401k Plan data: JAVA MEDICAL GROUP 401(K) PLAN plan

JAVA MEDICAL GROUP 401(K) PLAN 401k Plan overview

Plan Name	JAVA MEDICAL GROUP 401(K) PLAN
Plan identification number	001

JAVA MEDICAL GROUP 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.
Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
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

JAVA MEDICAL CENTER, LLC has sponsored the creation of one or more 401k plans.

Company Name: JAVA MEDICAL CENTER, LLC

Employer identification number (EIN): 823684621

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan JAVA MEDICAL GROUP 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2021-01-01 MARTHA HENLEY 2022-12-26
001 2020-01-01 MARTHA MCCORMICK 2021-10-14
001 2019-01-01
001 2018-07-01

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2021-01-01	MARTHA HENLEY	2022-12-26
001	2020-01-01	MARTHA MCCORMICK	2021-10-14
001	2019-01-01
001	2018-07-01

Plan Statistics for JAVA MEDICAL GROUP 401(K) PLAN

401k plan membership statisitcs for JAVA MEDICAL GROUP 401(K) PLAN

Measure Date Value
2021: JAVA MEDICAL GROUP 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 750
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 705
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 97
Total of all active and inactive participants 2021-01-01 802
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 2
Total participants 2021-01-01 804
Number of participants with account balances 2021-01-01 597
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: JAVA MEDICAL GROUP 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 732
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 701
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 48
Total of all active and inactive participants 2020-01-01 749
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 1
Total participants 2020-01-01 750
Number of participants with account balances 2020-01-01 548
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: JAVA MEDICAL GROUP 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 122
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 715
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 17
Total of all active and inactive participants 2019-01-01 732
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 732
Number of participants with account balances 2019-01-01 526
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: JAVA MEDICAL GROUP 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-07-01 0
Total number of active participants reported on line 7a of the Form 5500 2018-07-01 116
Number of retired or separated participants receiving benefits 2018-07-01 0
Number of other retired or separated participants entitled to future benefits 2018-07-01 6
Total of all active and inactive participants 2018-07-01 122
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-07-01 0
Total participants 2018-07-01 122
Number of participants with account balances 2018-07-01 93
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-07-01 0

Measure	Date	Value
2021: JAVA MEDICAL GROUP 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	750
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	705
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	97
Total of all active and inactive participants	2021-01-01	802
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	2
Total participants	2021-01-01	804
Number of participants with account balances	2021-01-01	597
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: JAVA MEDICAL GROUP 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	732
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	701
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	48
Total of all active and inactive participants	2020-01-01	749
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	1
Total participants	2020-01-01	750
Number of participants with account balances	2020-01-01	548
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: JAVA MEDICAL GROUP 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	122
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	715
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	17
Total of all active and inactive participants	2019-01-01	732
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	732
Number of participants with account balances	2019-01-01	526
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: JAVA MEDICAL GROUP 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-07-01	0
Total number of active participants reported on line 7a of the Form 5500	2018-07-01	116
Number of retired or separated participants receiving benefits	2018-07-01	0
Number of other retired or separated participants entitled to future benefits	2018-07-01	6
Total of all active and inactive participants	2018-07-01	122
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-07-01	0
Total participants	2018-07-01	122
Number of participants with account balances	2018-07-01	93
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-07-01	0

