401k Plan data: ALPINE PEDIATRICS, P.C. PROFIT SHARING PLAN plan

ALPINE PEDIATRICS, P.C. PROFIT SHARING PLAN 401k Plan overview

Plan Name	ALPINE PEDIATRICS, P.C. PROFIT SHARING PLAN
Plan identification number	001

ALPINE PEDIATRICS, P.C. PROFIT SHARING PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
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.
Participant-directed brokerage accounts provided as an investment option under the plan.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

ALPINE PEDIATRICS, P.C. has sponsored the creation of one or more 401k plans.

Company Name: ALPINE PEDIATRICS, P.C.

Employer identification number (EIN): 870546501

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ALPINE PEDIATRICS, P.C. PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01
001 2021-01-01
001 2020-01-01
001 2019-01-01
001 2018-01-01
001 2018-01-01
001 2017-01-01 BRETT KNORR
001 2016-01-01 BRETT K KNORR
001 2015-01-01 BRETT K KNORR 2017-07-07
001 2015-01-01 BRETT K KNORR 2016-10-10
001 2014-01-01 BRETT K KNORR 2015-10-06
001 2013-01-01 BRETT K KNORR 2014-10-15
001 2012-01-01 BRETT K KNORR 2013-10-01
001 2011-01-01 BRETT K. KNORR 2012-10-15
001 2010-01-01 BRETT K. KNORR 2011-10-17

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2022-01-01
001	2021-01-01
001	2020-01-01
001	2019-01-01
001	2018-01-01
001	2018-01-01
001	2017-01-01	BRETT KNORR
001	2016-01-01	BRETT K KNORR
001	2015-01-01	BRETT K KNORR	2017-07-07
001	2015-01-01	BRETT K KNORR	2016-10-10
001	2014-01-01	BRETT K KNORR	2015-10-06
001	2013-01-01	BRETT K KNORR	2014-10-15
001	2012-01-01	BRETT K KNORR	2013-10-01
001	2011-01-01	BRETT K. KNORR	2012-10-15
001	2010-01-01	BRETT K. KNORR	2011-10-17

Plan Statistics for ALPINE PEDIATRICS, P.C. PROFIT SHARING PLAN

401k plan membership statisitcs for ALPINE PEDIATRICS, P.C. PROFIT SHARING PLAN

Measure Date Value
2022: ALPINE PEDIATRICS, P.C. PROFIT SHARING PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 120
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 90
Number of retired or separated participants receiving benefits 2022-01-01 39
Number of other retired or separated participants entitled to future benefits 2022-01-01 0
Total of all active and inactive participants 2022-01-01 129
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 129
Number of participants with account balances 2022-01-01 125
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 8
2021: ALPINE PEDIATRICS, P.C. PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 127
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 83
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 37
Total of all active and inactive participants 2021-01-01 120
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 120
Number of participants with account balances 2021-01-01 118
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: ALPINE PEDIATRICS, P.C. PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 117
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 89
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 29
Total of all active and inactive participants 2020-01-01 118
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 118
Number of participants with account balances 2020-01-01 117
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 14
2019: ALPINE PEDIATRICS, P.C. PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 110
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 87
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 30
Total of all active and inactive participants 2019-01-01 117
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 117
Number of participants with account balances 2019-01-01 103
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 17
2018: ALPINE PEDIATRICS, P.C. PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 145
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 82
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 24
Total of all active and inactive participants 2018-01-01 106
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 106
Number of participants with account balances 2018-01-01 105
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 1
2017: ALPINE PEDIATRICS, P.C. PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 140
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 75
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 65
Total of all active and inactive participants 2017-01-01 140
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 140
Number of participants with account balances 2017-01-01 132
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 9
2016: ALPINE PEDIATRICS, P.C. PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 122
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 80
Number of retired or separated participants receiving benefits 2016-01-01 16
Number of other retired or separated participants entitled to future benefits 2016-01-01 40
Total of all active and inactive participants 2016-01-01 136
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 136
Number of participants with account balances 2016-01-01 136
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 13

