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{"sheet":"COVER AND TABLE","index":0,"n_rows":49,"n_cols":8,"rows_kept":49,"cut":false,"hidden":false,"merged":[[0,0,0,7],[1,0,1,7],[2,0,2,7],[5,0,5,7],[55,0,55,5],[6,0,6,7],[33,0,33,7],[34,0,34,7],[41,0,41,5],[51,0,51,5],[52,0,52,5],[53,0,53,5],[39,0,39,7],[56,0,56,5],[63,0,63,5],[48,0,48,5],[49,0,49,5],[42,0,42,5],[44,0,44,5],[45,0,45,5],[60,0,60,5],[54,0,54,5],[61,0,61,5],[62,0,62,5],[58,0,58,5],[59,0,59,5],[57,0,57,5]]}
[]
[]
[]
[]
[]
["Company Name"]
["TDI License Number"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
["Reporting Year Ending"]
["2015-12-31"]
[]
[]
[]
[]
["Table of Contents"]
[]
["Jurat Page",null,null,null,null,null,null,1]
["Balance Sheet",null,null,null,null,null,null,2]
["Income Statement/Statement of Equity",null,null,null,null,null,null,3]
["Cash Flow",null,null,null,null,null,null,4]
["Invested Assets Schedule",null,null,null,null,null,null,5]
["Expense Schedule",null,null,null,null,null,null,6]
["Reserve Schedule",null,null,null,null,null,null,7]
["Notes",null,null,null,null,null,null,8]

{"sheet":"JURAT ","index":1,"n_rows":48,"n_cols":14,"rows_kept":48,"cut":false,"hidden":false,"merged":[[1,0,1,14],[0,0,0,14],[2,0,2,14],[5,4,5,9],[6,4,6,9],[7,4,7,9],[8,4,8,9],[10,0,10,14],[12,2,12,6],[12,10,12,14],[13,2,13,6],[14,2,14,6],[15,2,15,6],[15,10,15,14],[13,10,13,14],[14,10,14,14],[17,6,17,14],[21,1,21,4],[23,1,23,4],[24,1,24,4],[25,1,25,4],[22,1,22,4],[24,6,24,9],[25,6,25,9],[19,1,19,14],[31,11,31,14],[33,11,33,14],[34,11,34,14],[31,6,31,9],[21,11,21,14],[23,11,23,14],[24,11,24,14],[25,11,25,14],[21,6,21,9],[23,6,23,9],[22,6,22,9],[22,11,22,14],[29,0,29,14],[28,13,28,14],[36,11,36,14],[28,3,28,12],[41,8,41,9],[43,2,43,5],[36,1,36,4],[32,11,32,14],[33,6,33,9],[34,6,34,9],[35,6,35,9],[36,6,36,9],[32,6,32,9],[35,11,35,14],[31,1,31,4],[32,1,32,4],[33,1,33,4],[34,1,34,4]]}
[{"$f":"'COVER AND TABLE'!A6","v":"Company Name"}]
["Jurat Page"]
[{"$f":"'COVER AND TABLE'!A35","v":"2015-12-31"}]
[]
[]
[null,"Date of Trust Information"]
[null,"Annual Report Contact Person:"]
[null,"Contact Phone Number:"]
[null,"Contact E-Mail Address:"]
[]
["OFFICERS*"]
[]
["President/CEO:",null,null,null,null,null,null,null,"Treasurer/CFO:"]
["Secretary/Counsel:",null,null,null,null,null,null,null,"Controller:"]
["Other/Additional:",null,null,null,null,null,null,null,"Other/Additional:"]
["Other/Additional:",null,null,null,null,null,null,null,"Other/Additional:"]
[]
[null,null,null,null,"TPA NAME"]
[]
[null,"DIRECTORS*"]
[]
[]
[]
[]
[]
[]
[]
[]
["The officers and managers of",null,null,{"$f":"'[1]COVER AND TABLE'!A6","v":"Company Name"},null,null,null,null,null,null,null,null,null,"being duly "]
["sworn, each for himself deposes and says they are the above described officers and managers of the said self funded PEO, and that on the last day of the period presented, all of the herein described assets were the absolute property of the said insurer, free and clear from any liens or claims thereon, except as stated, and that this annual report, together with related exhibits, schedules, and explanations therein contained, annexed, or referred to are a full and true statement of all the assets and liabilities and of the condition and affairs of the said insurer as of the date presented, and of its income and deductions therefrom for the year ended on that date, according to he best of their information, knowledge and belief, respectively."]
[]
[]
[null,null,null,null,null,null,"Signature",null,null,null,null,"Signature"]
[]
[null,null,null,null,null,null,"Executive Officer (Print Name)",null,null,null,null,"Executive Officer (Print Name)"]
[]
[null,null,null,null,null,null,"Title",null,null,null,null,"Title"]
[]
[]
[]
[null,null,"Subscribed and sworn to"]
[null,null,"before me this",null,null,null,null,null,"Day of",null,null,null,","]
[]
[]
[]
[]
[null,"*","Show full name and indicate by number sign (#) those officers and directors who "]
[null,null,"did not occupy the indicated position in the previous annual report."]

