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EMPLOYEE GROUP MEDICAL INSURANCE PLAN 401k Plan overview

Plan NameEMPLOYEE GROUP MEDICAL INSURANCE PLAN
Plan identification number 503

EMPLOYEE GROUP MEDICAL INSURANCE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)

401k Sponsoring company profile

FLORIDA EYE ASSOICATES INC has sponsored the creation of one or more 401k plans.

Company Name:FLORIDA EYE ASSOICATES INC
Employer identification number (EIN):593401517
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEE GROUP MEDICAL INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032021-09-01
5032020-09-01

Plan Statistics for EMPLOYEE GROUP MEDICAL INSURANCE PLAN

401k plan membership statisitcs for EMPLOYEE GROUP MEDICAL INSURANCE PLAN

Measure Date Value
2021: EMPLOYEE GROUP MEDICAL INSURANCE PLAN 2021 401k membership
Total participants, beginning-of-year2021-09-0199
Total number of active participants reported on line 7a of the Form 55002021-09-0187
Number of retired or separated participants receiving benefits2021-09-010
Number of other retired or separated participants entitled to future benefits2021-09-010
Total of all active and inactive participants2021-09-0187
Total participants2021-09-0187
2020: EMPLOYEE GROUP MEDICAL INSURANCE PLAN 2020 401k membership
Total participants, beginning-of-year2020-09-0199
Total number of active participants reported on line 7a of the Form 55002020-09-0197
Number of retired or separated participants receiving benefits2020-09-010
Number of other retired or separated participants entitled to future benefits2020-09-010
Total of all active and inactive participants2020-09-0197
Total participants2020-09-0197

Form 5500 Responses for EMPLOYEE GROUP MEDICAL INSURANCE PLAN

2021: EMPLOYEE GROUP MEDICAL INSURANCE PLAN 2021 form 5500 responses
2021-09-01Type of plan entitySingle employer plan
2021-09-01Submission has been amendedNo
2021-09-01This submission is the final filingNo
2021-09-01This return/report is a short plan year return/report (less than 12 months)No
2021-09-01Plan is a collectively bargained planNo
2021-09-01Plan funding arrangement – InsuranceYes
2021-09-01Plan benefit arrangement – InsuranceYes
2020: EMPLOYEE GROUP MEDICAL INSURANCE PLAN 2020 form 5500 responses
2020-09-01Type of plan entitySingle employer plan
2020-09-01Submission has been amendedNo
2020-09-01This submission is the final filingNo
2020-09-01This return/report is a short plan year return/report (less than 12 months)No
2020-09-01Plan is a collectively bargained planNo
2020-09-01Plan funding arrangement – InsuranceYes
2020-09-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

FLORIDA HEALTH CARE PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 13567 )
Policy contract number000866
Policy instance 1
Insurance contract or identification number000866
Number of Individuals Covered10
Insurance policy start date2021-09-01
Insurance policy end date2022-08-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees0
Insurance broker organization code?3
HEALTH FIRST HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 95019 )
Policy contract number113187
Policy instance 1
Insurance contract or identification number113187
Number of Individuals Covered97
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,134,903
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3

Potentially related plans

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