401k Plan data: VALLEY ANESTHESIOLOGY CONSULTANTS, LTD. PROFIT SHARING PLAN plan

VALLEY ANESTHESIOLOGY CONSULTANTS, LTD. PROFIT SHARING PLAN 401k Plan overview

Plan Name	VALLEY ANESTHESIOLOGY CONSULTANTS, LTD. PROFIT SHARING PLAN
Plan identification number	001

VALLEY ANESTHESIOLOGY CONSULTANTS, LTD. PROFIT SHARING 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.
Participant-directed brokerage accounts provided as an investment option under the plan.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

VALLEY ANESTHESIOLOGY CONSULTANTS, LTD. has sponsored the creation of one or more 401k plans.

Company Name: VALLEY ANESTHESIOLOGY CONSULTANTS, LTD.

Employer identification number (EIN): 860621497

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan VALLEY ANESTHESIOLOGY CONSULTANTS, LTD. PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2018-01-01
001 2017-01-01
001 2017-01-01
001 2016-01-01
001 2016-01-01 BRIAN SCHNEIDER 2017-10-16
001 2016-01-01 BRIAN SCHNEIDER 2017-10-16
001 2015-01-01 BRIAN SCHNEIDER
001 2015-01-01 BRIAN SCHNEIDER
001 2014-01-01 BRIAN SCHNEIDER
001 2013-01-01 BRIAN SCHNEIDER
001 2012-01-01 MICHAEL DUPUY
001 2011-01-01 MICHAEL DUPUY
001 2009-01-01 MICHAEL DUPUY

Plan Statistics for VALLEY ANESTHESIOLOGY CONSULTANTS, LTD. PROFIT SHARING PLAN

401k plan membership statisitcs for VALLEY ANESTHESIOLOGY CONSULTANTS, LTD. PROFIT SHARING PLAN

Measure Date Value
2017: VALLEY ANESTHESIOLOGY CONSULTANTS, LTD. PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 213
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 0
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 10
Total of all active and inactive participants 2017-01-01 10
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 10
Number of participants with account balances 2017-01-01 10
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: VALLEY ANESTHESIOLOGY CONSULTANTS, LTD. PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 431
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 0
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 207
Total of all active and inactive participants 2016-01-01 207
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 207
Number of participants with account balances 2016-01-01 207
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: VALLEY ANESTHESIOLOGY CONSULTANTS, LTD. PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 433
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 0
Number of retired or separated participants receiving benefits 2015-01-01 14
Number of other retired or separated participants entitled to future benefits 2015-01-01 420
Total of all active and inactive participants 2015-01-01 434
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 434
Number of participants with account balances 2015-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 3
2014: VALLEY ANESTHESIOLOGY CONSULTANTS, LTD. PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 390
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 399
Number of retired or separated participants receiving benefits 2014-01-01 3
Number of other retired or separated participants entitled to future benefits 2014-01-01 28
Total of all active and inactive participants 2014-01-01 430
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 430
Number of participants with account balances 2014-01-01 429
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: VALLEY ANESTHESIOLOGY CONSULTANTS, LTD. PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 375
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 369
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 26
Total of all active and inactive participants 2013-01-01 395
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 395
Number of participants with account balances 2013-01-01 395
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: VALLEY ANESTHESIOLOGY CONSULTANTS, LTD. PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 361
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 346
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 28
Total of all active and inactive participants 2012-01-01 374
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 374
Number of participants with account balances 2012-01-01 374
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: VALLEY ANESTHESIOLOGY CONSULTANTS, LTD. PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 354
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 330
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 32
Total of all active and inactive participants 2011-01-01 362
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 362
Number of participants with account balances 2011-01-01 362
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 9
2009: VALLEY ANESTHESIOLOGY CONSULTANTS, LTD. PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 348
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 347
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 39
Total of all active and inactive participants 2009-01-01 386
Total participants 2009-01-01 386
Number of participants with account balances 2009-01-01 336
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2017: VALLEY ANESTHESIOLOGY CONSULTANTS, LTD. PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	213
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	0
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	10
Total of all active and inactive participants	2017-01-01	10
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	10
Number of participants with account balances	2017-01-01	10
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: VALLEY ANESTHESIOLOGY CONSULTANTS, LTD. PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	431
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	0
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	207
Total of all active and inactive participants	2016-01-01	207
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	207
Number of participants with account balances	2016-01-01	207
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: VALLEY ANESTHESIOLOGY CONSULTANTS, LTD. PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	433
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	0
Number of retired or separated participants receiving benefits	2015-01-01	14
Number of other retired or separated participants entitled to future benefits	2015-01-01	420
Total of all active and inactive participants	2015-01-01	434
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	434
Number of participants with account balances	2015-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	3
2014: VALLEY ANESTHESIOLOGY CONSULTANTS, LTD. PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	390
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	399
Number of retired or separated participants receiving benefits	2014-01-01	3
Number of other retired or separated participants entitled to future benefits	2014-01-01	28
Total of all active and inactive participants	2014-01-01	430
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	430
Number of participants with account balances	2014-01-01	429
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: VALLEY ANESTHESIOLOGY CONSULTANTS, LTD. PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	375
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	369
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	26
Total of all active and inactive participants	2013-01-01	395
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	395
Number of participants with account balances	2013-01-01	395
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: VALLEY ANESTHESIOLOGY CONSULTANTS, LTD. PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	361
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	346
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	28
Total of all active and inactive participants	2012-01-01	374
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	374
Number of participants with account balances	2012-01-01	374
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: VALLEY ANESTHESIOLOGY CONSULTANTS, LTD. PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	354
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	330
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	32
Total of all active and inactive participants	2011-01-01	362
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	362
Number of participants with account balances	2011-01-01	362
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	9
2009: VALLEY ANESTHESIOLOGY CONSULTANTS, LTD. PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	348
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	347
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	39
Total of all active and inactive participants	2009-01-01	386
Total participants	2009-01-01	386
Number of participants with account balances	2009-01-01	336
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on VALLEY ANESTHESIOLOGY CONSULTANTS, LTD. PROFIT SHARING PLAN