{"sheet":"BALANCE SHEET","index":2,"n_rows":31,"n_cols":8,"rows_kept":31,"cut":false,"hidden":false,"merged":[[30,0,30,2],[29,0,29,2],[0,0,0,8],[1,0,1,8],[2,0,2,8],[7,0,7,3],[15,0,15,2],[17,0,17,2],[5,0,5,2],[27,0,27,2]]}
[{"$f":"'COVER AND TABLE'!A6","v":"Company Name"}]
["Balance Sheet"]
[{"$f":"'COVER AND TABLE'!A35:H35","v":"2015-12-31"}]
[]
[]
[null,null,null,null,null,{"$f":"'COVER AND TABLE'!A35","v":"2015-12-31"},null,{"$f":"DATE(YEAR(F6)-1,MONTH(F6),DAY(F6))","v":"2014-12-31"}]
[]
["ASSETS"]
["Cash"]
["Invested Assets"]
["Unaffiliated Receivables"]
["Affiliated Receivables"]
["Prepaid Expenses"]
["Insurance Receivable"]
["Other Assets"]
["Total Assets",null,null,null,null,{"$f":"SUM(F9:F15)","v":0},null,{"$f":"SUM(H9:H15)","v":0}]
[]
["LIABILITIES"]
["Unpaid Losses (Net of Insurance)"]
["Unpaid Claim Adjustment Expense"]
["Reserves (Net of Insurance) "]
["Insurance Payable"]
["Prepaid Contributions"]
["Accrued General Administrative Expense"]
["Unaffiliated Payables"]
["Affiliated Payables"]
["Other Liabilities"]
["Total Liabilities",null,null,null,null,{"$f":"SUM(F19:F27)","v":0},null,{"$f":"SUM(H19:H27)","v":0}]
[]
["NET ASSETS"]
["Total Net Assets",null,null,null,null,{"$f":"F16+F28","v":0},null,{"$f":"H16+H28","v":0}]

