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NORTHERN VISION EYE CARE, P.C. 401(K) PLAN 401k Plan overview

Plan NameNORTHERN VISION EYE CARE, P.C. 401(K) PLAN
Plan identification number 001

NORTHERN VISION EYE CARE, P.C. 401(K) PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

NORTHERN VISION EYE CARE, P.C. has sponsored the creation of one or more 401k plans.

Company Name:NORTHERN VISION EYE CARE, P.C.
Employer identification number (EIN):383383909
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NORTHERN VISION EYE CARE, P.C. 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012021-01-01ERIN HOWE2021-09-29
0012020-01-01ROBERT K BUTRYN2021-07-21
0012019-01-01ROBERT K BUTRYN2020-07-29
0012018-01-01ROBERT K BUTRYN2019-09-10
0012017-01-01
0012016-01-01
0012015-01-01
0012014-01-01ROBERT K BUTRYN2015-10-14
0012013-01-01
0012012-01-01PAMELA LAWRIE AS PRACTITIONER2013-10-07
0012011-01-01PAMELA LAWRIE AS PRACTITIONER2012-08-23
0012010-01-01ROBERT BUTRYN2011-09-26

Plan Statistics for NORTHERN VISION EYE CARE, P.C. 401(K) PLAN

401k plan membership statisitcs for NORTHERN VISION EYE CARE, P.C. 401(K) PLAN

Measure Date Value
2021: NORTHERN VISION EYE CARE, P.C. 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-0116
Total number of active participants reported on line 7a of the Form 55002021-01-010
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 participants2021-01-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-010
Number of participants with account balances2021-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: NORTHERN VISION EYE CARE, P.C. 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-0116
Total number of active participants reported on line 7a of the Form 55002020-01-018
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-018
Total of all active and inactive participants2020-01-0116
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-0116
Number of participants with account balances2020-01-0115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: NORTHERN VISION EYE CARE, P.C. 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-0116
Total number of active participants reported on line 7a of the Form 55002019-01-0114
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-012
Total of all active and inactive participants2019-01-0116
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-0116
Number of participants with account balances2019-01-0115
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: NORTHERN VISION EYE CARE, P.C. 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-0113
Total number of active participants reported on line 7a of the Form 55002018-01-0113
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-011
Total of all active and inactive participants2018-01-0114
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-0114
Number of participants with account balances2018-01-0114
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: NORTHERN VISION EYE CARE, P.C. 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0114
Total number of active participants reported on line 7a of the Form 55002017-01-0110
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-012
Total of all active and inactive participants2017-01-0112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-0112
Number of participants with account balances2017-01-0112
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: NORTHERN VISION EYE CARE, P.C. 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0111
Total number of active participants reported on line 7a of the Form 55002016-01-019
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-012
Total of all active and inactive participants2016-01-0111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-0111
Number of participants with account balances2016-01-0111
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010

