401k Plan data: METROPOLITAN VETERINARY ASSOCIATES, INC. EMPLOYEE BENEFITS PLAN plan

METROPOLITAN VETERINARY ASSOCIATES, INC. EMPLOYEE BENEFITS PLAN 401k Plan overview

Plan Name	METROPOLITAN VETERINARY ASSOCIATES, INC. EMPLOYEE BENEFITS PLAN
Plan identification number	501

METROPOLITAN VETERINARY ASSOCIATES, INC. EMPLOYEE BENEFITS PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Long-term disability cover Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

METROPOLITAN VETERINARY ASSOCIATES, INC. has sponsored the creation of one or more 401k plans.

Company Name: METROPOLITAN VETERINARY ASSOCIATES, INC.

Employer identification number (EIN): 232423356

NAIC Classification: 621399
NAIC Description: Offices of All Other Miscellaneous Health Practitioners

Form 5500 Filing Information

Submission information for form 5500 for 401k plan METROPOLITAN VETERINARY ASSOCIATES, INC. EMPLOYEE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2023-12-01 STACEY CONNELL 2024-10-07
501 2022-12-01 STACEY CONNELL 2024-08-15
501 2021-12-01 STACEY CONNELL 2023-04-21
501 2020-12-01 STACEY CONNELL 2022-05-02
501 2019-12-01 STACEY CONNELL 2021-03-08

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
501	2023-12-01	STACEY CONNELL	2024-10-07
501	2022-12-01	STACEY CONNELL	2024-08-15
501	2021-12-01	STACEY CONNELL	2023-04-21
501	2020-12-01	STACEY CONNELL	2022-05-02
501	2019-12-01	STACEY CONNELL	2021-03-08

Form 5500 Responses for METROPOLITAN VETERINARY ASSOCIATES, INC. EMPLOYEE BENEFITS PLAN

2023: METROPOLITAN VETERINARY ASSOCIATES, INC. EMPLOYEE BENEFITS PLAN 2023 form 5500 responses
2023-12-01	Type of plan entity	Single employer plan
2023-12-01	This submission is the final filing	Yes
2023-12-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2023-12-01	Plan funding arrangement – Insurance	Yes
2023-12-01	Plan benefit arrangement – Insurance	Yes
2022: METROPOLITAN VETERINARY ASSOCIATES, INC. EMPLOYEE BENEFITS 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: METROPOLITAN VETERINARY ASSOCIATES, INC. EMPLOYEE BENEFITS PLAN 2021 form 5500 responses
2021-12-01	Type of plan entity	Single employer plan
2021-12-01	Plan funding arrangement – Insurance	Yes
2021-12-01	Plan benefit arrangement – Insurance	Yes
2020: METROPOLITAN VETERINARY ASSOCIATES, INC. EMPLOYEE BENEFITS PLAN 2020 form 5500 responses
2020-12-01	Type of plan entity	Single employer plan
2020-12-01	Plan funding arrangement – Insurance	Yes
2020-12-01	Plan benefit arrangement – Insurance	Yes
2019: METROPOLITAN VETERINARY ASSOCIATES, INC. EMPLOYEE BENEFITS PLAN 2019 form 5500 responses
2019-12-01	Type of plan entity	Single employer plan
2019-12-01	First time form 5500 has been submitted	Yes
2019-12-01	Plan funding arrangement – Insurance	Yes
2019-12-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )

Policy contract number

A16683-099

Policy instance

Insurance contract or identification number	A16683-099
Number of Individuals Covered	180
Insurance policy start date	2023-12-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $694
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $5,431
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 93688 )

Policy contract number

8360

Policy instance

Insurance contract or identification number	8360
Number of Individuals Covered	131
Insurance policy start date	2023-12-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $2,829
Total amount of fees paid to insurance company	USD $4,286
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )

Policy contract number

936470

Policy instance

Insurance contract or identification number	936470
Number of Individuals Covered	33
Insurance policy start date	2023-12-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $951
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $4,760
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