{"sheet":"PL","index":3,"n_rows":36,"n_cols":8,"rows_kept":36,"cut":false,"hidden":false,"merged":[[12,0,12,3],[15,0,15,2],[17,0,17,3],[0,0,0,8],[1,0,1,8],[2,0,2,8],[5,0,5,2],[7,0,7,3],[10,0,10,2],[35,0,35,2],[29,0,29,2],[24,0,24,2],[26,0,26,2],[27,0,27,2]]}
[{"$f":"'COVER AND TABLE'!A6","v":"Company Name"}]
["Income Statement/Statement of Equity"]
[{"$f":"'COVER AND TABLE'!A35:H35","v":"2015-12-31"}]
[]
[]
[null,null,null,null,null,{"$f":"'COVER AND TABLE'!A35","v":"2015-12-31"},null,{"$f":"DATE(YEAR(F6)-1,MONTH(F6),DAY(F6))","v":"2014-12-31"}]
[]
["REVENUES"]
["Contributions "]
["Investment Income/Capital Gains"]
["Total Revenue",null,null,null,null,{"$f":"SUM(F9:F10)","v":0},null,{"$f":"SUM(H9:H10)","v":0}]
[]
["EXPENSES"]
["Benefit Distributions (Net Insurance )"]
["Increase In Reserves"]
["Total Benefit Expense",null,null,null,null,{"$f":"SUM(F14:F15)","v":0},null,{"$f":"SUM(H14:H15)","v":0}]
[]
["NONBENEFIT DISTRIBUTIONS"]
["Claims Adjustment Expense"]
["Insurance Premiums"]
["General Admin Expense"]
["Investment Losses/Capital Losses"]
["Federal Income Taxes"]
["Other Expense"]
["Total Expenses",null,null,null,null,{"$f":"F16+SUM(F19:F24)","v":0},null,{"$f":"H16+SUM(H19:H24)","v":0}]
[]
["NET INCOME"]
["Total Net Income (Loss)",null,null,null,null,{"$f":"F11-F25","v":0},null,{"$f":"H11-H25","v":0}]
[]
["NET ASSETS"]
["Prior Year End Net Assets",null,null,null,null,{"$f":"'BALANCE SHEET'!H31","v":0}]
["Net Income (Net Losses)",null,null,null,null,{"$f":"F28","v":0},null,{"$f":"H28","v":0}]
["Sponsoring PEO Contributions "]
["Unrealized Gains (Losses)"]
["Other Increases (Decreases)"]
["Year End Net Assets",null,null,null,null,{"$f":"SUM(F31:F35)","v":0},null,{"$f":"SUM(H31:H35)","v":0}]

{"sheet":"Sheet2","index":4,"n_rows":0,"n_cols":0,"rows_kept":0,"cut":false,"hidden":true,"merged":[]}

{"sheet":"Sheet3","index":5,"n_rows":0,"n_cols":0,"rows_kept":0,"cut":false,"hidden":true,"merged":[]}

{"sheet":"CASH FLOW","index":6,"n_rows":33,"n_cols":8,"rows_kept":33,"cut":false,"hidden":false,"merged":[[16,0,16,2],[0,0,0,8],[1,0,1,8],[2,0,2,8],[5,0,5,2],[7,0,7,3],[32,0,32,2],[18,0,18,3],[22,0,22,2],[24,0,24,3],[28,0,28,2]]}
[{"$f":"'COVER AND TABLE'!A6","v":"Company Name"}]
["Cash Flow"]
[{"$f":"'COVER AND TABLE'!A35:H35","v":"2015-12-31"}]
[]
[]
[null,null,null,null,null,{"$f":"'COVER AND TABLE'!A35","v":"2015-12-31"},null,{"$f":"DATE(YEAR(F6)-1,MONTH(F6),DAY(F6))","v":"2014-12-31"}]
[]
["CASH FROM OPERATIONS"]
["Member Contributions Collected Net of Insurance"]
["Benefits Paid (Net of Insurance)"]
["(Increase) Decrease in Receivables"]
["(Decrease) Increase in Payables"]
["Claims Adjustment Expenses Paid"]
["General Admin Expenses Paid"]
["Other Cash Paid"]
["Income Taxes Paid (Recovered)"]
["Total Net Cash from Operations",null,null,null,null,{"$f":"SUM(F9:F16)","v":0},null,{"$f":"SUM(H9:H16)","v":0}]
[]
["CASH FROM INVESTMENTS"]
["Proceeds From Sale of Securities"]
["Net Investment Income"]
["Purchase of Securities"]
["Net Cash from Investments",null,null,null,null,{"$f":"SUM(F20:F22)","v":0},null,{"$f":"SUM(H20:H22)","v":0}]
[]
["CASH FROM FINANCING AND MISC SOURCES"]
["Sponsoring PEO Contribution"]
["Other Cash Provided"]
["Other Cash Applied"]
["Net Cash from Financing and Misc Sources",null,null,null,null,{"$f":"SUM(F26:F28)","v":0},null,{"$f":"SUM(H26:H28)","v":0}]
[]
["Net Increase (Decrease) in Cash",null,null,null,null,{"$f":"F29+F23+F17","v":0},null,{"$f":"H29+H23+H17","v":0}]
["Cash Beginning of Year"]
["Cash End of Year",null,null,null,null,{"$f":"SUM(F31:F32)","v":0},null,{"$f":"SUM(H31:H32)","v":0}]

