401k Plan data: UNITY CARE 403(B) PLAN plan

UNITY CARE 403(B) PLAN 401k Plan overview

Plan Name	UNITY CARE 403(B) PLAN
Plan identification number	002

UNITY CARE 403(B) 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(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.
Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
Code section 403(b)(7) accounts - See Limited Pension Plan Reporting instructions for Code section 403(b)(7) custodial accounts for regulated investment company stock for certain exempt organizations.
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

UNITY CARE GROUP, INC. has sponsored the creation of one or more 401k plans.

Company Name: UNITY CARE GROUP, INC.

Employer identification number (EIN): 770323115

NAIC Classification: 812990
NAIC Description: All Other Personal Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan UNITY CARE 403(B) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2022-01-01
002 2021-01-01
002 2020-01-01
002 2019-01-01 SHAILENDRA BAGHEL 2020-10-12 SHAILENDRA BAGHEL 2020-10-12
002 2018-01-01 GARY RUMMELHOFF 2019-10-15 GARY RUMMELHOFF 2019-10-15
002 2017-01-01
002 2016-01-01 GARY RUMMELHOFF 2018-10-15

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2022-01-01
002	2021-01-01
002	2020-01-01
002	2019-01-01	SHAILENDRA BAGHEL	2020-10-12	SHAILENDRA BAGHEL	2020-10-12
002	2018-01-01	GARY RUMMELHOFF	2019-10-15	GARY RUMMELHOFF	2019-10-15
002	2017-01-01
002	2016-01-01	GARY RUMMELHOFF	2018-10-15

Plan Statistics for UNITY CARE 403(B) PLAN

401k plan membership statisitcs for UNITY CARE 403(B) PLAN

Measure Date Value
2019: UNITY CARE 403(B) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 179
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 41
Number of other retired or separated participants entitled to future benefits 2019-01-01 35
Total of all active and inactive participants 2019-01-01 76
Total participants 2019-01-01 76
Number of participants with account balances 2019-01-01 42
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: UNITY CARE 403(B) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 207
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 157
Number of other retired or separated participants entitled to future benefits 2018-01-01 18
Total of all active and inactive participants 2018-01-01 175
Total participants 2018-01-01 175
Number of participants with account balances 2018-01-01 49
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 6
2017: UNITY CARE 403(B) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 161
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 200
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 11
Total of all active and inactive participants 2017-01-01 211
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 211
Number of participants with account balances 2017-01-01 46
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: UNITY CARE 403(B) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 116
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 177
Number of other retired or separated participants entitled to future benefits 2016-01-01 8
Total of all active and inactive participants 2016-01-01 185
Total participants 2016-01-01 185
Number of participants with account balances 2016-01-01 40

Measure	Date	Value
2019: UNITY CARE 403(B) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	179
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	41
Number of other retired or separated participants entitled to future benefits	2019-01-01	35
Total of all active and inactive participants	2019-01-01	76
Total participants	2019-01-01	76
Number of participants with account balances	2019-01-01	42
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: UNITY CARE 403(B) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	207
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	157
Number of other retired or separated participants entitled to future benefits	2018-01-01	18
Total of all active and inactive participants	2018-01-01	175
Total participants	2018-01-01	175
Number of participants with account balances	2018-01-01	49
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	6
2017: UNITY CARE 403(B) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	161
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	200
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	11
Total of all active and inactive participants	2017-01-01	211
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	211
Number of participants with account balances	2017-01-01	46
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: UNITY CARE 403(B) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	116
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	177
Number of other retired or separated participants entitled to future benefits	2016-01-01	8
Total of all active and inactive participants	2016-01-01	185
Total participants	2016-01-01	185
Number of participants with account balances	2016-01-01	40

