VISION FIRST EYE CARE GROUP HEALTH BENEFIT PLAN 401k Plan overview
| Plan Name | VISION FIRST EYE CARE GROUP HEALTH BENEFIT PLAN |
| Plan identification number | 501 |
VISION FIRST EYE CARE GROUP HEALTH BENEFIT PLAN Benefits
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits | - Health (other than dental or vision)
|
401k Sponsoring company profile
PINNACLE EYE CARE, INC. D/B/A VISION FIRST has sponsored the creation of one or more 401k plans.
Additional information about PINNACLE EYE CARE, INC. D/B/A VISION FIRST
| Jurisdiction of Incorporation: | Ohio Secretary of State Business Services Division |
| Incorporation Date: | 2000-05-26 |
| Company Identification Number: | 1158864 |
| Legal Registered Office Address: |
16695 LUCKY BELL LANE
-
AUBURN
United States of America (USA)
440230000
|
More information about PINNACLE EYE CARE, INC. D/B/A VISION FIRST
Form 5500 Filing Information
Submission information for form 5500 for 401k plan VISION FIRST EYE CARE GROUP HEALTH BENEFIT PLAN
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|
| 501 | 2022-01-01 | DEREK RADCLIFFE | 2023-07-10 | | |
| 501 | 2021-01-01 | DEREK RADCLIFFE | 2022-08-22 | | |
Plan Statistics for VISION FIRST EYE CARE GROUP HEALTH BENEFIT PLAN
401k plan membership statisitcs for VISION FIRST EYE CARE GROUP HEALTH BENEFIT PLAN
| Measure | Date | Value |
|---|
| 2022: VISION FIRST EYE CARE GROUP HEALTH BENEFIT PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 109 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 95 |
| Total of all active and inactive participants | 2022-01-01 | 95 |
| 2021: VISION FIRST EYE CARE GROUP HEALTH BENEFIT PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 142 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 109 |
| Total of all active and inactive participants | 2021-01-01 | 109 |
Form 5500 Responses for VISION FIRST EYE CARE GROUP HEALTH BENEFIT PLAN
| 2022: VISION FIRST EYE CARE GROUP HEALTH BENEFIT PLAN 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: VISION FIRST EYE CARE GROUP HEALTH BENEFIT PLAN 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | First time form 5500 has been submitted | Yes |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
Insurance Providers Used on plan
| HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 ) |
| Policy contract number | 717738 |
| Policy instance | 1 |
| Insurance contract or identification number | 717738 | | Number of Individuals Covered | 95 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $35,136 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $800,961 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $29,545 | | Insurance broker organization code? | 3 |
|
| HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 ) |
| Policy contract number | 717738 |
| Policy instance | 1 |
| Insurance contract or identification number | 717738 | | Number of Individuals Covered | 109 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $30,872 | | Health Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $768,999 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $30,872 | | Insurance broker organization code? | 3 |
|
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