Measure	Date	Value
2022: ALPINE PEDIATRICS, P.C. PROFIT SHARING PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	120
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	90
Number of retired or separated participants receiving benefits	2022-01-01	39
Number of other retired or separated participants entitled to future benefits	2022-01-01	0
Total of all active and inactive participants	2022-01-01	129
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	129
Number of participants with account balances	2022-01-01	125
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	8
2021: ALPINE PEDIATRICS, P.C. PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	127
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	83
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	37
Total of all active and inactive participants	2021-01-01	120
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	120
Number of participants with account balances	2021-01-01	118
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: ALPINE PEDIATRICS, P.C. PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	117
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	89
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	29
Total of all active and inactive participants	2020-01-01	118
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	118
Number of participants with account balances	2020-01-01	117
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	14
2019: ALPINE PEDIATRICS, P.C. PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	110
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	87
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	30
Total of all active and inactive participants	2019-01-01	117
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	117
Number of participants with account balances	2019-01-01	103
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	17
2018: ALPINE PEDIATRICS, P.C. PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	145
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	82
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	24
Total of all active and inactive participants	2018-01-01	106
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	106
Number of participants with account balances	2018-01-01	105
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	1
2017: ALPINE PEDIATRICS, P.C. PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	140
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	75
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	65
Total of all active and inactive participants	2017-01-01	140
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	140
Number of participants with account balances	2017-01-01	132
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	9
2016: ALPINE PEDIATRICS, P.C. PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	122
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	80
Number of retired or separated participants receiving benefits	2016-01-01	16
Number of other retired or separated participants entitled to future benefits	2016-01-01	40
Total of all active and inactive participants	2016-01-01	136
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	136
Number of participants with account balances	2016-01-01	136
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	13