Financial Data on UNITY CARE 403(B) PLAN

Measure	Date	Value
2019 : UNITY CARE 403(B) PLAN 2019 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$2,201
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$2,201
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$102
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$102
Total income from all sources (including contributions)	2019-12-31	$288,188
Total income from all sources (including contributions)	2019-12-31	$288,188
Total of all expenses incurred	2019-12-31	$121,151
Total of all expenses incurred	2019-12-31	$121,151
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$116,608
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$116,608
Value of total corrective distributions	2019-12-31	$4,543
Value of total corrective distributions	2019-12-31	$4,543
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$138,935
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$138,935
Value of total assets at end of year	2019-12-31	$862,412
Value of total assets at end of year	2019-12-31	$862,412
Value of total assets at beginning of year	2019-12-31	$693,276
Value of total assets at beginning of year	2019-12-31	$693,276
Total interest from all sources	2019-12-31	$115
Total interest from all sources	2019-12-31	$115
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
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
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
Value of fidelity bond cover	2019-12-31	$500,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
If this is an individual account plan, was there a blackout period	2019-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$116,799
Contributions received from participants	2019-12-31	$116,799
Participant contributions at beginning of year	2019-12-31	$6,456
Participant contributions at beginning of year	2019-12-31	$6,456
Participant contributions at end of year	2019-12-31	$450
Participant contributions at end of year	2019-12-31	$450
Participant contributions at beginning of year	2019-12-31	$5,800
Participant contributions at beginning of year	2019-12-31	$5,800
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2019-12-31	$2,201
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2019-12-31	$2,201
Total non interest bearing cash at end of year	2019-12-31	$0
Total non interest bearing cash at end of year	2019-12-31	$0
Total non interest bearing cash at beginning of year	2019-12-31	$1,886
Total non interest bearing cash at beginning of year	2019-12-31	$1,886
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
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	$167,037
Value of net income/loss	2019-12-31	$167,037
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$860,211
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$860,211
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$693,174
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$693,174
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
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 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
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$786,068
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$786,068
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$679,134
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$679,134
Interest on participant loans	2019-12-31	$115
Interest on participant loans	2019-12-31	$115
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2019-12-31	$7,554
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2019-12-31	$7,554
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$68,159
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$68,159
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$149,138
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$149,138
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
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
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
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	$22,136
Contributions received in cash from employer	2019-12-31	$22,136
Employer contributions (assets) at end of year	2019-12-31	$181
Employer contributions (assets) at end of year	2019-12-31	$181
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$116,608
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$116,608
Did the plan have assets held for investment	2019-12-31	Yes
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
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
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
Liabilities. Value of acquisition indebtedness at beginning of year	2019-12-31	$102
Liabilities. Value of acquisition indebtedness at beginning of year	2019-12-31	$102
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
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	DSR CPA AND CONSULTANTS
Accountancy firm name	2019-12-31	DSR CPA AND CONSULTANTS
Accountancy firm EIN	2019-12-31	833983879
Accountancy firm EIN	2019-12-31	833983879
2018 : UNITY CARE 403(B) PLAN 2018 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$102
Total income from all sources (including contributions)	2018-12-31	$152,196
Total of all expenses incurred	2018-12-31	$23,292
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$23,292
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$224,996
Value of total assets at end of year	2018-12-31	$693,276
Value of total assets at beginning of year	2018-12-31	$564,270
Total interest from all sources	2018-12-31	$415
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	$500,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$170,034
Participant contributions at end of year	2018-12-31	$6,456
Participant contributions at beginning of year	2018-12-31	$9,008
Participant contributions at end of year	2018-12-31	$5,800
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$12,348
Total non interest bearing cash at end of year	2018-12-31	$1,886
Total non interest bearing cash at beginning of year	2018-12-31	$1,402
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	$128,904
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$693,174
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$564,270
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 registered invesment companies (eg mutual funds) at end of year	2018-12-31	$679,134
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$556,202
Interest on participant loans	2018-12-31	$415
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-73,215
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	$42,614
Employer contributions (assets) at beginning of year	2018-12-31	$-2,342
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$23,292
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
Liabilities. Value of acquisition indebtedness at end of year	2018-12-31	$102
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	ROBERT LEE & ASSOCIATES, LLP.
Accountancy firm EIN	2018-12-31	271155496
2017 : UNITY CARE 403(B) PLAN 2017 401k financial data
Total income from all sources (including contributions)	2017-12-31	$251,443
Total of all expenses incurred	2017-12-31	$16,399
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$16,399
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$188,140
Value of total assets at end of year	2017-12-31	$564,270
Value of total assets at beginning of year	2017-12-31	$329,226
Total interest from all sources	2017-12-31	$65
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$50,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$151,011
Participant contributions at end of year	2017-12-31	$9,008
Participant contributions at beginning of year	2017-12-31	$7,000
Total non interest bearing cash at end of year	2017-12-31	$1,402
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$235,044
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$564,270
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$329,226
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$556,202
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$323,343
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$0
Interest on participant loans	2017-12-31	$65
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$63,238
Net investment gain/loss from pooled separate accounts	2017-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$37,129
Employer contributions (assets) at end of year	2017-12-31	$-2,342
Employer contributions (assets) at beginning of year	2017-12-31	$-1,117
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$16,399
Did the plan have assets held for investment	2017-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	ROBERT LEE & ASSOCIATES, LLP.
Accountancy firm EIN	2017-12-31	271155496
2016 : UNITY CARE 403(B) PLAN 2016 401k financial data
Total income from all sources (including contributions)	2016-12-31	$329,226
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$320,097
Value of total assets at end of year	2016-12-31	$329,226
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$105,612
Participant contributions at end of year	2016-12-31	$7,000
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$183,773
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	$329,226
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$329,226
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
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$323,343
Value of interest in pooled separate accounts at end of year	2016-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$9,129
Net investment gain/loss from pooled separate accounts	2016-12-31	$0
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	$30,712
Employer contributions (assets) at end of year	2016-12-31	$-1,117
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	ROBERT LEE & ASSOCIATES, LLP.
Accountancy firm EIN	2016-12-31	271155496

Form 5500 Responses for UNITY CARE 403(B) PLAN

2019: UNITY CARE 403(B) PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: UNITY CARE 403(B) 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
2017: UNITY CARE 403(B) PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: UNITY CARE 403(B) PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	First time form 5500 has been submitted	Yes
2016-01-01	Submission has been amended	Yes
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

Insurance Providers Used on plan

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

570-80176

Policy instance

Insurance contract or identification number	570-80176
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $57
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes
Amount paid for insurance broker fees	57
Insurance broker organization code?	3

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )

Policy contract number

570-80176

Policy instance

Insurance contract or identification number	570-80176
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with unallocated funds for contracts of type guaranteed investment?	Yes

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Company Name:	UNITY CARE GROUP, INC.
Employer identification number (EIN):	770323115
NAIC Classification:	812990
NAIC Description:	All Other Personal Services