401k Plan data: PROVIDER CARE GROUP MIRROR 401(K) PLAN plan

PROVIDER CARE GROUP MIRROR 401(K) PLAN 401k Plan overview

Plan Name	PROVIDER CARE GROUP MIRROR 401(K) PLAN
Plan identification number	001

PROVIDER CARE GROUP MIRROR 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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

401k Sponsoring company profile

HCA PHYSICIAN SERVICES, INC. has sponsored the creation of one or more 401k plans.

Company Name: HCA PHYSICIAN SERVICES, INC.

Employer identification number (EIN): 621821475

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

Additional information about HCA PHYSICIAN SERVICES, INC.

Jurisdiction of Incorporation: Texas Secretary of State

Incorporation Date: 2002-04-03

Company Identification Number: 0800070862

Legal Registered Office Address: 350 N SAINT PAUL ST

DALLAS
United States of America (USA)
75201

More information about HCA PHYSICIAN SERVICES, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PROVIDER CARE GROUP MIRROR 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01 SHERRI HENRY 2023-12-06
001 2021-01-01 SHERRI HENRY 2022-10-14 SHERRI HENRY 2022-10-14
001 2020-01-01
001 2019-01-01
001 2018-01-01
001 2016-01-01 SABRINA RUDERER
001 2016-01-01 SABRINA RUDERER

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2022-01-01	SHERRI HENRY	2023-12-06
001	2021-01-01	SHERRI HENRY	2022-10-14	SHERRI HENRY	2022-10-14
001	2020-01-01
001	2019-01-01
001	2018-01-01
001	2016-01-01	SABRINA RUDERER
001	2016-01-01	SABRINA RUDERER

Plan Statistics for PROVIDER CARE GROUP MIRROR 401(K) PLAN

401k plan membership statisitcs for PROVIDER CARE GROUP MIRROR 401(K) PLAN

Measure Date Value
2022: PROVIDER CARE GROUP MIRROR 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 1,163
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 1,078
Number of other retired or separated participants entitled to future benefits 2022-01-01 267
Total of all active and inactive participants 2022-01-01 1,345
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 1,345
Number of participants with account balances 2022-01-01 1,193
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 165
2021: PROVIDER CARE GROUP MIRROR 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 1,022
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 930
Number of other retired or separated participants entitled to future benefits 2021-01-01 233
Total of all active and inactive participants 2021-01-01 1,163
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 1,163
Number of participants with account balances 2021-01-01 1,039
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 50
2020: PROVIDER CARE GROUP MIRROR 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 922
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 855
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 167
Total of all active and inactive participants 2020-01-01 1,022
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 1,022
Number of participants with account balances 2020-01-01 815
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 91
2019: PROVIDER CARE GROUP MIRROR 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 693
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 785
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 137
Total of all active and inactive participants 2019-01-01 922
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 922
Number of participants with account balances 2019-01-01 775
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 71
2018: PROVIDER CARE GROUP MIRROR 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 609
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 566
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 127
Total of all active and inactive participants 2018-01-01 693
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 693
Number of participants with account balances 2018-01-01 662
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 96
2016: PROVIDER CARE GROUP MIRROR 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 695
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 344
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 69
Total of all active and inactive participants 2016-01-01 413
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 413
Number of participants with account balances 2016-01-01 357
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 35

Measure	Date	Value
2022: PROVIDER CARE GROUP MIRROR 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	1,163
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	1,078
Number of other retired or separated participants entitled to future benefits	2022-01-01	267
Total of all active and inactive participants	2022-01-01	1,345
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	1,345
Number of participants with account balances	2022-01-01	1,193
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	165
2021: PROVIDER CARE GROUP MIRROR 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	1,022
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	930
Number of other retired or separated participants entitled to future benefits	2021-01-01	233
Total of all active and inactive participants	2021-01-01	1,163
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	1,163
Number of participants with account balances	2021-01-01	1,039
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	50
2020: PROVIDER CARE GROUP MIRROR 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	922
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	855
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	167
Total of all active and inactive participants	2020-01-01	1,022
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	1,022
Number of participants with account balances	2020-01-01	815
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	91
2019: PROVIDER CARE GROUP MIRROR 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	693
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	785
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	137
Total of all active and inactive participants	2019-01-01	922
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	922
Number of participants with account balances	2019-01-01	775
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	71
2018: PROVIDER CARE GROUP MIRROR 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	609
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	566
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	127
Total of all active and inactive participants	2018-01-01	693
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	693
Number of participants with account balances	2018-01-01	662
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	96
2016: PROVIDER CARE GROUP MIRROR 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	695
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	344
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	69
Total of all active and inactive participants	2016-01-01	413
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	413
Number of participants with account balances	2016-01-01	357
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	35