Measure	Date	Value
2017 : VALLEY ANESTHESIOLOGY CONSULTANTS, LTD. PROFIT SHARING PLAN 2017 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2017-12-31	$82,615
Total unrealized appreciation/depreciation of assets	2017-12-31	$82,615
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$112,435
Total income from all sources (including contributions)	2017-12-31	$1,008,585
Total loss/gain on sale of assets	2017-12-31	$93,770
Total of all expenses incurred	2017-12-31	$47,322,810
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$47,297,302
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$0
Value of total assets at end of year	2017-12-31	$58,583
Value of total assets at beginning of year	2017-12-31	$46,485,243
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$25,508
Total interest from all sources	2017-12-31	$12,315
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$92,004
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2017-12-31	$0
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$65,534
Assets. Real estate other than employer real property at beginning of year	2017-12-31	$68,214
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Participant contributions at beginning of year	2017-12-31	$14,825
Assets. Other investments not covered elsewhere at beginning of year	2017-12-31	$2,664,867
Value of other receiveables (less allowance for doubtful accounts) at end of year	2017-12-31	$23
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2017-12-31	$23
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2017-12-31	$1,081
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2017-12-31	$112,435
Other income not declared elsewhere	2017-12-31	$1,478
Administrative expenses (other) incurred	2017-12-31	$520
Total non interest bearing cash at end of year	2017-12-31	$920
Total non interest bearing cash at beginning of year	2017-12-31	$87,440
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$-46,314,225
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$58,583
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$46,372,808
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Assets. partnership/joint venture interests at beginning of year	2017-12-31	$851,496
Investment advisory and management fees	2017-12-31	$17,188
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$8
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$22,986,552
Interest earned on other investments	2017-12-31	$5,741
Income. Interest from corporate debt instruments	2017-12-31	$5,068
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2017-12-31	$41
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2017-12-31	$8,846,620
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2017-12-31	$8,846,620
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2017-12-31	$1,506
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$853,388
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$726,403
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Employer contributions (assets) at end of year	2017-12-31	$57,632
Employer contributions (assets) at beginning of year	2017-12-31	$52,602
Income. Dividends from preferred stock	2017-12-31	$113
Income. Dividends from common stock	2017-12-31	$26,357
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$47,297,302
Asset. Corporate debt instrument debt (other) at beginning of year	2017-12-31	$983,351
Contract administrator fees	2017-12-31	$8,320
Assets. Corporate common stocks other than exployer securities at beginning of year	2017-12-31	$9,075,865
Did the plan have assets held for investment	2017-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Aggregate proceeds on sale of assets	2017-12-31	$93,770
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	TULL FORSBERG & OLSON
Accountancy firm EIN	2017-12-31	860130568
2016 : VALLEY ANESTHESIOLOGY CONSULTANTS, LTD. PROFIT SHARING PLAN 2016 401k financial data
Unrealized appreciation/depreciation of real estate assets	2016-12-31	$1,868,863
Total unrealized appreciation/depreciation of assets	2016-12-31	$1,868,863
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$112,435
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$119,342
Total income from all sources (including contributions)	2016-12-31	$9,685,886
Total loss/gain on sale of assets	2016-12-31	$2,660,507
Total of all expenses incurred	2016-12-31	$123,866,733
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$123,378,609
Expenses. Certain deemed distributions of participant loans	2016-12-31	$7,163
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$13,411
Value of total assets at end of year	2016-12-31	$46,485,243
Value of total assets at beginning of year	2016-12-31	$160,672,997
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$480,961
Total interest from all sources	2016-12-31	$214,109
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$2,419,756
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2016-12-31	$0
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$1,715,155
Assets. Real estate other than employer real property at end of year	2016-12-31	$68,214
Assets. Real estate other than employer real property at beginning of year	2016-12-31	$517,415
Administrative expenses professional fees incurred	2016-12-31	$7,990
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$0
Participant contributions at end of year	2016-12-31	$14,825
Participant contributions at beginning of year	2016-12-31	$544,514
Assets. Other investments not covered elsewhere at end of year	2016-12-31	$2,664,867
Assets. Other investments not covered elsewhere at beginning of year	2016-12-31	$5,076,380
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$13,411
Value of other receiveables (less allowance for doubtful accounts) at end of year	2016-12-31	$23
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2016-12-31	$112,435
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2016-12-31	$119,342
Other income not declared elsewhere	2016-12-31	$175,050
Administrative expenses (other) incurred	2016-12-31	$8,360
Total non interest bearing cash at end of year	2016-12-31	$87,440
Total non interest bearing cash at beginning of year	2016-12-31	$984
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$-114,180,847
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$46,372,808
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$160,553,655
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Assets. partnership/joint venture interests at end of year	2016-12-31	$851,496
Assets. partnership/joint venture interests at beginning of year	2016-12-31	$767,115
Investment advisory and management fees	2016-12-31	$464,611
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$22,986,552
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$87,087,189
Interest on participant loans	2016-12-31	$15,109
Interest earned on other investments	2016-12-31	$23,071
Income. Interest from US Government securities	2016-12-31	$61,569
Income. Interest from corporate debt instruments	2016-12-31	$104,333
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2016-12-31	$8,846,620
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2016-12-31	$17,593,787
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2016-12-31	$17,593,787
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2016-12-31	$10,027
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$853,388
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$3,160,396
Asset value of US Government securities at end of year	2016-12-31	$0
Asset value of US Government securities at beginning of year	2016-12-31	$2,421,196
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$2,314,770
Net investment gain or loss from common/collective trusts	2016-12-31	$19,420
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$0
Employer contributions (assets) at end of year	2016-12-31	$52,602
Employer contributions (assets) at beginning of year	2016-12-31	$86,286
Income. Dividends from preferred stock	2016-12-31	$554
Income. Dividends from common stock	2016-12-31	$704,047
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$123,378,609
