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| Plan Name | GASTROENTEROLOGY CENTER OF THE MIDSOUTH ACCIDENT & CRITICAL ILLNESS INSURANCE PLAN |
| Plan identification number | 528 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | GASTROENTEROLOGY CENTER OF THE MIDSOUTH, P.C. |
| Employer identification number (EIN): | 621094933 |
| NAIC Classification: | 621111 |
| NAIC Description: | Offices of Physicians (except Mental Health Specialists) |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 528 | 2017-01-01 | DAVID HARANO |
| Measure | Date | Value |
|---|---|---|
| 2017: GASTROENTEROLOGY CENTER OF THE MIDSOUTH ACCIDENT & CRITICAL ILLNESS INSURANCE PLAN 2017 401k membership | ||
| Total participants, beginning-of-year | 2017-01-01 | 0 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 260 |
| Total of all active and inactive participants | 2017-01-01 | 260 |
| 2017: GASTROENTEROLOGY CENTER OF THE MIDSOUTH ACCIDENT & CRITICAL ILLNESS INSURANCE PLAN 2017 form 5500 responses | ||
|---|---|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | First time form 5500 has been submitted | Yes |
| 2017-01-01 | This submission is the final filing | Yes |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) | |||||||||||||||||||||||||
| Policy contract number | 9566093 | ||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||
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