403(b) Middlesex Health Savings and Investment Plan Investment Performance

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PERFORMANCE UPDATE  
 
MIDDLESEX HEALTH 403B PLAN  
 
Average Annual Total Returns as of 10/31/2021    (shown in percentages)  

 Variable annuities and mutual funds offered through a retirement plan are intended as long-term investments designed for retirement purposes. Money distributed from a 403(b) plan, 401(a)/(k) plan, or a 457 plan will be taxed as ordinary income in the year the money is distributed. Early withdrawals from a 403(b) plan and a 401(a)/(k) plan, if taken prior to age 59 1/2, will be subject to the IRS 10% premature distribution penalty tax, unless an exception applies. This IRS premature distribution penalty tax does not apply to 457 plans. Account values fluctuate with market conditions, and when surrendered the principal may be worth more or less than the original amount invested. 

 The performance data quoted represents past performance.  Past performance does not guarantee future results.  For month-end performance which may be lower or higher than the performance data shown please call 800-584-6001.  Investment return and principal value of an investment will fluctuate so that, when sold, an investment may be worth more or less than the original cost.  

 The returns assume reinvestment of all dividends (ordinary income and capital gains) and are net of management fees and other fund operating expenses.  An asset based service fee is deducted by Voya from your account quarterly, at an annual rate of 0.15% of balances held in each of the funds, including Voya Fixed Plus Account III.  The performance data shown below does not reflect this administrative expense.  If such fees had been reflected, the performance data shown for each option would have been lower. 

 You should consider the investment objectives, risks and charges, and expenses of the funds carefully before investing.  The prospectus contains this and other information.  Anyone who wishes to obtain a free copy of the fund prospectuses may call their Voya representative or the number above.  Please read the prospectus carefully before investing. 

 Returns less than one year are not annualized.  Fund Inception Date is the date of inception for the underlying fund, and is the date used in calculating the periodic returns.  This date may also precede the portfolio's inclusion in the product. 