Asset. Corporate debt instrument debt (other) at end of year	2016-12-31	$983,351
Asset. Corporate debt instrument debt (other) at beginning of year	2016-12-31	$5,281,160
Contract administrator fees	2016-12-31	$0
Assets. Corporate common stocks other than exployer securities at end of year	2016-12-31	$9,075,865
Assets. Corporate common stocks other than exployer securities at beginning of year	2016-12-31	$38,136,575
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Aggregate proceeds on sale of assets	2016-12-31	$2,660,507
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	TULL FORSBERG & OLSON
Accountancy firm EIN	2016-12-31	860130568
2015 : VALLEY ANESTHESIOLOGY CONSULTANTS, LTD. PROFIT SHARING PLAN 2015 401k financial data
Unrealized appreciation/depreciation of real estate assets	2015-12-31	$-2,426,003
Unrealized appreciation/depreciation of other (non real estate) assets	2015-12-31	$-2,690,503
Total unrealized appreciation/depreciation of assets	2015-12-31	$-2,426,003
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$174,991
Total income from all sources (including contributions)	2015-12-31	$10,020,148
Total loss/gain on sale of assets	2015-12-31	$378,233
Total of all expenses incurred	2015-12-31	$3,688,106
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$3,682,316
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$11,467,337
Value of total assets at end of year	2015-12-31	$168,301,696
Value of total assets at beginning of year	2015-12-31	$162,144,645
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$5,790
Total interest from all sources	2015-12-31	$44,314
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$1,624,457
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2015-12-31	$0
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$1,624,457
Assets. Real estate other than employer real property at end of year	2015-12-31	$517,415
Assets. Real estate other than employer real property at beginning of year	2015-12-31	$507,789
Administrative expenses professional fees incurred	2015-12-31	$5,790
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$4,402,581
Participant contributions at end of year	2015-12-31	$544,514
Participant contributions at beginning of year	2015-12-31	$1,222,313
Participant contributions at beginning of year	2015-12-31	$3,351
Assets. Other investments not covered elsewhere at end of year	2015-12-31	$5,076,380
Assets. Other investments not covered elsewhere at beginning of year	2015-12-31	$9,077,253
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2015-12-31	$28,168
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2015-12-31	$119,342
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2015-12-31	$174,991
Other income not declared elsewhere	2015-12-31	$11,297
Administrative expenses (other) incurred	2015-12-31	$9,596
Total non interest bearing cash at end of year	2015-12-31	$984
Total non interest bearing cash at beginning of year	2015-12-31	$362,724
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$6,332,042
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$168,301,696
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$161,969,654
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Assets. partnership/joint venture interests at end of year	2015-12-31	$767,115
Assets. partnership/joint venture interests at beginning of year	2015-12-31	$301,189
Investment advisory and management fees	2015-12-31	$577,013
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$164,824,754
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$80,592,799
Interest on participant loans	2015-12-31	$44,314
Interest earned on other investments	2015-12-31	$108,487
Income. Interest from US Government securities	2015-12-31	$77,868
Income. Interest from corporate debt instruments	2015-12-31	$149,349
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2015-12-31	$2,932,428
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2015-12-31	$17,393,262
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2015-12-31	$17,393,262
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2015-12-31	$2,144
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$3,160,396
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$3,028,842
Asset value of US Government securities at end of year	2015-12-31	$2,421,196
Asset value of US Government securities at beginning of year	2015-12-31	$2,599,128
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-1,068,190
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$7,064,756
Employer contributions (assets) at end of year	2015-12-31	$86,286
Employer contributions (assets) at beginning of year	2015-12-31	$126,686
Income. Dividends from common stock	2015-12-31	$905,136
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$3,682,316
Asset. Corporate debt instrument debt (other) at end of year	2015-12-31	$5,281,160
Asset. Corporate debt instrument debt (other) at beginning of year	2015-12-31	$4,849,127
Contract administrator fees	2015-12-31	$4,760
Assets. Corporate common stocks other than exployer securities at end of year	2015-12-31	$38,136,575
Assets. Corporate common stocks other than exployer securities at beginning of year	2015-12-31	$42,052,014
Did the plan have assets held for investment	2015-12-31	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	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Aggregate proceeds on sale of assets	2015-12-31	$8,807,678
Aggregate carrying amount (costs) on sale of assets	2015-12-31	$8,429,445
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	TULL FORSBERG & OLSON
Accountancy firm EIN	2015-12-31	860130568
2014 : VALLEY ANESTHESIOLOGY CONSULTANTS, LTD. PROFIT SHARING PLAN 2014 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2014-12-31	$3,317,800
Total unrealized appreciation/depreciation of assets	2014-12-31	$3,317,800
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$174,991
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$27,914
Expenses. Interest paid	2014-12-31	$11
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2014-12-31	$11
Total income from all sources (including contributions)	2014-12-31	$20,582,264
Total loss/gain on sale of assets	2014-12-31	$926,666
Total of all expenses incurred	2014-12-31	$6,786,338
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$6,219,107
Expenses. Certain deemed distributions of participant loans	2014-12-31	$2,300
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$12,307,218
Value of total assets at end of year	2014-12-31	$162,144,645
Value of total assets at beginning of year	2014-12-31	$148,201,642
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$564,920
Total interest from all sources	2014-12-31	$224,361
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$4,966,316
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$3,743,596
Assets. Real estate other than employer real property at end of year	2014-12-31	$507,789
Assets. Real estate other than employer real property at beginning of year	2014-12-31	$433,549
Administrative expenses professional fees incurred	2014-12-31	$31,926
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2014-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$4,109,417
Participant contributions at end of year	2014-12-31	$1,222,313
Participant contributions at beginning of year	2014-12-31	$1,163,000
Participant contributions at end of year	2014-12-31	$3,351
Participant contributions at beginning of year	2014-12-31	$47
Assets. Other investments not covered elsewhere at end of year	2014-12-31	$9,077,253
Assets. Other investments not covered elsewhere at beginning of year	2014-12-31	$276,804
Value of other receiveables (less allowance for doubtful accounts) at end of year	2014-12-31	$28,168
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2014-12-31	$1,476
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2014-12-31	$174,991
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2014-12-31	$27,764
Other income not declared elsewhere	2014-12-31	$271
Administrative expenses (other) incurred	2014-12-31	$7,929
Total non interest bearing cash at end of year	2014-12-31	$362,724
