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HOCKING ATHENS PERRY COMMUNITY ACTION AGENCY, INC. VISION CARE PLAN 401k Plan overview

Plan NameHOCKING ATHENS PERRY COMMUNITY ACTION AGENCY, INC. VISION CARE PLAN
Plan identification number 504

HOCKING ATHENS PERRY COMMUNITY ACTION AGENCY, INC. VISION CARE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Vision

401k Sponsoring company profile

HOCKING.ATHENS.PERRY COMMUNITY ACTION has sponsored the creation of one or more 401k plans.

Company Name:HOCKING.ATHENS.PERRY COMMUNITY ACTION
Employer identification number (EIN):310718322
NAIC Classification:624100
NAIC Description: Individual and Family Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HOCKING ATHENS PERRY COMMUNITY ACTION AGENCY, INC. VISION CARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5042018-04-01MARY ANNE KIELISZEWSKI
5042017-04-01MARY ANNE KIELISZEWSKI
5042016-04-01MARY ANNE KIELISZEWSKI
5042015-04-01MARY ANNE KIELISZEWSKI
5042014-04-01
5042013-04-01
5042012-04-01MARY ANNE KIELISZEWSKI, MBA
5042011-04-01MARY ANNE KIELISZEWSKI, MBA

Plan Statistics for HOCKING ATHENS PERRY COMMUNITY ACTION AGENCY, INC. VISION CARE PLAN

401k plan membership statisitcs for HOCKING ATHENS PERRY COMMUNITY ACTION AGENCY, INC. VISION CARE PLAN

Measure Date Value
2018: HOCKING ATHENS PERRY COMMUNITY ACTION AGENCY, INC. VISION CARE PLAN 2018 401k membership
Total participants, beginning-of-year2018-04-01162
Total number of active participants reported on line 7a of the Form 55002018-04-010
Number of retired or separated participants receiving benefits2018-04-010
Number of other retired or separated participants entitled to future benefits2018-04-010
Total of all active and inactive participants2018-04-010
2017: HOCKING ATHENS PERRY COMMUNITY ACTION AGENCY, INC. VISION CARE PLAN 2017 401k membership
Total participants, beginning-of-year2017-04-01145
Total number of active participants reported on line 7a of the Form 55002017-04-01163
Number of retired or separated participants receiving benefits2017-04-010
Number of other retired or separated participants entitled to future benefits2017-04-010
Total of all active and inactive participants2017-04-01163
2016: HOCKING ATHENS PERRY COMMUNITY ACTION AGENCY, INC. VISION CARE PLAN 2016 401k membership
Total participants, beginning-of-year2016-04-01146
Total number of active participants reported on line 7a of the Form 55002016-04-01147
Number of retired or separated participants receiving benefits2016-04-010
Number of other retired or separated participants entitled to future benefits2016-04-010
Total of all active and inactive participants2016-04-01147
2015: HOCKING ATHENS PERRY COMMUNITY ACTION AGENCY, INC. VISION CARE PLAN 2015 401k membership
Total participants, beginning-of-year2015-04-01146
Total number of active participants reported on line 7a of the Form 55002015-04-01149
Number of retired or separated participants receiving benefits2015-04-010
Number of other retired or separated participants entitled to future benefits2015-04-010
Total of all active and inactive participants2015-04-01149
2014: HOCKING ATHENS PERRY COMMUNITY ACTION AGENCY, INC. VISION CARE PLAN 2014 401k membership
Total participants, beginning-of-year2014-04-01146
Total number of active participants reported on line 7a of the Form 55002014-04-01133
Total of all active and inactive participants2014-04-01133
2013: HOCKING ATHENS PERRY COMMUNITY ACTION AGENCY, INC. VISION CARE PLAN 2013 401k membership
Total participants, beginning-of-year2013-04-01194
Total number of active participants reported on line 7a of the Form 55002013-04-01146
Total of all active and inactive participants2013-04-01146
2012: HOCKING ATHENS PERRY COMMUNITY ACTION AGENCY, INC. VISION CARE PLAN 2012 401k membership
Total participants, beginning-of-year2012-04-01166
Total number of active participants reported on line 7a of the Form 55002012-04-01194
Total of all active and inactive participants2012-04-01194
2011: HOCKING ATHENS PERRY COMMUNITY ACTION AGENCY, INC. VISION CARE PLAN 2011 401k membership
Total participants, beginning-of-year2011-04-01171
Total number of active participants reported on line 7a of the Form 55002011-04-01155
Total of all active and inactive participants2011-04-01155

