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| Plan Name | PREMIER MEDICAL ASSOCIATES |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | PREMIER MEDICAL ASSOCIATES |
| Employer identification number (EIN): | 853949537 |
| NAIC Classification: | 621498 |
| NAIC Description: | All Other Outpatient Care Centers |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2022-10-01 | CRAIG ESQUENAZI | 2023-10-16 |
| Measure | Date | Value |
|---|---|---|
| 2022: PREMIER MEDICAL ASSOCIATES 2022 401k membership | ||
| Total participants, beginning-of-year | 2022-10-01 | 170 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-10-01 | 181 |
| Number of retired or separated participants receiving benefits | 2022-10-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2022-10-01 | 0 |
| Total of all active and inactive participants | 2022-10-01 | 182 |
| Number of employers contributing to the scheme | 2022-10-01 | 0 |
| 2022: PREMIER MEDICAL ASSOCIATES 2022 form 5500 responses | ||
|---|---|---|
| 2022-10-01 | Type of plan entity | Single employer plan |
| 2022-10-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2022-10-01 | Plan funding arrangement – Insurance | Yes |
| 2022-10-01 | Plan benefit arrangement – Insurance | Yes |
| BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 ) | |||||||||||||||||||||||||||||||||
| Policy contract number | K2665 | ||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||
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| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) | |||||||||||||||||||||||||||||||||
| Policy contract number | 170619 | ||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||
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