Total non interest bearing cash at beginning of year	2014-12-31	$228,066
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$13,795,926
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$161,969,654
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$148,173,728
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Assets. partnership/joint venture interests at end of year	2014-12-31	$301,189
Assets. partnership/joint venture interests at beginning of year	2014-12-31	$257,295
Investment advisory and management fees	2014-12-31	$514,911
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$80,592,799
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$63,807,027
Interest on participant loans	2014-12-31	$54,224
Interest earned on other investments	2014-12-31	$43,739
Income. Interest from US Government securities	2014-12-31	$52,944
Income. Interest from corporate debt instruments	2014-12-31	$68,888
Value of interest in common/collective trusts at beginning of year	2014-12-31	$13,504,041
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2014-12-31	$17,393,262
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2014-12-31	$20,804,113
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2014-12-31	$20,804,113
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2014-12-31	$4,566
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$3,028,842
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$2,790,233
Asset value of US Government securities at end of year	2014-12-31	$2,599,128
Asset value of US Government securities at beginning of year	2014-12-31	$2,470,539
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$-1,159,162
Net investment gain/loss from pooled separate accounts	2014-12-31	$-1,445
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$8,197,801
Employer contributions (assets) at end of year	2014-12-31	$126,686
Employer contributions (assets) at beginning of year	2014-12-31	$48,076
Income. Dividends from common stock	2014-12-31	$1,222,720
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$6,219,107
Asset. Corporate debt instrument debt (other) at end of year	2014-12-31	$4,849,127
Asset. Corporate debt instrument debt (other) at beginning of year	2014-12-31	$4,898,915
Contract administrator fees	2014-12-31	$10,154
Assets. Corporate common stocks other than exployer securities at end of year	2014-12-31	$42,052,014
Assets. Corporate common stocks other than exployer securities at beginning of year	2014-12-31	$37,518,461
Did the plan have assets held for investment	2014-12-31	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	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Aggregate proceeds on sale of assets	2014-12-31	$926,666
Liabilities. Value of acquisition indebtedness at beginning of year	2014-12-31	$150
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	TULL FORSBERG & OLSON
Accountancy firm EIN	2014-12-31	860130568
2013 : VALLEY ANESTHESIOLOGY CONSULTANTS, LTD. PROFIT SHARING PLAN 2013 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2013-12-31	$4,256,906
Total unrealized appreciation/depreciation of assets	2013-12-31	$4,256,906
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$27,914
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$11,893
Expenses. Interest paid	2013-12-31	$18
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2013-12-31	$18
Total income from all sources (including contributions)	2013-12-31	$27,592,374
Total loss/gain on sale of assets	2013-12-31	$196,745
Total of all expenses incurred	2013-12-31	$3,305,781
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$2,795,381
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$12,372,552
Value of total assets at end of year	2013-12-31	$148,201,642
Value of total assets at beginning of year	2013-12-31	$123,899,028
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$510,382
Total interest from all sources	2013-12-31	$311,185
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$2,898,238
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-12-31	$2,195,191
Assets. Real estate other than employer real property at end of year	2013-12-31	$433,549
Assets. Real estate other than employer real property at beginning of year	2013-12-31	$630,905
Administrative expenses professional fees incurred	2013-12-31	$23,806
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$4,042,605
Participant contributions at end of year	2013-12-31	$1,163,000
Participant contributions at beginning of year	2013-12-31	$1,073,920
Participant contributions at end of year	2013-12-31	$47
Participant contributions at beginning of year	2013-12-31	$1,850
Assets. Other investments not covered elsewhere at end of year	2013-12-31	$276,804
Assets. Other investments not covered elsewhere at beginning of year	2013-12-31	$384,177
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$573,198
Value of other receiveables (less allowance for doubtful accounts) at end of year	2013-12-31	$1,476
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2013-12-31	$9,953,082
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2013-12-31	$27,764
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2013-12-31	$11,695
Other income not declared elsewhere	2013-12-31	$95,768
Administrative expenses (other) incurred	2013-12-31	$7,344
Total non interest bearing cash at end of year	2013-12-31	$228,066
Total non interest bearing cash at beginning of year	2013-12-31	$164,006
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$24,286,593
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$148,173,728
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$123,887,135
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Assets. partnership/joint venture interests at end of year	2013-12-31	$257,295
Assets. partnership/joint venture interests at beginning of year	2013-12-31	$195,300
Investment advisory and management fees	2013-12-31	$479,232
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$63,807,027
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$53,021,495
Interest on participant loans	2013-12-31	$46,735
Interest earned on other investments	2013-12-31	$74,164
Income. Interest from US Government securities	2013-12-31	$11,576
Income. Interest from corporate debt instruments	2013-12-31	$176,202
Value of interest in common/collective trusts at end of year	2013-12-31	$13,504,041
Value of interest in common/collective trusts at beginning of year	2013-12-31	$11,013,379
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2013-12-31	$20,804,113
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2013-12-31	$23,743,132
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2013-12-31	$23,743,132
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2013-12-31	$2,508
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2013-12-31	$2,790,233
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2013-12-31	$1,374,614
Asset value of US Government securities at end of year	2013-12-31	$2,470,539
Asset value of US Government securities at beginning of year	2013-12-31	$2,602,593
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$7,460,980
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$7,756,749
Employer contributions (assets) at end of year	2013-12-31	$48,076
Employer contributions (assets) at beginning of year	2013-12-31	$35,338
Income. Dividends from preferred stock	2013-12-31	$14,034
Income. Dividends from common stock	2013-12-31	$689,013
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$2,795,381
Asset. Corporate debt instrument debt (other) at end of year	2013-12-31	$4,898,915
Asset. Corporate debt instrument debt (other) at beginning of year	2013-12-31	$2,035,143
Assets. Corporate common stocks other than exployer securities at end of year	2013-12-31	$37,518,461
Assets. Corporate common stocks other than exployer securities at beginning of year	2013-12-31	$17,670,094
Did the plan have assets held for investment	2013-12-31	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	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Aggregate proceeds on sale of assets	2013-12-31	$196,745
