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| Plan Name | EYE PHYSICIANS OF FLORIDA DENTAL PLAN |
| Plan identification number | 502 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | EYE PHYSICIANS OF FLORIDA, LLP |
| Employer identification number (EIN): | 352308681 |
| 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 |
|---|---|---|---|---|---|
| 502 | 2017-10-01 | ANNIE JUILLET | 2019-08-26 | ||
| 502 | 2017-10-01 | ANNIE JUILLET | 2019-08-28 |
| Measure | Date | Value |
|---|---|---|
| 2017: EYE PHYSICIANS OF FLORIDA DENTAL PLAN 2017 401k membership | ||
| Total participants, beginning-of-year | 2017-10-01 | 103 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-10-01 | 106 |
| Number of retired or separated participants receiving benefits | 2017-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-10-01 | 0 |
| Total of all active and inactive participants | 2017-10-01 | 106 |
| Number of employers contributing to the scheme | 2017-10-01 | 0 |
| 2017: EYE PHYSICIANS OF FLORIDA DENTAL PLAN 2017 form 5500 responses | ||
|---|---|---|
| 2017-10-01 | Type of plan entity | Single employer plan |
| 2017-10-01 | First time form 5500 has been submitted | Yes |
| 2017-10-01 | Submission has been amended | Yes |
| 2017-10-01 | This submission is the final filing | Yes |
| 2017-10-01 | Plan funding arrangement – Insurance | Yes |
| 2017-10-01 | Plan benefit arrangement – Insurance | Yes |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |
| Policy contract number | 530261 |
| Policy instance | 1 |