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BUFFALO RUN CASINO VISION PLAN 401k Plan overview

Plan NameBUFFALO RUN CASINO VISION PLAN
Plan identification number 504

BUFFALO RUN CASINO VISION PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Vision
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

BUFFALO RUN CASINO has sponsored the creation of one or more 401k plans.

Company Name:BUFFALO RUN CASINO
Employer identification number (EIN):611464172
NAIC Classification:713200
NAIC Description: Gambling Industries

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BUFFALO RUN CASINO VISION PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5042022-02-01KIM KROKROSKIA2023-07-07
5042021-02-01DONNA SMITH2022-08-01
5042020-02-01DONNA SMITH2021-06-25
5042019-07-01DONNA SMITH2020-08-19
5042018-07-01STEPHEN BASHORE2019-12-23
5042017-07-01
5042016-07-01
5042015-07-01STEPHEN BASHORE
5042014-07-01STEPHEN BASHORE
5042013-07-01STEPHEN BASHORE

Plan Statistics for BUFFALO RUN CASINO VISION PLAN

401k plan membership statisitcs for BUFFALO RUN CASINO VISION PLAN

Measure Date Value
2022: BUFFALO RUN CASINO VISION PLAN 2022 401k membership
Total participants, beginning-of-year2022-02-01206
Total number of active participants reported on line 7a of the Form 55002022-02-01193
Number of retired or separated participants receiving benefits2022-02-010
Number of other retired or separated participants entitled to future benefits2022-02-010
Total of all active and inactive participants2022-02-01193
Number of employers contributing to the scheme2022-02-010
2021: BUFFALO RUN CASINO VISION PLAN 2021 401k membership
Total participants, beginning-of-year2021-02-01159
Total number of active participants reported on line 7a of the Form 55002021-02-01206
Number of retired or separated participants receiving benefits2021-02-010
Number of other retired or separated participants entitled to future benefits2021-02-010
Total of all active and inactive participants2021-02-01206
Number of employers contributing to the scheme2021-02-010
2020: BUFFALO RUN CASINO VISION PLAN 2020 401k membership
Total participants, beginning-of-year2020-02-01180
Total number of active participants reported on line 7a of the Form 55002020-02-01159
Number of retired or separated participants receiving benefits2020-02-010
Number of other retired or separated participants entitled to future benefits2020-02-010
Total of all active and inactive participants2020-02-01159
Number of employers contributing to the scheme2020-02-010
2019: BUFFALO RUN CASINO VISION PLAN 2019 401k membership
Total participants, beginning-of-year2019-07-01238
Total number of active participants reported on line 7a of the Form 55002019-07-01180
Number of retired or separated participants receiving benefits2019-07-010
Number of other retired or separated participants entitled to future benefits2019-07-010
Total of all active and inactive participants2019-07-01180
Number of employers contributing to the scheme2019-07-010
2018: BUFFALO RUN CASINO VISION PLAN 2018 401k membership
Total participants, beginning-of-year2018-07-01211
Total number of active participants reported on line 7a of the Form 55002018-07-0197
Number of retired or separated participants receiving benefits2018-07-010
Number of other retired or separated participants entitled to future benefits2018-07-010
Total of all active and inactive participants2018-07-0197
Number of employers contributing to the scheme2018-07-010
2017: BUFFALO RUN CASINO VISION PLAN 2017 401k membership
Total participants, beginning-of-year2017-07-01205
Total number of active participants reported on line 7a of the Form 55002017-07-01211
Number of retired or separated participants receiving benefits2017-07-010
Number of other retired or separated participants entitled to future benefits2017-07-010
Total of all active and inactive participants2017-07-01211
Number of employers contributing to the scheme2017-07-010
2016: BUFFALO RUN CASINO VISION PLAN 2016 401k membership
Total participants, beginning-of-year2016-07-01180
Total number of active participants reported on line 7a of the Form 55002016-07-01102
Number of retired or separated participants receiving benefits2016-07-010
Number of other retired or separated participants entitled to future benefits2016-07-010
Total of all active and inactive participants2016-07-01102
2015: BUFFALO RUN CASINO VISION PLAN 2015 401k membership
Total participants, beginning-of-year2015-07-01177
Total number of active participants reported on line 7a of the Form 55002015-07-01177
Number of retired or separated participants receiving benefits2015-07-010
Number of other retired or separated participants entitled to future benefits2015-07-010
Total of all active and inactive participants2015-07-01177
2014: BUFFALO RUN CASINO VISION PLAN 2014 401k membership
Total participants, beginning-of-year2014-07-01136
Total number of active participants reported on line 7a of the Form 55002014-07-01139
Number of retired or separated participants receiving benefits2014-07-010
Number of other retired or separated participants entitled to future benefits2014-07-010
Total of all active and inactive participants2014-07-01139
2013: BUFFALO RUN CASINO VISION PLAN 2013 401k membership
Total participants, beginning-of-year2013-07-01100
Total number of active participants reported on line 7a of the Form 55002013-07-01136
Number of retired or separated participants receiving benefits2013-07-010
Number of other retired or separated participants entitled to future benefits2013-07-010
Total of all active and inactive participants2013-07-01136

