| Plan Name | THE OPEN DOOR NETWORK BENEFIT PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | THE OPEN DOOR NETWORK |
| Employer identification number (EIN): | 953604240 |
| NAIC Classification: | 624200 |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2023-12-01 | KATHERINE GOMEZ | |||
| 501 | 2022-12-01 | KATHERINE GOMEZ | 2024-08-13 | KATHERINE GOMEZ | 2024-08-13 |
| 501 | 2021-12-01 | KATHERINE GOMEZ | 2023-04-24 | KATHERINE GOMEZ | 2023-04-24 |
| Measure | Date | Value |
|---|---|---|
| 2022: THE OPEN DOOR NETWORK BENEFIT PLAN 2022 401k membership | ||
| Total participants, beginning-of-year | 2022-12-01 | 165 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-12-01 | 190 |
| Total of all active and inactive participants | 2022-12-01 | 190 |
| 2021: THE OPEN DOOR NETWORK BENEFIT PLAN 2021 401k membership | ||
| Total participants, beginning-of-year | 2021-12-01 | 0 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-12-01 | 165 |
| Total of all active and inactive participants | 2021-12-01 | 165 |
| 2022: THE OPEN DOOR NETWORK BENEFIT PLAN 2022 form 5500 responses | ||
|---|---|---|
| 2022-12-01 | Type of plan entity | Single employer plan |
| 2022-12-01 | Plan funding arrangement – Insurance | Yes |
| 2022-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: THE OPEN DOOR NETWORK BENEFIT PLAN 2021 form 5500 responses | ||
| 2021-12-01 | Type of plan entity | Single employer plan |
| 2021-12-01 | First time form 5500 has been submitted | Yes |
| 2021-12-01 | Plan funding arrangement – Insurance | Yes |
| 2021-12-01 | Plan benefit arrangement – Insurance | Yes |
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) | |
| Policy contract number | 10204391001 |
| Policy instance | 10 |
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) | |
| Policy contract number | 10204391001 |
| Policy instance | 9 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) | |
| Policy contract number | 71366 |
| Policy instance | 8 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) | |
| Policy contract number | 71366 |
| Policy instance | 7 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) | |
| Policy contract number | 71366 |
| Policy instance | 6 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) | |
| Policy contract number | 71366 |
| Policy instance | 5 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) | |
| Policy contract number | 71366 |
| Policy instance | 4 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) | |
| Policy contract number | 71366 |
| Policy instance | 3 |
| PREMIER ACCESS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60237 ) | |
| Policy contract number | 18703 |
| Policy instance | 2 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 298168 |
| Policy instance | 1 |
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) | |
| Policy contract number | 10204391001 |
| Policy instance | 4 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |
| Policy contract number | |
| Policy instance | 3 |
| PREMIER ACCESS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60237 ) | |
| Policy contract number | 18703 |
| Policy instance | 2 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 298168 |
| Policy instance | 1 |