| Plan Name | VISION PLAN FOR THE EMPLOYEES OF PEDIATRIC HOME SERVICE |
| Plan identification number | 506 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | PEDIATRIC HOME RESPIRATORY SERVICES, LLC D/B/A PEDIATRIC HOME SERVICE |
| Employer identification number (EIN): | 411656511 |
| NAIC Classification: | 621610 |
| NAIC Description: | Home Health Care Services |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 506 | 2024-01-01 | ADAM ALBRECHT | |||
| 506 | 2023-01-01 | ||||
| 506 | 2023-01-01 | DRUE POUNDS | |||
| 506 | 2022-01-01 | ||||
| 506 | 2022-01-01 | JEFF HOOD | |||
| 506 | 2021-01-01 | JEFF HOOD | 2022-06-15 | ||
| 506 | 2020-01-01 | JAMISON A. YOUNG | 2021-04-09 | ||
| 506 | 2019-01-01 | JAMISON A. YOUNG | 2020-06-23 | ||
| 506 | 2018-01-01 | ||||
| 506 | 2017-01-01 |
| 2023: VISION PLAN FOR THE EMPLOYEES OF PEDIATRIC HOME SERVICE 2023 form 5500 responses | ||
|---|---|---|
| 2023-01-01 | Type of plan entity | Single employer plan |
| 2023-01-01 | Submission has been amended | No |
| 2023-01-01 | This submission is the final filing | No |
| 2023-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2023-01-01 | Plan is a collectively bargained plan | No |
| 2023-01-01 | Plan funding arrangement – Insurance | Yes |
| 2023-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022: VISION PLAN FOR THE EMPLOYEES OF PEDIATRIC HOME SERVICE 2022 form 5500 responses | ||
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Submission has been amended | No |
| 2022-01-01 | This submission is the final filing | No |
| 2022-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2022-01-01 | Plan is a collectively bargained plan | No |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: VISION PLAN FOR THE EMPLOYEES OF PEDIATRIC HOME SERVICE 2021 form 5500 responses | ||
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: VISION PLAN FOR THE EMPLOYEES OF PEDIATRIC HOME SERVICE 2020 form 5500 responses | ||
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: VISION PLAN FOR THE EMPLOYEES OF PEDIATRIC HOME SERVICE 2019 form 5500 responses | ||
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: VISION PLAN FOR THE EMPLOYEES OF PEDIATRIC HOME SERVICE 2018 form 5500 responses | ||
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: VISION PLAN FOR THE EMPLOYEES OF PEDIATRIC HOME SERVICE 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 | 10084531001 | ||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||
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| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) | |||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 10084531001 | ||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||
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| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) | |||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 10084531001 | ||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) | |||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 10084531001 | ||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) | |||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 10084531001 | ||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) | |||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 10084531001 | ||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) | |||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 10084531001 | ||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||