| Plan Name | ST. PAUL RADIOLOGY VISION |
| Plan identification number | 503 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | MIDWEST RADIOLOGY, P.A. |
| Employer identification number (EIN): | 410916626 |
| 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 |
|---|---|---|---|---|---|
| 503 | 2019-01-01 | BARRY LINDO | 2020-07-14 | ||
| 503 | 2019-01-01 | TERESA HOFFBECK | 2021-07-04 | ||
| 503 | 2017-01-01 |
| Measure | Date | Value |
|---|---|---|
| 2019: ST. PAUL RADIOLOGY VISION 2019 401k membership | ||
| Total participants, beginning-of-year | 2019-01-01 | 102 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 212 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 0 |
| Total of all active and inactive participants | 2019-01-01 | 212 |
| Number of employers contributing to the scheme | 2019-01-01 | 0 |
| 2017: ST. PAUL RADIOLOGY VISION 2017 401k membership | ||
| Total participants, beginning-of-year | 2017-01-01 | 100 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 91 |
| Number of retired or separated participants receiving benefits | 2017-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-01-01 | 0 |
| Total of all active and inactive participants | 2017-01-01 | 91 |
| 2019: ST. PAUL RADIOLOGY VISION 2019 form 5500 responses | ||
|---|---|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Submission has been amended | Yes |
| 2019-01-01 | This submission is the final filing | Yes |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: ST. PAUL RADIOLOGY VISION 2017 form 5500 responses | ||
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | First time form 5500 has been submitted | Yes |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) | |
| Policy contract number | 98364201001 |
| Policy instance | 1 |
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) | |
| Policy contract number | 9836420 |
| Policy instance | 1 |