Liabilities. Value of acquisition indebtedness at end of year	2013-12-31	$150
Liabilities. Value of acquisition indebtedness at beginning of year	2013-12-31	$198
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	TULL FORSBERG & OLSON
Accountancy firm EIN	2013-12-31	860130568
2012 : VALLEY ANESTHESIOLOGY CONSULTANTS, LTD. PROFIT SHARING PLAN 2012 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2012-12-31	$2,658,141
Total unrealized appreciation/depreciation of assets	2012-12-31	$2,658,141
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$11,893
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$13,899
Total income from all sources (including contributions)	2012-12-31	$32,962,796
Total loss/gain on sale of assets	2012-12-31	$465,915
Total of all expenses incurred	2012-12-31	$1,891,973
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$1,526,710
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$23,131,623
Value of total assets at end of year	2012-12-31	$123,899,028
Value of total assets at beginning of year	2012-12-31	$92,830,211
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$365,263
Total interest from all sources	2012-12-31	$341,457
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$542,306
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Assets. Real estate other than employer real property at end of year	2012-12-31	$630,905
Assets. Real estate other than employer real property at beginning of year	2012-12-31	$293,837
Administrative expenses professional fees incurred	2012-12-31	$360,364
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$500,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$3,780,927
Participant contributions at end of year	2012-12-31	$1,073,920
Participant contributions at beginning of year	2012-12-31	$784,661
Participant contributions at end of year	2012-12-31	$1,850
Participant contributions at beginning of year	2012-12-31	$4,646
Assets. Other investments not covered elsewhere at end of year	2012-12-31	$384,177
Assets. Other investments not covered elsewhere at beginning of year	2012-12-31	$2,497,229
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$11,880,555
Value of other receiveables (less allowance for doubtful accounts) at end of year	2012-12-31	$9,953,082
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2012-12-31	$-1,467
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2012-12-31	$11,695
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2012-12-31	$13,813
Other income not declared elsewhere	2012-12-31	$569
Administrative expenses (other) incurred	2012-12-31	$4,849
Total non interest bearing cash at end of year	2012-12-31	$164,006
Total non interest bearing cash at beginning of year	2012-12-31	$606,866
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$31,070,823
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$123,887,135
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$92,816,312
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Assets. partnership/joint venture interests at end of year	2012-12-31	$195,300
Assets. partnership/joint venture interests at beginning of year	2012-12-31	$1,192,544
Investment advisory and management fees	2012-12-31	$50
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$53,021,495
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$44,431,849
Interest on participant loans	2012-12-31	$64,521
Interest earned on other investments	2012-12-31	$69,407
Income. Interest from US Government securities	2012-12-31	$45,890
Income. Interest from corporate debt instruments	2012-12-31	$159,330
Value of interest in common/collective trusts at end of year	2012-12-31	$11,013,379
Value of interest in common/collective trusts at beginning of year	2012-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-12-31	$23,743,132
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-12-31	$16,049,816
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-12-31	$16,049,816
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-12-31	$2,309
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$1,374,614
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$1,051,114
Asset value of US Government securities at end of year	2012-12-31	$2,602,593
Asset value of US Government securities at beginning of year	2012-12-31	$1,771,828
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$5,822,785
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$7,470,141
Employer contributions (assets) at end of year	2012-12-31	$35,338
Employer contributions (assets) at beginning of year	2012-12-31	$38,566
Income. Dividends from preferred stock	2012-12-31	$14
Income. Dividends from common stock	2012-12-31	$542,292
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$1,526,710
Asset. Corporate debt instrument debt (other) at end of year	2012-12-31	$2,035,143
Asset. Corporate debt instrument debt (other) at beginning of year	2012-12-31	$4,606,233
Assets. Corporate common stocks other than exployer securities at end of year	2012-12-31	$17,670,094
Assets. Corporate common stocks other than exployer securities at beginning of year	2012-12-31	$19,502,489
Did the plan have assets held for investment	2012-12-31	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	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Aggregate proceeds on sale of assets	2012-12-31	$465,915
Liabilities. Value of acquisition indebtedness at end of year	2012-12-31	$198
Liabilities. Value of acquisition indebtedness at beginning of year	2012-12-31	$86
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	No
Opinion of an independent qualified public accountant for this plan	2012-12-31	Unqualified
Accountancy firm name	2012-12-31	TULL FORSBERG & OLSON
Accountancy firm EIN	2012-12-31	860130568
2011 : VALLEY ANESTHESIOLOGY CONSULTANTS, LTD. PROFIT SHARING PLAN 2011 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2011-12-31	$-1,054,247
Total unrealized appreciation/depreciation of assets	2011-12-31	$-1,054,247
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$13,899
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$14,881
Total income from all sources (including contributions)	2011-12-31	$8,737,993
Total loss/gain on sale of assets	2011-12-31	$-187,881
Total of all expenses incurred	2011-12-31	$1,760,909
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$1,426,702
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$10,300,037
Value of total assets at end of year	2011-12-31	$92,830,211
Value of total assets at beginning of year	2011-12-31	$85,854,109
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$334,207
Total interest from all sources	2011-12-31	$369,357
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$431,381
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Assets. Real estate other than employer real property at end of year	2011-12-31	$293,837
Assets. Real estate other than employer real property at beginning of year	2011-12-31	$300,530
Administrative expenses professional fees incurred	2011-12-31	$329,337
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$500,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$3,446,696
Participant contributions at end of year	2011-12-31	$784,661
Participant contributions at beginning of year	2011-12-31	$753,069
Participant contributions at end of year	2011-12-31	$4,646
Participant contributions at beginning of year	2011-12-31	$5,956
Assets. Other investments not covered elsewhere at end of year	2011-12-31	$2,497,229
Assets. Other investments not covered elsewhere at beginning of year	2011-12-31	$2,136,533
Value of other receiveables (less allowance for doubtful accounts) at end of year	2011-12-31	$-1,467
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2011-12-31	$113,052
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2011-12-31	$13,813
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2011-12-31	$14,831
Other income not declared elsewhere	2011-12-31	$3,427
Administrative expenses (other) incurred	2011-12-31	$4,864
Total non interest bearing cash at end of year	2011-12-31	$606,866
Total non interest bearing cash at beginning of year	2011-12-31	$655,570
