opinion of an independent qualified public accountant for this plan2013-09-30Unqualified
Accountancy firm name2013-09-30COULTER & JUSTUS, P.C.
Accountancy firm EIN2013-09-30621532536
2012 : ORTHOTENNESSEE GROUP MEDICAL AND DENTAL PLAN 2012 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-09-30$432,140
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-09-30$646,183
Total income from all sources (including contributions)2012-09-30$3,114,521
Total of all expenses incurred2012-09-30$3,114,521
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-09-30$2,940,180
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-09-30$3,114,521
Value of total assets at end of year2012-09-30$432,140
Value of total assets at beginning of year2012-09-30$646,183
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-09-30$174,341
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-09-30No
Was this plan covered by a fidelity bond2012-09-30Yes
Value of fidelity bond cover2012-09-30$1,000,000
If this is an individual account plan, was there a blackout period2012-09-30No
Were there any nonexempt tranactions with any party-in-interest2012-09-30No
Contributions received from participants2012-09-30$512,019
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2012-09-30$320,000
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-09-30$582,109
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-09-30No
Value of net income/loss2012-09-30$0
Value of net assets at end of year (total assets less liabilities)2012-09-30$0
Value of net assets at beginning of year (total assets less liabilities)2012-09-30$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-09-30No
Were any loans by the plan or fixed income obligations due to the plan in default2012-09-30No
Were any leases to which the plan was party in default or uncollectible2012-09-30No
Expenses. Payments to insurance carriers foe the provision of benefits2012-09-30$264,082
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-09-30No
Was there a failure to transmit to the plan any participant contributions2012-09-30No
Has the plan failed to provide any benefit when due under the plan2012-09-30No
Contributions received in cash from employer2012-09-30$2,602,502
Employer contributions (assets) at end of year2012-09-30$432,140
Employer contributions (assets) at beginning of year2012-09-30$646,183
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-09-30$2,676,098
Contract administrator fees2012-09-30$174,341
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32012-09-30No
Liabilities. Value of benefit claims payable at end of year2012-09-30$112,140
Liabilities. Value of benefit claims payable at beginning of year2012-09-30$64,074
Did the plan have assets held for investment2012-09-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-09-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-09-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-09-30No
Opinion of an independent qualified public accountant for this plan2012-09-30Unqualified
Accountancy firm name2012-09-30COULTER & JUSTUS, P.C.
Accountancy firm EIN2012-09-30621532536
2011 : ORTHOTENNESSEE GROUP MEDICAL AND DENTAL PLAN 2011 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$646,183
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$283,815
Total income from all sources (including contributions)2011-12-31$4,407,367
Total of all expenses incurred2011-12-31$4,407,367
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$4,177,557
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$4,407,367
Value of total assets at end of year2011-12-31$646,183
Value of total assets at beginning of year2011-12-31$283,815
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$229,810
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$1,000,000
If this is an individual account plan, was there a blackout period2011-12-31No
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$672,012
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2011-12-31$582,109
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2011-12-31$226,000
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$0
Value of net assets at end of year (total assets less liabilities)2011-12-31$0
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$337,646
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$3,735,355
Employer contributions (assets) at end of year2011-12-31$646,183
Employer contributions (assets) at beginning of year2011-12-31$283,815
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$3,839,911
Contract administrator fees2011-12-31$229,810
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32011-12-31No
Liabilities. Value of benefit claims payable at end of year2011-12-31$64,074
Liabilities. Value of benefit claims payable at beginning of year2011-12-31$57,815
Did the plan have assets held for investment2011-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31No
Opinion of an independent qualified public accountant for this plan2011-12-31Unqualified
Accountancy firm name2011-12-31COULTER & JUSTUS, P.C.
