401k Plan data: WELLPATH 401(K) PLAN plan

WELLPATH 401(K) PLAN 401k Plan overview

Plan Name	WELLPATH 401(K) PLAN
Plan identification number	001

WELLPATH 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.
Plan covering Self-Employed individuals.
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.
Plan sponsor(s) received services of leased employees, as defined in Code section 414(n), during the plan year.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

WELLPATH HOLDINGS, INC. has sponsored the creation of one or more 401k plans.

Company Name: WELLPATH HOLDINGS, INC.

Employer identification number (EIN): 831316669

NAIC Classification: 621498
NAIC Description: All Other Outpatient Care Centers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WELLPATH 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
001 2021-01-01
001 2020-01-01
001 2020-01-01

Plan Statistics for WELLPATH 401(K) PLAN

401k plan membership statisitcs for WELLPATH 401(K) PLAN

Measure Date Value
2022: WELLPATH 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 12,855
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 11,221
Number of retired or separated participants receiving benefits 2022-01-01 13
Number of other retired or separated participants entitled to future benefits 2022-01-01 2,503
Total of all active and inactive participants 2022-01-01 13,737
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 13,737
Number of participants with account balances 2022-01-01 12,125
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 228
2021: WELLPATH 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 12,977
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 10,351
Number of retired or separated participants receiving benefits 2021-01-01 13
Number of other retired or separated participants entitled to future benefits 2021-01-01 2,092
Total of all active and inactive participants 2021-01-01 12,456
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 12,456
Number of participants with account balances 2021-01-01 10,330
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 359
2020: WELLPATH 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 14,075
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 11,303
Number of retired or separated participants receiving benefits 2020-01-01 7
Number of other retired or separated participants entitled to future benefits 2020-01-01 1,366
Total of all active and inactive participants 2020-01-01 12,676
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 12,676
Number of participants with account balances 2020-01-01 8,482
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 145

Measure	Date	Value
2022: WELLPATH 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	12,855
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	11,221
Number of retired or separated participants receiving benefits	2022-01-01	13
Number of other retired or separated participants entitled to future benefits	2022-01-01	2,503
Total of all active and inactive participants	2022-01-01	13,737
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	13,737
Number of participants with account balances	2022-01-01	12,125
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	228
2021: WELLPATH 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	12,977
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	10,351
Number of retired or separated participants receiving benefits	2021-01-01	13
Number of other retired or separated participants entitled to future benefits	2021-01-01	2,092
Total of all active and inactive participants	2021-01-01	12,456
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	12,456
Number of participants with account balances	2021-01-01	10,330
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	359
2020: WELLPATH 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	14,075
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	11,303
Number of retired or separated participants receiving benefits	2020-01-01	7
Number of other retired or separated participants entitled to future benefits	2020-01-01	1,366
Total of all active and inactive participants	2020-01-01	12,676
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	12,676
Number of participants with account balances	2020-01-01	8,482
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	145

