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| Plan Name | EYE PHYSICIANS & SURGEONS OF CHICAGO, S.C. CAPITAL ACCUMULATION PLAN AND TRUST |
| Plan identification number | 001 |
| 401k Plan Type | Defined Contribution Pension |
| Plan Features/Benefits |
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| Company Name: | EYE PHYSICIANS & SURGEONS OF CHICAGO, S.C. |
| Employer identification number (EIN): | 363843619 |
| 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 |
|---|---|---|---|---|---|
| 001 | 2022-01-01 | BARRY HERST | 2023-08-09 | BARRY HERST | 2023-08-09 |
| 001 | 2019-01-01 | BARRY S. HERST, M.D. | 2020-07-21 | BARRY S. HERST, M.D. | 2020-07-21 |
| 001 | 2019-01-01 | ||||
| 001 | 2018-01-01 | ||||
| 001 | 2017-01-01 | ||||
| 001 | 2016-01-01 | ||||
| 001 | 2015-01-01 | ||||
| 001 | 2014-01-01 | ||||
| 001 | 2013-01-01 | ||||
| 001 | 2012-01-01 | BARRY S. HERST, M.D. | 2013-03-28 | BARRY S. HERST, M.D. | 2013-03-28 |
| 001 | 2011-01-01 | BARRY S. HERST, M.D. | 2012-05-24 | BARRY S. HERST, M.D. | 2012-05-24 |
| 001 | 2010-01-01 | BARRY S. HERST, M.D. | 2011-06-23 | BARRY S. HERST, M.D. | 2011-06-23 |
| Measure | Date | Value |
|---|---|---|
| 2019: EYE PHYSICIANS & SURGEONS OF CHICAGO, S.C. CAPITAL ACCUMULATION PLAN AND TRUST 2019 401k membership | ||
| Total participants, beginning-of-year | 2019-01-01 | 20 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 16 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 3 |
| Total of all active and inactive participants | 2019-01-01 | 19 |
| Total participants | 2019-01-01 | 19 |
| Number of participants with account balances | 2019-01-01 | 19 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2019-01-01 | 0 |
| Measure | Date | Value |
|---|---|---|
| 2019 : EYE PHYSICIANS & SURGEONS OF CHICAGO, S.C. CAPITAL ACCUMULATION PLAN AND TRUST 2019 401k financial data | ||
| Total income from all sources | 2019-12-31 | $947,396 |
| Expenses. Total of all expenses incurred | 2019-12-31 | $15,667 |
| Benefits paid (including direct rollovers) | 2019-12-31 | $4,535 |
| Total plan assets at end of year | 2019-12-31 | $4,192,587 |
| Total plan assets at beginning of year | 2019-12-31 | $3,260,858 |
| Value of fidelity bond covering the plan | 2019-12-31 | $500,000 |
| Total contributions received or receivable from participants | 2019-12-31 | $117,540 |
| Other income received | 2019-12-31 | $782,722 |
| Net income (gross income less expenses) | 2019-12-31 | $931,729 |
| Net plan assets at end of year (total assets less liabilities) | 2019-12-31 | $4,192,587 |
| Net plan assets at beginning of year (total assets less liabilities) | 2019-12-31 | $3,260,858 |
| Assets. Value of participant loans | 2019-12-31 | $1,300 |
| Total contributions received or receivable from employer(s) | 2019-12-31 | $47,134 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2019-12-31 | $11,132 |
| 2019: EYE PHYSICIANS & SURGEONS OF CHICAGO, S.C. CAPITAL ACCUMULATION PLAN AND TRUST 2019 form 5500 responses | ||
|---|---|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Submission has been amended | No |
| 2019-01-01 | This submission is the final filing | No |
| 2019-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-01-01 | Plan is a collectively bargained plan | No |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan funding arrangement – Trust | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement - Trust | Yes |
| VOYA RETIRIEMENT INSURANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 86509 ) | |||||||||||||||||||||
| Policy contract number | PHF548 | ||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||
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