Financial Data on PROVIDER CARE GROUP MIRROR 401(K) PLAN

Measure	Date	Value
2022 : PROVIDER CARE GROUP MIRROR 401(K) PLAN 2022 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$9,944
Total income from all sources (including contributions)	2022-12-31	$126,498
Total of all expenses incurred	2022-12-31	$8,129,681
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$7,898,447
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$21,169,730
Value of total assets at end of year	2022-12-31	$107,324,729
Value of total assets at beginning of year	2022-12-31	$115,337,856
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$231,234
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$15,000,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$12,156,249
Participant contributions at end of year	2022-12-31	$303,712
Participant contributions at beginning of year	2022-12-31	$258,935
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$3,259,539
Administrative expenses (other) incurred	2022-12-31	$231,234
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$-8,003,183
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$107,324,729
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$115,327,912
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Value of interest in master investment trust accounts at end of year	2022-12-31	$101,046,518
Value of interest in master investment trust accounts at beginning of year	2022-12-31	$110,010,631
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$5,753,942
Employer contributions (assets) at end of year	2022-12-31	$5,974,499
Employer contributions (assets) at beginning of year	2022-12-31	$5,068,290
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$7,898,447
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2022-12-31	No
Liabilities. Value of benefit claims payable at end of year	2022-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2022-12-31	$9,944
Did the plan have assets held for investment	2022-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	LBMC, PC
Accountancy firm EIN	2022-12-31	621199757
2021 : PROVIDER CARE GROUP MIRROR 401(K) PLAN 2021 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$9,944
Total income from all sources (including contributions)	2021-12-31	$33,258,763
Total of all expenses incurred	2021-12-31	$9,090,034
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$8,710,284
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$17,528,910
Value of total assets at end of year	2021-12-31	$115,337,856
Value of total assets at beginning of year	2021-12-31	$91,159,183
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$379,750
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$15,000,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$10,515,594
Participant contributions at end of year	2021-12-31	$258,935
Participant contributions at beginning of year	2021-12-31	$162,318
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$1,945,026
Administrative expenses (other) incurred	2021-12-31	$379,750
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$24,168,729
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$115,327,912
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$91,159,183
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest in master investment trust accounts at end of year	2021-12-31	$110,010,631
Value of interest in master investment trust accounts at beginning of year	2021-12-31	$86,319,451
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$5,068,290
Employer contributions (assets) at end of year	2021-12-31	$5,068,290
Employer contributions (assets) at beginning of year	2021-12-31	$4,677,414
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$8,710,284
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2021-12-31	No
Liabilities. Value of benefit claims payable at end of year	2021-12-31	$9,944
Did the plan have assets held for investment	2021-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	LBMC, PC
Accountancy firm EIN	2021-12-31	621199757
2020 : PROVIDER CARE GROUP MIRROR 401(K) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total transfer of assets from this plan	2020-12-31	$210,511
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$26,918,977
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$7,636,193
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$7,636,193
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$14,655,721
Value of total assets at end of year	2020-12-31	$91,159,183
Value of total assets at beginning of year	2020-12-31	$72,086,910
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$0
Total interest from all sources	2020-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$15,000,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$9,323,005
Participant contributions at end of year	2020-12-31	$162,318
Participant contributions at beginning of year	2020-12-31	$4,867
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$637,583
Other income not declared elsewhere	2020-12-31	$-139,663
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$19,282,784
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$91,159,183
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$72,086,910
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in master investment trust accounts at end of year	2020-12-31	$86,319,451
Value of interest in master investment trust accounts at beginning of year	2020-12-31	$68,191,888
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$4,695,133
Employer contributions (assets) at end of year	2020-12-31	$4,677,414
Employer contributions (assets) at beginning of year	2020-12-31	$3,890,155
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$7,636,193
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Unqualified
Accountancy firm name	2020-12-31	HAYNIE & COMPANY
Accountancy firm EIN	2020-12-31	870325228
2019 : PROVIDER CARE GROUP MIRROR 401(K) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total transfer of assets from this plan	2019-12-31	$5,203,353
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$28,097,476
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$5,370,299
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$5,370,299
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$14,664,367
Value of total assets at end of year	2019-12-31	$72,086,910
Value of total assets at beginning of year	2019-12-31	$54,563,086
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$0
Total interest from all sources	2019-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$15,000,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$8,434,586
Participant contributions at end of year	2019-12-31	$4,867