Financial Data on WELLPATH 401(K) PLAN

Measure	Date	Value
2022 : WELLPATH 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	$9,814,713
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$31,482,202
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$30,457,733
Expenses. Certain deemed distributions of participant loans	2022-12-31	$476,547
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$47,515,108
Value of total assets at end of year	2022-12-31	$210,361,920
Value of total assets at beginning of year	2022-12-31	$232,029,409
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$547,922
Total interest from all sources	2022-12-31	$430,411
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$5,322,664
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	$5,322,664
Administrative expenses professional fees incurred	2022-12-31	$26,500
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$3,000,000
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	$35,067,754
Participant contributions at end of year	2022-12-31	$4,214,157
Participant contributions at beginning of year	2022-12-31	$4,000,740
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$3,801,035
Other income not declared elsewhere	2022-12-31	$7,517
Administrative expenses (other) incurred	2022-12-31	$29,303
Total non interest bearing cash at end of year	2022-12-31	$305
Total non interest bearing cash 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	$-21,667,489
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$210,361,920
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$232,029,409
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
Investment advisory and management fees	2022-12-31	$77,500
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$178,807,319
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$213,278,094
Interest on participant loans	2022-12-31	$171,906
Interest earned on other investments	2022-12-31	$258,505
Value of interest in common/collective trusts at end of year	2022-12-31	$27,340,139
Value of interest in common/collective trusts at beginning of year	2022-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$14,750,575
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-43,376,845
Net investment gain or loss from common/collective trusts	2022-12-31	$-84,142
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$8,646,319
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$30,457,733
Contract administrator fees	2022-12-31	$414,619
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	LBMC
Accountancy firm EIN	2022-12-31	621199757
2021 : WELLPATH 401(K) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total transfer of assets to this plan	2021-12-31	$24,195
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	$67,531,177
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$26,207,468
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$25,223,426
Expenses. Certain deemed distributions of participant loans	2021-12-31	$362,520
Value of total corrective distributions	2021-12-31	$117,012
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$43,191,256
Value of total assets at end of year	2021-12-31	$232,029,409
Value of total assets at beginning of year	2021-12-31	$190,681,505
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$504,510
Total interest from all sources	2021-12-31	$472,372
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$8,751,942
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	$8,751,942
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$3,000,000
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	$29,503,611
Participant contributions at end of year	2021-12-31	$4,000,740
Participant contributions at beginning of year	2021-12-31	$3,963,674
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$4,577,255
Other income not declared elsewhere	2021-12-31	$-708,049
Administrative expenses (other) incurred	2021-12-31	$504,510
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	$41,323,709
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$232,029,409
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$190,681,505
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	$213,278,094
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$171,424,309
Interest on participant loans	2021-12-31	$189,256
Interest earned on other investments	2021-12-31	$283,116
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$14,750,575
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$15,293,522
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$15,823,656
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$9,110,390
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$25,223,426
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	LBMC
Accountancy firm EIN	2021-12-31	621199757
2020 : WELLPATH 401(K) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total transfer of assets to this plan	2020-12-31	$32,085,816
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$55,779,625
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$21,777,815
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$20,859,040
Expenses. Certain deemed distributions of participant loans	2020-12-31	$263,961
Value of total corrective distributions	2020-12-31	$329,936
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$34,087,848
Value of total assets at end of year	2020-12-31	$190,681,505
Value of total assets at beginning of year	2020-12-31	$124,593,879
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$324,878
Total interest from all sources	2020-12-31	$518,026
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$2,673,688
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	$2,673,688
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$3,000,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$23,982,518
Participant contributions at end of year	2020-12-31	$3,963,674
Participant contributions at beginning of year	2020-12-31	$3,342,764
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$2,441,603
Other income not declared elsewhere	2020-12-31	$-689,229
Administrative expenses (other) incurred	2020-12-31	$324,878
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	$34,001,810
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$190,681,505
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$124,593,879
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	$171,424,309
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$121,251,115
Interest on participant loans	2020-12-31	$201,870
Interest earned on other investments	2020-12-31	$316,055
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2020-12-31	$101
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$15,293,522
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$19,189,292
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$7,663,727
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$20,859,040
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	LBMC
Accountancy firm EIN	2020-12-31	621199757

Form 5500 Responses for WELLPATH 401(K) PLAN

2022: WELLPATH 401(K) PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Mulitple 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: WELLPATH 401(K) PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Mulitple 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: WELLPATH 401(K) PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	Yes
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

Insurance Providers Used on plan

PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )

Policy contract number

075516

Policy instance

Insurance contract or identification number	075516
Number of Individuals Covered	13737
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with 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

PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )

Policy contract number

075516

Policy instance

Insurance contract or identification number	075516
Number of Individuals Covered	12456
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with 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

PRUDENTIAL RETIREMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 93629 )

Policy contract number

075516

Policy instance

Insurance contract or identification number	075516
Number of Individuals Covered	12676
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?	No
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
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0

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Company Name:	WELLPATH HOLDINGS, INC.
Employer identification number (EIN):	831316669
NAIC Classification:	621498
NAIC Description:	All Other Outpatient Care Centers