UNITED CONCORDIA DENTAL PLANS OF PENNSYLVANIA, INC. (National Association of Insurance Commissioners NAIC id number: 47089 )

Policy contract number

A16683-199

Policy instance

Insurance contract or identification number	A16683-199
Number of Individuals Covered	17
Insurance policy start date	2023-12-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $35
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $304
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

28690

Policy instance

Insurance contract or identification number	28690
Number of Individuals Covered	131
Insurance policy start date	2023-12-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $75
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,347
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

CTX73

Policy instance

Insurance contract or identification number	CTX73
Number of Individuals Covered	10
Insurance policy start date	2023-12-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $182
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	ACCIDENT, CANCER
Welfare Benefit Premiums Paid to Carrier	USD $1,565
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

KEYSTONE HEALTH PLAN EAST (National Association of Insurance Commissioners NAIC id number: 95056 )

Policy contract number

8360

Policy instance

Insurance contract or identification number	8360
Number of Individuals Covered	84
Insurance policy start date	2023-12-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $2,468
Total amount of fees paid to insurance company	USD $1,436
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 93688 )

Policy contract number

8360

Policy instance

KEYSTONE HEALTH PLAN EAST (National Association of Insurance Commissioners NAIC id number: 95056 )

Policy contract number

8360

Policy instance

UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )

Policy contract number

A16683-000

Policy instance

UNITED CONCORDIA DENTAL PLANS OF PENNSYLVANIA, INC. (National Association of Insurance Commissioners NAIC id number: 47089 )

Policy contract number

A16683-001

Policy instance

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

28690

Policy instance

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

CTX73

Policy instance

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )

Policy contract number

936470

Policy instance

DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )

Policy contract number

F010922

Policy instance

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )

Policy contract number

936470

Policy instance

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

CTX73

Policy instance

DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )

Policy contract number

F010922

Policy instance

NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )

Policy contract number

28690

Policy instance

UNITED CONCORDIA DENTAL PLANS OF PENNSYLVANIA, INC. (National Association of Insurance Commissioners NAIC id number: 47089 )

Policy contract number

A16683-001

Policy instance

UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )

Policy contract number

A16683-000

Policy instance

KEYSTONE HEALTH PLAN EAST (National Association of Insurance Commissioners NAIC id number: 95056 )

Policy contract number

8360

Policy instance

INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 93688 )

Policy contract number

8360

Policy instance

INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 93688 )

Policy contract number

8360

Policy instance

KEYSTONE HEALTH PLAN EAST (National Association of Insurance Commissioners NAIC id number: 95056 )

Policy contract number

8360

Policy instance

UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )

Policy contract number

A16683-000

Policy instance

UNITED CONCORDIA DENTAL PLANS OF PENNSYLVANIA, INC. (National Association of Insurance Commissioners NAIC id number: 47089 )

Policy contract number

A16683-001

Policy instance

NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )

Policy contract number

28690

Policy instance

DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )

Policy contract number

F010922

Policy instance

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

CTX73

Policy instance

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )

Policy contract number

936470

Policy instance

KEYSTONE HEALTH PLAN EAST (National Association of Insurance Commissioners NAIC id number: 95056 )

Policy contract number

10103992

Policy instance

UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )

Policy contract number

A16683-000

Policy instance

UNITED CONCORDIA DENTAL PLANS OF PENNSYLVANIA, INC. (National Association of Insurance Commissioners NAIC id number: 47089 )

Policy contract number

A16683-001

Policy instance

NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )

Policy contract number

28690

Policy instance

DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )

Policy contract number

F010922

Policy instance

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

CTX73

Policy instance

INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 93688 )

Policy contract number

10103990

Policy instance

Potentially related plans

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Company Name:	METROPOLITAN VETERINARY ASSOCIATES, INC.
Employer identification number (EIN):	232423356
NAIC Classification:	621399
NAIC Description:	Offices of All Other Miscellaneous Health Practitioners