{"sheet":"INVESTED ASSET SCHEDULE","index":7,"n_rows":34,"n_cols":8,"rows_kept":34,"cut":false,"hidden":false,"merged":[[26,0,28,0],[13,0,14,0],[32,2,32,6],[33,0,33,7],[0,0,0,7],[1,0,1,7],[3,0,3,6],[2,0,2,7]]}
[{"$f":"'COVER AND TABLE'!A6","v":"Company Name"}]
["Invested Asset Schedule"]
[{"$f":"'COVER AND TABLE'!A35:H35","v":"2015-12-31"}]
[]
[null,null,null,null,null,null,"# of","Reported"]
["Type","CUSIP #","Description","Book Value","*Fair Value","*Par Value","Shares","Amount"]
["Bonds"]
[]
[]
["Stocks"]
[]
[]
[]
["Affiliated Investment"]
[]
[]
[]
["Other Investment"]
[]
[]
["Real Estate"]
[]
[]
["Mortgages"]
[]
[]
["Note: List any impaired invested assets"]
[]
[]
[]
[]
[]
[null,null,"Total Invested Assets as Reported on the Balance Sheet",null,null,null,null,{"$f":"SUM(H7:H32)","v":0}]
["* Report fair value and par value / # shares amounts as applicable"]

{"sheet":"EXPENSE SCHEDULE","index":8,"n_rows":16,"n_cols":6,"rows_kept":16,"cut":false,"hidden":false,"merged":[[15,0,15,2],[0,0,0,5],[1,0,1,5],[2,0,2,5],[5,0,5,2],[7,0,7,3]]}
[{"$f":"'COVER AND TABLE'!A6","v":"Company Name"}]
["General Admin Expense Schedule"]
[{"$f":"'COVER AND TABLE'!A35:H35","v":"2015-12-31"}]
[]
[]
[null,null,null,null,null,{"$f":"'COVER AND TABLE'!A35","v":"2015-12-31"}]
[]
["GENERAL ADMIN EXPENSE"]
["Salaries/Wages"]
["Fee Paid To Plan Administrator"]
["Legal Fees/Expenses"]
["Auditing/Actuarial"]
["Traveling"]
["Marketing"]
["Other Expense"]
["Total General Admin Expense",null,null,null,null,{"$f":"SUM(F9:F15)","v":0}]

{"sheet":"RESERVE SCHEDULE","index":9,"n_rows":23,"n_cols":6,"rows_kept":23,"cut":false,"hidden":false,"merged":[[15,0,15,3],[22,0,22,2],[7,2,7,5],[0,0,0,5],[1,0,1,5],[2,0,2,5],[5,0,5,2]]}
[{"$f":"'COVER AND TABLE'!A6","v":"Company Name"}]
["Reserve Schedule Current Year End"]
[{"$f":"'COVER AND TABLE'!A35:H35","v":"2015-12-31"}]
[]
[]
[null,null,null,null,null,{"$f":"'COVER AND TABLE'!A35","v":"2015-12-31"}]
[]
["Name of Stop Loss Carrier:"]
[]
["Recommended Level of Specific Stop Loss"]
["Recommeded Level of Aggregate Stop Loss"]
["Attachment Point"]
["Deposit Amount"]
[]
[]
["CLAIMS/DISTRIBUTION ACTIVITY (ALL AMOUNTS NET OF EXCESS OF LOSS PAID)"]
["Current Year End Claims"]
["(Current Year End Stop Loss Recoveries)"]
["(Current Year End Distributions)"]
["Current Year End Unpaid Losses",null,null,null,0,{"$f":"F17-F18-F19","v":0}]
["Total Current Year End Distributions and Unpaid Losses",null,null,null,null,{"$f":"F19+F20-F12","v":0}]
["(Stop Loss Attachment Point)"]
["Total Current Year End Reserves",null,null,null,null,{"$f":"F21-F22","v":0}]