Accountancy firm EIN2011-12-31621532536
2010 : ORTHOTENNESSEE GROUP MEDICAL AND DENTAL PLAN 2010 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$283,815
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$195,099
Total income from all sources (including contributions)2010-12-31$3,787,337
Total of all expenses incurred2010-12-31$3,787,337
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$3,554,054
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$3,787,337
Value of total assets at end of year2010-12-31$283,815
Value of total assets at beginning of year2010-12-31$195,099
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$233,283
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$1,000,000
If this is an individual account plan, was there a blackout period2010-12-31No
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$654,930
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2010-12-31$226,000
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2010-12-31$159,000
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$0
Value of net assets at end of year (total assets less liabilities)2010-12-31$0
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$308,503
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$3,132,407
Employer contributions (assets) at end of year2010-12-31$283,815
Employer contributions (assets) at beginning of year2010-12-31$195,099
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$3,245,551
Contract administrator fees2010-12-31$233,283
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32010-12-31No
Liabilities. Value of benefit claims payable at end of year2010-12-31$57,815
Liabilities. Value of benefit claims payable at beginning of year2010-12-31$36,099
Did the plan have assets held for investment2010-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31No
Opinion of an independent qualified public accountant for this plan2010-12-31Unqualified
Accountancy firm name2010-12-31COULTER & JUSTUS, P.C.
Accountancy firm EIN2010-12-31621532536

Form 5500 Responses for ORTHOTENNESSEE GROUP MEDICAL AND DENTAL PLAN

2022: ORTHOTENNESSEE GROUP MEDICAL AND DENTAL PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: ORTHOTENNESSEE GROUP MEDICAL AND DENTAL PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: ORTHOTENNESSEE GROUP MEDICAL AND DENTAL PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: ORTHOTENNESSEE GROUP MEDICAL AND DENTAL PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: ORTHOTENNESSEE GROUP MEDICAL AND DENTAL PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: ORTHOTENNESSEE GROUP MEDICAL AND DENTAL PLAN 2017 form 5500 responses
2017-10-01Type of plan entitySingle employer plan
2017-10-01This return/report is a short plan year return/report (less than 12 months)Yes
2017-10-01Plan funding arrangement – InsuranceYes
2017-10-01Plan funding arrangement – General assets of the sponsorYes
2017-10-01Plan benefit arrangement – InsuranceYes
2017-10-01Plan benefit arrangement – General assets of the sponsorYes
2016: ORTHOTENNESSEE GROUP MEDICAL AND DENTAL PLAN 2016 form 5500 responses
2016-10-01Type of plan entitySingle employer plan
2016-10-01Plan funding arrangement – InsuranceYes
2016-10-01Plan funding arrangement – General assets of the sponsorYes
2016-10-01Plan benefit arrangement – InsuranceYes
2016-10-01Plan benefit arrangement – General assets of the sponsorYes
2015: ORTHOTENNESSEE GROUP MEDICAL AND DENTAL PLAN 2015 form 5500 responses
2015-10-01Type of plan entitySingle employer plan
2015-10-01Plan funding arrangement – InsuranceYes
2015-10-01Plan funding arrangement – General assets of the sponsorYes
2015-10-01Plan benefit arrangement – InsuranceYes
2015-10-01Plan benefit arrangement – General assets of the sponsorYes
2014: ORTHOTENNESSEE GROUP MEDICAL AND DENTAL PLAN 2014 form 5500 responses
2014-10-01Type of plan entitySingle employer plan
2014-10-01Plan funding arrangement – InsuranceYes
2014-10-01Plan funding arrangement – General assets of the sponsorYes
2014-10-01Plan benefit arrangement – InsuranceYes
2014-10-01Plan benefit arrangement – General assets of the sponsorYes
2013: ORTHOTENNESSEE GROUP MEDICAL AND DENTAL PLAN 2013 form 5500 responses
2013-10-01Type of plan entitySingle employer plan
2013-10-01Plan funding arrangement – InsuranceYes
2013-10-01Plan funding arrangement – General assets of the sponsorYes
2013-10-01Plan benefit arrangement – InsuranceYes
2013-10-01Plan benefit arrangement – General assets of the sponsorYes
2012: ORTHOTENNESSEE GROUP MEDICAL AND DENTAL PLAN 2012 form 5500 responses
2012-10-01Type of plan entitySingle employer plan
2012-10-01Plan funding arrangement – InsuranceYes
2012-10-01Plan funding arrangement – General assets of the sponsorYes
2012-10-01Plan benefit arrangement – InsuranceYes
2012-10-01Plan benefit arrangement – General assets of the sponsorYes
2012-01-01Type of plan entitySingle employer plan
2012-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: ORTHOTENNESSEE GROUP MEDICAL AND DENTAL PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: ORTHOTENNESSEE GROUP MEDICAL AND DENTAL PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01This submission is the final filingNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number606403
Policy instance 3
Insurance contract or identification number606403
Number of Individuals Covered161
Insurance policy start date2021-05-01
Insurance policy end date2022-01-01
Total amount of commissions paid to insurance brokerUSD $6,714
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $44,758
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,714
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberLIFE-76029
Policy instance 2
Insurance contract or identification numberLIFE-76029
Number of Individuals Covered760
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $3,930
Total amount of fees paid to insurance companyUSD $2,444
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $26,197
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,930