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$6,977,084
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$92,816,312
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$85,839,228
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Assets. partnership/joint venture interests at end of year	2011-12-31	$1,192,544
Assets. partnership/joint venture interests at beginning of year	2011-12-31	$1,101,977
Investment advisory and management fees	2011-12-31	$6
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$44,431,849
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$42,909,135
Interest on participant loans	2011-12-31	$30,770
Interest earned on other investments	2011-12-31	$135,528
Income. Interest from US Government securities	2011-12-31	$32,551
Income. Interest from corporate debt instruments	2011-12-31	$166,828
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-12-31	$16,049,816
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-12-31	$14,362,006
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-12-31	$14,362,006
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-12-31	$3,680
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$1,051,114
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$955,795
Asset value of US Government securities at end of year	2011-12-31	$1,771,828
Asset value of US Government securities at beginning of year	2011-12-31	$1,721,780
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-1,124,081
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$6,853,341
Employer contributions (assets) at end of year	2011-12-31	$38,566
Employer contributions (assets) at beginning of year	2011-12-31	$24,494
Income. Dividends from common stock	2011-12-31	$431,381
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$1,426,702
Asset. Corporate debt instrument debt (other) at end of year	2011-12-31	$4,606,233
Asset. Corporate debt instrument debt (other) at beginning of year	2011-12-31	$4,057,389
Assets. Corporate common stocks other than exployer securities at end of year	2011-12-31	$19,502,489
Assets. Corporate common stocks other than exployer securities at beginning of year	2011-12-31	$16,756,823
Did the plan have assets held for investment	2011-12-31	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	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Aggregate proceeds on sale of assets	2011-12-31	$-187,881
Liabilities. Value of acquisition indebtedness at end of year	2011-12-31	$86
Liabilities. Value of acquisition indebtedness at beginning of year	2011-12-31	$50
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	No
Opinion of an independent qualified public accountant for this plan	2011-12-31	Unqualified
Accountancy firm name	2011-12-31	TULL FORSBERG & OLSON
Accountancy firm EIN	2011-12-31	860130568
2010 : VALLEY ANESTHESIOLOGY CONSULTANTS, LTD. PROFIT SHARING PLAN 2010 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2010-12-31	$2,866,207
Total unrealized appreciation/depreciation of assets	2010-12-31	$2,866,207
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$14,881
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$16,266
Total income from all sources (including contributions)	2010-12-31	$18,318,890
Total loss/gain on sale of assets	2010-12-31	$-194,740
Total of all expenses incurred	2010-12-31	$1,103,405
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$834,876
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$10,006,893
Value of total assets at end of year	2010-12-31	$85,854,109
Value of total assets at beginning of year	2010-12-31	$68,640,009
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$268,529
Total interest from all sources	2010-12-31	$325,707
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$258,321
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Assets. Real estate other than employer real property at end of year	2010-12-31	$300,530
Assets. Real estate other than employer real property at beginning of year	2010-12-31	$862,416
Administrative expenses professional fees incurred	2010-12-31	$264,119
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$500,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$3,342,006
Participant contributions at end of year	2010-12-31	$753,069
Participant contributions at beginning of year	2010-12-31	$596,305
Participant contributions at end of year	2010-12-31	$5,956
Participant contributions at beginning of year	2010-12-31	$6,311
Assets. Other investments not covered elsewhere at end of year	2010-12-31	$2,136,533
Assets. Other investments not covered elsewhere at beginning of year	2010-12-31	$1,665,741
Value of other receiveables (less allowance for doubtful accounts) at end of year	2010-12-31	$113,052
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2010-12-31	$27,797
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2010-12-31	$14,831
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2010-12-31	$16,266
Other income not declared elsewhere	2010-12-31	$730
Administrative expenses (other) incurred	2010-12-31	$4,213
Total non interest bearing cash at end of year	2010-12-31	$655,570
Total non interest bearing cash at beginning of year	2010-12-31	$515,225
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$17,215,485
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$85,839,228
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$68,623,743
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Assets. partnership/joint venture interests at end of year	2010-12-31	$1,101,977
Assets. partnership/joint venture interests at beginning of year	2010-12-31	$1,018,221
Investment advisory and management fees	2010-12-31	$197
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$42,909,135
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$33,026,428
Interest on participant loans	2010-12-31	$27,169
Interest earned on other investments	2010-12-31	$109,072
Income. Interest from US Government securities	2010-12-31	$27,340
Income. Interest from corporate debt instruments	2010-12-31	$156,525
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2010-12-31	$14,362,006
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2010-12-31	$12,923,000
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2010-12-31	$12,923,000
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2010-12-31	$5,601
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$955,795
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$632,235
Asset value of US Government securities at end of year	2010-12-31	$1,721,780
Asset value of US Government securities at beginning of year	2010-12-31	$1,975,550
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$5,055,772
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$6,664,887
Employer contributions (assets) at end of year	2010-12-31	$24,494
Employer contributions (assets) at beginning of year	2010-12-31	$278
Income. Dividends from common stock	2010-12-31	$258,321
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$834,876
Asset. Corporate debt instrument debt (other) at end of year	2010-12-31	$4,057,389
Asset. Corporate debt instrument debt (other) at beginning of year	2010-12-31	$3,730,674
Assets. Corporate common stocks other than exployer securities at end of year	2010-12-31	$16,756,823
Assets. Corporate common stocks other than exployer securities at beginning of year	2010-12-31	$11,659,828
Did the plan have assets held for investment	2010-12-31	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	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Aggregate proceeds on sale of assets	2010-12-31	$-194,740
Liabilities. Value of acquisition indebtedness at end of year	2010-12-31	$50
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	No
Opinion of an independent qualified public accountant for this plan	2010-12-31	Unqualified
Accountancy firm name	2010-12-31	TULL FORSBERG & OLSON
Accountancy firm EIN	2010-12-31	860130568
2009 : VALLEY ANESTHESIOLOGY CONSULTANTS, LTD. PROFIT SHARING PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for VALLEY ANESTHESIOLOGY CONSULTANTS, LTD. PROFIT SHARING PLAN