Financial Data on NORTHERN VISION EYE CARE, P.C. 401(K) PLAN

Measure Date Value
2021 : NORTHERN VISION EYE CARE, P.C. 401(K) PLAN 2021 401k financial data
Total income from all sources2021-09-15$76,101
Expenses. Total of all expenses incurred2021-09-15$617,968
Benefits paid (including direct rollovers)2021-09-15$617,968
Total plan assets at end of year2021-09-15$0
Total plan assets at beginning of year2021-09-15$541,867
Value of fidelity bond covering the plan2021-09-15$100,000
Total contributions received or receivable from participants2021-09-15$14,305
Other income received2021-09-15$59,233
Net income (gross income less expenses)2021-09-15$-541,867
Net plan assets at end of year (total assets less liabilities)2021-09-15$0
Net plan assets at beginning of year (total assets less liabilities)2021-09-15$541,867
Total contributions received or receivable from employer(s)2021-09-15$2,563
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-09-15$0
2020 : NORTHERN VISION EYE CARE, P.C. 401(K) PLAN 2020 401k financial data
Total income from all sources2020-12-31$117,513
Expenses. Total of all expenses incurred2020-12-31$10,423
Benefits paid (including direct rollovers)2020-12-31$10,423
Total plan assets at end of year2020-12-31$541,867
Total plan assets at beginning of year2020-12-31$434,777
Value of fidelity bond covering the plan2020-12-31$100,000
Total contributions received or receivable from participants2020-12-31$15,784
Other income received2020-12-31$95,200
Net income (gross income less expenses)2020-12-31$107,090
Net plan assets at end of year (total assets less liabilities)2020-12-31$541,867
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$434,777
Total contributions received or receivable from employer(s)2020-12-31$6,529
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
2019 : NORTHERN VISION EYE CARE, P.C. 401(K) PLAN 2019 401k financial data
Total income from all sources2019-12-31$89,739
Expenses. Total of all expenses incurred2019-12-31$3,912
Benefits paid (including direct rollovers)2019-12-31$3,912
Total plan assets at end of year2019-12-31$434,777
Total plan assets at beginning of year2019-12-31$348,950
Value of fidelity bond covering the plan2019-12-31$100,000
Total contributions received or receivable from participants2019-12-31$25,591
Other income received2019-12-31$51,623
Net income (gross income less expenses)2019-12-31$85,827
Net plan assets at end of year (total assets less liabilities)2019-12-31$434,777
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$348,950
Total contributions received or receivable from employer(s)2019-12-31$12,525
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
2018 : NORTHERN VISION EYE CARE, P.C. 401(K) PLAN 2018 401k financial data
Total income from all sources2018-12-31$14,661
Expenses. Total of all expenses incurred2018-12-31$5,237
Benefits paid (including direct rollovers)2018-12-31$5,237
Total plan assets at end of year2018-12-31$348,950
Total plan assets at beginning of year2018-12-31$339,526
Value of fidelity bond covering the plan2018-12-31$100,000
Total contributions received or receivable from participants2018-12-31$29,659
Other income received2018-12-31$-27,073
Net income (gross income less expenses)2018-12-31$9,424
Net plan assets at end of year (total assets less liabilities)2018-12-31$348,950
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$339,526
Total contributions received or receivable from employer(s)2018-12-31$12,075
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
2017 : NORTHERN VISION EYE CARE, P.C. 401(K) PLAN 2017 401k financial data
Total income from all sources2017-12-31$55,800
Expenses. Total of all expenses incurred2017-12-31$1,558
Benefits paid (including direct rollovers)2017-12-31$1,558
Total plan assets at end of year2017-12-31$339,526
Total plan assets at beginning of year2017-12-31$285,284
Value of fidelity bond covering the plan2017-12-31$100,000
Total contributions received or receivable from participants2017-12-31$31,833
Other income received2017-12-31$11,106
Net income (gross income less expenses)2017-12-31$54,242
Net plan assets at end of year (total assets less liabilities)2017-12-31$339,526
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$285,284
Total contributions received or receivable from employer(s)2017-12-31$12,861
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
2016 : NORTHERN VISION EYE CARE, P.C. 401(K) PLAN 2016 401k financial data
Total income from all sources2016-12-31$35,127
Expenses. Total of all expenses incurred2016-12-31$34,099
Benefits paid (including direct rollovers)2016-12-31$34,099
Total plan assets at end of year2016-12-31$285,284
Total plan assets at beginning of year2016-12-31$284,256
Value of fidelity bond covering the plan2016-12-31$100,000
Total contributions received or receivable from participants2016-12-31$7,477
Other income received2016-12-31$14,150
Net income (gross income less expenses)2016-12-31$1,028
Net plan assets at end of year (total assets less liabilities)2016-12-31$285,284
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$284,256
Total contributions received or receivable from employer(s)2016-12-31$13,500
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0

Form 5500 Responses for NORTHERN VISION EYE CARE, P.C. 401(K) PLAN

2021: NORTHERN VISION EYE CARE, P.C. 401(K) PLAN 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 filingYes
2021-01-01This return/report is a short plan year return/report (less than 12 months)Yes
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: NORTHERN VISION EYE CARE, P.C. 401(K) PLAN 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: NORTHERN VISION EYE CARE, P.C. 401(K) PLAN 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: NORTHERN VISION EYE CARE, P.C. 401(K) PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: NORTHERN VISION EYE CARE, P.C. 401(K) PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: NORTHERN VISION EYE CARE, P.C. 401(K) PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number65537
Policy instance 1
Insurance contract or identification number65537
Number of Individuals Covered0
Insurance policy start date2021-01-01
Insurance policy end date2021-09-15
Total amount of commissions paid to insurance brokerUSD $501
Total amount of fees paid to insurance companyUSD $1,300
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees1300
Additional information about fees paid to insurance brokerADMINISTRATION FEES
Insurance broker organization code?4
Commission paid to Insurance BrokerUSD $501
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number65537
Policy instance 1
Insurance contract or identification number65537
Number of Individuals Covered15
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $614
Total amount of fees paid to insurance companyUSD $300
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $614
Insurance broker organization code?3
Amount paid for insurance broker fees300
Additional information about fees paid to insurance brokerADMINISTRATION FEES
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number65537
Policy instance 1
Insurance contract or identification number65537
Number of Individuals Covered15
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $476
Total amount of fees paid to insurance companyUSD $200
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $476
Insurance broker organization code?3
Amount paid for insurance broker fees200
Additional information about fees paid to insurance brokerADMINISTRATION FEES
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number65537
Policy instance 1
Insurance contract or identification number65537
Number of Individuals Covered12
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $209
Total amount of fees paid to insurance companyUSD $125
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $208
Insurance broker organization code?3
Amount paid for insurance broker fees125
Additional information about fees paid to insurance brokerADMINISTRATION FEES
Insurance broker nameREHMANN FINANCIAL GROUP

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