401k Plan data: SWEETGRASS PEDIATRICS 401(K) PLAN plan

SWEETGRASS PEDIATRICS 401(K) PLAN 401k Plan overview

Plan Name	SWEETGRASS PEDIATRICS 401(K) PLAN
Plan identification number	001

SWEETGRASS PEDIATRICS 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
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.
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

SWEETGRASS PEDIATRICS has sponsored the creation of one or more 401k plans.

Company Name: SWEETGRASS PEDIATRICS

Employer identification number (EIN): 810568231

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SWEETGRASS PEDIATRICS 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 SHELLEY DUGGINS 2023-10-16
001 2021-01-01 SHELLEY DUGGINS 2022-10-03
001 2020-01-01 SHELLEY DUGGINS 2021-10-14
001 2020-01-01 SHELLEY DUGGINS 2022-10-03
001 2019-01-01 SHELLEY DUGGINS 2020-10-12

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2022-01-01	SHELLEY DUGGINS	2023-10-16
001	2021-01-01	SHELLEY DUGGINS	2022-10-03
001	2020-01-01	SHELLEY DUGGINS	2021-10-14
001	2020-01-01	SHELLEY DUGGINS	2022-10-03
001	2019-01-01	SHELLEY DUGGINS	2020-10-12

Plan Statistics for SWEETGRASS PEDIATRICS 401(K) PLAN

401k plan membership statisitcs for SWEETGRASS PEDIATRICS 401(K) PLAN

Measure Date Value
2022: SWEETGRASS PEDIATRICS 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 113
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 103
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 13
Total of all active and inactive participants 2022-01-01 116
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 116
Number of participants with account balances 2022-01-01 83
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 8
2021: SWEETGRASS PEDIATRICS 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 117
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 97
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 15
Total of all active and inactive participants 2021-01-01 112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 112
Number of participants with account balances 2021-01-01 100
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 19
2020: SWEETGRASS PEDIATRICS 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 127
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 95
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 16
Total of all active and inactive participants 2020-01-01 111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 111
Number of participants with account balances 2020-01-01 16
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 2
2019: SWEETGRASS PEDIATRICS 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 129
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 106
Number of retired or separated participants receiving benefits 2019-01-01 2
Number of other retired or separated participants entitled to future benefits 2019-01-01 19
Total of all active and inactive participants 2019-01-01 127
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 127
Number of participants with account balances 2019-01-01 120
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 24

Measure	Date	Value
2022: SWEETGRASS PEDIATRICS 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	113
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	103
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	13
Total of all active and inactive participants	2022-01-01	116
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	116
Number of participants with account balances	2022-01-01	83
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	8
2021: SWEETGRASS PEDIATRICS 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	117
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	97
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	15
Total of all active and inactive participants	2021-01-01	112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	112
Number of participants with account balances	2021-01-01	100
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	19
2020: SWEETGRASS PEDIATRICS 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	127
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	95
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	16
Total of all active and inactive participants	2020-01-01	111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	111
Number of participants with account balances	2020-01-01	16
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	2
2019: SWEETGRASS PEDIATRICS 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	129
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	106
Number of retired or separated participants receiving benefits	2019-01-01	2
Number of other retired or separated participants entitled to future benefits	2019-01-01	19
Total of all active and inactive participants	2019-01-01	127
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	127
Number of participants with account balances	2019-01-01	120
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	24