Form 5500 Responses for BUFFALO RUN CASINO VISION PLAN

2022: BUFFALO RUN CASINO VISION PLAN 2022 form 5500 responses
2022-02-01Type of plan entitySingle employer plan
2022-02-01Plan funding arrangement – InsuranceYes
2022-02-01Plan benefit arrangement – InsuranceYes
2021: BUFFALO RUN CASINO VISION PLAN 2021 form 5500 responses
2021-02-01Type of plan entitySingle employer plan
2021-02-01Plan funding arrangement – InsuranceYes
2021-02-01Plan benefit arrangement – InsuranceYes
2020: BUFFALO RUN CASINO VISION PLAN 2020 form 5500 responses
2020-02-01Type of plan entitySingle employer plan
2020-02-01Plan funding arrangement – InsuranceYes
2020-02-01Plan benefit arrangement – InsuranceYes
2019: BUFFALO RUN CASINO VISION PLAN 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01This return/report is a short plan year return/report (less than 12 months)Yes
2019-07-01Plan funding arrangement – InsuranceYes
2019-07-01Plan benefit arrangement – InsuranceYes
2018: BUFFALO RUN CASINO VISION PLAN 2018 form 5500 responses
2018-07-01Type of plan entitySingle employer plan
2018-07-01Plan funding arrangement – InsuranceYes
2018-07-01Plan benefit arrangement – InsuranceYes
2017: BUFFALO RUN CASINO VISION PLAN 2017 form 5500 responses
2017-07-01Type of plan entitySingle employer plan
2017-07-01Plan funding arrangement – InsuranceYes
2017-07-01Plan benefit arrangement – InsuranceYes
2016: BUFFALO RUN CASINO VISION PLAN 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01Submission has been amendedNo
2016-07-01This submission is the final filingNo
2016-07-01This return/report is a short plan year return/report (less than 12 months)No
2016-07-01Plan is a collectively bargained planNo
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan benefit arrangement – InsuranceYes
2015: BUFFALO RUN CASINO VISION PLAN 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01Submission has been amendedNo
2015-07-01This submission is the final filingNo
2015-07-01This return/report is a short plan year return/report (less than 12 months)No
2015-07-01Plan is a collectively bargained planNo
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan benefit arrangement – InsuranceYes
2014: BUFFALO RUN CASINO VISION PLAN 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01Submission has been amendedNo
2014-07-01This submission is the final filingNo
2014-07-01This return/report is a short plan year return/report (less than 12 months)No
2014-07-01Plan is a collectively bargained planNo
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan benefit arrangement – InsuranceYes
2013: BUFFALO RUN CASINO VISION PLAN 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01First time form 5500 has been submittedYes
2013-07-01Submission has been amendedNo
2013-07-01This submission is the final filingNo
2013-07-01This return/report is a short plan year return/report (less than 12 months)No
2013-07-01Plan is a collectively bargained planNo
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30085394
Policy instance 1
Insurance contract or identification number30085394
Number of Individuals Covered193
Insurance policy start date2022-02-01
Insurance policy end date2023-01-31
Total amount of commissions paid to insurance brokerUSD $1,707
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $17,128
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,707
Amount paid for insurance broker fees0
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30085394
Policy instance 1
Insurance contract or identification number30085394
Number of Individuals Covered206
Insurance policy start date2021-02-01
Insurance policy end date2022-01-31
Total amount of commissions paid to insurance brokerUSD $1,662
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,304
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,087
Amount paid for insurance broker fees0
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30085394
Policy instance 1
Insurance contract or identification number30085394
Number of Individuals Covered159
Insurance policy start date2020-02-01
Insurance policy end date2021-01-31
Total amount of commissions paid to insurance brokerUSD $1,711
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $15,743
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,711
Amount paid for insurance broker fees0
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30085394
Policy instance 1
Insurance contract or identification number30085394
Number of Individuals Covered180
Insurance policy start date2019-07-01
Insurance policy end date2020-01-31
Total amount of commissions paid to insurance brokerUSD $913
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,425
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $913
Amount paid for insurance broker fees0
Insurance broker organization code?3
PRIMARY CARE VISION SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number114/115
Policy instance 1
Insurance contract or identification number114/115
Number of Individuals Covered228
Insurance policy start date2018-07-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $459
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,592
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $459
Amount paid for insurance broker fees0
Insurance broker organization code?3
PRIMARY CARE VISION SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number114/115
Policy instance 1
Insurance contract or identification number114/115
Number of Individuals Covered220
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $1,998
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,976
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,998
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES, INC.
PRIMARY CARE VISION SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number114/115
Policy instance 1
Insurance contract or identification number114/115
Number of Individuals Covered177
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Total amount of commissions paid to insurance brokerUSD $1,878
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 $17,949
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $1,878
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES, INC.
PRIMARY CARE VISION SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number114/115
Policy instance 1
Insurance contract or identification number114/115
Number of Individuals Covered149
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $1,715
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 $17,145
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $1,715
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES, INC.
PRIMARY CARE VISION SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number114/115
Policy instance 1
Insurance contract or identification number114/115
Number of Individuals Covered136
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $1,489
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 $14,891
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $1,489
Insurance broker organization code?3
Insurance broker nameTHE HOLMES ORGANISATION

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