Form 5500 Responses for HOCKING ATHENS PERRY COMMUNITY ACTION AGENCY, INC. VISION CARE PLAN

2018: HOCKING ATHENS PERRY COMMUNITY ACTION AGENCY, INC. VISION CARE PLAN 2018 form 5500 responses
2018-04-01Type of plan entitySingle employer plan
2018-04-01Submission has been amendedNo
2018-04-01This submission is the final filingYes
2018-04-01This return/report is a short plan year return/report (less than 12 months)No
2018-04-01Plan is a collectively bargained planNo
2018-04-01Plan funding arrangement – InsuranceYes
2018-04-01Plan benefit arrangement – InsuranceYes
2017: HOCKING ATHENS PERRY COMMUNITY ACTION AGENCY, INC. VISION CARE PLAN 2017 form 5500 responses
2017-04-01Type of plan entitySingle employer plan
2017-04-01Submission has been amendedNo
2017-04-01This submission is the final filingNo
2017-04-01This return/report is a short plan year return/report (less than 12 months)No
2017-04-01Plan is a collectively bargained planNo
2017-04-01Plan funding arrangement – InsuranceYes
2017-04-01Plan benefit arrangement – InsuranceYes
2016: HOCKING ATHENS PERRY COMMUNITY ACTION AGENCY, INC. VISION CARE PLAN 2016 form 5500 responses
2016-04-01Type of plan entitySingle employer plan
2016-04-01Submission has been amendedNo
2016-04-01This submission is the final filingNo
2016-04-01This return/report is a short plan year return/report (less than 12 months)No
2016-04-01Plan is a collectively bargained planNo
2016-04-01Plan funding arrangement – InsuranceYes
2016-04-01Plan benefit arrangement – InsuranceYes
2015: HOCKING ATHENS PERRY COMMUNITY ACTION AGENCY, INC. VISION CARE PLAN 2015 form 5500 responses
2015-04-01Type of plan entitySingle employer plan
2015-04-01Submission has been amendedNo
2015-04-01This submission is the final filingNo
2015-04-01This return/report is a short plan year return/report (less than 12 months)No
2015-04-01Plan is a collectively bargained planNo
2015-04-01Plan funding arrangement – InsuranceYes
2015-04-01Plan benefit arrangement – InsuranceYes
2014: HOCKING ATHENS PERRY COMMUNITY ACTION AGENCY, INC. VISION CARE PLAN 2014 form 5500 responses
2014-04-01Type of plan entitySingle employer plan
2014-04-01Plan funding arrangement – InsuranceYes
2014-04-01Plan benefit arrangement – InsuranceYes
2013: HOCKING ATHENS PERRY COMMUNITY ACTION AGENCY, INC. VISION CARE PLAN 2013 form 5500 responses
2013-04-01Type of plan entitySingle employer plan
2013-04-01Plan funding arrangement – InsuranceYes
2013-04-01Plan benefit arrangement – InsuranceYes
2012: HOCKING ATHENS PERRY COMMUNITY ACTION AGENCY, INC. VISION CARE PLAN 2012 form 5500 responses
2012-04-01Type of plan entitySingle employer plan
2012-04-01Plan funding arrangement – InsuranceYes
2012-04-01Plan benefit arrangement – InsuranceYes
2011: HOCKING ATHENS PERRY COMMUNITY ACTION AGENCY, INC. VISION CARE PLAN 2011 form 5500 responses
2011-04-01Type of plan entitySingle employer plan
2011-04-01Plan funding arrangement – InsuranceYes
2011-04-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30019454
Policy instance 1
Insurance contract or identification number30019454
Number of Individuals Covered186
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $1,321
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
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 $26,636
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,321
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 )
Policy contract number30019454
Policy instance 1
Insurance contract or identification number30019454
Number of Individuals Covered146
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $1,199
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
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 $22,880
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,199
Insurance broker organization code?3
Insurance broker nameSOUTHEAST PLANNING ASSOCIATES INC.
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 )
Policy contract number30019454
Policy instance 1
Insurance contract or identification number30019454
Number of Individuals Covered140
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $1,095
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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 BenefitYes
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 $19,682
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,095
Insurance broker organization code?3
Insurance broker nameSOUTHEAST PLANNING ASSOCIATES INC.
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 )
Policy contract number30019454
Policy instance 1
Insurance contract or identification number30019454
Number of Individuals Covered133
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $1,094
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,109
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,094
Insurance broker organization code?3
Insurance broker nameSOUTHEAST PLANNING ASSOCIATES INC.
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 )
Policy contract number30019454
Policy instance 1
Insurance contract or identification number30019454
Number of Individuals Covered146
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $1,189
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,772
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,189
Insurance broker organization code?3
Insurance broker nameSOUTHEAST PLANNING ASSOCIATES INC.
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 )
Policy contract number30019454
Policy instance 1
Insurance contract or identification number30019454
Number of Individuals Covered194
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $1,149
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,438
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,149
Insurance broker organization code?3
Insurance broker nameSOUTHEAST PLANNING ASSOCIATES INC.
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 )
Policy contract number30019454
Policy instance 1
Insurance contract or identification number30019454
Number of Individuals Covered166
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $1,148
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $21,402
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 )
Policy contract number30019454
Policy instance 1
Insurance contract or identification number30019454
Number of Individuals Covered171
Insurance policy start date2010-04-01
Insurance policy end date2011-03-31
Total amount of commissions paid to insurance brokerUSD $1,000
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $23,225
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,000
Insurance broker organization code?3
Insurance broker nameDANIEL STYPULA

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