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Plan Name | CLARKSON OPTOMETRY EMPLOYEE HEALTH & WELFARE BENEFITS PLAN |
Plan identification number | 501 |
401k Plan Type | Welfare Benefit |
Plan Features/Benefits |
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Company Name: | CLARKSON OPTOMETRY, INC. |
Employer identification number (EIN): | 464956595 |
NAIC Classification: | 446130 |
NAIC Description: | Optical Goods Stores |
Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
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501 | 2022-01-01 | ANN M. BUSCAVAGE | 2023-10-03 | ||
501 | 2021-01-01 | JOE SCHUSTER | 2022-10-11 |
Measure | Date | Value |
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2022: CLARKSON OPTOMETRY EMPLOYEE HEALTH & WELFARE BENEFITS PLAN 2022 401k membership | ||
Total participants, beginning-of-year | 2022-01-01 | 201 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 201 |
Number of retired or separated participants receiving benefits | 2022-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 0 |
Total of all active and inactive participants | 2022-01-01 | 201 |
Number of employers contributing to the scheme | 2022-01-01 | 0 |
2021: CLARKSON OPTOMETRY EMPLOYEE HEALTH & WELFARE BENEFITS PLAN 2021 401k membership | ||
Total participants, beginning-of-year | 2021-01-01 | 213 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 213 |
Number of retired or separated participants receiving benefits | 2021-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 0 |
Total of all active and inactive participants | 2021-01-01 | 213 |
Number of employers contributing to the scheme | 2021-01-01 | 0 |
2022: CLARKSON OPTOMETRY EMPLOYEE HEALTH & WELFARE BENEFITS PLAN 2022 form 5500 responses | ||
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2022-01-01 | Type of plan entity | Single employer plan |
2022-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2022-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2021: CLARKSON OPTOMETRY EMPLOYEE HEALTH & WELFARE BENEFITS PLAN 2021 form 5500 responses | ||
2021-01-01 | Type of plan entity | Single employer plan |
2021-01-01 | First time form 5500 has been submitted | Yes |
2021-01-01 | Plan funding arrangement – Insurance | Yes |
2021-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2021-01-01 | Plan benefit arrangement – Insurance | Yes |
2021-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
DELTA DENTAL OF MISSOURI (National Association of Insurance Commissioners NAIC id number: 55697 ) | |||||||||||||||||||||||||||||||||||||||||
Policy contract number | 22680000 | ||||||||||||||||||||||||||||||||||||||||
Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) | |||||||||||||||||||||||||||||||||||||||||
Policy contract number | 3004658 | ||||||||||||||||||||||||||||||||||||||||
Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||
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RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 ) | |||||||||||||||||||||||||||||||||||||||||
Policy contract number | 69722-2 | ||||||||||||||||||||||||||||||||||||||||
Policy instance | 3 | ||||||||||||||||||||||||||||||||||||||||
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THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |||||||||||||||||||||||||||||||||||||||||
Policy contract number | SA3890LF051501 | ||||||||||||||||||||||||||||||||||||||||
Policy instance | 4 | ||||||||||||||||||||||||||||||||||||||||
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