{"sheet":"NOTES","index":10,"n_rows":48,"n_cols":3,"rows_kept":48,"cut":false,"hidden":false,"merged":[[43,0,43,2],[25,0,25,1],[35,0,35,1],[0,0,0,1],[1,0,1,1],[2,0,2,1],[13,0,13,1]]}
[{"$f":"'COVER AND TABLE'!A6","v":"Company Name"}]
["Financial Statement Notes"]
[{"$f":"'COVER AND TABLE'!A35:H35","v":"2015-12-31"}]
[]
[]
["Name of Professional Employer Organization:"]
["General Description of Self Funded PEO Operation:"]
["Significant Accounting Policies:"]
["Name of Third Party Administrator:"]
["Name of CPA:"]
["Name of Actuary:"]
[]
[]
["LIST MEMBERS OF THE BOARD OF TRUSTESS:"]
["Name","Employer"]
[]
[]
[]
[]
[]
[]
["Number Of New Participants Added During The Year"]
["Number Of Participants That Left The Trust During The Year"]
[]
[]
["DELEGATION OF FUNCTIONS TO A CONTRACTING REGULATED ENTITY"]
[null,"CONTRACTING REGULATED ENTITY","DELEGATED FUNCTION"]
[]
[]
[]
[]
[]
[]
[]
[]
["TRANSACTIONS BETWEEN AFFILIATE PARTIES"]
["AFFILIATED ENTITY","TRANSACTION/DELEGATED FUNCTION","TDI APPROVAL DATE"]
[]
[]
[]
[]
[]
["Any Pending Regulatory Action By The Texas Department of Licensing And Registration"]
[]
["Expiration Date of TDLR License"]
["Fidelity Bond Coverage and Issuer"]
["E&O Coverage And Issuer"]
["Any Transfer of Funds from the Trust to the Sponsoring PEO"]

{"sheet":"CROSSCHECK","index":11,"n_rows":11,"n_cols":3,"rows_kept":11,"cut":false,"hidden":false,"merged":[[1,1,1,2]]}
[]
[null,{"$f":"'COVER AND TABLE'!A35","v":"2015-12-31"}]
[null,"Test","Result"]
[]
["Invested Assets",{"$f":"IF(ABS('INVESTED ASSET SCHEDULE'!H33-'BALANCE SHEET'!H31)<2,\"PASS\",\"FAIL\")","v":"PASS"},{"$f":"'INVESTED ASSET SCHEDULE'!H33-'BALANCE SHEET'!H31","v":0}]
[]
["Unpaid Losses (Net of Insurance)",{"$f":"IF(ABS('BALANCE SHEET'!F19-'RESERVE SCHEDULE'!F20)<2,\"PASS\",\"FAIL\")","v":"PASS"},{"$f":"'BALANCE SHEET'!F19-'RESERVE SCHEDULE'!F20","v":0}]
[]
["Reserves (Net of Insurance)",{"$f":"IF(ABS('BALANCE SHEET'!F21-'RESERVE SCHEDULE'!F23)<2,\"PASS\",\"FAIL\")","v":"PASS"},{"$f":"'BALANCE SHEET'!F21-'RESERVE SCHEDULE'!F23","v":0}]
[]
["General Admin Expense",{"$f":"IF(ABS(PL!F21-'EXPENSE SCHEDULE'!F16)<2,\"PASS\",\"FAIL\")","v":"PASS"},{"$f":"PL!F21-'EXPENSE SCHEDULE'!F16","v":0}]