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MANN EYE CENTER WELFARE BENEFIT PLAN 401k Plan overview

Plan NameMANN EYE CENTER WELFARE BENEFIT PLAN
Plan identification number 501

MANN EYE CENTER WELFARE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

MANN EYE CENTER PA has sponsored the creation of one or more 401k plans.

Company Name:MANN EYE CENTER PA
Employer identification number (EIN):470914928
NAIC Classification:621320
NAIC Description:Offices of Optometrists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MANN EYE CENTER WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01MOIRA LONG2023-08-31
5012021-01-01MOIRA LONG2022-05-13
5012020-01-01MOIRA LONG2021-05-03
5012010-01-01REBECCA CONWAY
5012009-01-01REBECCA CONWAY

Plan Statistics for MANN EYE CENTER WELFARE BENEFIT PLAN

401k plan membership statisitcs for MANN EYE CENTER WELFARE BENEFIT PLAN

Measure Date Value
2022: MANN EYE CENTER WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01323
Total number of active participants reported on line 7a of the Form 55002022-01-01330
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01330
Number of employers contributing to the scheme2022-01-010
2021: MANN EYE CENTER WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01138
Total number of active participants reported on line 7a of the Form 55002021-01-01153
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 participants2021-01-01153
Number of employers contributing to the scheme2021-01-010
2020: MANN EYE CENTER WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01278
Total number of active participants reported on line 7a of the Form 55002020-01-01138
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01138
Number of employers contributing to the scheme2020-01-010
2010: MANN EYE CENTER WELFARE BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01108
Total number of active participants reported on line 7a of the Form 55002010-01-0199
Total of all active and inactive participants2010-01-0199
Total participants2010-01-0199
2009: MANN EYE CENTER WELFARE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01102
Total number of active participants reported on line 7a of the Form 55002009-01-01108
Total of all active and inactive participants2009-01-01108
Total participants2009-01-01108

Form 5500 Responses for MANN EYE CENTER WELFARE BENEFIT PLAN

2022: MANN EYE CENTER WELFARE BENEFIT PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: MANN EYE CENTER WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: MANN EYE CENTER WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2010: MANN EYE CENTER WELFARE BENEFIT PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: MANN EYE CENTER WELFARE BENEFIT PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01First time form 5500 has been submittedYes
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number633905
Policy instance 1
Insurance contract or identification number633905
Number of Individuals Covered233
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $15,602
Total amount of fees paid to insurance companyUSD $1,512
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $157,809
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,602
Amount paid for insurance broker fees1512
Additional information about fees paid to insurance brokerGENERAL AGENT PAYMENTS
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number633905
Policy instance 2
Insurance contract or identification number633905
Number of Individuals Covered339
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $110,795
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $558,794
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees110795
Additional information about fees paid to insurance brokerBENEFIT ADVISOR FEES, INCENTIVE COMPENSATION
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVTL0BYMB
Policy instance 3
Insurance contract or identification numberGVTL0BYMB
Number of Individuals Covered345
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $23,406
Total amount of fees paid to insurance companyUSD $10,934
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT,CRITICAL ILLNESS,ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $200,901
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,775
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerADMINISTRATION
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number149316
Policy instance 1
Insurance contract or identification number149316
Number of Individuals Covered441
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $14,831
Total amount of fees paid to insurance companyUSD $124,068
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,218,154
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,831
Amount paid for insurance broker fees124068
Additional information about fees paid to insurance broker2020 PINNACLE MEDICAL AND SPECIALTY NEW BUSINESS INCENTIVE RISK, INDIRECT AND DIRECT COMPENSATION
Insurance broker organization code?3
CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )
Policy contract number26439
Policy instance 2
Insurance contract or identification number26439
Number of Individuals Covered153
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $1,790
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, ACCIDENT, CRITICAL ILLNESS, HOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $14,625
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $897
Amount paid for insurance broker fees0
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number149316
Policy instance 1
Insurance contract or identification number149316
Number of Individuals Covered437
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $11,671
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,934,886
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,988
Amount paid for insurance broker fees0
Insurance broker organization code?3
CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )
Policy contract number26439
Policy instance 2
Insurance contract or identification number26439
Number of Individuals Covered138
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $2,639
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, ACCIDENT, CRITICAL ILLNESS, HOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $14,125
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,639
Amount paid for insurance broker fees0
Insurance broker organization code?3

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