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| Plan Name | PCP URGENT CARE HOLDINGS, LLC DBA PATIENT PLUS URGENT CARE EMPLOYEE BENEFIT PLAN & TRUST |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | PCP URGENT CARE HOLDINGS, LLC |
| Employer identification number (EIN): | 300876536 |
| 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 |
|---|---|---|---|---|---|
| 501 | 2021-12-01 |
| Measure | Date | Value |
|---|---|---|
| 2021: PCP URGENT CARE HOLDINGS, LLC DBA PATIENT PLUS URGENT CARE EMPLOYEE BENEFIT PLAN & TRUST 2021 401k membership | ||
| Total participants, beginning-of-year | 2021-12-01 | 62 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-12-01 | 54 |
| Total of all active and inactive participants | 2021-12-01 | 54 |
| Measure | Date | Value |
|---|---|---|
| 2022 : PCP URGENT CARE HOLDINGS, LLC DBA PATIENT PLUS URGENT CARE EMPLOYEE BENEFIT PLAN & TRUST 2022 401k financial data | ||
| Total plan liabilities at end of year | 2022-11-30 | $147 |
| Total income from all sources | 2022-11-30 | $445,324 |
| Expenses. Total of all expenses incurred | 2022-11-30 | $445,471 |
| Benefits paid (including direct rollovers) | 2022-11-30 | $355,159 |
| Expenses. Other expenses not covered elsewhere | 2022-11-30 | $90,312 |
| Net income (gross income less expenses) | 2022-11-30 | $-147 |
| Net plan assets at end of year (total assets less liabilities) | 2022-11-30 | $-147 |
| Total contributions received or receivable from employer(s) | 2022-11-30 | $445,324 |
| 2021: PCP URGENT CARE HOLDINGS, LLC DBA PATIENT PLUS URGENT CARE EMPLOYEE BENEFIT PLAN & TRUST 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 funding arrangement – Trust | Yes |
| 2021-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-12-01 | Plan benefit arrangement - Trust | Yes |
| VERITY HEALTHNET (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||||
| Policy contract number | NOT AVAILABLE | ||||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||||
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