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VISION INSURANCE PLAN 401k Plan overview

Plan NameVISION INSURANCE PLAN
Plan identification number 507

VISION INSURANCE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Vision

401k Sponsoring company profile

CHAMPLAIN VALLEY PHYSICIANS HOSPITAL has sponsored the creation of one or more 401k plans.

Company Name:CHAMPLAIN VALLEY PHYSICIANS HOSPITAL
Employer identification number (EIN):141338471
NAIC Classification:622000
NAIC Description: Hospitals

Additional information about CHAMPLAIN VALLEY PHYSICIANS HOSPITAL

Jurisdiction of Incorporation: New York Department of State
Incorporation Date: 1910-10-13
Company Identification Number: 29737
Legal Registered Office Address: 75 BEEKMAN STREET
Clinton
PLATTSBURGH
United States of America (USA)
12901

More information about CHAMPLAIN VALLEY PHYSICIANS HOSPITAL

Form 5500 Filing Information

Submission information for form 5500 for 401k plan VISION INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5072021-01-01JUDY PETERSON2022-10-14 MICHELLE LEBEAU2022-10-14
5072021-01-01JUDY PETERSON2023-07-06 MICHELLE LEBEAU2023-07-06
5072020-01-01
5072019-01-01
5072018-01-01
5072017-01-01MICHELLE LEBEAU
5072016-01-01STEPHENS MUNDY
5072015-01-01STEPHENS MUNDY
5072014-01-01STEPHENS MUNDY

Plan Statistics for VISION INSURANCE PLAN

401k plan membership statisitcs for VISION INSURANCE PLAN

Measure Date Value
2021: VISION INSURANCE PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-012,025
Total number of active participants reported on line 7a of the Form 55002021-01-011,779
Number of retired or separated participants receiving benefits2021-01-0158
Total of all active and inactive participants2021-01-011,837
2020: VISION INSURANCE PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-011,009
Total number of active participants reported on line 7a of the Form 55002020-01-011,967
Number of retired or separated participants receiving benefits2020-01-0158
Total of all active and inactive participants2020-01-012,025
Total participants2020-01-012,025
2019: VISION INSURANCE PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01963
Total number of active participants reported on line 7a of the Form 55002019-01-01985
Number of retired or separated participants receiving benefits2019-01-0124
Total of all active and inactive participants2019-01-011,009
Total participants2019-01-011,009
2018: VISION INSURANCE PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-011,139
Total number of active participants reported on line 7a of the Form 55002018-01-01963
Total of all active and inactive participants2018-01-01963
Total participants2018-01-01963
2017: VISION INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-011,087
Total number of active participants reported on line 7a of the Form 55002017-01-011,139
Total of all active and inactive participants2017-01-011,139
Total participants2017-01-011,139
2016: VISION INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-011,108
Total number of active participants reported on line 7a of the Form 55002016-01-011,087
Total of all active and inactive participants2016-01-011,087
Total participants2016-01-011,087
2015: VISION INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01851
Total number of active participants reported on line 7a of the Form 55002015-01-011,037
Total of all active and inactive participants2015-01-011,037
Total participants2015-01-011,037
2014: VISION INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01821
Total number of active participants reported on line 7a of the Form 55002014-01-01851
Total of all active and inactive participants2014-01-01851
Total participants2014-01-01851

Form 5500 Responses for VISION INSURANCE PLAN

2021: VISION INSURANCE PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedYes
2021-01-01This submission is the final filingYes
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: VISION INSURANCE PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: VISION INSURANCE PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: VISION INSURANCE PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: VISION INSURANCE PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: VISION INSURANCE PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: VISION INSURANCE PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: VISION INSURANCE PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01First time form 5500 has been submittedYes
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 )
Policy contract number720762
Policy instance 1
EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 )
Policy contract number720762
Policy instance 1
EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 )
Policy contract number720762
Policy instance 1
EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 )
Policy contract number720762
Policy instance 1
EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 )
Policy contract number720762
Policy instance 1
EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 )
Policy contract number720762
Policy instance 1
EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 )
Policy contract number720762
Policy instance 1

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