 Investment Options 1-Mo 3-Mo YTD 1-Yr 3-Yr 5-Yr10-Yr InceptFund Inception Date Gross Fund Exp %* Net Fund Exp %* 
Stability of Principal   
   Stability of Principal 
Voya Fixed Plus Account III - 4020 (1)(4)0.100.290.961.181.451.581.90   
Bonds   
   Intermediate Core Bond 
Vanguard® Total Bond Market Index Fund - Institutional - 799 -0.02-1.12-1.59-0.335.683.112.9609/18/19950.04 0.04  
   Intermediate Core-Plus Bond 
PGIM Total Return Bond Fund - Class R6 - 6591 (5)0.02-1.29-1.431.616.504.214.4101/10/19950.41 0.39  
Asset Allocation   
   Lifecycle - Index 
Vanguard® Institutional Target Retirement 2015 Fund - Inst - 4701 (2)1.610.395.2912.409.657.856.5606/26/20150.09 0.09  
Vanguard® Institutional Target Retirement 2020 Fund - Inst - 4702 (2)2.320.937.5817.4211.549.487.7606/26/20150.09 0.09  
Vanguard® Institutional Target Retirement 2025 Fund - Inst - 4703 (2)2.811.299.1120.9812.8810.668.5706/26/20150.09 0.09  
Vanguard® Institutional Target Retirement 2030 Fund - Inst - 4704 (2)3.221.6310.5624.0713.8311.599.1606/26/20150.09 0.09  
Vanguard® Institutional Target Retirement 2035 Fund - Inst - 4705 (2)3.641.9612.0427.2214.7712.499.7506/26/20150.09 0.09  
Vanguard® Institutional Target Retirement 2040 Fund - Inst - 4706 (2)4.032.3313.5630.4415.6913.4010.3106/26/20150.09 0.09  
Vanguard® Institutional Target Retirement 2045 Fund - Inst - 4707 (2)4.432.6915.0633.6616.6214.0710.8306/26/20150.09 0.09  
Vanguard® Institutional Target Retirement 2050 Fund - Inst - 4708 (2)4.542.8015.3234.1016.7614.1410.8906/26/20150.09 0.09  
Vanguard® Institutional Target Retirement 2055 Fund - Inst - 4709 (2)4.522.7915.3134.1216.7814.1610.9006/26/20150.09 0.09  
Vanguard® Institutional Target Retirement 2060 Fund - Inst - 4710 (2)4.512.7515.3034.1116.8114.1510.8906/26/20150.09 0.09  
Vanguard® Institutional Target Retirement Income Fund- Inst - 4711 (2)1.490.314.7611.109.146.835.9706/26/20150.09 0.09  
Large Cap Value/Blend   
   Large Blend 
Vanguard® Institutional Index Fund - Institutional Shares - 566 7.005.1224.0242.8821.4618.9016.1907/31/19900.04 0.04  
   Large Value 
MFS® Value Fund - Class R6 - 9857 5.613.8322.0940.1915.4113.3713.4001/02/19960.47 0.47  
Large Cap Growth   
   Large Growth 
T. Rowe Price Blue Chip Growth Fund - I Class - 7577 (3)5.823.6319.7132.7325.6824.2219.4306/30/19930.56 0.56  
Small/Mid/Specialty   
   Mid-Cap Growth 
Eaton Vance Atlanta Capital SMID-Cap Fund - Class R6 - 6724 6.302.3718.4942.5618.1117.6115.7811/28/20030.82 0.82  
Vanguard® Extended Market Index Fund - Institutional Shares - 7499 5.433.2517.7549.3421.9518.5915.4501/01/19860.05 0.05  
   Small Value 
AB Discovery Value Fund - Class Z - 6342 3.894.4231.1062.4313.6112.0712.6103/29/20010.81 0.81  
Global / International   
   Foreign Large Blend 
Vanguard® Total International Stock Index Fund - Adm™ Sh - 9889 2.650.859.2030.5912.479.977.1404/29/19960.11 0.11  
   Foreign Large Growth 
American Funds EuroPacific Growth Fund® - Class R-6 - 1723 1.941.066.0328.4017.6513.089.8004/16/19840.46 0.46  
 The risks of investing in small company stocks may include relatively low trading volumes, a greater degree of change in earnings and greater short-term volatility. 
 Foreign investing involves special risks such as currency fluctuation and public disclosure, as well as economic and political risks. 
 Some of the Funds invest in securities guaranteed by the U.S. Government as to the timely payment of principal and interest; however, shares of the Funds are not insured nor guaranteed. 
 High yielding fixed-income securities generally are subject to greater market fluctuations and risks of loss of income and principal than are investments in lower yielding fixed-income securities. 
 Sector funds may involve greater-than average risk and are often more volatile than funds holding a diversified portfolio of stocks in many industries. Examples include: banking, biotechnology, chemicals, energy, environmental services, natural resources, precious metals, technology, telecommunications, and utilities. 
 *The Gross Expense Ratios shown do not reflect any temporary fee or expense waivers that may be in effect for a fund. The performance of a fund with a temporary fee or expense waiver would have been lower if the gross fund fees / expenses listed had been reflected. 



PERFORMANCE UPDATE  
 
MIDDLESEX HEALTH 403B PLAN  
 
Average Annual Total Returns as of 09/30/2021    (shown in percentages)  

 Variable annuities and mutual funds offered through a retirement plan are intended as long-term investments designed for retirement purposes. Money distributed from a 403(b) plan, 401(a)/(k) plan, or a 457 plan will be taxed as ordinary income in the year the money is distributed. Early withdrawals from a 403(b) plan and a 401(a)/(k) plan, if taken prior to age 59 1/2, will be subject to the IRS 10% premature distribution penalty tax, unless an exception applies. This IRS premature distribution penalty tax does not apply to 457 plans. Account values fluctuate with market conditions, and when surrendered the principal may be worth more or less than the original amount invested. 

 The performance data quoted represents past performance.  Past performance does not guarantee future results.  For month-end performance which may be lower or higher than the performance data shown please call 800-584-6001.  Investment return and principal value of an investment will fluctuate so that, when sold, an investment may be worth more or less than the original cost.  

 The returns assume reinvestment of all dividends (ordinary income and capital gains) and are net of management fees and other fund operating expenses.  An asset based service fee is deducted by Voya from your account quarterly, at an annual rate of 0.15% of balances held in each of the funds, including Voya Fixed Plus Account III.  The performance data shown below does not reflect this administrative expense.  If such fees had been reflected, the performance data shown for each option would have been lower. 

 Returns less than one year are not annualized.  Fund Inception Date is the date of inception for the underlying fund, and is the date used in calculating the periodic returns.  This date may also precede the portfolio's inclusion in the product. 


