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| Plan Name | PREMIER MEDICAL ALLIANCE, LLC LIFE AND DISABILITY |
| Plan identification number | 502 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | PREMIER MEDICAL ALLIANCE, LLC |
| Employer identification number (EIN): | 462656846 |
| NAIC Classification: | 621111 |
| NAIC Description: | Offices of Physicians (except Mental Health Specialists) |
Additional information about PREMIER MEDICAL ALLIANCE, LLC
| Jurisdiction of Incorporation: | Florida Department of State Division of Corporations |
| Incorporation Date: | 2008-03-14 |
| Company Identification Number: | L08000026838 |
| Legal Registered Office Address: |
595 S. FEDERAL HWY., SUITE 250 BOCA RATON 33432 |
More information about PREMIER MEDICAL ALLIANCE, LLC
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 502 | 2016-01-01 | ALAN LIEBESKIND | |||
| 502 | 2015-01-01 | ALAN M LIEBESKIND |
| Measure | Date | Value |
|---|---|---|
| 2016: PREMIER MEDICAL ALLIANCE, LLC LIFE AND DISABILITY 2016 401k membership | ||
| Total participants, beginning-of-year | 2016-01-01 | 201 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 36 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-01-01 | 0 |
| Total of all active and inactive participants | 2016-01-01 | 36 |
| 2015: PREMIER MEDICAL ALLIANCE, LLC LIFE AND DISABILITY 2015 401k membership | ||
| Total participants, beginning-of-year | 2015-01-01 | 163 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 131 |
| Number of retired or separated participants receiving benefits | 2015-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-01-01 | 0 |
| Total of all active and inactive participants | 2015-01-01 | 131 |
| 2016: PREMIER MEDICAL ALLIANCE, LLC LIFE AND DISABILITY 2016 form 5500 responses | ||
|---|---|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Submission has been amended | No |
| 2016-01-01 | This submission is the final filing | No |
| 2016-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-01-01 | Plan is a collectively bargained plan | No |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: PREMIER MEDICAL ALLIANCE, LLC LIFE AND DISABILITY 2015 form 5500 responses | ||
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | First time form 5500 has been submitted | Yes |
| 2015-01-01 | Submission has been amended | No |
| 2015-01-01 | This submission is the final filing | No |
| 2015-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-01-01 | Plan is a collectively bargained plan | No |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | GLUG0ATP2 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 466316 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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