Financial Data on ALPINE PEDIATRICS, P.C. PROFIT SHARING PLAN

Measure	Date	Value
2022 : ALPINE PEDIATRICS, P.C. PROFIT SHARING PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$1,056
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$1,056
Total income from all sources (including contributions)	2022-12-31	$-2,527,220
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$383,641
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$256,264
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$1,317,255
Value of total assets at end of year	2022-12-31	$16,553,620
Value of total assets at beginning of year	2022-12-31	$19,464,481
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$127,377
Total interest from all sources	2022-12-31	$3,160
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$144,573
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-12-31	$144,573
Administrative expenses professional fees incurred	2022-12-31	$127,377
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$500,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$552,027
Participant contributions at end of year	2022-12-31	$60,712
Participant contributions at beginning of year	2022-12-31	$35,033
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2022-12-31	$1,056
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2022-12-31	$1,056
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$-2,910,861
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$16,552,564
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$19,463,425
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$15,973,949
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$18,981,462
Interest on participant loans	2022-12-31	$3,160
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-3,992,208
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$765,228
Employer contributions (assets) at end of year	2022-12-31	$518,959
Employer contributions (assets) at beginning of year	2022-12-31	$447,986
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$256,264
Did the plan have assets held for investment	2022-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Disclaimer
Accountancy firm name	2022-12-31	GILBERT & STEWART
Accountancy firm EIN	2022-12-31	874033149
2021 : ALPINE PEDIATRICS, P.C. PROFIT SHARING PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$1,056
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$1,013
Total income from all sources (including contributions)	2021-12-31	$4,097,447
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$365,545
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$240,095
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$1,202,294
Value of total assets at end of year	2021-12-31	$19,464,481
Value of total assets at beginning of year	2021-12-31	$15,732,536
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$125,450
Total interest from all sources	2021-12-31	$3,153
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$418,251
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$520,876
Participant contributions at end of year	2021-12-31	$35,033
Participant contributions at beginning of year	2021-12-31	$60,388
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2021-12-31	$1,056
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2021-12-31	$1,013
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$3,731,902
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$19,463,425
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$15,731,523
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Investment advisory and management fees	2021-12-31	$82,979
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$18,981,462
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$15,231,442
Income. Interest from loans (other than to participants)	2021-12-31	$3,153
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$2,473,749
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$681,418
Employer contributions (assets) at end of year	2021-12-31	$447,986
Employer contributions (assets) at beginning of year	2021-12-31	$440,706
Income. Dividends from common stock	2021-12-31	$418,251
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$240,095
Contract administrator fees	2021-12-31	$42,471
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Disclaimer
Accountancy firm name	2021-12-31	GILBERT & STEWART
Accountancy firm EIN	2021-12-31	874033149
2020 : ALPINE PEDIATRICS, P.C. PROFIT SHARING PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$1,013
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$972
Total income from all sources (including contributions)	2020-12-31	$3,693,055
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$285,473
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$189,052
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$1,138,035
Value of total assets at end of year	2020-12-31	$15,732,536
Value of total assets at beginning of year	2020-12-31	$12,324,913
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$96,421
Total interest from all sources	2020-12-31	$5,121
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$327,789
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Administrative expenses professional fees incurred	2020-12-31	$28,343
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$478,468
Participant contributions at end of year	2020-12-31	$60,388
Participant contributions at beginning of year	2020-12-31	$93,373
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$2,125
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2020-12-31	$1,013
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2020-12-31	$972
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Income. Non cash contributions	2020-12-31	$0
Value of net income/loss	2020-12-31	$3,407,582
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$15,731,523
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$12,323,941
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Investment advisory and management fees	2020-12-31	$68,078
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$15,231,442
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$11,799,100
Interest on participant loans	2020-12-31	$5,121
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$2,222,110
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$657,442
Employer contributions (assets) at end of year	2020-12-31	$440,706
Employer contributions (assets) at beginning of year	2020-12-31	$432,440
Income. Dividends from common stock	2020-12-31	$327,789
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$189,052
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	GILBERT & STEWART
Accountancy firm EIN	2020-12-31	874033149
2019 : ALPINE PEDIATRICS, P.C. PROFIT SHARING PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$972
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$3,537,264
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$152,357
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$50,298
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$1,058,965
Value of total assets at end of year	2019-12-31	$12,324,913
Value of total assets at beginning of year	2019-12-31	$8,939,034
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$102,059
Total interest from all sources	2019-12-31	$4,123
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$220,447
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$424,278
Participant contributions at end of year	2019-12-31	$93,373
Participant contributions at beginning of year	2019-12-31	$54,476
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$30,120
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2019-12-31	$972
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2019-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$3,384,907
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$12,323,941
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$8,939,034
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$11,799,100
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$8,476,349
Interest on participant loans	2019-12-31	$4,123
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$2,253,729
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$604,567
Employer contributions (assets) at end of year	2019-12-31	$432,440
Employer contributions (assets) at beginning of year	2019-12-31	$408,209
Income. Dividends from common stock	2019-12-31	$220,447
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$50,298
Contract administrator fees	2019-12-31	$102,059
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	GILBERT & STEWART
Accountancy firm EIN	2019-12-31	874033149
2018 : ALPINE PEDIATRICS, P.C. PROFIT SHARING PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$891
Total income from all sources (including contributions)	2018-12-31	$459,058
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$170,211
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$93,461
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$942,527
Value of total assets at end of year	2018-12-31	$8,939,034
Value of total assets at beginning of year	2018-12-31	$8,651,078
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$76,750
Total interest from all sources	2018-12-31	$1,530
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$123,197
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$500,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$357,893
Participant contributions at end of year	2018-12-31	$54,476
Participant contributions at beginning of year	2018-12-31	$72,977
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$1,897
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2018-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2018-12-31	$891
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$288,847
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$8,939,034
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$8,650,187
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$8,476,349
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$8,070,291
Interest on participant loans	2018-12-31	$1,530
Net investment gain or loss from common/collective trusts	2018-12-31	$-608,196
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$582,737
Employer contributions (assets) at end of year	2018-12-31	$408,209
Employer contributions (assets) at beginning of year	2018-12-31	$507,810
Income. Dividends from common stock	2018-12-31	$123,197
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$93,461
Contract administrator fees	2018-12-31	$76,750
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2018-12-31	Yes
Did the plan have assets held for investment	2018-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	GILBERT & STEWART
Accountancy firm EIN	2018-12-31	874033149
2017 : ALPINE PEDIATRICS, P.C. PROFIT SHARING PLAN 2017 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets	2017-12-31	$0
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$891
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$1,385
Total income from all sources (including contributions)	2017-12-31	$2,173,905
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$86,056
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$31,078
Value of total corrective distributions	2017-12-31	$891
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$824,542
Value of total assets at end of year	2017-12-31	$8,651,078
Value of total assets at beginning of year	2017-12-31	$6,563,723
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$54,087
Total interest from all sources	2017-12-31	$5,443
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Administrative expenses professional fees incurred	2017-12-31	$4,029
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$500,000
If this is an individual account plan, was there a blackout period	2017-12-31	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$315,745
Participant contributions at end of year	2017-12-31	$72,977
Participant contributions at beginning of year	2017-12-31	$138,764
Participant contributions at end of year	2017-12-31	$0
Participant contributions at beginning of year	2017-12-31	$1,620
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$987
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2017-12-31	$891
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2017-12-31	$1,385
Administrative expenses (other) incurred	2017-12-31	$47
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	$2,087,849
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$8,650,187
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$6,562,338
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
Investment advisory and management fees	2017-12-31	$49,986
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$8,070,291
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$6,009,059
Interest on participant loans	2017-12-31	$5,443
Value of interest in master investment trust accounts at end of year	2017-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2017-12-31	$0
Net investment gain or loss from common/collective trusts	2017-12-31	$1,343,920
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$507,810
Employer contributions (assets) at end of year	2017-12-31	$507,810
Employer contributions (assets) at beginning of year	2017-12-31	$414,280
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$31,078
Contract administrator fees	2017-12-31	$25
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2017-12-31	Yes
Did the plan have assets held for investment	2017-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	GILBERT & STEWART
Accountancy firm EIN	2017-12-31	874033149
2016 : ALPINE PEDIATRICS, P.C. PROFIT SHARING PLAN 2016 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$1,385
Total income from all sources (including contributions)	2016-12-31	$1,369,072
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$78,064
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$30,987
Value of total corrective distributions	2016-12-31	$1,384
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$751,516
Value of total assets at end of year	2016-12-31	$6,563,723
Value of total assets at beginning of year	2016-12-31	$5,271,330
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$45,693
Total interest from all sources	2016-12-31	$2,488
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$500,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$308,269
Participant contributions at end of year	2016-12-31	$138,764
Participant contributions at beginning of year	2016-12-31	$2,367
Participant contributions at end of year	2016-12-31	$1,620
Participant contributions at beginning of year	2016-12-31	$-2,745
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$29,917
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2016-12-31	$1,169
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2016-12-31	$1,385
Administrative expenses (other) incurred	2016-12-31	$45,693
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	$1,291,008
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$6,562,338
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$5,271,330
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$6,009,059
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$4,916,728
Interest on participant loans	2016-12-31	$2,488
Value of interest in master investment trust accounts at end of year	2016-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2016-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$93,068
Net investment gain/loss from pooled separate accounts	2016-12-31	$522,000
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	$413,330
Employer contributions (assets) at end of year	2016-12-31	$414,280
Employer contributions (assets) at beginning of year	2016-12-31	$354,980
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$29,818
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 carrying amount (costs) on sale of assets	2016-12-31	$0
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	GILBERT & STEWART
Accountancy firm EIN	2016-12-31	874033149