2017: VALLEY ANESTHESIOLOGY CONSULTANTS, LTD. PROFIT SHARING PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: VALLEY ANESTHESIOLOGY CONSULTANTS, LTD. PROFIT SHARING PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	Yes
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: VALLEY ANESTHESIOLOGY CONSULTANTS, LTD. PROFIT SHARING PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: VALLEY ANESTHESIOLOGY CONSULTANTS, LTD. PROFIT SHARING PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: VALLEY ANESTHESIOLOGY CONSULTANTS, LTD. PROFIT SHARING PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: VALLEY ANESTHESIOLOGY CONSULTANTS, LTD. PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: VALLEY ANESTHESIOLOGY CONSULTANTS, LTD. PROFIT SHARING PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: VALLEY ANESTHESIOLOGY CONSULTANTS, LTD. PROFIT SHARING PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )

Policy contract number

VM13001668

Policy instance

Insurance contract or identification number	VM13001668
Number of Individuals Covered	0
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
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?	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

NATIONAL WESTERN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66850 )

Policy contract number

0101336888

Policy instance

Insurance contract or identification number	0101336888
Number of Individuals Covered	0
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
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?	1
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

ALLIANZ LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 90611 )

Policy contract number

71160625

Policy instance

Insurance contract or identification number	71160625
Number of Individuals Covered	0
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
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?	1
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

PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )

Policy contract number

VR09035120

Policy instance

Insurance contract or identification number	VR09035120
Number of Individuals Covered	0
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
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?	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

PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )

Policy contract number

VM13001668

Policy instance

Insurance contract or identification number	VM13001668
Number of Individuals Covered	1
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $1,166
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	Yes
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

PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )

Policy contract number

VR09035120

Policy instance

Insurance contract or identification number	VR09035120
Number of Individuals Covered	1
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $2,429
Are there contracts with allocated funds for individual policies?	Yes
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

ALLIANZ LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 90611 )

Policy contract number

71160625

Policy instance

Insurance contract or identification number	71160625
Number of Individuals Covered	1
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Are there contracts with allocated funds for individual policies?	Yes
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

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

E0820462

Policy instance

Insurance contract or identification number	E0820462
Number of Individuals Covered	1
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $1,205
Are there contracts with allocated funds for individual policies?	Yes
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

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

2321838

Policy instance

Insurance contract or identification number	2321838
Number of Individuals Covered	1
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Are there contracts with allocated funds for individual policies?	Yes
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

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

2327945

Policy instance

Insurance contract or identification number	2327945
Number of Individuals Covered	1
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Are there contracts with allocated funds for individual policies?	Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

954197322

Policy instance

Insurance contract or identification number	954197322
Number of Individuals Covered	1
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $1,943
Are there contracts with allocated funds for individual policies?	No
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?	Yes
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
Other information about contract	GROUP VARIABLE ANNUITY CONTRACT WITH A GUARANTEED FUND

NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )

Policy contract number

C0634

Policy instance

Insurance contract or identification number	C0634
Number of Individuals Covered	1
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $1,063
Total amount of fees paid to insurance company	USD $435
Are there contracts with allocated funds for individual policies?	Yes
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

NATIONAL WESTERN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66850 )

Policy contract number

0101336888

Policy instance

Insurance contract or identification number	0101336888
Number of Individuals Covered	1
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Are there contracts with allocated funds for individual policies?	Yes
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

ALLIANZ LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 90611 )

Policy contract number

71160625

Policy instance

Insurance contract or identification number	71160625
Number of Individuals Covered	1
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $41,097
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	Yes
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
Commission paid to Insurance Broker	USD $29,355
Insurance broker organization code?	3
Insurance broker name	FINANCIAL INDEPENDENCE GROUP

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

2321838

Policy instance

Insurance contract or identification number	2321838
Number of Individuals Covered	1
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
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?	No
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
Commission paid to Insurance Broker	USD $0
Insurance broker organization code?	3
Insurance broker name	GREGORY GEORGE

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

954197322

Policy instance

Insurance contract or identification number	954197322
Number of Individuals Covered	1
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
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?	Yes
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
Other information about contract	GROUP VARIABLE ANNUITY CONTRACT WITH A GUARANTEED FUND
Commission paid to Insurance Broker	USD $1,943
Insurance broker organization code?	3
Insurance broker name	UBS FINANCIAL SERVICES

JACKSON NATIONAL (National Association of Insurance Commissioners NAIC id number: 65056 )

Policy contract number

1005303164

Policy instance

Insurance contract or identification number	1005303164
Number of Individuals Covered	1
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
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?	Yes
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
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	MARCUS EUGENE ORTEGA

NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )

Policy contract number

C0634

Policy instance

Insurance contract or identification number	C0634
Number of Individuals Covered	1
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $1,071
Total amount of fees paid to insurance company	USD $749
Are there contracts with allocated funds for individual policies?	Yes
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
Commission paid to Insurance Broker	USD $293
Amount paid for insurance broker fees	261
Additional information about fees paid to insurance broker	SERVICING FEES AND OTHER COMPENSATION
Insurance broker organization code?	3
Insurance broker name	GROSS FNCL GRP LLC

PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )

Policy contract number

VR09035120

Policy instance

Insurance contract or identification number	VR09035120
Number of Individuals Covered	1
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $2,860
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	Yes
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
Commission paid to Insurance Broker	USD $2,860
Insurance broker organization code?	3
Insurance broker name	METLIFE SECURITIES INC.

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

E0820462

Policy instance

Insurance contract or identification number	E0820462
Number of Individuals Covered	1
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $1,205
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	Yes
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
Commission paid to Insurance Broker	USD $1,205
Insurance broker organization code?	3
Insurance broker name	E THOMAS HOLDER JR

PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )

Policy contract number

VM13001668

Policy instance

Insurance contract or identification number	VM13001668
Number of Individuals Covered	1
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $665
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	Yes
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
Commission paid to Insurance Broker	USD $665
Insurance broker organization code?	3
Insurance broker name	TRUSTMONT FINANCIAL GROUP INC

NATIONAL WESTERN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66850 )

Policy contract number

0101336888

Policy instance

Insurance contract or identification number	0101336888
Number of Individuals Covered	1
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
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?	No
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
Commission paid to Insurance Broker	USD $0
Insurance broker organization code?	3
Insurance broker name	STRATEGIC INSURANCE INC

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

2327945

Policy instance

Insurance contract or identification number	2327945
Number of Individuals Covered	1
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
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?	No
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Insurance broker organization code?	3
Insurance broker name	GREGORY GEORGE

JOHN HANCOCK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 90425 )

Policy contract number

2321838

Policy instance

Insurance contract or identification number	2321838
Number of Individuals Covered	1
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Are there contracts with allocated funds for individual policies?	No
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

JOHN HANCOCK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 90425 )

