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| Plan Name | BASIC LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT |
| Plan identification number | 504 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | CARDIOVASCULAR MEDICINE ASSOCIATES, P.A. |
| Employer identification number (EIN): | 650511644 |
| 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 |
|---|---|---|---|---|---|
| 504 | 2022-10-15 | QASIM AHMAD | 2024-08-14 | ||
| 504 | 2021-10-15 | QASIM AHMAD | 2023-03-29 |
| Measure | Date | Value |
|---|---|---|
| 2022: BASIC LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT 2022 401k membership | ||
| Total participants, beginning-of-year | 2022-10-15 | 108 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-10-15 | 100 |
| Number of retired or separated participants receiving benefits | 2022-10-15 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-10-15 | 0 |
| Total of all active and inactive participants | 2022-10-15 | 100 |
| Number of employers contributing to the scheme | 2022-10-15 | 0 |
| 2021: BASIC LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT 2021 401k membership | ||
| Total participants, beginning-of-year | 2021-10-15 | 116 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-10-15 | 108 |
| Number of retired or separated participants receiving benefits | 2021-10-15 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-10-15 | 0 |
| Total of all active and inactive participants | 2021-10-15 | 108 |
| Number of employers contributing to the scheme | 2021-10-15 | 0 |
| 2022: BASIC LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT 2022 form 5500 responses | ||
|---|---|---|
| 2022-10-15 | Type of plan entity | Single employer plan |
| 2022-10-15 | Plan funding arrangement – Insurance | Yes |
| 2022-10-15 | Plan benefit arrangement – Insurance | Yes |
| 2021: BASIC LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT 2021 form 5500 responses | ||
| 2021-10-15 | Type of plan entity | Single employer plan |
| 2021-10-15 | First time form 5500 has been submitted | Yes |
| 2021-10-15 | Plan funding arrangement – Insurance | Yes |
| 2021-10-15 | Plan benefit arrangement – Insurance | Yes |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) | |
| Policy contract number | 797914 |
| Policy instance | 1 |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) | |
| Policy contract number | 797914 |
| Policy instance | 1 |
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