Participant contributions at beginning of year	2019-12-31	$1,802
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$2,347,726
Other income not declared elsewhere	2019-12-31	$-134,847
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$22,727,177
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$72,086,910
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$54,563,086
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in master investment trust accounts at end of year	2019-12-31	$68,191,888
Value of interest in master investment trust accounts at beginning of year	2019-12-31	$51,374,315
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$3,882,055
Employer contributions (assets) at end of year	2019-12-31	$3,890,155
Employer contributions (assets) at beginning of year	2019-12-31	$3,186,969
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$5,370,299
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	JUDD, THOMAS, SMITH & COMPANY, P.C.
Accountancy firm EIN	2019-12-31	751668928
2018 : PROVIDER CARE GROUP MIRROR 401(K) PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total transfer of assets to this plan	2018-12-31	$152,303
Total transfer of assets from this plan	2018-12-31	$197,157
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$8,255,902
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$6,100,650
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$6,100,650
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$10,913,053
Value of total assets at end of year	2018-12-31	$54,563,086
Value of total assets at beginning of year	2018-12-31	$52,452,688
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$0
Total interest from all sources	2018-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$15,000,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$6,813,326
Participant contributions at end of year	2018-12-31	$1,802
Participant contributions at beginning of year	2018-12-31	$537
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$912,758
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$2,155,252
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$54,563,086
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$52,452,688
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in master investment trust accounts at end of year	2018-12-31	$51,374,315
Value of interest in master investment trust accounts at beginning of year	2018-12-31	$52,442,372
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$3,186,969
Employer contributions (assets) at end of year	2018-12-31	$3,186,969
Employer contributions (assets) at beginning of year	2018-12-31	$9,779
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$6,100,650
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2018-12-31	No
Did the plan have assets held for investment	2018-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	JUDD, THOMAS, SMITH & COMPANY, P.C.
Accountancy firm EIN	2018-12-31	751668928
2016 : PROVIDER CARE GROUP MIRROR 401(K) PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total transfer of assets from this plan	2016-12-31	$42,584,150
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$2,791
Total income from all sources (including contributions)	2016-12-31	$9,884,096
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$3,825,998
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$3,674,363
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$6,300,712
Value of total assets at end of year	2016-12-31	$40,120,718
Value of total assets at beginning of year	2016-12-31	$76,649,561
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$151,635
Total interest from all sources	2016-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Administrative expenses professional fees incurred	2016-12-31	$28,190
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$1,500,000
If this is an individual account plan, was there a blackout period	2016-12-31	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$4,287,963
Participant contributions at end of year	2016-12-31	$16,879
Participant contributions at beginning of year	2016-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$37,753
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2016-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2016-12-31	$2,791
Other income not declared elsewhere	2016-12-31	$-7,397
Administrative expenses (other) incurred	2016-12-31	$4,620
Total non interest bearing cash at end of year	2016-12-31	$0
Total non interest bearing cash at beginning of year	2016-12-31	$72,870,914
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$6,058,098
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$40,120,718
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$76,646,770
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Investment advisory and management fees	2016-12-31	$77,277
Value of interest in master investment trust accounts at end of year	2016-12-31	$40,100,759
Value of interest in master investment trust accounts at beginning of year	2016-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2016-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2016-12-31	$41
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2016-12-31	$41
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$1,974,996
Employer contributions (assets) at end of year	2016-12-31	$3,080
Employer contributions (assets) at beginning of year	2016-12-31	$3,778,606
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$3,674,363
Contract administrator fees	2016-12-31	$41,548
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2016-12-31	Yes
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	JUDD, THOMAS, SMITH & COMPANY, P.C.
Accountancy firm EIN	2016-12-31	751668928

Form 5500 Responses for PROVIDER CARE GROUP MIRROR 401(K) PLAN

2022: PROVIDER CARE GROUP MIRROR 401(K) PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: PROVIDER CARE GROUP MIRROR 401(K) PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: PROVIDER CARE GROUP MIRROR 401(K) PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: PROVIDER CARE GROUP MIRROR 401(K) PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: PROVIDER CARE GROUP MIRROR 401(K) PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2016: PROVIDER CARE GROUP MIRROR 401(K) PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	HCA PHYSICIAN SERVICES, INC.
Employer identification number (EIN):	621821475
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)

Jurisdiction of Incorporation:	Texas Secretary of State
Incorporation Date:	2002-04-03
Company Identification Number:	0800070862
Legal Registered Office Address:	350 N SAINT PAUL ST DALLAS United States of America (USA) 75201