Form 5500 Responses for ALPINE PEDIATRICS, P.C. PROFIT SHARING PLAN

2022: ALPINE PEDIATRICS, P.C. PROFIT SHARING PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: ALPINE PEDIATRICS, P.C. PROFIT SHARING PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: ALPINE PEDIATRICS, P.C. PROFIT SHARING PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: ALPINE PEDIATRICS, P.C. PROFIT SHARING PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: ALPINE PEDIATRICS, P.C. PROFIT SHARING PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	Yes
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: ALPINE PEDIATRICS, P.C. 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 - Trust	Yes
2016: ALPINE PEDIATRICS, P.C. PROFIT SHARING PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

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

Policy contract number

502225-01

Policy instance

Insurance contract or identification number	502225-01
Number of Individuals Covered	0
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

502225-01

Policy instance

Insurance contract or identification number	502225-01
Number of Individuals Covered	16
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

502225-01

Policy instance

Insurance contract or identification number	502225-01
Number of Individuals Covered	16
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

502225-01

Policy instance

Insurance contract or identification number	502225-01
Number of Individuals Covered	17
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

502225-01

Policy instance

Insurance contract or identification number	502225-01
Number of Individuals Covered	17
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

502225-01

Policy instance

Insurance contract or identification number	502225-01
Number of Individuals Covered	63
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	ALPINE PEDIATRICS, P.C.
Employer identification number (EIN):	870546501
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)