Amount paid for insurance broker fees2444
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberLTD-80033
Policy instance 1
Insurance contract or identification numberLTD-80033
Number of Individuals Covered760
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $21,132
Total amount of fees paid to insurance companyUSD $13,209
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $140,883
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $21,132
Amount paid for insurance broker fees13209
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number606402
Policy instance 1
Insurance contract or identification number606402
Number of Individuals Covered652
Insurance policy start date2020-05-01
Insurance policy end date2021-05-01
Total amount of commissions paid to insurance brokerUSD $58,624
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $358,294
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $58,624
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number606403
Policy instance 2
Insurance contract or identification number606403
Number of Individuals Covered168
Insurance policy start date2020-05-01
Insurance policy end date2021-05-01
Total amount of commissions paid to insurance brokerUSD $11,036
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $68,069
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,036
Insurance broker organization code?3
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number0010683703
Policy instance 3
Insurance contract or identification number0010683703
Number of Individuals Covered167
Insurance policy start date2020-05-01
Insurance policy end date2021-05-01
Total amount of commissions paid to insurance brokerUSD $4,125
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $45,850
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,020
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberR0598078
Policy instance 4
Insurance contract or identification numberR0598078
Number of Individuals Covered226
Insurance policy start date2020-05-01
Insurance policy end date2021-05-01
Total amount of commissions paid to insurance brokerUSD $4,891
Total amount of fees paid to insurance companyUSD $31
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $51,826
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,172
Amount paid for insurance broker fees31
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION PAID
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number606403
Policy instance 2
Insurance contract or identification number606403
Number of Individuals Covered179
Insurance policy start date2019-05-01
Insurance policy end date2020-05-01
Total amount of commissions paid to insurance brokerUSD $10,913
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $78,264
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,913
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number606402
Policy instance 1
Insurance contract or identification number606402
Number of Individuals Covered628
Insurance policy start date2019-05-01
Insurance policy end date2020-05-01
Total amount of commissions paid to insurance brokerUSD $58,624
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $423,347
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $58,624
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberR0598078
Policy instance 4
Insurance contract or identification numberR0598078
Number of Individuals Covered226
Insurance policy start date2019-01-01
Insurance policy end date2020-01-01
Total amount of commissions paid to insurance brokerUSD $15,008
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $60,829
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,602
Insurance broker organization code?3
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number0010683703
Policy instance 3
Insurance contract or identification number0010683703
Number of Individuals Covered174
Insurance policy start date2019-01-01
Insurance policy end date2020-01-01
Total amount of commissions paid to insurance brokerUSD $15,521
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $51,449
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,834
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number606403
Policy instance 2
Insurance contract or identification number606403
Number of Individuals Covered186
Insurance policy start date2019-01-01
Insurance policy end date2020-01-01
Total amount of commissions paid to insurance brokerUSD $10,250
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $64,267
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,250
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number606402
Policy instance 1
Insurance contract or identification number606402
Number of Individuals Covered608
Insurance policy start date2019-01-01
Insurance policy end date2020-01-01
Total amount of commissions paid to insurance brokerUSD $57,839
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $354,989
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $57,839
Insurance broker organization code?3
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number0010683703
Policy instance 1
Insurance contract or identification number0010683703
Number of Individuals Covered94
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $2,245
Total amount of fees paid to insurance companyUSD $0
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $35,756
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,601
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number676120G
Policy instance 1
Insurance contract or identification number676120G
Number of Individuals Covered510
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
Total amount of commissions paid to insurance brokerUSD $31,924
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $456,047
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $31,924
Insurance broker organization code?3
Insurance broker nameJOHN HILDRETH
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number4038860010
Policy instance 2
