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| Plan Name | WEST TEXAS EYECARE 401(K) PLAN |
| Plan identification number | 002 |
| 401k Plan Type | Defined Contribution Pension |
| Plan Features/Benefits |
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| Company Name: | WEST TEXAS EYECARE |
| Employer identification number (EIN): | 453073035 |
| NAIC Classification: | 621320 |
| NAIC Description: | Offices of Optometrists |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 002 | 2022-01-01 | HULON H. PASS, O.D. | 2023-10-03 | HULON H. PASS, O.D. | 2023-10-03 |
| 002 | 2021-01-01 | HULON H. PASS, O.D. | 2022-09-28 | HULON H. PASS, O.D. | 2022-09-28 |
| 002 | 2020-01-01 | HULON H. PASS, O.D. | 2021-10-05 | HULON H. PASS, O.D. | 2021-10-05 |
| 002 | 2019-01-01 | HULON H. PASS, O.D. | 2020-09-28 | HULON H. PASS, O.D. | 2020-09-28 |
| 002 | 2018-01-01 | HULON H. PASS, O.D. | 2019-09-16 | HULON H. PASS, O.D. | 2019-09-16 |
| 002 | 2017-01-01 | HULON H. PASS, O.D. | 2018-09-13 | HULON H. PASS, O.D. | 2018-09-13 |
| 002 | 2016-01-01 | HULON H. PASS, O.D. | 2017-09-19 | HULON H. PASS, O.D. | 2017-09-19 |
| 002 | 2015-01-01 | HULON H. PASS, O.D. | 2016-08-05 | HULON H. PASS, O.D. | 2016-08-05 |
| 002 | 2014-01-01 | HULON H. PASS, O.D. | 2015-07-30 | HULON H. PASS, O.D. | 2015-07-30 |
| 002 | 2013-01-01 | HULON H. PASS, O.D. | 2014-09-08 | HULON H. PASS, O.D. | 2014-09-08 |
| 002 | 2012-01-01 | HULON H. PASS, O.D. | HULON H. PASS, O.D. | 2013-10-09 |
| Measure | Date | Value |
|---|---|---|
| 2012: WEST TEXAS EYECARE 401(K) PLAN 2012 401k membership | ||
| Total participants, beginning-of-year | 2012-01-01 | 12 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 5 |
| Number of retired or separated participants receiving benefits | 2012-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2012-01-01 | 6 |
| Total of all active and inactive participants | 2012-01-01 | 11 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2012-01-01 | 0 |
| Total participants | 2012-01-01 | 11 |
| Number of participants with account balances | 2012-01-01 | 11 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2012-01-01 | 1 |
| Measure | Date | Value |
|---|---|---|
| 2012 : WEST TEXAS EYECARE 401(K) PLAN 2012 401k financial data | ||
| Total income from all sources | 2012-12-31 | $211,598 |
| Expenses. Total of all expenses incurred | 2012-12-31 | $16,281 |
| Benefits paid (including direct rollovers) | 2012-12-31 | $16,281 |
| Total plan assets at end of year | 2012-12-31 | $1,041,786 |
| Total plan assets at beginning of year | 2012-12-31 | $846,469 |
| Total contributions received or receivable from participants | 2012-12-31 | $41,636 |
| Other income received | 2012-12-31 | $119,894 |
| Net income (gross income less expenses) | 2012-12-31 | $195,317 |
| Net plan assets at end of year (total assets less liabilities) | 2012-12-31 | $1,041,786 |
| Net plan assets at beginning of year (total assets less liabilities) | 2012-12-31 | $846,469 |
| Total contributions received or receivable from employer(s) | 2012-12-31 | $50,068 |
| 2012: WEST TEXAS EYECARE 401(K) PLAN 2012 form 5500 responses | ||
|---|---|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Submission has been amended | No |
| 2012-01-01 | This submission is the final filing | No |
| 2012-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-01-01 | Plan is a collectively bargained plan | No |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan funding arrangement – Trust | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement - Trust | Yes |
| NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | GAP-B0CU0C | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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