Financial Data on SWEETGRASS PEDIATRICS 401(K) PLAN

Measure	Date	Value
2022 : SWEETGRASS PEDIATRICS 401(K) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
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	$0
Total income from all sources (including contributions)	2022-12-31	$-166,256
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$105,648
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$60,459
Expenses. Certain deemed distributions of participant loans	2022-12-31	$2,163
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$595,613
Value of total assets at end of year	2022-12-31	$4,697,270
Value of total assets at beginning of year	2022-12-31	$4,969,174
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$43,026
Total interest from all sources	2022-12-31	$1,001
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$165,503
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-12-31	$165,503
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$1,000,000
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	$441,280
Participant contributions at end of year	2022-12-31	$24,750
Participant contributions at beginning of year	2022-12-31	$18,277
Participant contributions at end of year	2022-12-31	$0
Participant contributions at beginning of year	2022-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$3,414
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2022-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2022-12-31	$0
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	$-271,904
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$4,697,270
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$4,969,174
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 registered invesment companies (eg mutual funds) at end of year	2022-12-31	$4,497,188
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$4,784,908
Value of interest in pooled separate accounts at end of year	2022-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2022-12-31	$0
Interest on participant loans	2022-12-31	$1,001
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$175,332
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$165,989
Net investment gain/loss from pooled separate accounts	2022-12-31	$-928,373
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	Yes
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	$150,919
Employer contributions (assets) at end of year	2022-12-31	$0
Employer contributions (assets) at beginning of year	2022-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$60,459
Contract administrator fees	2022-12-31	$43,026
Did the plan have assets held for investment	2022-12-31	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	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	SWEENEY CONRAD, P.S.
Accountancy firm EIN	2022-12-31	911301672
2021 : SWEETGRASS PEDIATRICS 401(K) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$1,112,616
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$457,491
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$425,786
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$585,856
Value of total assets at end of year	2021-12-31	$4,969,174
Value of total assets at beginning of year	2021-12-31	$4,314,049
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$31,705
Total interest from all sources	2021-12-31	$983
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$293,456
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2021-12-31	$293,456
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$430,219
Participant contributions at end of year	2021-12-31	$18,277
Participant contributions at beginning of year	2021-12-31	$21,415
Participant contributions at end of year	2021-12-31	$0
Participant contributions at beginning of year	2021-12-31	$11,357
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2021-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2021-12-31	$0
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	$655,125
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$4,969,174
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$4,314,049
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 registered invesment companies (eg mutual funds) at end of year	2021-12-31	$4,784,908
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$4,159,520
Value of interest in pooled separate accounts at end of year	2021-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$0
Interest on participant loans	2021-12-31	$983
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$165,989
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$116,577
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$232,321
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	Yes
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	$155,637
Employer contributions (assets) at end of year	2021-12-31	$0
Employer contributions (assets) at beginning of year	2021-12-31	$5,180
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$425,786
Contract administrator fees	2021-12-31	$31,705
Did the plan have assets held for investment	2021-12-31	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	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	SWEENEY CONRAD, P.S.
Accountancy firm EIN	2021-12-31	911301672
2020 : SWEETGRASS PEDIATRICS 401(K) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
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	$450
Total income from all sources (including contributions)	2020-12-31	$872,991
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$184,350
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$154,893
Expenses. Certain deemed distributions of participant loans	2020-12-31	$2,574
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$582,298
Value of total assets at end of year	2020-12-31	$4,314,049
Value of total assets at beginning of year	2020-12-31	$3,625,858
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$26,883
Total interest from all sources	2020-12-31	$1,314
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$166,064
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-31	$166,064
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$385,000
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	$389,331
Participant contributions at end of year	2020-12-31	$21,415
Participant contributions at beginning of year	2020-12-31	$25,115
Participant contributions at end of year	2020-12-31	$11,357
Participant contributions at beginning of year	2020-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$40,000
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2020-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2020-12-31	$450
Other income not declared elsewhere	2020-12-31	$4,738
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	$688,641
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$4,314,049
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$3,625,408
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 registered invesment companies (eg mutual funds) at end of year	2020-12-31	$4,159,520
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$0
Value of interest in pooled separate accounts at end of year	2020-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$3,585,203
Interest on participant loans	2020-12-31	$1,314
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$116,577
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$15,540
Net investment gain/loss from pooled separate accounts	2020-12-31	$118,577
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	Yes
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	$152,967
Employer contributions (assets) at end of year	2020-12-31	$5,180
Employer contributions (assets) at beginning of year	2020-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$154,893
Contract administrator fees	2020-12-31	$26,883
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	SWEENEY CONRAD, P.S.
Accountancy firm EIN	2020-12-31	911301672
2019 : SWEETGRASS PEDIATRICS 401(K) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$450
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$450
Total income from all sources (including contributions)	2019-12-31	$1,268,697
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$255,849
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$229,224
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$614,704
Value of total assets at end of year	2019-12-31	$3,625,858
Value of total assets at beginning of year	2019-12-31	$2,613,010
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$26,625
Total interest from all sources	2019-12-31	$1,468
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	$385,000
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	$423,821
Participant contributions at end of year	2019-12-31	$25,115
Participant contributions at beginning of year	2019-12-31	$24,729
Participant contributions at end of year	2019-12-31	$0
Participant contributions at beginning of year	2019-12-31	$473
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$23,409
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2019-12-31	$450
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2019-12-31	$450
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	$1,012,848
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$3,625,408
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$2,612,560
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 pooled separate accounts at end of year	2019-12-31	$3,585,203
Value of interest in pooled separate accounts at beginning of year	2019-12-31	$2,572,746
Interest on participant loans	2019-12-31	$1,345
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-31	$123
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2019-12-31	$15,540
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2019-12-31	$14,911
Net investment gain/loss from pooled separate accounts	2019-12-31	$652,525
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	Yes
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	$167,474
Employer contributions (assets) at end of year	2019-12-31	$0
Employer contributions (assets) at beginning of year	2019-12-31	$151
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$229,224
Contract administrator fees	2019-12-31	$26,625
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	SWEENEY CONRAD, P.S.
Accountancy firm EIN	2019-12-31	911301672

Form 5500 Responses for SWEETGRASS PEDIATRICS 401(K) PLAN

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

Insurance Providers Used on plan

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

1260788-01

Policy instance

Insurance contract or identification number	1260788-01
Number of Individuals Covered	80
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Insurance broker organization code?	3

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

1260788-01

Policy instance

Insurance contract or identification number	1260788-01
Number of Individuals Covered	97
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Insurance broker organization code?	3

TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )

Policy contract number

601734-000

Policy instance

Insurance contract or identification number	601734-000
Number of Individuals Covered	0
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $4,537
Total amount of fees paid to insurance company	USD $716
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,537
Insurance broker organization code?	3
Amount paid for insurance broker fees	716
Additional information about fees paid to insurance broker	FEES

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

1260788-01

Policy instance

Insurance contract or identification number	1260788-01
Number of Individuals Covered	105
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Insurance broker organization code?	3

TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70688 )

Policy contract number

601734-000

Policy instance

Insurance contract or identification number	601734-000
Number of Individuals Covered	120
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $15,758
Total amount of fees paid to insurance company	USD $1,318
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $15,758
Insurance broker organization code?	3
Amount paid for insurance broker fees	1006
Additional information about fees paid to insurance broker	FEES

Potentially related plans

SWEETGRASS PEDIATRICS 401(K) PLAN [EIN = 510568231]

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Company Name:	SWEETGRASS PEDIATRICS
Employer identification number (EIN):	810568231
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)