401k Plan data: EYE HEALTH AMERICA 401(K) PLAN plan

EYE HEALTH AMERICA 401(K) PLAN 401k Plan overview

Plan Name	EYE HEALTH AMERICA 401(K) PLAN
Plan identification number	001

EYE HEALTH AMERICA 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

EYE HEALTH AMERICA, LLC has sponsored the creation of one or more 401k plans.

Company Name: EYE HEALTH AMERICA, LLC

Employer identification number (EIN): 823212492

NAIC Classification: 621320
NAIC Description: Offices of Optometrists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EYE HEALTH AMERICA 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01 JOANN WRIGHT 2023-10-06
001 2021-01-01 JOANN WRIGHT 2022-10-05
001 2020-01-01 JOANN WRIGHT 2021-10-15
001 2019-01-01

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2022-01-01	JOANN WRIGHT	2023-10-06
001	2021-01-01	JOANN WRIGHT	2022-10-05
001	2020-01-01	JOANN WRIGHT	2021-10-15
001	2019-01-01

Plan Statistics for EYE HEALTH AMERICA 401(K) PLAN

401k plan membership statisitcs for EYE HEALTH AMERICA 401(K) PLAN

Measure Date Value
2022: EYE HEALTH AMERICA 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 1,158
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 1,083
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 136
Total of all active and inactive participants 2022-01-01 1,219
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 1,219
Number of participants with account balances 2022-01-01 1,161
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 217
2021: EYE HEALTH AMERICA 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 680
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 866
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 114
Total of all active and inactive participants 2021-01-01 980
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 980
Number of participants with account balances 2021-01-01 930
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 50
2020: EYE HEALTH AMERICA 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 679
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 613
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 67
Total of all active and inactive participants 2020-01-01 680
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 680
Number of participants with account balances 2020-01-01 657
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 88
2019: EYE HEALTH AMERICA 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 389
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 626
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 141
Total of all active and inactive participants 2019-01-01 767
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 767
Number of participants with account balances 2019-01-01 731
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 61

Measure	Date	Value
2022: EYE HEALTH AMERICA 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	1,158
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	1,083
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	136
Total of all active and inactive participants	2022-01-01	1,219
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	1,219
Number of participants with account balances	2022-01-01	1,161
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	217
2021: EYE HEALTH AMERICA 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	680
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	866
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	114
Total of all active and inactive participants	2021-01-01	980
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	980
Number of participants with account balances	2021-01-01	930
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	50
2020: EYE HEALTH AMERICA 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	679
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	613
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	67
Total of all active and inactive participants	2020-01-01	680
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	680
Number of participants with account balances	2020-01-01	657
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	88
2019: EYE HEALTH AMERICA 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	389
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	626
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	141
Total of all active and inactive participants	2019-01-01	767
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	767
Number of participants with account balances	2019-01-01	731
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	61