Policy contract number

2327945

Policy instance

Insurance contract or identification number	2327945
Number of Individuals Covered	1
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Are there contracts with allocated funds for individual policies?	No
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

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

95-4197322

Policy instance

Insurance contract or identification number	95-4197322
Number of Individuals Covered	1
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $5,972
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
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 $5,972
Insurance broker organization code?	3
Insurance broker name	UBS FINANCIAL SERVICES INC

JACKSON NATIONAL (National Association of Insurance Commissioners NAIC id number: 65056 )

Policy contract number

1005303164

Policy instance

Insurance contract or identification number	1005303164
Number of Individuals Covered	1
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $4,500
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,500
Insurance broker organization code?	3
Insurance broker name	MARCUS EUGENE ORTEGA

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

E0820462

Policy instance

Insurance contract or identification number	E0820462
Number of Individuals Covered	1
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $1,093
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,093
Insurance broker organization code?	3
Insurance broker name	E THOMAS HOLDER JR.

NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )

Policy contract number

C0634

Policy instance

Insurance contract or identification number	C0634
Number of Individuals Covered	1
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $9,783
Total amount of fees paid to insurance company	USD $4,802
Are there contracts with allocated funds for individual policies?	Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $7,340
Amount paid for insurance broker fees	4062
Additional information about fees paid to insurance broker	7
Insurance broker organization code?	3
Insurance broker name	GROSS FNCL GROUP LLC

PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )

Policy contract number

VM13001668

Policy instance

Insurance contract or identification number	VM13001668
Number of Individuals Covered	1
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $22,000
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $22,000
Insurance broker organization code?	3
Insurance broker name	TRUSTMONT FINANCIAL GROUP INC.

PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )

Policy contract number

VR09035120

Policy instance

Insurance contract or identification number	VR09035120
Number of Individuals Covered	1
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $2,805
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,805
Insurance broker organization code?	3
Insurance broker name	METLIFE SECURITIES INC

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

E0820462

Policy instance

Insurance contract or identification number	E0820462
Number of Individuals Covered	1
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $1,052
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,052
Insurance broker organization code?	3
Insurance broker name	E THOMAS HOLDER JR.

JOHN HANCOCK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 90425 )

Policy contract number

2321838

Policy instance

Insurance contract or identification number	2321838
Number of Individuals Covered	1
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Are there contracts with allocated funds for individual policies?	No
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

JOHN HANCOCK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 90425 )

Policy contract number

2327945

Policy instance

Insurance contract or identification number	2327945
Number of Individuals Covered	1
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Are there contracts with allocated funds for individual policies?	No
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

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

95-4197322

Policy instance

Insurance contract or identification number	95-4197322
Number of Individuals Covered	1
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $1,316
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
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 $1,316
Insurance broker organization code?	3
Insurance broker name	UBS FINANCIAL SERVICES INC

JACKSON NATIONAL (National Association of Insurance Commissioners NAIC id number: 65056 )

Policy contract number

1005303164

Policy instance

Insurance contract or identification number	1005303164
Number of Individuals Covered	1
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Are there contracts with allocated funds for individual policies?	Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Insurance broker organization code?	3
Insurance broker name	MARCUS EUGENE ORTEGA

PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )

Policy contract number

VR09035120

Policy instance

Insurance contract or identification number	VR09035120
Number of Individuals Covered	1
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $2,855
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,855
Insurance broker organization code?	3
Insurance broker name	METLIFE SECURITIES

PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )

Policy contract number

VR09035120

Policy instance

Insurance contract or identification number	VR09035120
Number of Individuals Covered	1
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $2,695
Total amount of fees paid to insurance company	USD $123
Are there contracts with allocated funds for individual policies?	Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

JACKSON NATIONAL (National Association of Insurance Commissioners NAIC id number: 65056 )

Policy contract number

1005303164

Policy instance

Insurance contract or identification number	1005303164
Number of Individuals Covered	1
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Are there contracts with allocated funds for individual policies?	Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

95-4197322

Policy instance

Insurance contract or identification number	95-4197322
Number of Individuals Covered	1
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Are there contracts with allocated funds for individual policies?	No
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

JOHN HANCOCK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 90425 )

Policy contract number

2327945

Policy instance

Insurance contract or identification number	2327945
Number of Individuals Covered	1
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $2,158
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
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

JOHN HANCOCK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 90425 )

Policy contract number

2321838

Policy instance

Insurance contract or identification number	2321838
Number of Individuals Covered	1
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Are there contracts with allocated funds for individual policies?	No
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

PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )

Policy contract number

VR09035120

Policy instance

Insurance contract or identification number	VR09035120
Number of Individuals Covered	1
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $2,818
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

95-4197322

Policy instance

Insurance contract or identification number	95-4197322
Number of Individuals Covered	1
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Are there contracts with allocated funds for individual policies?	No
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

JOHN HANCOCK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 90425 )

Policy contract number

2327945

Policy instance

Insurance contract or identification number	2327945
Number of Individuals Covered	1
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Are there contracts with allocated funds for individual policies?	No
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

JOHN HANCOCK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 90425 )

Policy contract number

2321838

Policy instance

Insurance contract or identification number	2321838
Number of Individuals Covered	1
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Are there contracts with allocated funds for individual policies?	No
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

JACKSON NATIONAL (National Association of Insurance Commissioners NAIC id number: 65056 )

Policy contract number

1005303164

Policy instance

Insurance contract or identification number	1005303164
Number of Individuals Covered	1
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $4,881
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	VALLEY ANESTHESIOLOGY CONSULTANTS, LTD.
Employer identification number (EIN):	860621497
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2018-01-01
001	2017-01-01
001	2017-01-01
001	2016-01-01
001	2016-01-01	BRIAN SCHNEIDER	2017-10-16
001	2016-01-01	BRIAN SCHNEIDER	2017-10-16
001	2015-01-01	BRIAN SCHNEIDER
001	2015-01-01	BRIAN SCHNEIDER
001	2014-01-01	BRIAN SCHNEIDER
001	2013-01-01	BRIAN SCHNEIDER
001	2012-01-01	MICHAEL DUPUY
001	2011-01-01	MICHAEL DUPUY
001	2009-01-01	MICHAEL DUPUY