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BUCKS-MONT EYE ASSOCIATES, PC GROUP HEALTH PLAN (501) 401k Plan overview

Plan NameBUCKS-MONT EYE ASSOCIATES, PC GROUP HEALTH PLAN (501)
Plan identification number 501

BUCKS-MONT EYE ASSOCIATES, PC GROUP HEALTH PLAN (501) Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)

401k Sponsoring company profile

BUCKS-MONT EYE ASSOCIATES, PC has sponsored the creation of one or more 401k plans.

Company Name:BUCKS-MONT EYE ASSOCIATES, PC
Employer identification number (EIN):233071575
NAIC Classification:621399
NAIC Description:Offices of All Other Miscellaneous Health Practitioners

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BUCKS-MONT EYE ASSOCIATES, PC GROUP HEALTH PLAN (501)

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01
5012021-01-01
5012020-01-01
5012019-01-01
5012018-03-01J STEVEN ROBINSON OD

Plan Statistics for BUCKS-MONT EYE ASSOCIATES, PC GROUP HEALTH PLAN (501)

401k plan membership statisitcs for BUCKS-MONT EYE ASSOCIATES, PC GROUP HEALTH PLAN (501)

Measure Date Value
2022: BUCKS-MONT EYE ASSOCIATES, PC GROUP HEALTH PLAN (501) 2022 401k membership
Total participants, beginning-of-year2022-01-0128
Total number of active participants reported on line 7a of the Form 55002022-01-0125
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-0125
2021: BUCKS-MONT EYE ASSOCIATES, PC GROUP HEALTH PLAN (501) 2021 401k membership
Total participants, beginning-of-year2021-01-0132
Total number of active participants reported on line 7a of the Form 55002021-01-0128
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-0128
2020: BUCKS-MONT EYE ASSOCIATES, PC GROUP HEALTH PLAN (501) 2020 401k membership
Total participants, beginning-of-year2020-01-0124
Total number of active participants reported on line 7a of the Form 55002020-01-0132
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-0132
2019: BUCKS-MONT EYE ASSOCIATES, PC GROUP HEALTH PLAN (501) 2019 401k membership
Total participants, beginning-of-year2019-01-0133
Total number of active participants reported on line 7a of the Form 55002019-01-0124
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-0124
2018: BUCKS-MONT EYE ASSOCIATES, PC GROUP HEALTH PLAN (501) 2018 401k membership
Total participants, beginning-of-year2018-03-0135
Total number of active participants reported on line 7a of the Form 55002018-03-0133
Number of retired or separated participants receiving benefits2018-03-010
Number of other retired or separated participants entitled to future benefits2018-03-010
Total of all active and inactive participants2018-03-0133

Financial Data on BUCKS-MONT EYE ASSOCIATES, PC GROUP HEALTH PLAN (501)

