| Plan Name | PARTNERS IN VISION, INC. MEDICAL PLAN |
| Plan identification number | 503 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | PARTNERS IN VISION, INC. |
| Employer identification number (EIN): | 223686693 |
| NAIC Classification: | 621320 |
| NAIC Description: | Offices of Optometrists |
Additional information about PARTNERS IN VISION, INC.
| Jurisdiction of Incorporation: | Texas Secretary of State |
| Incorporation Date: | 2017-05-22 |
| Company Identification Number: | 0802728307 |
| Legal Registered Office Address: |
PO BOX 810069 DALLAS United States of America (USA) 75381 |
More information about PARTNERS IN VISION, INC.
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 503 | 2018-09-01 | DEBBIE GOTTAS | 2020-06-09 |
| 2018: PARTNERS IN VISION, INC. MEDICAL PLAN 2018 form 5500 responses | ||
|---|---|---|
| 2018-09-01 | Type of plan entity | Single employer plan |
| 2018-09-01 | First time form 5500 has been submitted | Yes |
| 2018-09-01 | Submission has been amended | No |
| 2018-09-01 | This submission is the final filing | Yes |
| 2018-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-09-01 | Plan is a collectively bargained plan | No |
| 2018-09-01 | Plan funding arrangement – Insurance | Yes |
| 2018-09-01 | Plan benefit arrangement – Insurance | Yes |
| OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 78026 ) | |
| Policy contract number | PI17973 |
| Policy instance | 1 |