Financial Data on EYE HEALTH AMERICA 401(K) PLAN

Measure	Date	Value
2022 : EYE HEALTH AMERICA 401(K) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$2,684
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total income from all sources (including contributions)	2022-12-31	$4,678,167
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$1,877,351
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$1,741,711
Value of total corrective distributions	2022-12-31	$2,684
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$9,031,703
Value of total assets at end of year	2022-12-31	$27,685,723
Value of total assets at beginning of year	2022-12-31	$24,882,223
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$132,956
Total interest from all sources	2022-12-31	$14,298
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$1,146,475
Total dividends received from registered investment company shares (eg mutual funds)	2022-12-31	$1,146,475
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$500,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$3,287,338
Participant contributions at end of year	2022-12-31	$265,052
Participant contributions at beginning of year	2022-12-31	$192,099
Participant contributions at end of year	2022-12-31	$40
Participant contributions at beginning of year	2022-12-31	$684
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$4,334,582
Value of other receiveables (less allowance for doubtful accounts) at end of year	2022-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2022-12-31	$0
Other income not declared elsewhere	2022-12-31	$52,925
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$2,800,816
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$27,683,039
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$24,882,223
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$26,645,036
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$24,381,645
Interest on participant loans	2022-12-31	$11,288
Interest earned on other investments	2022-12-31	$3,010
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$635,810
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$307,795
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-5,567,234
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$1,409,783
Employer contributions (assets) at end of year	2022-12-31	$139,785
Employer contributions (assets) at beginning of year	2022-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$1,741,711
Contract administrator fees	2022-12-31	$132,956
Liabilities. Value of benefit claims payable at end of year	2022-12-31	$2,684
Liabilities. Value of benefit claims payable at beginning of year	2022-12-31	$0
Did the plan have assets held for investment	2022-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	WARREN AVERETT, LLC
Accountancy firm EIN	2022-12-31	454084437
2021 : EYE HEALTH AMERICA 401(K) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$7,928,181
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$1,897,355
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$1,812,047
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$4,791,625
Value of total assets at end of year	2021-12-31	$24,882,223
Value of total assets at beginning of year	2021-12-31	$18,851,397
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$85,308
Total interest from all sources	2021-12-31	$11,438
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$1,031,186
Total dividends received from registered investment company shares (eg mutual funds)	2021-12-31	$1,031,186
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$2,383,328
Participant contributions at end of year	2021-12-31	$192,099
Participant contributions at beginning of year	2021-12-31	$158,839
Participant contributions at end of year	2021-12-31	$684
Participant contributions at beginning of year	2021-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2021-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2021-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$1,351,665
Value of other receiveables (less allowance for doubtful accounts) at end of year	2021-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2021-12-31	$0
Other income not declared elsewhere	2021-12-31	$18,320
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$6,030,826
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$24,882,223
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$18,851,397
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$24,381,645
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$18,491,258
Interest on participant loans	2021-12-31	$9,490
Interest earned on other investments	2021-12-31	$1,948
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$307,795
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$173,367
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$2,075,612
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$1,056,632
Employer contributions (assets) at end of year	2021-12-31	$0
Employer contributions (assets) at beginning of year	2021-12-31	$27,933
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$1,812,047
Contract administrator fees	2021-12-31	$85,308
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	WARREN AVERETT, LLC
Accountancy firm EIN	2021-12-31	454084437
2020 : EYE HEALTH AMERICA 401(K) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$5,706,612
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$3,569,620
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$3,506,005
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$3,506,037
Value of total assets at end of year	2020-12-31	$18,851,397
Value of total assets at beginning of year	2020-12-31	$16,714,405
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$63,615
Total interest from all sources	2020-12-31	$5,407
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$552,872
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-31	$552,872
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
If this is an individual account plan, was there a blackout period	2020-12-31	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$1,886,720
Participant contributions at end of year	2020-12-31	$158,839
Participant contributions at beginning of year	2020-12-31	$98,304
Assets. Other investments not covered elsewhere at end of year	2020-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2020-12-31	$1,621,520
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$635,322
Value of other receiveables (less allowance for doubtful accounts) at end of year	2020-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2020-12-31	$470,614
Other income not declared elsewhere	2020-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$2,136,992
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$18,851,397
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$16,714,405
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$18,491,258
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$13,885,371
Interest on participant loans	2020-12-31	$5,407
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2020-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2020-12-31	$567,805
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2020-12-31	$567,805
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$173,367
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$1,642,296
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$983,995
Employer contributions (assets) at end of year	2020-12-31	$27,933
Employer contributions (assets) at beginning of year	2020-12-31	$70,791
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$3,506,005
Contract administrator fees	2020-12-31	$63,615
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2020-12-31	Yes
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	WARREN AVERETT, LLC
Accountancy firm EIN	2020-12-31	454084437
2019 : EYE HEALTH AMERICA 401(K) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total transfer of assets to this plan	2019-12-31	$11,444,936
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$6,057,811
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$788,342
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$779,437
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$3,415,121
Value of total assets at end of year	2019-12-31	$16,714,405
Value of total assets at beginning of year	2019-12-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$8,905
Total interest from all sources	2019-12-31	$17,551
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$306,669
Total dividends received from registered investment company shares (eg mutual funds)	2019-12-31	$306,669
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$500,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$1,759,642
Participant contributions at end of year	2019-12-31	$98,304
Assets. Other investments not covered elsewhere at end of year	2019-12-31	$1,621,520
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$815,972
Value of other receiveables (less allowance for doubtful accounts) at end of year	2019-12-31	$470,614
Other income not declared elsewhere	2019-12-31	$153,066
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$5,269,469
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$16,714,405
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$13,885,371
Interest on participant loans	2019-12-31	$4,806
Income. Interest from loans (other than to participants)	2019-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2019-12-31	$567,805
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2019-12-31	$12,745
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$2,165,404
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$839,507
Employer contributions (assets) at end of year	2019-12-31	$70,791
Employer contributions (assets) at beginning of year	2019-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$779,437
Contract administrator fees	2019-12-31	$8,905
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	WARREN AVERETT, LLC
Accountancy firm EIN	2019-12-31	454084437

Form 5500 Responses for EYE HEALTH AMERICA 401(K) PLAN

2022: EYE HEALTH AMERICA 401(K) PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: EYE HEALTH AMERICA 401(K) PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: EYE HEALTH AMERICA 401(K) PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: EYE HEALTH AMERICA 401(K) PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

510378-01

Policy instance

Insurance contract or identification number	510378-01
Number of Individuals Covered	1161
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

510378-01

Policy instance

Insurance contract or identification number	510378-01
Number of Individuals Covered	930
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

510378-01

Policy instance

Insurance contract or identification number	510378-01
Number of Individuals Covered	657
Insurance policy start date	2020-10-01
Insurance policy end date	2020-12-31
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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

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Company Name:	EYE HEALTH AMERICA, LLC
Employer identification number (EIN):	823212492
NAIC Classification:	621320
NAIC Description:	Offices of Optometrists