Financial Data on JAVA MEDICAL GROUP 401(K) PLAN

Measure	Date	Value
2021 : JAVA MEDICAL GROUP 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	$2,107,198
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$1,408,332
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$1,400,105
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$1,063,440
Value of total assets at end of year	2021-12-31	$7,859,160
Value of total assets at beginning of year	2021-12-31	$7,160,294
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$8,227
Total interest from all sources	2021-12-31	$8,490
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$329,926
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	$329,926
Administrative expenses professional fees incurred	2021-12-31	$8,227
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
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	$1,063,440
Participant contributions at end of year	2021-12-31	$139,253
Participant contributions at beginning of year	2021-12-31	$176,542
Total non interest bearing cash at end of year	2021-12-31	$12,427
Total non interest bearing cash at beginning of year	2021-12-31	$1,729
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	$698,866
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$7,859,160
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$7,160,294
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	$7,223,072
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$6,480,566
Interest on participant loans	2021-12-31	$8,036
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2021-12-31	$484,408
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2021-12-31	$501,457
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2021-12-31	$501,457
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2021-12-31	$454
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$705,342
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$1,400,105
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	Disclaimer
Accountancy firm name	2021-12-31	CRI CARR RIGGS & INGRAM
Accountancy firm EIN	2021-12-31	721396621
2020 : JAVA MEDICAL GROUP 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	$21,102
Total income from all sources (including contributions)	2020-12-31	$1,959,909
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$1,729,366
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$1,723,722
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$988,841
Value of total assets at end of year	2020-12-31	$7,160,294
Value of total assets at beginning of year	2020-12-31	$6,950,853
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$5,644
Total interest from all sources	2020-12-31	$12,904
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$192,226
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	$192,226
Administrative expenses professional fees incurred	2020-12-31	$5,644
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
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	$984,395
Participant contributions at end of year	2020-12-31	$176,542
Participant contributions at beginning of year	2020-12-31	$209,556
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$4,446
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2020-12-31	$21,102
Total non interest bearing cash at end of year	2020-12-31	$1,729
Total non interest bearing cash at beginning of year	2020-12-31	$20,390
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	$230,543
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$7,160,294
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$6,929,751
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	$6,480,566
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$6,210,880
Interest on participant loans	2020-12-31	$10,834
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2020-12-31	$501,457
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2020-12-31	$510,027
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2020-12-31	$510,027
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2020-12-31	$2,070
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$765,938
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$1,723,722
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	Disclaimer
Accountancy firm name	2020-12-31	CRI CARR RIGGS & INGRAM
Accountancy firm EIN	2020-12-31	721396621
2019 : JAVA MEDICAL GROUP 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	$21,102
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	$6,085,160
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$178,792
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$176,444
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$5,126,532
Value of total assets at end of year	2019-12-31	$6,950,853
Value of total assets at beginning of year	2019-12-31	$1,023,383
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$2,348
Total interest from all sources	2019-12-31	$18,927
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$195,774
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$195,774
Administrative expenses professional fees incurred	2019-12-31	$2,348
Was this plan covered by a fidelity bond	2019-12-31	Yes
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
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	$690,938
Participant contributions at end of year	2019-12-31	$209,556
Participant contributions at beginning of year	2019-12-31	$18,553
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$4,435,594
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2019-12-31	$21,102
Total non interest bearing cash at end of year	2019-12-31	$20,390
Total non interest bearing cash at beginning of year	2019-12-31	$6,294
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	$5,906,368
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$6,929,751
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$1,023,383
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 registered invesment companies (eg mutual funds) at end of year	2019-12-31	$6,210,880
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$904,621
Income. Interest from loans (other than to participants)	2019-12-31	$12,347
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2019-12-31	$510,027
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2019-12-31	$93,915
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2019-12-31	$93,915
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-31	$6,580
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$743,927
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
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$176,444
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	CRI CARR RIGGS & INGRAM
Accountancy firm EIN	2019-12-31	721396621
2018 : JAVA MEDICAL GROUP 401(K) PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
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	$1,045,385
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$22,002
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$21,738
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$1,114,445
Value of total assets at end of year	2018-12-31	$1,023,383
Value of total assets at beginning of year	2018-12-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$264
Total interest from all sources	2018-12-31	$842
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$32,910
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Administrative expenses professional fees incurred	2018-12-31	$264
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
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	$69,625
Participant contributions at end of year	2018-12-31	$18,553
Participant contributions at beginning of year	2018-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$1,044,820
Total non interest bearing cash at end of year	2018-12-31	$6,294
Total non interest bearing cash at beginning of year	2018-12-31	$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	2018-12-31	No
Value of net income/loss	2018-12-31	$1,023,383
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$1,023,383
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	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	$904,621
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$0
Interest on participant loans	2018-12-31	$493
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2018-12-31	$93,915
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2018-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2018-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2018-12-31	$349
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-102,812
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
Income. Dividends from preferred stock	2018-12-31	$32,910
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$21,738
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

Form 5500 Responses for JAVA MEDICAL GROUP 401(K) PLAN

2021: JAVA MEDICAL GROUP 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 – Trust	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: JAVA MEDICAL GROUP 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: JAVA MEDICAL GROUP 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: JAVA MEDICAL GROUP 401(K) PLAN 2018 form 5500 responses
2018-07-01	Type of plan entity	Single employer plan
2018-07-01	First time form 5500 has been submitted	Yes
2018-07-01	Submission has been amended	No
2018-07-01	This submission is the final filing	No
2018-07-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2018-07-01	Plan is a collectively bargained plan	No
2018-07-01	Plan funding arrangement – Trust	Yes
2018-07-01	Plan benefit arrangement - Trust	Yes

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Company Name:	JAVA MEDICAL CENTER, LLC
Employer identification number (EIN):	823684621
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)