 Investment Options 1-Mo 3-Mo YTD 1-Yr 3-Yr 5-Yr10-Yr InceptFund Inception Date Gross Fund Exp %* Net Fund Exp %* 
Stability of Principal   
   Stability of Principal 
Voya Fixed Plus Account III - 4020 (1)(4)0.090.290.861.201.471.591.92   
Bonds   
   Intermediate Core Bond 
Vanguard® Total Bond Market Index Fund - Institutional - 799 -0.900.11-1.57-0.915.432.952.9809/18/19950.04 0.04  
   Intermediate Core-Plus Bond 
PGIM Total Return Bond Fund - Class R6 - 6591 (5)-1.13-0.01-1.450.906.284.024.5801/10/19950.41 0.39  
Asset Allocation   
   Lifecycle - Index 
Vanguard® Institutional Target Retirement 2015 Fund - Inst - 4701 (2)-1.81-0.163.629.657.827.216.3806/26/20150.09 0.09  
Vanguard® Institutional Target Retirement 2020 Fund - Inst - 4702 (2)-2.34-0.405.1413.439.058.647.4706/26/20150.09 0.09  
Vanguard® Institutional Target Retirement 2025 Fund - Inst - 4703 (2)-2.74-0.616.1216.069.929.688.2106/26/20150.09 0.09  
Vanguard® Institutional Target Retirement 2030 Fund - Inst - 4704 (2)-2.99-0.767.1118.4010.5110.498.7406/26/20150.09 0.09  
Vanguard® Institutional Target Retirement 2035 Fund - Inst - 4705 (2)-3.24-0.868.1120.7011.0511.299.2606/26/20150.09 0.09  
Vanguard® Institutional Target Retirement 2040 Fund - Inst - 4706 (2)-3.46-0.969.1723.1211.5912.089.7606/26/20150.09 0.09  
Vanguard® Institutional Target Retirement 2045 Fund - Inst - 4707 (2)-3.71-1.0510.1725.4912.1912.6510.2106/26/20150.09 0.09  
Vanguard® Institutional Target Retirement 2050 Fund - Inst - 4708 (2)-3.76-1.0810.3125.7812.2812.7010.2606/26/20150.09 0.09  
Vanguard® Institutional Target Retirement 2055 Fund - Inst - 4709 (2)-3.75-1.0710.3225.7812.3112.7210.2706/26/20150.09 0.09  
Vanguard® Institutional Target Retirement 2060 Fund - Inst - 4710 (2)-3.73-1.0710.3225.7912.3312.7210.2706/26/20150.09 0.09  
Vanguard® Institutional Target Retirement Income Fund- Inst - 4711 (2)-1.75-0.093.228.597.616.285.8106/26/20150.09 0.09  
Large Cap Value/Blend   
   Large Blend 
Vanguard® Institutional Index Fund - Institutional Shares - 566 -4.650.5715.9029.9815.9716.8716.6107/31/19900.04 0.04  
   Large Value 
MFS® Value Fund - Class R6 - 9857 -4.100.6715.6130.1811.4711.7114.0201/02/19960.47 0.47  
Large Cap Growth   
   Large Growth 
T. Rowe Price Blue Chip Growth Fund - I Class - 7577 (3)-5.720.4513.1322.4119.4522.5520.1906/30/19930.56 0.56  
Small/Mid/Specialty   
   Mid-Cap Growth 
Eaton Vance Atlanta Capital SMID-Cap Fund - Class R6 - 6724 -4.61-2.4111.4635.1911.8015.1616.5711/28/20030.82 0.82  
Vanguard® Extended Market Index Fund - Institutional Shares - 7499 -4.00-3.2711.6942.3315.6616.4216.3801/01/19860.05 0.05  
   Small Value 
AB Discovery Value Fund - Class Z - 6342 -2.26-0.5126.2063.008.6410.6913.7403/29/20010.81 0.81  
Global / International   
   Foreign Large Blend 
Vanguard® Total International Stock Index Fund - Adm™ Sh - 9889 -3.41-3.006.3824.368.319.017.8904/29/19960.11 0.11  
   Foreign Large Growth 
American Funds EuroPacific Growth Fund® - Class R-6 - 1723 -4.11-2.354.0124.7613.2112.1710.6304/16/19840.46 0.46  
 The risks of investing in small company stocks may include relatively low trading volumes, a greater degree of change in earnings and greater short-term volatility. 
 Foreign investing involves special risks such as currency fluctuation and public disclosure, as well as economic and political risks. 
 Some of the Funds invest in securities guaranteed by the U.S. Government as to the timely payment of principal and interest; however, shares of the Funds are not insured nor guaranteed. 
 High yielding fixed-income securities generally are subject to greater market fluctuations and risks of loss of income and principal than are investments in lower yielding fixed-income securities. 
 Sector funds may involve greater-than average risk and are often more volatile than funds holding a diversified portfolio of stocks in many industries. Examples include: banking, biotechnology, chemicals, energy, environmental services, natural resources, precious metals, technology, telecommunications, and utilities. 
 *The Gross Expense Ratios shown do not reflect any temporary fee or expense waivers that may be in effect for a fund. The performance of a fund with a temporary fee or expense waiver would have been lower if the gross fund fees / expenses listed had been reflected. 