Measure Date Value
2022 : BUCKS-MONT EYE ASSOCIATES, PC GROUP HEALTH PLAN (501) 2022 401k financial data
Total plan liabilities at end of year2022-12-31$22,685
Total plan liabilities at beginning of year2022-12-31$37,169
Total income from all sources2022-12-31$350,887
Expenses. Total of all expenses incurred2022-12-31$323,804
Benefits paid (including direct rollovers)2022-12-31$180,197
Total plan assets at end of year2022-12-31$12,599
Total plan assets at beginning of year2022-12-31$0
Value of fidelity bond covering the plan2022-12-31$500,000
Total contributions received or receivable from participants2022-12-31$40,617
Expenses. Other expenses not covered elsewhere2022-12-31$130,676
Contributions received from other sources (not participants or employers)2022-12-31$0
Other income received2022-12-31$0
Noncash contributions received2022-12-31$0
Net income (gross income less expenses)2022-12-31$27,083
Net plan assets at end of year (total assets less liabilities)2022-12-31$-10,086
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$-37,169
Total contributions received or receivable from employer(s)2022-12-31$310,270
Value of certain deemed distributions of participant loans2022-12-31$0
Value of corrective distributions2022-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2022-12-31$12,931
2021 : BUCKS-MONT EYE ASSOCIATES, PC GROUP HEALTH PLAN (501) 2021 401k financial data
Total plan liabilities at end of year2021-12-31$37,169
Total plan liabilities at beginning of year2021-12-31$25,668
Total income from all sources2021-12-31$338,663
Expenses. Total of all expenses incurred2021-12-31$360,177
Benefits paid (including direct rollovers)2021-12-31$222,615
Total plan assets at end of year2021-12-31$0
Total plan assets at beginning of year2021-12-31$10,013
Value of fidelity bond covering the plan2021-12-31$500,000
Total contributions received or receivable from participants2021-12-31$42,802
Expenses. Other expenses not covered elsewhere2021-12-31$124,006
Contributions received from other sources (not participants or employers)2021-12-31$4,548
Net income (gross income less expenses)2021-12-31$-21,514
Net plan assets at end of year (total assets less liabilities)2021-12-31$-37,169
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$-15,655
Total contributions received or receivable from employer(s)2021-12-31$291,313
Expenses. Administrative service providers (salaries,fees and commissions)2021-12-31$13,556
2020 : BUCKS-MONT EYE ASSOCIATES, PC GROUP HEALTH PLAN (501) 2020 401k financial data
Total plan liabilities at end of year2020-12-31$25,668
Total plan liabilities at beginning of year2020-12-31$23,302
Total income from all sources2020-12-31$392,508
Expenses. Total of all expenses incurred2020-12-31$366,474
Benefits paid (including direct rollovers)2020-12-31$213,682
Total plan assets at end of year2020-12-31$10,013
Total plan assets at beginning of year2020-12-31$-18,387
Value of fidelity bond covering the plan2020-12-31$500,000
Total contributions received or receivable from participants2020-12-31$0
Expenses. Other expenses not covered elsewhere2020-12-31$137,359
Contributions received from other sources (not participants or employers)2020-12-31$0
Other income received2020-12-31$0
Net income (gross income less expenses)2020-12-31$26,034
Net plan assets at end of year (total assets less liabilities)2020-12-31$-15,655
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$-41,689
Total contributions received or receivable from employer(s)2020-12-31$392,508
Value of corrective distributions2020-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$15,433
2019 : BUCKS-MONT EYE ASSOCIATES, PC GROUP HEALTH PLAN (501) 2019 401k financial data
Total plan liabilities at end of year2019-12-31$41,688
Total plan liabilities at beginning of year2019-12-31$0
Total income from all sources2019-12-31$316,505
Expenses. Total of all expenses incurred2019-12-31$382,160
Benefits paid (including direct rollovers)2019-12-31$252,964
Total plan assets at end of year2019-12-31$0
Total plan assets at beginning of year2019-12-31$23,967
Value of fidelity bond covering the plan2019-12-31$500,000
Total contributions received or receivable from participants2019-12-31$15,798
Expenses. Other expenses not covered elsewhere2019-12-31$113,838
Net income (gross income less expenses)2019-12-31$-65,655
Net plan assets at end of year (total assets less liabilities)2019-12-31$-41,688
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$23,967
Total contributions received or receivable from employer(s)2019-12-31$300,707
Value of corrective distributions2019-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$15,358
2018 : BUCKS-MONT EYE ASSOCIATES, PC GROUP HEALTH PLAN (501) 2018 401k financial data
Total plan liabilities at end of year2018-12-31$0
Total income from all sources2018-12-31$298,350
Expenses. Total of all expenses incurred2018-12-31$274,383
Benefits paid (including direct rollovers)2018-12-31$153,605
Total plan assets at end of year2018-12-31$23,967
Value of fidelity bond covering the plan2018-12-31$500,000
Total contributions received or receivable from participants2018-12-31$30,607
Expenses. Other expenses not covered elsewhere2018-12-31$108,086
Contributions received from other sources (not participants or employers)2018-12-31$0
Net income (gross income less expenses)2018-12-31$23,967
Net plan assets at end of year (total assets less liabilities)2018-12-31$23,967
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$0
Total contributions received or receivable from employer(s)2018-12-31$267,743
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$12,692

Form 5500 Responses for BUCKS-MONT EYE ASSOCIATES, PC GROUP HEALTH PLAN (501)

2022: BUCKS-MONT EYE ASSOCIATES, PC GROUP HEALTH PLAN (501) 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: BUCKS-MONT EYE ASSOCIATES, PC GROUP HEALTH PLAN (501) 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: BUCKS-MONT EYE ASSOCIATES, PC GROUP HEALTH PLAN (501) 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: BUCKS-MONT EYE ASSOCIATES, PC GROUP HEALTH PLAN (501) 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: BUCKS-MONT EYE ASSOCIATES, PC GROUP HEALTH PLAN (501) 2018 form 5500 responses
2018-03-01Type of plan entitySingle employer plan
2018-03-01First time form 5500 has been submittedYes
2018-03-01Submission has been amendedNo
2018-03-01This submission is the final filingNo
2018-03-01This return/report is a short plan year return/report (less than 12 months)Yes
2018-03-01Plan is a collectively bargained planNo
2018-03-01Plan funding arrangement – InsuranceYes
2018-03-01Plan funding arrangement – TrustYes
2018-03-01Plan benefit arrangement – InsuranceYes
2018-03-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number30500355
Policy instance 1
Insurance contract or identification number30500355
Number of Individuals Covered25
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $109,052
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number30500355
Policy instance 1
Insurance contract or identification number30500355
Number of Individuals Covered28
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $101,115
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number30500355
Policy instance 1
Insurance contract or identification number30500355
Number of Individuals Covered32
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $111,206
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberVERIS
Policy instance 1
Insurance contract or identification numberVERIS
Number of Individuals Covered24
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $97,368
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract numberVERIS
Policy instance 1
Insurance contract or identification numberVERIS
Number of Individuals Covered33
Insurance policy start date2018-03-01
Insurance policy end date2018-12-31
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $73,995
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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