Insurance contract or identification number4038860010
Number of Individuals Covered509
Insurance policy start date2014-10-01
Insurance policy end date2015-09-30
Total amount of commissions paid to insurance brokerUSD $33,448
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $222,985
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $33,448
Insurance broker organization code?3
Insurance broker nameTRINITY BENEFIT ADVISORS
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number4038860010
Policy instance 2
Insurance contract or identification number4038860010
Number of Individuals Covered487
Insurance policy start date2013-10-01
Insurance policy end date2014-09-30
Total amount of commissions paid to insurance brokerUSD $28,627
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $190,844
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28,627
Insurance broker organization code?3
Insurance broker nameTRINITY BENEFIT ADVISORS
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number676120G
Policy instance 1
Insurance contract or identification number676120G
Number of Individuals Covered491
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
Total amount of commissions paid to insurance brokerUSD $30,880
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $442,035
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $30,880
Insurance broker organization code?3
Insurance broker nameJOHN HILDRETH
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number676120G
Policy instance 1
Insurance contract or identification number676120G
Number of Individuals Covered472
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
Total amount of commissions paid to insurance brokerUSD $29,815
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $425,099
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $29,815
Insurance broker organization code?3
Insurance broker nameJOHN HILDRETH
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number4038860010
Policy instance 2
Insurance contract or identification number4038860010
Number of Individuals Covered475
Insurance policy start date2012-10-01
Insurance policy end date2013-09-30
Total amount of commissions paid to insurance brokerUSD $25,057
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $167,046
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,057
Insurance broker organization code?3
Insurance broker nameTRINITY BENEFIT ADVISORS
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number4038860010
Policy instance 2
Insurance contract or identification number4038860010
Number of Individuals Covered441
Insurance policy start date2011-10-01
Insurance policy end date2012-09-30
Total amount of commissions paid to insurance brokerUSD $28,598
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $142,990
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28,598
Insurance broker organization code?3
Insurance broker nameGROUP INS SERV INC
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number676120G
Policy instance 1
Insurance contract or identification number676120G
Number of Individuals Covered454
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Total amount of commissions paid to insurance brokerUSD $28,592
Total amount of fees paid to insurance companyUSD $4,875
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $408,999
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28,592
Amount paid for insurance broker fees4875
Additional information about fees paid to insurance brokerADMINISTRATIVE SERVICES
Insurance broker organization code?3
Insurance broker nameJOHN HILDRETH
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number676120G
Policy instance 1
Insurance contract or identification number676120G
Number of Individuals Covered438
Insurance policy start date2010-05-01
Insurance policy end date2011-04-30
Total amount of commissions paid to insurance brokerUSD $27,337
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $389,873
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number4038860010
Policy instance 2
Insurance contract or identification number4038860010
Number of Individuals Covered431
Insurance policy start date2011-10-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $1,180
Total amount of fees paid to insurance companyUSD $3,541
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $23,605
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE7254451
Policy instance 1
Insurance contract or identification numberE7254451
Number of Individuals Covered428
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $3,117
Total amount of fees paid to insurance companyUSD $627
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $308,503
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,462
Insurance broker organization code?3
Amount paid for insurance broker fees243
Additional information about fees paid to insurance brokerADMINISTRATIVE SERVICES
Insurance broker name
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE7440530
Policy instance 2
Insurance contract or identification numberE7440530
Number of Individuals Covered428
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $46
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26
Insurance broker organization code?3
Insurance broker name
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number676120G
Policy instance 3
Insurance contract or identification number676120G
Number of Individuals Covered413
Insurance policy start date2009-05-01
Insurance policy end date2010-04-30
Total amount of commissions paid to insurance brokerUSD $25,599
Total amount of fees paid to insurance companyUSD $4,505
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $365,686
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,599
Amount paid for insurance broker fees4505
Additional information about fees paid to insurance brokerADMINISTRATIVE SERVICES
Insurance broker organization code?3
Insurance broker nameJOHN HILDRETH

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