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Plan Name | PRIMARY CARE HEALTH PARTNERS HEALTH AND WELFARE PLAN |
Plan identification number | 506 |
401k Plan Type | Welfare Benefit |
Plan Features/Benefits |
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Company Name: | PRIMARY CARE HEALTH PARTNERS |
Employer identification number (EIN): | 030362571 |
NAIC Classification: | 621111 |
NAIC Description: | Offices of Physicians (except Mental Health Specialists) |
Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
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506 | 2022-01-01 | SHERYL TROVILLE | 2023-10-06 |
Measure | Date | Value |
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2022: PRIMARY CARE HEALTH PARTNERS HEALTH AND WELFARE PLAN 2022 401k membership | ||
Total participants, beginning-of-year | 2022-01-01 | 100 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 112 |
Number of retired or separated participants receiving benefits | 2022-01-01 | 0 |
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 | 112 |
Number of employers contributing to the scheme | 2022-01-01 | 0 |
2022: PRIMARY CARE HEALTH PARTNERS HEALTH AND WELFARE PLAN 2022 form 5500 responses | ||
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2022-01-01 | Type of plan entity | Single employer plan |
2022-01-01 | First time form 5500 has been submitted | Yes |
2022-01-01 | Plan funding arrangement – Insurance | Yes |
2022-01-01 | Plan benefit arrangement – Insurance | Yes |
DELTA DENTAL PLAN OF VERMONT, INC. (National Association of Insurance Commissioners NAIC id number: 53279 ) | |||||||||||||||||||||||||||||||||||||||||
Policy contract number | 70437 | ||||||||||||||||||||||||||||||||||||||||
Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) | |||||||||||||||||||||||||||||||||||||||||
Policy contract number | 30002499 | ||||||||||||||||||||||||||||||||||||||||
Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||
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PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) | |||||||||||||||||||||||||||||||||||||||||
Policy contract number | 8212066 | ||||||||||||||||||||||||||||||||||||||||
Policy instance | 3 | ||||||||||||||||||||||||||||||||||||||||
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RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |||||||||||||||||||||||||||||||||||||||||
Policy contract number | GL163510 | ||||||||||||||||||||||||||||||||||||||||
Policy instance | 4 | ||||||||||||||||||||||||||||||||||||||||
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