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| Plan Name | ODA PRIMARY HEALTHCARE VOLUNTARY BENEFITS |
| Plan identification number | 505 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | ODA PRIMARY HEALTHCARE NETWORK, INC |
| Employer identification number (EIN): | 112329960 |
| NAIC Classification: | 621111 |
| NAIC Description: | Offices of Physicians (except Mental Health Specialists) |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 505 | 2021-01-01 | ESTHER FRIEDLAND | 2022-07-14 | ||
| 505 | 2020-01-01 | ESTHER FRIEDLAND | 2021-07-21 | ||
| 505 | 2020-01-01 | ESTHER FRIEDLAND | 2022-06-15 |
| Measure | Date | Value |
|---|---|---|
| 2021: ODA PRIMARY HEALTHCARE VOLUNTARY BENEFITS 2021 401k membership | ||
| Total participants, beginning-of-year | 2021-01-01 | 119 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 0 |
| 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 | 0 |
| Total of all active and inactive participants | 2021-01-01 | 0 |
| Number of employers contributing to the scheme | 2021-01-01 | 0 |
| 2020: ODA PRIMARY HEALTHCARE VOLUNTARY BENEFITS 2020 401k membership | ||
| Total participants, beginning-of-year | 2020-01-01 | 152 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 0 |
| 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 | 0 |
| Total of all active and inactive participants | 2020-01-01 | 0 |
| Number of employers contributing to the scheme | 2020-01-01 | 0 |
| 2021: ODA PRIMARY HEALTHCARE VOLUNTARY BENEFITS 2021 form 5500 responses | ||
|---|---|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | This submission is the final filing | Yes |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: ODA PRIMARY HEALTHCARE VOLUNTARY BENEFITS 2020 form 5500 responses | ||
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | First time form 5500 has been submitted | Yes |
| 2020-01-01 | Submission has been amended | Yes |
| 2020-01-01 | This submission is the final filing | Yes |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| THE PAUL REVERE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67598 ) | |
| Policy contract number | E5170485 |
| Policy instance | 1 |
| THE PAUL REVERE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67598 ) | |
| Policy contract number | E5170485 |
| Policy instance | 1 |
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