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| Plan Name | VISION FIRST EYE CARE GROUP LIFE BENEFIT PLAN |
| Plan identification number | 502 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | PINNACLE EYE CARE, INC. D/B/A VISION FIRST |
| Employer identification number (EIN): | 752993005 |
| NAIC Classification: | 446130 |
| NAIC Description: | Optical Goods Stores |
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
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 502 | 2022-01-01 | DEREK RADCLIFFE | 2023-07-10 | ||
| 502 | 2021-01-01 | DEREK RADCLIFFE | 2022-08-22 |
| Measure | Date | Value |
|---|---|---|
| 2022: VISION FIRST EYE CARE GROUP LIFE BENEFIT PLAN 2022 401k membership | ||
| Total participants, beginning-of-year | 2022-01-01 | 142 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 179 |
| Total of all active and inactive participants | 2022-01-01 | 179 |
| 2021: VISION FIRST EYE CARE GROUP LIFE 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 | 142 |
| Total of all active and inactive participants | 2021-01-01 | 142 |
| 2022: VISION FIRST EYE CARE GROUP LIFE 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 LIFE 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 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |||||||||||||||||||||||||||||||||||
| Policy contract number | 00027626 | ||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||
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| AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 ) | |||||||||||||||||||||||||||||||||||
| Policy contract number | G 00612740 | ||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||
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