ADDITIONAL NOTES 
(1) The current rate for the Voya Fixed Plus Account III MC 901, Fund 4020 is 1.15%, expressed as an annual effective yield. The current rate may change and be higher or lower than the previously identified rate but is guaranteed not to be less than 1.00%. VRIAC will not apply a decrease to the current rate following a rate change initiated solely by us prior to the last day of the three-month period measured from the first day of the month in which such change was effective. Note: The current rate for an initial investment in the fixed account previously identified may be in effect for less than a full three-month period. 

(2) Vanguard Target Retirement Funds:  Investments in Target Retirement Funds are subject to the risks of their underlying funds. The year in the fund name refers to the approximate year (the target date) when an investor in the fund would retire and leave the workforce. The fund will gradually shift its emphasis from more aggressive investments to more conservative ones based on its target date. An investment in a Target Retirement Fund is not guaranteed at any time, including on or after the target date.
These fund suggestions are based on an estimated retirement age of approximately 65. Should you choose to retire significantly earlier or later, you may want to consider a fund with an asset allocation more appropriate to your particular situation.

All investing is subject to risk, including the possible loss of the money you invest. Diversification does not ensure a profit or protect against a loss. Investments in bonds are subject to interest rate, credit, and inflation risk.
 
(3) T. Rowe Price Blue Chip Growth Fund - I Class: Through April 30, 2018, T. Rowe Price Associates, Inc. has agreed to pay the operating expenses of the fund excluding management fees; interest; expenses related to borrowings, taxes and brokerage; nonrecurring, extraordinary expenses; and acquired fund fees and expenses ("Operating Expenses"), to the extent the Operating Expenses exceed 0.05% of the average daily net assets. Any expenses paid under this agreement are subject to reimbursement to T. Rowe Price Associates, Inc. by the fund or class whenever the fund's Operating Expenses are below 0.05%. However, no reimbursement will be made more than three years after the payment of the Operating Expenses or if such reimbursement would cause the fund's Operating Expenses to exceed 0.05%. The agreement may be terminated at any time beyond April 30, 2018, with approval by the fund's Board of Directors. 

(4) The Investment Option is neither a mutual fund nor part of a Separate Account.  The returns listed do not include the impact of contract charges.  Please refer to the contract or disclosure book to determine which Fixed Interest Options are available for your specific plan.  The Investment Option is offered through Voya Retirement Insurance and Annuity Company. 

(5) PGIM Total Return Bond Fund - Class R6: PGIM Investments LLC (PGIM Investments) has contractually agreed, through February 28, 2022, to limit Total Annual Fund Operating Expenses after fee waivers and/or expense reimbursements to 0.39% of average daily net assets for Class R6 shares. This contractual waiver excludes interest, brokerage, taxes (such as income and foreign withholding taxes, stamp duty and deferred tax expenses), acquired fund fees and expenses, extraordinary expenses, and certain other Fund expenses such as dividend and interest expense and broker charges on short sales. Where applicable, PGIM Investments agrees to waive management fees or shared operating expenses on any share class to the same extent that it waives such expenses on any other share class. In addition, Total Annual Fund Operating Expenses for Class R6 shares will not exceed Total Annual Fund Operating Expenses for Class Z shares. Fees and/or expenses waived and/or reimbursed by PGIM Investments may be recouped by PGIM Investments within the same fiscal year during which such waiver and/or reimbursement is made if such recoupment can be realized without exceeding the expense limit in effect at the time of the recoupment for that fiscal year. This waiver may not be terminated prior to February 28, 2022 without the prior approval of the Fund's Board of Directors. 
 The chart shows the performance for each investment option for the time periods shown. 



Creation Date: Friday, November 26, 2021